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DR. GAJANAN BHALERAO (PT) MPTh Neuro, MIACP, MIFNR, MIAP SENIOR LECTURE Masters in physiotherapy, Neurosciences Sancheti Institute College of physiotherapy, Shivajinagar, Pune. Mobile : 9822623701 Email:Gajanan_bhalerao@yahoo.com, gajanan.neurophysio@gmail.com PUBLICATIONS:- Comparison of Motor Relearning program versus Bobath Approach in acute stroke rehabilitation: Journal of Orthopedics And Rehabilitation, India, 2011 RESEARCH PAPER PRESENTATIONS & AWARDS:- INTERNATIONAL 1.Winner Of Young Presenters Scholarship From Epilepsy Foundation India, in the conference of“International congress on neurology and rehabilitation Goa April 2010”, STATE LEVEL: 1. Winner of best paper award in engeering and technology category In Avishkar 201o of Maharashtra university of health sciences (MUHS), Nashik India. 2.WINNER OF BEST PAPER FOR scientific paper presentation in AVISHKAR 2010 of Maharashtra University of Health Sciences (MUHS), AURANGABAD, India. REESOURCE PERSON/COURSE INSTRUCTOR:- I have conducted Conducted workshop on 1. 2D & 3D Gait Analysis and its Management 2. MOTOR RELEARNING PROGRAM- for stroke rehab 3.Spinal Cord Injury Rehabilitation

Sunday 13 November 2011

HOW TO IMPROVE AROUSAL IN PATIENTS HAVING COMATOSE STATUS OR LOW SCORE ON GLASGO COMA SCALE?

Patients with brain injury or stroke patients with loss of consciousness they have multiple problems. Major problem is loss of consciousness, less arousal and alertness. Along with loss sensory motor control. Coma stimulation program emphasis on use of sensory stimuli of different nature. Such as use  of auditory stimuli, olfactory, visual & somato sensory stimulation. These multiple stimuli works but it takes lot of time and slow process. The stimulation or arousal doesn’t persist longer.

During my experiences of treating these patients with brain injury and comatose patients.  I learned that stimulus better and lasting result follow


 PRINCIPLE OF TREATMENT
1.We have to give multiple sensory stimuli simultaneously
2. Stimulus should be able to stimuli larger area of body.
3. Work more on righting reactions.
4.Work reactive postural control stimulation
5.Target more on improving head control and postural control.
6. Work in upright position such as sitting or standing.

I GOT BEST RESULTS WITH
7.Working on bed mobility- initially when patients are not able to do it. Do repetitive passive rolling, supine to prone, supine to rolling to sit.
8. Standing – passive standing with maximum support. Either on tilt table or standing with 2 persons support. Use knee support and ankle foot orthosis (AFO).
9. Walking training- start early ambulation. Initially we have to passively assist him in walking.

The key of effectiveness of these techniques are involves the principle of treatment from 1 to 6.
This helps in multiple sensory stimuli, postural control training in upright position, improves reactive control and righting reactions of body. This ultimately improves arousal & Improves motor control and postural control of body.

2 comments:

  1. Sir but can we give such treatment to a bedridden comatose patients?
    We can treat them in sitting or long sitting.. so how to provide multiple sensory input in sitting?

    thanx,

    Rohan Sawant

    ReplyDelete
  2. In sitting we can teach to do supine to sit multiple time. from both sides. initially we have to do it passively then slowly they start participating in it.
    Dear Rohan please go through the topic on other blog too.
    blog of neurorehabilitation. www.gajananbhalerao.wordpress.com
    there are multiple interesting topic i posted for discussion

    ReplyDelete