Sunday 27 August 2017

Dizziness & Vestibular Rehabilitation

If you are suffering from dizziness, wooziness, light-headedness or unsteadiness then you are not alone. It has been estimated that 65% of individuals over the age of 60 experience dizziness or loss of balance on a regular basis, and vestibular problems account for one third patients reporting to doctors with symptoms of vertigo and dizziness.1, 2 In fact, recent research out of Johns Hopkins University suggests that as many as 35% of adults over the age of 40 in the United States (i.e., 69 million Americans) have some form of vestibular dysfunction as measured by a postural balance test.3

Dizziness can result in an inability to work, leave the house, walk, or stand. It also contributes to falls and severe injuries. Physiotherapy and vestibular rehabilitation as part of overall healthcare plan can help provide relief.

Physiotherapy for dizziness typically consists of vestibular rehabilitation. This is an exercised-based program to encourage the central nervous system to compensate for problems with the Vestibular apparatus
An assessment is typically carried out first to assess sensation, gather information about pain and severity, muscle strength, range of motion, posture, balance, coordination, and general abilities. Once this assessment is complete, a fully customized exercise plan is created aiming at decreasing symptoms and improving the function.

The treatment model contains Balance/coordination activities to retrain body awareness, Eye and head movement exercises which reduce dizziness & Flexibility and/or strengthening exercises.

At home exercises & proper counselling are the integral part of the treatment programme.  

A proper treatment model promoting a healthy lifestyle can help restore a person’s balance, mobility, and coordination. With vestibular rehabilitation, a person’s dizziness can reduce or get eliminated and they can return to their normal standard of living.

References:

1Hobeika CP. Equilibrium and balance in the elderly. Ear Nose Throat J. August 1999; 78(8): 558–62, 565–6.
2Neuhauser HK, Radtke A, von Brevern M Et al. Burden of dizziness and vertigo in the community. Arch Intern Med. 2008; 168(19):2118–2124.
3Agrawal Y, Carey JP, Della Santina CC, Schubert MC, Minor LB. Disorders of balance and vestibular function in US adults. Arch Intern Med. 2009; 169(10): 938 944.

Tuesday 1 August 2017

Special Needs & Nutritional Complexities

Good nutrition is critical from infants to teen to adults in order to sustain healthy growth and development. A healthy diet needs to meet the changing nutritional needs of a growing child and should prepare him/her for maintaining healthy eating habits lifelong. As Parents and/or caregiver We are obliged to inculcate healthy eating habits in children that meets their nutritional requirements and leads to proper growth as they are in a stage of continuous mental and physical development. But as children grow, they develop their own individual personality, tastes and preferences to everything around them including food. An exposure to various tastes, textures, combinations of food leads to development likes and dislikes towards certain food stuffs. Thus, making child meet their supply on nutrients is very difficult and thus requires a strict nutritional regime & discipline.
If you are a parent to special need child, then this becomes all the more difficult owing to complexities involved. For example, a child with autism spectrum disorder may have a deep negative reaction to textures, tastes or colours. Children with Down syndrome, prefer softer foods because of difficulties encountered when chewing or swallowing. Special need Children are often on prolonged medications which affects their food habits & weight gain. A child’s ability to consume is also a key factor in nutrition; Children with Cerebral Palsy often struggle, choke or worse on providing food hence absolute care is to be taken while feeding them. Issues like acid reflux or Gastroesophageal reflux disorder, Dysphagia, misaligned teeth, gum swelling, etc. can also impact a child’s nutritional plan as it dominantly affects the selection of foods. Some children can be overweight / obese due to mobility issues, reduced calorie usage or some might be underweight due to speedy metabolism, swallowing issues etc.

Overcoming the nutritional challenges in the children with Special Needs is a complex issue which needs co-joint efforts of family, pediatrician, therapist & nutritionist. It is very necessary to overcome the specific barriers children have, to help them create a healthy relationship with food & proper nutrition as nutrition & child development go hand in hand.