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Happy World Physiotherapy Day
September 8

➡️➡️⚕️Spina bifida also known as a neural tube defect. It occurs during development prior to birth. It’s when the spinal cord, brain, or meninges (their protective covering) does not completely develop. It can be anywhere along the spine and usually can be seen in an opening in the baby’s back at birth. It may also appear as a sack of fluid that has grown outside the body on the spine. This sack may or may not include the spinal cord inside.

🔷Types of spina bifida
There are three types of spina bifida: myelomeningocele, meningocele, and spina bifida occulta.

1️⃣Myelomeningocele ;
This is the most common and serious type of spina bifida. It involves a sack outside the opening in the baby’s back somewhere on the spine. This sack contains parts of the spinal cord and nerves. The spinal cord and nerves in the sack will be damaged.

People with myelomeningocele have physical disabilities that range from moderate to severe.

2️⃣Meningocele ;
This type of spina bifida also involves a sack of fluid outside an opening in the baby’s back. However, the sack does not contain any part of the spinal cord. Because there isn’t a lot of nerve damage, meningocele causes only minor disabilities.

3️⃣Spina Bifida Occulta ;
This is a mild type of spina bifida. It may also go by the term “hidden” spina bifida. It does not cause any disabilities and may go unnoticed until later in life. There is usually no opening in the baby’s back, but only a gap in the spine. In this type, there is no damage to the spinal cord or the nerves.

☑️Abnormal movement of the shoulder blade (scapula) is known as scapula dyskinesis. This occurs in a variety of shoulder problems.

➡️Type 1 - Infero-medial scapula border prominence
This becomes more evident in the cocking position of overhead sports. It is often associated with tightness at the anterior side of the shoulder (in flexibility of the pectoralis major/ minor muscles) and weakness of the lower trapezius and serratus anterior muscles.

➡️Type 2 - Medial border prominence
This pattern is winging of the entire medial border of the scapula at rest. It becomes more prominent in the cocking position and after repetitive elevation of the upper extremity. It is caused by fatigue of the scapula stabilising muscles (trapezius and rhomboids).

➡️Type 3 - supero-medial border prominence
This type of dyskinesis is displayed as a prominence of the superior medial border of the scapula and often associated with impingement and rotator cuff injury.

➡️Buerger’s disease, also called thromboangiitis obliterans, is an inflammation of small- and medium-sized blood vessels. Although any artery can be affected, it usually presents with blockages of the arteries to the feet and hands, leading to pain and tissue damage.
This eventually damages or destroys skin tissues and may lead to infection and gangrene. Buerger's disease usually first shows in your hands and feet and may eventually affect larger areas of your arms and legs.

➡️Symptoms :

-Tingling or numbness in the hands or feet.
-Pale, reddish or blue-tinted hands or feet.
-Pain that may come and go in your legs and feet or in your arms and hands. -This pain may occur when you use your hands or feet and eases when you stop that activity (claudication), or when you're at rest.
-Inflammation along a vein just below the skin's surface (due to a blood clot in the vein).
-Fingers and toes that turn pale when exposed to cold (Raynaud's phenomenon).
-Painful open sores on your fingers and toes.

⚠️⚠️Multisystem inflammatory syndrome in children (MIS-C)
➡️➡️ Is a serious condition that appears to be linked to coronavirus disease 2019 (COVID-19). Most children who become infected with the COVID-19 virus have only a mild illness. But in children who go on to develop MIS-C, some organs and tissues — such as the heart, lungs, blood vessels, kidneys, digestive system, brain, skin or eyes — become severely inflamed. Signs and symptoms depend on which areas of the body are affeted.

Rarely, some adults develop signs and symptoms similar to MIS-C. This new and serious syndrome, called multisystem inflammatory syndrome in adults (MIS-A), occurs in adults who were previously infected with the COVID-19 virus and many didn't even know it. MIS-A seems to occur weeks after COVID-19 infection, though some people have a current infection. If MIS-A is suspected, a diagnostic or antibody test for COVID-19 can help confirm current or past infection with the virus, which aids in diagnosing MIS-A.

☑️☑️(MIS-C) include those below, though not all children have the same symptoms.

-Fever that lasts 24 hours or longer
-Vomiting
-Diarrhea
-Pain in the stomach
-Skin rash
-Feeling unusually tired
-Fast heartbeat
-Rapid breathing
-Red eyes
-Redness or swelling of the lips and tongue
-Redness or swelling of the hands or feet
-Headache, dizziness or lightheadedness
-Enlarged lymph nodes

✔️✔️Emergency warning signs of MIS-C :-
-Severe stomach pain
-Difficulty breathing
-Pale, gray or blue-colored skin, lips or nail beds — depending on skin tone
-New confusion
-Inability to wake up or stay awake

How to monitor & report COVID-19 VACCINE side effects.

➡️What is the Tonic Labyrinthine Reflex (TLR)?

The TLR is a primitive reflex. Primitive reflexes are controlled by the brain stem and are innate movement patterns that integrate into our postural reflexes which we utilize all our lives. This reflex develops 8-10 weeks after conception and should be integrated 3-4 months after delivery. The TLR is responsible for helping the baby adapt to gravity after birth, develop muscle tone, and stimulate the proprioceptive sense. This reflex gives the child an opportunity to practice balance, changes in muscle tone as well as integrate the vestibular and kinesthetic senses which are imperative for the child to be cognizant of the position of his body in relationship to his surroundings.

The Tonic Labyrinthine Reflex helps with stability; it helps us develop muscle tone, balance, posture, and coordination throughout the whole body. Often when the TLR Reflex is not integrated, there is more rigidity in the leg muscles and tensions in the neck. The function of the TLR is to link the vestibular sense to the proprioceptive and to develop a sense of balance. The vestibular sense reacts to head movement. For good balance, the vestibular sense must work in cooperation with the proprioceptive sense.

****TLR helps the child to adapt to the new gravitational conditions after delivery and gives the child an early primitive reaction to gravity. Every time the head bends forward it decreases the tone of the extensor muscles and the neck, back and legs bend. Every time the baby bends the head backward it increases the tone of the extensor muscles and the body and limbs are stretched.
The TLR is active during the birthing process and remains present until 4 months of age. It is linked with our vestibular system, which is responsible for our balance. It is important during the birthing process to avoid suffocation. It can be seen clearly at the age of 2 months. Because this reflex is initially poorly developed, an infant has poor head control. Better head control is established as the TLR develops.