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Computer Chips in Humans
Surgeons at Stoke Mandeville hospital prepare to create the human cyborgs by implanting computer chips in a British professor and his wife to see if they can communicate sensation and movements by thought alone.

Robots Replacing Physical Therapists?
If you think you have job security as a rehab/physio professional, guess again. Motor movement of stroke patients have been seen to improve with physical therapy performed by a robot.

Rationale For Physical Therapy Robots
View healthcare cost statistics on page two of this article. Compare costs of human-powered physical therapy versus those provided by a physical therapy robot.

Computer Software in Rehabilitation & Physiotherapy
Computer software in physical therapy and rehabilitation is available for exercise programs, billing, outcome tracking, scheduling and other rehabilitation administration or educational uses.

Artificial Muscle... can it be true?
MIT research efforts use a polymer hydrogel to produce characteristics similar to human muscle for robots.

Tele Rehabilitation in Physical Therapy
Tele Rehabilitation may be the way to stay connected with our physical therapy patients. See how a "hands-on" profession can keep in touch with distant patients.

Physios work in many different places and situations, including:

·Hospitals 
·Medical centres
·Nursing homes 
·Private practices 
 ·Rehabilitation centres 
·Sports clubs
·Sports clinics 
·Gymnasiums
. Fitness centres

                            Water Exercise: Pools, Spas and Arthritis

Introduction

            Nearly 43 million Americans have some form of arthritis or a related condition. Although there are over 100 different kinds of arthritis, most forms are characterized by swelling, warmth, redness, pain and stiffness of joints that can lead to loss of joint motion or function. However, with proper diagnosis and  treatment, the signs and symptoms of arthritis can be controlled, joint damage can be limited or prevented, and joint motion and flexibility can be improved.

                Because there are many effective and safe ways to minimize pain and loss of motion from arthritis, you need to work with your doctor and other appropriate health professionals to develop an effective, individualized treatment program. Your specific program will depend on many things such as the type of arthritis you have, how it affects you, the severity of the disease, and the joints affected. Your age, occupation, and leisure and everyday activities also influence which treatment program is appropriate for you. Your treatment  will probably include a combination of  :

                      rest and relaxation

                           exercise

                           use of heat and warm water

                           use of cold

                           joint protection

                           self-help aids

                           appropriate medications

Why Water Exercise?

         Pain in your joints may make you want to hold them very still and avoid activity. However, limiting use of your joints will, over time, cause the joints, ligaments and  muscles to lose range of motion and weaken. Muscles may  also shorten and tighten up, causing you to feel more pain and stiffness and be less able to do the things you want to do.

         Regular exercise helps keep joints moving, restores and preserves flexibility and strength, and protects joints against further damage. Exercise can also improve your coordination, endurance and ability to perform daily tasks (such as walking or writing), increase energy and reduce fatigue, and lead to an improved sense of   self-esteem and accomplishment.

           The soothing warmth and buoyancy of warm water make it a safe, ideal environment for relieving arthritis pain and stiffness and improving the range of movement of joints affected by arthritis. Exercising in a warm-water pool or hot tub is one method of hydrotherapy, or using water to help treat a condition. Immersing in warm water raises your body temperature, causing your blood vessels to dilate and increasing circulation.

           Water exercise is a gentle way to exercise joints and muscles. Water supports joints and lessens stress on them to encourage free movement, and may also act as resistance to help build muscle strength. Using a spa adds a third component to the therapy - massage. Jet nozzles release a mixture of warm water and air, massaging your body and helping you relax tight muscles. Talk with your doctor to determine whether water exercise is appropriate for you.

Water Exercise at Home :

        If you obtain benefits from water exercise, you may want to consider installing a pool or purchasing a spa (hot tub) for your home. A hot tub provides the warmth, massage and buoyancy needed to both relax and exercise joints and muscles in the convenience of your home. The size and shape of a hot tub will determine the types of exercises you can do in it. Most spas or hot tubs allow for range-of-motion exercises of joints commonly affected by arthritis, such as the knee and hip. Warm water allows muscles to become relaxed, which can then make it easier to perform exercises and daily tasks. Relaxed muscles also can create an overall feeling of comfort.

Using a Pool or Hot Tub Safely :

       The use of heat is recommended for many people with arthritis and related conditions, but not all. Your doctor can help you determine if it is appropriate for you. Benefits of heat can include muscle relaxation, decreased pain and stiffness, and greater ease when performing exercises and daily activities.

         Warm water is an especially good way to apply heat to joints affected by arthritis. Extremely hot water is not safe and is not necessary to get results; mild heat is just as effective and easier for the body to tolerate. The water temperature should feel soothing and comfortable, not hot. In a pool, water temperatures from 83 to 88 degrees F are usually comfortable for exercise.

         If you are just soaking or doing very gentle movements   while sitting in a spa, you can usually tolerate  slightly higher temperatures. Soaking time will vary depending on the water temperature and your tolerance for heat. New hot tub users should vary the temperature and length of stay until they can determine what is most comfortable. Start slowly, and extend the time in the spa as you feel comfortable. For most people, soaking time should not exceed 10 to 15 minutes at temperatures between 98 and 104 degrees F. Remember, too, that children and elderly people are more prone to become overheated and may need to soak for less time.

       Many people with arthritis and related conditions find that pain and stiffness are worse in the morning. Doctors often advise soaking in warm water before beginning your daily activities to help relieve the pain. You may find it just as beneficial to use spas or warm water pools at other times: in the afternoon to help relax muscles and joints after a full day of activities, to loosen muscles before doing exercises, in the evening before bedtime to relax you for a restful sleep. However, too much heat can actually have a stimulating effect on some people. If this is true for you, enjoying the warm water just before bed may not be an ideal time.

      Never use a pool or hot tub during or after drinking alcohol or using drugs. These may cause sleepiness, drowsiness or changes in blood pressure. Pregnant women should not enter a hot tub without first consulting their doctor.

Exercising in Your Pool or Spa

       When first entering a spa or pool, relax and enjoy the soothing water. When your muscles and joints feel more comfortable and relaxed, slowly begin your exercise routine. Allow enough time after exercising to relax muscles again before getting out of the water.

         Exercises can be done while sitting in a hot tub or while sitting or standing in a pool. Consult your doctor or physical therapist to determine which exercises are appropriate for you. The Arthritis Foundation recommends the following guidelines when doing water exercises:

                               Submerge the body part you are exercising.

                    Move the body part slowly and gently.

                    Begin and end with easy exercises.

                    Move the joint through complete range of motion if

                    possible. Do not force movement, but gently stretch.

                          Do three to eight repetitions as tolerated. Pain that lasts for more than two hours after exercise may indicate overuse. Do fewer repetitions next time.  Be aware of the weakening effects of heat when exercising in warm water. Start slowly and don't over do. Check with your doctor or surgeon before doing any of the exercises if you have joint damage or have had joint replacement surgery.

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Walking & Arthritis

          Walking is good for anyone, especially people with  arthritis. Its an endurance exercise, which means it strengthens your heart, helps your lungs work more efficiently and gives you more stamina so you don't tire as easily. As a weight-bearing exercise (one that puts full weight on your bones), walking helps strengthen bones, reducing the risk of osteoporosis (thinning of the bones). This is especially important if you are taking glucocorticoids for your arthritis, which can  weaken bones.

          Walking strengthens your muscles and helps maintain joint flexibility. For people with arthritis, muscle and joint benefits are important because joints become more stiff and muscles weaken with inactivity. As walking strengthens the muscles and tissues surrounding the joints, it helps to better protect those joints and keep them ready for daily activities.

         In addition to all the physical benefits, walking also  brings with it a host of psychological perks. Regular exercise helps you sleep better, controls your weight and lifts your spirits. It can play an important part in combating the depression, fatigue and stress that accompany your arthritis.

 Getting Started

         Walking is often overlooked as a way to keep fit and flexible because its so easy - most of us have done it since infancy. But the simplicity is part of what makes walking an ideal exercise for many people. You can walk anywhere, any time and at any level you prefer on a particular day. Walking requires no special skills and is inexpensive. Keep these tips in mind as you prepare to step out into the ranks of walkers everywhere as with any exercise program, talk with your doctor to determine the best level of intensity and length of time for your walks.

           Wear shoes specifically designed for walking. The shoes should have flexible and non-sticky soles that absorb shock well, good arch supports, cushioned insoles and roomy toe boxes.

         Make sure your walking shoes fit correctly. If  your socks wear through in the toes, your shoes are either too short or your foot is sliding forward with each step. Wear your walking socks when you go to purchase the shoes to help you get a better fit.

Stepping Out

      Once you are ready to go, there are several things that  can help make your walks more enjoyable and injury-free. Take the time to warm up and cool down by strolling for a few minutes before and after your walk. Be sure to include some stretches in your warm-up and cool-down periods, holding each stretch for 20-30 seconds. Be careful not to bounce when stretching. Use an assistive device such as a cane if it eases your stride or allows you to cover longer distances more comfortably.

      Walk at your own pace. Everyone has a walking speed  that suits them best, so find one that is comfortable for you. Remember that your comfortable pace may vary from one day to the next, depending on how you feel. Faster speeds put more stress on your knees, so try not to walk too fast when you begin.

 Keeping It Fun

     The simplicity of walking makes it a favourite exercise for many people. But the simplicity also can make it difficult to keep motivated unless you mix up your routine from time to time. Consider these options to help keep your walking time more interesting:

* Change your location.

* If you normally walk in a neighbourhood, try out the local mall or airport concourse

* go to a different neighbourhood.

* Plan vacations to include good places to walk.

* Find a partner. Having a regular partner can be a social outlet, a boredom reliever and    commitment reinforces. And who says you can only have one partner?

* Walking with a group can be a good way to keep in touch with old friends or make some new ones.

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                                  Exercise and Arthritis                          

Introduction

             You may think that exercise and arthritis do not go hand in hand. If so, you would be mistaken. It was thought for many years that if you had arthritis you should not exercise because it would damage your joints. Now, however, research has shown that exercise is an essential tool in managing your arthritis.

          Regular, moderate exercise offers a whole host of benefits to people with arthritis. Mainly, exercise reduces joint pain and stiffness, builds strong muscle around the joints, and increases flexibility and endurance. But it also helps promote overall health and fitness by giving you more energy, helping you sleep better, controlling your weight, decreasing depression,  and giving you more self-esteem. Furthermore, exercise can help stave off other health problems such as osteoporosis and heart disease.

             Starting an exercise program can seem like a daunting proposition. The important thing to remember is to start slow and make it fun. It is always good to start with flexibility exercises, which are basically stretching exercises that will improve your range of motion and help you perform daily activities. Once you feel comfortable you can move on to weight training and endurance exercises such as bicycling. You may be reluctant to exercise because you are in such pain. If this is the case you may want to start with a water exercise program. In the water your body’s buoyancy reduces stress on your hips, knees, and spine.

              An exercise program can include anything from walking around the block, taking a yoga class, or playing a round of golf. In this section we’ve attempted to give you all the information you will need on how to start exercising and the proper way to incorporate exercise into the management of your arthritis.

               Whatever exercise program you decide on you should always consult with your doctor before starting out. Two other types of health professionals that can help you develop an exercise program that fits your specific needs are a physical or occupational therapist. A physical therapist can show you the proper techniques and precautions when performing certain types of exercise. An occupational therapist can show you how to perform daily activities without putting additional stress on your joints and can provide you with splints or assistive devices that can make working out more comfortable.

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Bone and Joint Decade

By Carol Haley

        By knowing how your joints function when they are in tip-top shape, you can better understand the problems you face when a joint, or joints, are damaged or in pain.

          Joints literally keep the human frame together. From the top of our heads to the tips of our toes, joints link our 206 bones, make our bodies flexible, and enable our muscles to maneuver into thousands of positions. Some joints, such as those in the cranium where rigidity is desirable, don't move at all. Others, such as those in the pelvic area, move very little. But most joints    move a lot. Hinge joints, as in our elbows and knees,    swing back and forth like doors. Ball-and-socket joints, as in our hip and shoulder, enable bones to twist and turn in many directions while remaining firmly connected  to each other.

           The movable joints in our bodies thrive on use and deteriorate with disease, injury, neglect or excessive overuse. So the adage “use it or lose it” is particularly apt - but in moderation. Even without arthritis, joints tend to stiffen as we age, so regular exercise and stretching become increasingly important.

Jaw: The jaw joints are famous for helping us with two important activities - processing food and talking. Because of their proximity to the ears, eyes, nose, throat, tongue, sinuses and cervical spine, their malfunction (disease of the tempromandibular joint) can have a profound effect on these organs.

Spine: Literally the backbone of the body, the spine begins at the base of the skull and extends to the sacrum. It is composed of 24 vertebrae stacked one on top of another to provide a flexible column of support for the spinal cord. The movement of these vertebrae allows us to stoop, squat, turn and nod our heads, and twist our shoulders and hips.

              The spine works on the motion-segment principle: Many small movements add up to big ones. Each individual vertebra can move only a little in relation to its neighbours. But putting all the units together creates awesome movement. Watch when a batter stands at the plate and swings at the ball. The cumulative effect of tiny spinal movements rippling up the back permits a broad, sweeping swing.

Shoulder: The series of joints from the shoulder to the fingertips makes our arms extremely flexible. The shoulder's ball-and-socket joint enables us to move the arm in almost any direction. The rotator cuff - a common site of injury in baseball pitchers - is composed of muscles and tendons that hold the shoulder joint in place and allow us to lift an arm and reach overhead. Shoulder injuries caused by excessive overhead arm motion are common, and can be caused by activities such as painting or hanging curtains.

Elbow: The elbow operates as a simple hinge that bends and straightens the arm. Although the joint allows some twisting and turning of the forearm, most of the forearm's movement results from rotation of the radius and ulna, the bones of the lower arm.

Wrist: Two major arteries, three major nerves and 20 tendons pass through the eight-bone wrist. Today, conditions such as carpal tunnel syndrome - in which cumulative micro-injury results in compression of the median nerve - focus considerable attention on the wrist.

Hand: Truly a marvel, each hand is built around a skeletal network of 19 bones connected by a multitude of complex joints. At the base of the fingers are saddle joints, some allowing movement (those at the base of the thumb and the fourth and fifth fingers) and some more fixed (those at the base of the second and third fingers). The remaining finger joints are modified hinges, enabling the fingers to bend over toward the palm, but not toward each other.

                      For years, engineers have tried to build a robot that can mimic the human hand. But the hand's movements are too complicated to copy exactly without feedback from the eyes and touch-sensitive skin. Robot hands are used in factory production lines very effectively for single tasks. While human hands can paint, weld, drill, screw, adjust and assemble, a separate robot hand and arm design is required for each of these diverse jobs.

Hip: Watch a ballet dancer perform and you will note what an incredible range of movement the hip joints permit. As the junction of the femur with the socket of the pelvis, the hip is the leg's equivalent of the shoulder, although its much stronger. It is also more stable to allow it to withstand the stresses of walking. For example, during normal walking, the force placed on the hip is three to four times our body weight; in running, it is five times.

                        Although stronger than the shoulder, the hip is much less mobile. Large movements, such as drawing the leg back in order to kick, are possible only because the whole pelvis tilts over the other hip. When a hip is damaged severely enough to limit activity hip replacement surgery can often make it possible to resume a more active lifestyle. In 1996, the last recent year for which figures are available, some 130,000 Americans underwent hip replacement surgery.

Knee: The knee works like the hinge joint in the elbow, allowing us to fold our legs under when we kneel or stretch them out to take a big step. It can swivel only slightly, helping turn the foot to point the toes out or in. The biggest and heaviest joint, the knee carries nearly half the body's weight and works like a hinge to move the shin and foot forward and backward. Inside the knee, extra ligaments and cartilage stabilize and support the joint and prevent its moving from side to side. Still, the knee is injured more often than any other joint. In 1996, the most recent year for which figures are available, 245,000 Americans had knee replacement surgery.

Ankle: The ankle is a hinge joint linking the lower ends of the tibia and the fibula (the bones of the lower leg) to the talus, the topmost of the tarsal bones in the foot, allowing the foot to make up-and-down movements. Foot: Though the wrist is different from the ankle, the 26 foot bones share the same arrangement as the corresponding bones in the hand. Hand bones are more delicate and their joints more flexible, while the foot is designed for bearing weight.

                Our feet transport most of us more than 100,000 miles in a lifetime - equal to about four trips around the world. Women generally average 10 miles a day, outdistancing men who walk an average of seven miles a day. With each step taken by a person weighing 130 pounds, the foot absorbs 500 pounds of pressure, which comes to about 5 million pounds of impact on the feet in an average day. Its no surprise then, that nearly eight out of 10 Americans will experience some foot and ankle problems.

               Carol Haley is an Atlanta-based freelance writer.

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DR. SAEED AHMAD, PRESIDENT
Indian Association of Chartered Physiotherapists
   Neuro Science & Physiotherapy Centre,
Towards IIM, Hardoi By Pass, Sitapur Road,
Lucknow, U.P., India
Phone: 9839070304
E-mail: info@iacp.org

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