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OVERVIEW OF
NEURO MUSCULAR CONDITIONS
G P KUMAR
PROFESSOR,
COLLEGE OF PHYSIOTHERAPY,
SUMANDEEP VIDYAPEETH,
VADODARA, GUJARAT
Lower Motor Neuron comprises
AHC
Nerve Root
Plexus
Nerve
Deformities
Goniometry (ROM)
Deformities
Stretching
Splinting
Increased Fatigue
Challenges in Neuro Muscular
conditions
Primary Impairment - Muscle weakness, same in all conditions
BUT..
Natural History of disease
Features and progression of diseases
Variability in time
Acute, Chronic
Convalescence
Frequent turning
To concentrate on increase
available strength
To substitute
Replace paralysed muscle
To correct
Stretch shortened muscles
Surgery in Polio
Performed for correction of paralytic deformities
Arthrodesis
Spinal Muscular Atrophy
Type II Kugelberg Welander
Ambulatory stage
Bedridden stage
Ambulatory stage
Strengthening and endurance exercises
Bakker JPJ, de Groot IJM, Beckerman H, de Jong BA, Lankhorst GJ. The effects of knee-ankle-foot orthoses in
the treatment of Duchenne muscular dystrophy: review of the literature. Clin Rehabil 2000; 14: 34359
Wheel chair stage
Wheel chair prescription
Scoliosis prevention
Chest Physiotherapy
Functional independence
Bedridden stage
Chest physiotherapy
Bed mobility
Functional independence
Polymyositis
Weakness caused by immune responses in and around
the muscle fibre
Potential recovery
Avoid fatigue
Evidences
Exercises
Improves strength
Carried over to function?
Deterioration in strength?
moderate resistance or aerobic training regimes did not give
rise to deteriorations in strength
Very high-intensity resistance training No specific evidence
for deterioration still better to avoid to protect joints and
avoid over working
Electrical stimulation - Evidences
Direct muscle stimulation to the denervated quadriceps
have found improvements in muscle mass and force
production
In Polio
Lighter orthosis reduces oxygen consumption and physiological cost
Remember.
Primary impairment in Neuromuscular conditions is
Muscle weakness