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From Paralysis to Progress: Rehabilitation After Thalamic Haemorrhage in a Hypertensive Patient

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*

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Neuro-Rehabilitation, Rehab Articles

Sensor integration therapy in autism

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*

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Neuro-Rehabilitation, Rehab Articles

Cancer Rehabilitation – The Road Less travelled!

Cancer Rehabilitation – The Road Less travelled! Understanding Autism Spectrum Disorder: Cancer rehabilitation is a crucial aspect of cancer care that aims to help individuals maintain or restore their physical, emotional, and social well-being after a cancer diagnosis and treatment. It’s a multidisciplinary approach that involves a team of healthcare professionals working together to address the various challenges patients may face. “In 2018, approximately 180,000 cancer cases and 92,000 cancer deaths in the region were causally linked to alcohol, with risks starting from the first gram consumed and increasing with the amount.” Overall Cancer Burden: Total Cases:In 2022, India recorded an estimated 46 million new cancer cases. Incidence Rate:The crude incidence rate in 2022 was approximately 4 per 100,000 individuals. Lifetime Risk:It’s estimated that 1 in 9 people in India are likely to develop cancer during their lifetime. Projected Increase:Cancer incidence in India is projected to increase by 8% in 2025 compared to 2020. Oral Cancer:India accounts for over 85% of oral cancer cases reported worldwide. Tobacco use is a major contributing factor. Cervical Cancer:One woman dies of cervical cancer every 8 minutes in India. Rural women have a higher risk compared to urban women. Breast Cancer:The incidence rates rise in the early thirties and peak between 50-64 years. The lifetime risk in urban areas is about 1 in 22 women, compared to 1 in 60 in rural areas. Why cancer rehabilitation is important For the Family:  Reduces Caregiver Burden: As patients regain independence through rehabilitation, the physical and emotional demands on family caregivers can decrease. This allows family members to return to some of their own routines and reduces the risk of caregiver burnout. Provides Education and Support: Rehabilitation teams often educate family members on how to best support the patient, manage their symptoms at home, and create a safe and supportive environment. This can empower families and reduce feelings of helplessness. Improves Family Dynamics: When the patient’s physical and emotional well-being improves, it can positively impact family dynamics, reducing stress and tension within the household. Offers Emotional Support for Caregivers: Some rehabilitation programs extend emotional support and counselling to family members who are also navigating the challenges of a loved one’s cancer journey. Facilitates Communication: Rehabilitation teams can act as a bridge between the patient, family, and the broader medical team, improving communication and ensuring everyone is on the same page regarding the patient’s recovery. Promotes Hope and Active Participation: Seeing a loved one actively working towards recovery and regaining function through rehabilitation can instil hope and encourage the whole family to participate in the recovery process. Why cancer rehabilitation is important For the Patient: Addresses Physical Impairments: Cancer and its treatments (surgery, chemotherapy, radiation) can cause a range of physical issues like weakness, fatigue, pain, swelling (lymphedema), balance problems, and reduced mobility. Rehabilitation helps to restore function, build strength and endurance, improve balance, and manage pain, enabling patients to perform daily activities with greater ease and independence. Manages Side Effects: Rehabilitation professionals can help patients cope with and manage the often debilitating side effects of cancer treatment, such as neuropathy, fatigue, and cognitive difficulties (“chemo brain”). Enhances Independence: By improving physical and cognitive function, rehabilitation empowers patients to be more self-sufficient in their daily lives, reducing their reliance on others for basic tasks. This can significantly boost their self-esteem and sense of control. Improves Quality of Life: Cancer rehabilitation aims to improve overall well-being by addressing physical comfort, functional abilities, emotional health, and social participation. This allows patients to engage more fully in life, pursue hobbies, and maintain meaningful relationships. Supports Emotional and Psychological Well-being: Dealing with cancer is emotionally challenging. Rehabilitation programs often include psychological support, counselling, and strategies to cope with anxiety, depression, fear of recurrence, and changes in body image. Facilitates Return to Activities: Rehabilitation helps patients return to work, school, social activities, and hobbies they enjoyed before their diagnosis, promoting a sense of normalcy and reintegration into their previous life. Reduces Hospitalizations: By proactively addressing physical and functional limitations, rehabilitation can potentially reduce the need for hospital readmissions due to complications or decreased functional status. Prehabilitation Benefits: Starting rehabilitation before cancer treatment (prehabilitation) can optimize a patient’s physical and mental health, potentially leading to better tolerance of treatment and faster recovery. Cancer Rehab Team: Cancer rehabilitation team consists of, Physiatrist:Oversees the rehabilitation plan and manages medical issues related to function. Physiotherapist:Focuses on movement, strength, and mobility.  Occupational Therapist:Helps with daily living skills and adapting tasks.  Speech & Swallow therapist:Addresses communication and eating difficulties.  Clinical Psychologist:Provides emotional support and cognitive rehabilitation.  Medico Social Worker:Addresses social, emotional, and practical needs. Stages of Cancer Rehabilitation: Preventive – Occurs prior to start of treatment and goal is to reduce functional decline from cancer. Restorative – Occurs after Treatment Completion to bring the level of function back. Supportive – Occurs after diagnosis of Advanced Cancer To maintain the current functional level. Palliative – During end of life; caregiver/ Family training. Cancer patients have various symptoms which affect their day-to-day life. Fatigue Nausea Pain Anxiety Insomnia Lymphedema Shortness of breath “Tobacco use accounts for 25% of global cancer deaths and is the leading cause of lung cancer, with an estimated 186 million tobacco users in the WHO European Region.” Crucial Points on Cancer Rehab: “Fatigue needs to be evaluated with Electrolyte, endocrine panel, anemia panel, Kidney and liver function evaluation. Common medications used for cancer can also cause fatigue” Cancer Pain – Mostly associated with bone metastasis, Bone Pain responds well to local irradiation. This is important for rehab because moving or loading on affected bones can precipitate severe pain. Lymphedema Management: COMPLEX DECONGESTIVE THERAPY 2 Phases –  ✓ Reductive Phase and ✓ Maintenance Phase including MANUAL LYMPHATIC DRAINAGE (MLD) Phase 1 – 45mins of MLD followed by compression bandages, remedial exercises. ✓ Bandage should be applied 21 – 24hrs /day Phase 2 – Long term maintenance program ✓ Compression garments during day ✓ Compressive Bandages during Night Issues specific with Breast Cancer: ✓ Deficits in Shoulder Movement develops after surgical procedures for tumor removal and breast reconstruction. ✓ Axillary web syndrome ✓ Aromatase inhibitor Musculoskeletal Syndrome (AIMS) “Smoking increases the risk

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