Bismillah hir rahma

nir Raheem

TOPIC :PREVENTION
PRACTICE FOR
NEUROMUSCULAR
CONDITIONS
 Group Members
• Nabiha Ajmal
• Nusrat Javed
• Hina Ahmed
• Ayesha Liaquat
• Kinza Malik
• Normal neural physiological function is dependent
upon the nervous system being anatomically intact,
isolated from the external environment by the
blood-brain barrier and the meninges, stable ionic
concentrations and pH, and a constant supply of
oxygen and glucose.

• If damaged, the nervous system has limited ability

to repair itself.

• May result in many complications

 Prevention practice
for Parkinson disease
 Parkinson's diseases
It is a chronic, progressive, neurological,
degenerative disease that occurs due to dopamine
depletion in basal ganglia of brain.
• The impairments arise primarily due to damage to
the substantia nigra's dopaminergic neurons. The
diagnosis of PD relies on clinical observation, as
there are no imaging or laboratory findings specific
to PD.

• Its cardinal signs are

• (1) resting or postural tremor (small movements at
rest), (2) bradykinesia (slow movement),
• (3) rigidity (increased resistance to the passive
move­ment of a limb),
• (4) postural instability.
Parkinson disease
•Subcortical and brain-stem damage that occurs due to
various etiologies, including genetic abnormalities,
metabolic dysfunction, stroke, environmental toxins, infections, and
oxidative stress.
•The incidence rate for PD increases
with advancing age, with the median onset
at 62.4 years. Difficulty in diagnosis,
as many as 40% of cases may be undiagnosed.
•Its etiology is unknown it may result from
the interaction of weak environmental toxins
and a genetic predisposition.
 Signs and symptoms
• Motor signs: Micrographia (small
handwriting), masked face, stooped shuffling
(simian) gait with decreased arm swing,
difficulty arising from a chair, difficulty
turning in bed, and hypophonic (low volume)
speech.

• Nonmotor symptoms and signs are often

"apparent before the motor signs. Autonomic
dysfunction, slowed gastric and intestinal
motility, urinary dysfunction, sexual
dysfunction, pain, cognitive changes, speech
problems, and swallowing. Dementia ,
Depression, Aspiration pneumonia is a major
cause of morbidity and mortality in PD.
 Pharmacological
Management
• Medications currently are the best treatment for PD. e.g L-
dopa (levodopa) precursor of dopamine

• Overmedication can lead to problems with hallucinations,

dyskinesias (uncontrolled movements), insomnia/nausea,
reduced appetite, weight loss, and dystonia (abnormal muscle
tone).

• A most promising avenue is exercise's effect on slowing the

progression of Parkinson's disease.
 Non pharmacological
Management:
• Problems that may be managed with nonpharmacologic interventions include the
following:
• Difficulties with motor control, balance, posture, gait, and mobility
• Difficulties with ADLs and IADLs
• Problems with speech and swallowing
• Issues with proper nutrition
• Sleep dysfunction
• Pain
• Constipation
• Sexual dysfunction
• Psychosocial issues, including depression
 Physical therapy
• Features of a physical therapy program may include the following:
• Regular exercise, such as walking, swimming, and bicycle ergometry
• Stretching
• Strengthening
• Providing mobility aids, as needed
• Training in transfer techniques
• Training in techniques to improve posture and walking
• Fall prevention, including balance activities such as tai chi
• Secondary prevention in this population should focus on injury
prevention when the person is seizing. Protection may involve having the
person wear a helmet to prevent a head injury or hip protectors to reduce
the risk of a fractured hip if a fall were to occur during a seizure.

• Education for the individual and his or her family on what occurs during
a seizure and how to respond to that individual's seizure.

• Limits on high risk activities, such as driving, may be necessary.

 Prevention practice
for multiple sclerosis
 Multiple Sclerosis
• Pathology that damages the myelin that surrounds
axons in the central nervous system, resulting in
sclerosis (scarring) and neurological dysfunction.
The multiple sclerotic areas, also called a plaque.

• The cause of MS is unknown; however,

environmental and genetic factors appear to interact
to cause an autoimmune dysfunction.

• This condition most commonly affects young

adults between the ages of 20 and 40, with women
affected twice as often as men, and in individuals
with a Northern European genetic history.
 S/S
• Early clinical manifestations of MS include fatigue;
uncomfortable sensations in the arms, legs, trunk,
or face (eg, tingling, numbness, .pain, burning, or
itch­ing); and muscle weakness.

• These physical changes can be accompanied by

psychological changes, such as mood swings,
euphoria, depression, or apathy, problems with
memory, judgment, or attention.

• Since the demyelination process is unpredictable

and may vary in each individual, these slight
changes may not be recognized unless it is a very
aggressive pathology. The slight onset and
progression make MS often difficult to diagnose.
• In general, there is no way to prevent multiple sclerosis
(MS) or its attacks. For people with
relapsing-remitting MS and secondary progressive MS,
treatment with medicine may reduce the frequency of
relapses and delay disability. Mitoxantrone is approved for
the treatment of secondary (long-term) progressive and
progressive relapsing MS
 Physical therapy
Exercise programs are also designed to be intermittent to prevent sudden
‘attacks’ of pain and discomfort…

Patients with MS are at risk of falling, so physical therapy is aimed at controlling
posture and balance to minimize the risk of falls… Joint and muscle stiffness
(especially in the legs) can be corrected with stretching exercises.

Stiffness in the neck muscles can affect neck and head posture and control,
which can also be corrected with supports and exercise

Physical therapy can help with maintaining balance, walking ability, and range
of motion as well as reduce spasticity and weakness.
• People with multiple sclerosis can often maintain an
active lifestyle. stationary bicycle, walking. swimming, or
stretching reduces spasticity.