November 2025

From Paralysis to Progress: Rehabilitation After Thalamic Haemorrhage in a Hypertensive Patient Introduction Stroke rehabilitation plays a pivotal role in restoring functional independence and improving quality of life in patients who sober neurological deficits following intracerebral haemorrhage. The thalamus, a key relay centre in the brain, when aBected by haemorrhage, can lead to significant motor, sensory, and cognitive impairments. Early and structured rehabilitation is essential to maximize recovery potential. This case report presents a 54-year-old hypertensive male who suBered a right thalamic bleed, resulting in left-sided hemiparesis and speech disturbances. Emphasis is placed on his rehabilitation journey—starting from bedside physiotherapy to intensive inpatient rehabilitation—demonstrating the critical impact of multidisciplinary therapy on his functional outcomes.  Background A 54-year-old male from Chhattisgarh, with known comorbidities of Hypertension, was apparently well until 23rd July 2024, when he developed sudden onset weakness of left upper limb and lower limb, speech disturbances, reduced consciousness. He was taken to nearby hospital and radio imaging was done – found to have right thalamic bleed. He was managed conservatively. He was started on bedside physiotherapy and was later referred to CMC Vellore for rehabilitation. Rehabilitation was initiated and he achieved independent sitting and required maximum assistance for standing. For further rehabilitation he was admitted in HCAH Bangalore. Challenges and Goals – Status on Admission: GCS – E4V5M6, No tubes, Dysarthria present  Maximum Assistance for Standing Spasticity aBecting activities of daily living (ADL) Right knee swelling (sustained during travel) Goals: Line of Management – In view of Right Knee swelling, USG was done – found to have Sup rapatellar eBusion and MCL Sprain of grade 2 was noted; Suprapatellar aspiration was done and 20cc of eBusion aspirated, intraarticular knee steroid injection was given and post procedure Jones bandaging was done. Prophylactic antibiotics were given for 5 days. In view of spasticity over left biceps, triceps, pronator & gastrocnemius, motor point blocks with 0.5% bupivacaine were given and spasticity reduced significantly. Occupational Therapy – ADL and FA retraining.  Physiotherapy – stretching of spastic muscles, Strength training, Balance training with Bobo Balance Lab, Gait training.  Speech Therapy for Dysarthria. Comprehensive Rehabilitation Plan: Status of Discharge: At the time of discharge, he was hemodynamically stable, was able to sit and stand independently. He was independent for activities of daily living. Significant reduction in Knee swelling & pain was n oted and he was a ble to walk with Q uadri pod support.  Conclusion: This case highlights the importance of early, structured, and multidisciplinary rehabilitation in improving functional outcomes following a thalamic haemorrhage. Structured Evaluation and neurorehabilitation interventions by PMR, played a key role in enhancing mobility and independence in daily activities for the patient. Continued rehabilitation support remains essential for maximizing long-term recovery and quality of life.  Popular Posts All Posts Rehab Articles From Paralysis to Progress: Rehabilitation After Thalamic Haemorrhage … November 7, 2025 Sensor integration therapy in autism… November 7, 2025 Cancer Rehabilitation – The Road Less travelled!… October 22, 2025 Post Category Cancer Rehabilitation (1) Neuro Rehabilitation (2) Post Tags Cancer Rehabilitation Neuro Rehabilitation Dr. Deepak Prasad J MBBS MD PM&R CCPC FIPM Administrator As the Consultant and Incharge of the NeuroRehabilitation and Musculoskeletal & Sports Rehab Units at Hamsa Rehab, Kauvery Hospital Marathahalli, I lead and empower a diverse team of specialists—including physiotherapists, occupational therapists, speech & swallow therapists, and clinical psychologists, Rehabilitation Nurses—to provide patient-centered care and achieve outstanding results. I have also taken up the role of Consultant and Advisor for Geriatric Rehabilitation in Athulya Senior Care Bangalore region. Posts: 6 Leave a Reply Cancel Reply Logged in as webadmin. Edit your profile. Log out? Required fields are marked * Message*

Sensory Integration Therapy in Autism: A Physical Medicine & Rehabilitation Physician’s Perspective Understanding Autism Spectrum Disorder: Autism Spectrum Disorder (ASD) is a neurodevelopmental condition that impacts social interaction, communication, behaviour, and especially sensory processing. Many children with ASD experience oversensitivity or under sensitivity to everyday sensations such as sounds, touch, movement, textures, or lights. These sensory challenges can affect their ability to participate in daily activities and learning. What is Sensory Integration Therapy? Sensory Integration Therapy (SIT) is a play-based approach developed to help children with ASD process sensory input more effectively. The therapy uses movement, touch, and play to improve the way the brain responds to sensory stimulation from the surrounding environment. As PMR physicians, the focus is on how SIT supports overall participation and functional abilities, promoting independence and quality of life in children with autism. Targeted Sensory Systems Tactile System (Touch):Activities to help children feel comfortable with different textures, improving hand use and self-care skills. Vestibular System (Movement):Swinging and balance exercises to aid postural control and coordination. Proprioceptive System (Body Awareness):Push/pull and jumping activities to regulate energy, help with calmness, and enhance body awareness. Visual and Auditory Input:Games that encourage tracking, listening, and responding to sights and sounds for better classroom performance. Goals of SIT in PMR Practice Improve self-regulation and attention. Enhance motor planning and coordination. Support participation in daily routines and school activities. Encourage communication, social interaction, and independence. Benefits Noted in Clinical Practice Reduces sensory overload and meltdowns often seen in ASD. Improves focus and performance in class and therapy sessions. Boosts coordination, balance, and physical confidence. Facilitates participation in feeding, sleep, and everyday tasks. Promotes independence and self-esteem. The PMR Physician’s Role in SIT Assessment:Identifying sensory challenges and functional impacts in ASD. Interdisciplinary Collaboration:Working with occupational therapists, physiotherapists, and speech & language pathologists to design individualized therapy plans. Family Education:Training parents to implement sensory “diets” (daily routines) at home and recognize triggers or signs of distress. Goal Setting:Focusing on participation, independence, and functional skills essential for daily life. Tracking Progress:Regularly measuring changes in sensory responsiveness, behaviour, and participation in activities. Involving Parents and Caregivers Parents are essential partners in the therapeutic journey. They help by continuing sensory exercises at home, observing triggers, and celebrating small milestones that indicate growing sensory comfort and independence. Encouraging parental involvement ensures interventions go beyond the clinic and create positive changes in daily life. Key Takeaway Sensory Integration Therapy does not “change” the child; it helps open up the world for them by reducing sensory barriers and enhancing participation in meaningful activities. As PMR physicians, supporting sensory integration in ASD is about improving engagement, enabling skills for independence, and boosting confidence in each child. Multidisciplinary team consisting of Physiatrist, Physiotherapist, Occupational therapist, Speech & language pathologist collaboration with families is required to ensure every child with ASD receives personalized, evidence-based sensory interventions that meet their unique needs. Popular Posts All Posts Rehab Articles From Paralysis to Progress: Rehabilitation After Thalamic Haemorrhage … November 7, 2025 Sensor integration therapy in autism… November 7, 2025 Cancer Rehabilitation – The Road Less travelled!… October 22, 2025 Post Category Cancer Rehabilitation (1) Neuro Rehabilitation (2) Post Tags Cancer Rehabilitation Neuro Rehabilitation Leave a Reply Cancel Reply Logged in as webadmin. Edit your profile. Log out? Required fields are marked * Message*