One of our physiotherapists, Ying, works with a patient to perform coupling actions with very simple task instructions. Especially with stroke rehab, Ying advises against letting the patient know that they are actually doing something more complex. It’s stressful enough to be in pain.

For this particular grandma, she is undergoing rehabilitation for a stroke causing left sided movement paralysis. Ying is getting her to grip her fingers while I encourage wrist extension. At the same time, Ying is holding her hand in a functional manner (a resting C shape curve of her hand). It makes it easier for the patient to activate muscles when the muscles are in mid-length tension. Starting position of muscle activation is a big deal in slow stream rehab.

As a society, we are transiting away from a mentality of quick fixes. We are starting to realise the beauty of preventive medicine rather than reactive medicine. Investments are flowing into digital health solutions on preventive care models. And a preventive care model should include movement medicine, away from a reliance on symptomatic medication.

One of our physiotherapist demonstrating a physiotherapy rehab exercise for the upper body, for early-mid stage Parkinson Disease.

This exercise is meant to improve upper body mobility and strength. Improving flexibility and postural strength can help reduce the deterioration of the condition, especially if the patient is able to have access to early intervention.

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Parkinsons Disease (PD) is a progressive disease of the brain but the symptoms can be managed with physiotherapy.

With parkinsons, the brain is hypergeared towards the flexor muscles. This causes the body to stoop and curl forwards. Without adequate postural strength, the condition progresses much faster.

Another symptom of PD is distal tremors of the limbs. The tremors exponentially makes it harder for the patient to engage in large movement patterns. This indirectly limits patient’s ability to move at the hips and core.

For parkinsons, the primary driver is from the brain. Especially for this neurological condition, the physical presentation and symptoms of PD further fatigues the neurological system of the body and brain.

In other words, especially for PD, the symptoms further exacerbate the presentation itself, exponentially worsening the entire condition.

Indeed the primary symptom management is medicine but complementing it with physiotherapy can better help to manage the progression of PD.

This sitted exercise is effective in teaching the patient to engage the core and glutes to initiate movements and weight transfer. To do it, attempt to keep the low back straight and lean forwards and backwards in a controlled manner. The idea is to encourage more movements at the hips while taking away movements at the legs. Specifically for PD, this exercise helps the patient to focus away from the tremors.

This exercise can be modified for every patient - the type of tactile guidance and the type of seating position etc.

If your loved ones have parkinsons, a personalised physiotherapy care can greatly optimise their quality of life.

An effective physiotherapy management for parkinsons will include:

- An assessment of the stage and type of parkinsons

- Strengthening of areas of weaknesses which should directly include functional movements

- Exercises that biases the postural muscles while encouraging large movement patterns

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Are you doing a lot stretching of the foot, ultrasounding it, massaging but nothing works?

Take a step back and look at the position of the foot. The resting position of the foot often reflects the tone of the muscles along with other implications.

The challenge that most physiotherapists face when dealing with big toe issues is that it’s hard to draw a logical link between the big toe and the muscular chain higher up.

For this particular patient, he was walking with the left leg crossing over into his right. When the left foot lands on the ground, the foot has trouble placing flat on the ground (walk in a straight line and you will find that you will end up putting more weight on the outer foot) and it will be in a more supinated position. This is indicated by the more inclined sloping angle as indicated in (B).

The body is smart. When it loses stability somewhere, it tries to create stability using some other methods. For my patient, the long flexors of the big toe kicked in so as to pull the big toe down just to compensate for the reduced contact of that inner foot onto the ground.

But it fails. This ends up creating more problems at the foot. When the big toe is pulled to the ground by the long flexors, the big toe loses its resting curve. There’s gonna be a jamming effect at the big toe, you lose stability at the arch, lots of irritation at the plantar fascia along with irritation of the inner ankle tendons (think shin splints, posterior tib tendinitis etc).

To correct this issue, there’s only one way. Limit your time on soft tissue work which includes ultrasound, massage, stretching, taping, infrared, theragun etc. These are great and has its place but there’s also so much work needed to be done for specific and active strengthening rehab. And it’s the strength that will eventually change your movement pattern and get you moving correctly.

Observe how the body compensates, because what you see is the compensation and not always the cause. Then confirm it with a gait analysis and muscle testing. Balance with the patient’s opinions and thoughts about his condition and lifestyle goals. Lastly, form a hypothesis, identify the logic and treat it.

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Do you have neck pain? Been following youtube videos that tell you to stretch it out? And then getting even more pain or worse, tingling sensations down your arm? It’s time to think about strengthening the shoulder blade muscles to better position the shoulder!

Every individual presents with a unique position of the neck & shoulder along with structural differences. As such, it is not ideal to follow general youtube exercises for neck issues.

What would work to effectively correct your neck, shoulder and back pain - is a proper identification of any muscular weakness alongside a static and dynamic postural assessment.

Neck issues are often a result of upper body postural issues. Many neck muscles have attachment points to our shoulder blade. When we slouch or round our shoulders, the tension on our neck increases as well. Overtime, the head shifts into a forward position, further putting greater stress on the neck muscles.

Contact our team today to understand how we can help you!

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An effective physiotherapy treatment plan for the elderly has to include a thorough assessment of the medical history and current lifestyle and social environment. In addition, the goals of the patient has to be taken into consideration given how this is such an important life stage for the senior.

Maison teaches the elderly how to perform functional daily tasks in the most effective manner based on their current condition and symptoms.

Exercises will include learning how to engage the core and postural muscles, dynamic balance exercises in seated and standing as well as range of motion exercises to maintain an optimal amount of flexibility.

For the elderly with medical condition, all Maison therapists will perform a thorough perusal and understanding of the medical history before proceeding with the treatment. This is because the side effects of any medication as well as recent medical treatments have to be taken into consideration as part of the curation of the treatment plan.

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Optimising one’s balance is especially important for the elderly. This minimises the senior’s fall risk which helps to prevent a lot of exponential complications such as fractures, leading to prolonged bed bound and a subsequent significant reduction in mobility.

Improving the elderly’s balance also requires a thorough examination of his/her current functional ability as well as pre-morbid functional status. Does the elderly have the potential to revert back to a pre-morbid state of mobility? What are some of his current medical issues / medications?

Understanding a complete picture would allow the physiotherapist to properly prioritise treatment goals and plans.

Our physiotherapists work with nursing homes and elderly day care centers as well to provide for private physiotherapy services as required by the seniors. Some of the more ambulatory seniors present with musculoskeletal discomfort which limits their mobility. In these cases, we provide for exercise equipments to teach these seniors specific rehab exercises that they can directly benefit from and resume their pain-free mobility.

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