Although physical activity and exercise is known to benefit people with multiple sclerosis (MS), the ability of these individuals to participate in such interventions is difficult due to the mobility impairments caused by the disease. Keeogo is a lower-extremity powered exoskeleton that may be a potential solution for enabling people with MS to benefit from physical activity and exercise.

Last year, McGibbon et al evaluated the Keeogo exoskeleton for assisting ambulatory activities in people with multiple sclerosis in an open-label, randomized, cross-over trial that was used to examine the immediate performance effects when using the device, and the potential benefits of using the device in a home setting for 2 weeks. Clinical performance tests with and without the device included the 6 min walk test, timed up and go test and the 10-step stair test (up and down). An activity monitor was also used to measure physical activity at home, and a patient-reported questionnaire was used to determine the amount and extent of home use. Generalized linear models were used to test for trial effects, and correlation analysis used to examine relationships between trial effects and usage.

RESULTS:

Twenty-nine patients with MS participated. All measures showed small decrements in performance while wearing the device compared to not wearing the device. However, significant improvements in unassisted (Rehab effect) performance were found after using the device at home for 2 weeks, compared to 2 weeks at home without the device, and participants improved their ability to use the device over the trial period (Training effect). Rehab and Training effects were related to the self-reported extent that participants used Keeogo at home.

CONCLUSIONS:

Keeogo appears to deliver an exercise-mediated benefit to individuals with MS that improved their unassisted gait endurance and stair climbing ability. Keeogo might be a useful tool for delivering physical activity interventions to individuals with mobility impairment due to MS.

If you have been suffering from MS, please see a specialist at the PRI clinic. This multi-disciplinary team is specifically trained to properly introduce your body to the Keego^TM device, which will allow your body to achieve a remarkable improvement in your lifestyle. To book an appointment, please call or follow these links.

Tel:      (416) 477-1101

E-mail: reception@priclinic.com

Web:   www.priclinic.com

We look forward to helping you out!

The term rounded shoulders is used to describe a resting shoulder position that has moved forward from the body’s ideal alignment. Rounded shoulders, sometimes known as “mom posture,” are part of overall bad posture, and they can get worse if left untreated. There are a few simple exercises that can help keep the shoulders in their correct position and relieve the stress caused by slumping.

Causes and risk factors

Posture is an example of how a person’s habits can affect their physical body. Conditions such as text neck and rounded shoulders are some of the most common ways poor posture begins. Any activity that causes the body to look down and forward for long periods of time can contribute to slumped shoulders. These positions disrupt how the muscles in the neck, back, and shoulders normally function. It is these muscles that control the way the body maintains its posture throughout the day.

Daily tasks that may contribute to rounded shoulders include:

using a smartphone or tablet

using a computer or laptop

sitting for long periods

driving a vehicle

bending over repeatedly

carrying heavy objects all day

The risks of rounded shoulders include the negative impact they can have on health and appearance.

By inadvertently training the body to be hunched forward over time, the muscles interpret this slumped position as the body’s natural state. This can be very harmful for the body if left untreated.

Increased stress on the shoulder joints can cause pain around the neck and upper back.

It is best to correct rounded shoulders by adjusting the posture as soon as possible.

Diagnosis

Chiropractors and physical therapists may lead a person through a few tests to see if they have rounded shoulders.

The doctor may first look at the person’s resting position while they are standing. A person with slumped shoulders may seem to slouch, even when asked to stand up straight. Their hands are also likely to face behind them, with the thumbs pointed at each other.

A correct standing posture will see the hands facing towards the body with the thumbs facing ahead. This is a simple test, but it will give doctors a good indication of a person’s everyday posture.

Doctors may use a variety of other tests to help them diagnose rounded shoulders and poor posture, in order to recommend the best treatments.

It is always advisable to work directly with a knowledgeable practitioner to treat rounded shoulders.

Stretches and exercises

The good news is that, in most cases, rounded shoulders can be easily fixed or prevented.

Just as the muscles and joints have been trained to hunch forward, they can be retrained to find the correct resting position.

A simple exercise routine can be followed to support correct shoulder position and posture in many people. Dedicating 20-30 minutes a day to these exercises, at least twice a week, can help an individual improve their posture and alleviate any associated symptoms.

It may take time to notice the adjustment to the shoulders, but it is better not to rush or force the body into a position that is not comfortable.

Handclasp

The handclasp stretch is simple and can be done every day. Standing up straight with the hands by their sides, a person reaches their hands behind them to clasp them together.

Gently, they then pull the shoulders back, while taking care not to allow the neck to push forward.

The shoulders should be pulled back until the chest opens and a deep stretch is felt. The position should be held for 30 seconds.

Door chest stretches

Just as the shoulders were stretched, the chest needs to be stretched to keep a person’s posture strong. One simple way to do this involves the use of a doorframe.

Standing straight in front of a doorframe, a person should place one hand on either side of the frame, just above head height.

Moving one foot forward and gently lunging past the frame will stretch the chest and shoulders. Hold this position for 30 seconds.

Shoulder blade squeeze

This basic exercise reminds the body what good posture feels like, and helps build strength throughout the day.

Sitting up tall, a person should move both shoulder blades together, as if trying to hold a tennis ball between them. As they flex, the shoulders should move down and away from the ears.

This position should be held for 10 seconds, and repeated 10 times.

The T stretch

The T stretch is best done in the morning, just after waking, or in the night, just before sleeping.

The person lies flat on their back with their feet flat on the floor. Their knees will be bent and facing up.

The arms should be extended out to the sides of the body, palms facing up. When done correctly, there will be a slight stretch in the back and shoulders.

This position can be held for up to 10 minutes each day for the best results.

For more ideas on how to fix round shoulders please contact

Tel:      (416) 477-1101

E-mail: reception@priclinic.com

Web:   www.priclinic.com

Aquatic therapy is physical therapy that takes place in a pool or other aquatic environment under the supervision of a trained healthcare professional. Aquatic therapy is also known as water therapy, aquatic rehabilitation, aqua therapy, pool therapy, therapeutic aquatic exercise or hydrotherapy.

Aquatic therapy is considered an add-on certification for physical therapists and athletic trainers who often work closely with occupational therapists and exercise physiologists to develop a plan of care for each client.

Common goals of aqua therapy programs include:

Improving flexibility

Improving balance and coordination

Building muscle strength and endurance

Enhancing aerobic capacity

Assisting with gait and locomotion

Reducing stress and promoting relaxation

Aquatic therapy is different from aquatic exercise or aquatic fitness because it is a physical medicine and rehabilitation specialty that requires the involvement of a trained professional and is covered by many insurance providers due to the personalized nature of the treatment. Aquatic exercise does not need to be supervised by a trained professional. It is also not covered by insurance, and it often takes place in a group setting that includes multiple people with different levels of physical fitness.

Aquatic therapy should not be confused with adaptive aquatics, either. Adaptive aquatics is the process of teaching people with disabilities how to swim safely in the water. Aquatic therapy does not focus on teaching clients how to swim.

Water therapy services are generally offered in hospitals, sports medicine clinics and traditional outpatient rehabilitation centers. Senior living centers may also provide aquatic therapy services as a way to encourage their residents to maintain or improve fitness levels, balance and strength.

History of Aquatic Therapy

Water therapy has been used for thousands of years throughout the world. Consider the following examples:

Ancient Greeks and Romans bathed in hot springs to improve circulation and promote relaxation.

Hippocrates recommended bathing in spring water as a way to treat sickness.

Swiss monks were known to use thermal waters to treat sick or disabled people in their community.

Japanese hot springs, or onsens, are said to have medicinal effects that include healing chronic pain, treating skin problems, curing menstrual disorders and relieving constipation.

German physicians were firm believers in pediatric water therapy. Water birthing was very popular throughout Germany in the 1960s and 1970s.

Benefits of Aquatic Therapy

These are some of the ways that water’s natural properties create an ideal therapeutic environment:

Warm water provides a relaxing and soothing environment for aching joints and muscles.

Water’s natural viscosity or resistance can be used for muscle strengthening and increasing rehabilitation progressions.

Buoyancy allows for flotation and reduces the effects of gravity on injured or aching joints and muscles.

Hydrostatic pressure supports and stabilizes the client, allowing people with balance deficits to perform exercises without a fear of falling, decreasing pain and improving cardiovascular return.

Turbulence and wave propagation let the therapist gently manipulate the client through the desired exercises.

The respiratory muscles are forced to work harder in the water, allowing for a natural strengthening that benefits the client long after the therapy session has ended.

Compared to other forms of physical therapy, aquatic therapy results in a higher client compliance rate and less pain throughout the recovery process. Opportunities to significantly minimize the pain a client experiences should be taken seriously because with less pain, a client can enjoy a higher quality of life.

PRI started offering Aquatherapy classes over 5 years ago. Join us in our 92-degree salt-water pool. This is the safest possible low-impact therapy with world-class fitness results. Includes cardiovascular strengthening, core work, and stretching. If appropriate for patients, there are also running and jumping exercises. Bring your own towel and lock. Spacious locker room and post therapy shower space are also available.

For more ideas on how to keep your body healthy, contact our office at

Tel:      (416) 477-1101

E-mail: reception@priclinic.com

Web:   www.priclinic.com

What is a Groin Injury?

A groin injury is more technically known as an adductor muscle strain, which is an acute injury to the groin muscles on the inside of the thigh. Although many different muscles can be injured, the most common are the Adductor Longus, Medius and Magnus, and the Gracilis.

Symptoms of adductor strain may include dull and/or sharp pain the region (including when you lift your knee) in addition to bruising and swelling of the inner thigh, atypical warmth in the groin and/or inner thigh, weakness or tenderness in the area, and limping along with difficulty in functional movement. Walking much less running can become a tremendous is not impossible chore.

Like with most other injuries, a groin strain can be categorized as a Grade 1 to 3 injury with the stretch or muscle tear ranging from minor to more extreme, with severity of symptoms corresponding to the grade. Your first point of contact (physician or physiotherapist) will ask about whether you heard a popping sound when the event occurred, and/or if swelling and pain followed. When LeBron James’ injury happened there was no doubt about the significance as he grimaced and limped off the court.

Which Athletes Are Most Susceptible?

Data finds that ice hockey and soccer players are especially susceptible to adductor muscle strains, given the nature of the body movements applied to perform each. An estimated 10-11% of all ice hockey and soccer player injuries are groin strains. With these two sports being particularly popular in Greater Vancouver you can see why our clinic commonly sees athlete patients for this ailment. However, as this article’s all-star reference shows, no sport where running, jumping, kicking, or pivoting is done is isolated from this risk. Groin injuries are common in basketball, football, snowboarding, surfing, tennis, and even jogging/running. Knowing this will help you devise a prevention plan, which will be addressed below.

Risk Factors and Causes in Sports

Studies show that the most common risk factors for adductor muscle sprains include stiffness, previous history, an imbalance of hip adductors-to abductors strength, and a diminished ROM for hip abduction. The same studies find that while groin strain can come from quick changes in acceleration, speed, and direction, overuse injuries are considered to be the primary cause.

Treatment and Prevention

Training each of the 3 adductor muscles to improve both flexibility, range-of-motion (ROM), and strength is essential to treating and preventing groin strain. In addition, attention should be paid to the hips and lower extremities for additional support. A physiotherapist will walk you through a variety of exercises, including floor stretches, chair lifts, side lifts, and knee squeezes and bends. The following physical therapy treatments and therapies can be applied to address adductor muscle injury:

Massage therapy

Laser therapy to the pectineus and adductor complex to reduce inflammation and pain

Acupuncture and dry needling

K-taping (for when you’re back in training/playing)

IMS therapy

All of these are offered at PRI with professional therapists taking rehabilitating your groin injury.

Experts also find that groin injuries in professional sports typically occur in pre-season training, which indicates that extended periods of adductor complex inactivity are to blame. After months of less activity, the adductor muscles are not tasked as much as they should be, with flexibility, strength, and ROM falling to the wayside. Therefore it is imperative that athletes maintain their physiotherapist prescribed exercise regime throughout the entire year.

An improved Gait can also help make a difference, and so custom orthotics for both walking and playing footwear can become a part of your groin injury prevention plan. In addition, a physiotherapist can help identify biomechanical disorders of the lower limb (i.e. excessive pronation, leg length differences, etc.) that may contribute to groin strain risk and can provide corrective therapies.

Lastly, remember to warm up and cool down properly before game/activity time.

For more info, please reach out to:

Phone: (416) 477-1101

E-mail: reception@priclinic.com

Web:   www.priclinic.com