GB School of neuro rehab Intensive Training module

Posted on April 14, 2021October 14, 2023 by GajananBhalerao

GB School of neuro Rehab and aquatic therapy is one step Specialty center for all the needs of patients suffering for neurological diseases. GB School was developed for providing Intensive training for neuro rehabilitation by experts in neuro Rehab and using advance technologies to provide fast recovery of functional activities. Here we focus on Intensive training with following focus…

High intensity- high load training to improve Strengthening
High repetitions – each Patient does 50- repetition for each exercises ( with multiple breaks). Evidence shows 10000 repetition need to learn new movement.
High frequency- 6 days week
High opportunities to practice at home – more practice at home
Exercise designing focus with interesting, engaging and enjoyable activities

What is neuroplasticity of brain its role in recovery of injured brain?

What is Neuro Physiotherapy?

Posted on April 14, 2021October 7, 2021 by GajananBhalerao

Neurological physiotherapy involves the treatment of people with movement and function disorders that have cause by neurological diseases. These patients shows paralysis / loss of strength /muscle weakness, loss of sensation, poor balance and coordination, uncontrolled muscle spasm and tremors and loss of function . Neurological Physiotherapy works on improving motor control limbs and trunk, sensation, balance and coordination through high intensity repetitive strength training exercises, sensory reeducation/ facilitation and task specific training activities for mobility, balance and walking.

What is neuroplasticity of brain its role in recovery of injured brain?

SCI Rehabilitation

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SPINAL CORD INJURY REHAB

Posted on April 14, 2021May 17, 2022 by GajananBhalerao

Spinal Cord Injuries (SCI) can be defined as a traumatic or non-traumatic event that leads to neural damage that influences motor-, sensory – and respiratory function, as well as bladder -, bowel – and sexual function. The neurological interruption also affects the individual’s blood pressure, skin integrity and ability to regulate temperature.

SCIs don’t only have an impact on the individuals’ physical – and emotional well-being, but it also has a considerable impact on families, communities and healthcare systems worldwide. Literature indicates the peak age between 12 and 30 years, with an average life span as 30.2 years following injury.

SCI, most commonly, results in paraplegia or tetraplegia. Paraplegia is the loss in motor and/ or sensory function in the lower limbs (LLs) and trunk. While tetraplegia includes the upper limbs (ULs) to the motor and/ or sensory loss of the LLs and trunk.

Physiotherapy management

The acute management and rehabilitation of SCI depend on the level and type of injury to the spinal cord. Individuals with a SCI often require initial treatment in an intensive care unit with the rehabilitation process typically starting in the acute care setting, followed by extended treatment in a specialized Spinal Injury Unit.

The management of an individual with SCI is complex and lifelong requiring a multidisciplinary approach. A functional, goal-oriented, interdisciplinary, rehabilitation program should enable the individual with a spinal cord injury to live as full and independent a life as possible. Physiotherapy, occupational therapy, speech and language therapy, rehabilitation nurses, social workers, psychologists and other health work as a team to decide on goals with the individual and develop a plan of discharge that is appropriate for the individuals level of injury and circumstances.

Five key steps in the management of individuals with SCI are;

Assessing impairments, activity limitations and participation restrictions
Setting goals relevant to activity limitations and participation restrictions
Identifying key impairments that are limiting achievement of goals
Identifying and administering physiotherapy treatments (strengthening, joint mobility, motor skill development, cardiovascular fitness, respiratory functioning, pain managing)
Measuring the outcome of treatments

The management of individuals with a SCI can be divided into 3 Phases;

Acute,
Sub-acute (Rehabilitation), and
Chronic (Long Term).

During the acute and subacute phases of treatment, rehabilitation strategies focus more on prevention of secondary complications, promoting neuro recovery, addressing underlying impairments and maximizing function. In the chronic phase, compensatory or assistive approaches are often used

We work mainly on

Objective

Bed mobility
Sitting balance training
Transfers training
wheelchair mobility skills
Standing balance
Treadmill walking
Waling training with orthotics

Click on below for more videos

PARAPLEGIC REHAB

QUADRIPLEGIC REHAB

PARAPLEGIC CASE STUDIES

Why Aquatic therapy? What is the benefit? Who can Benefit from it?

Posted on September 22, 2016October 7, 2021 by GajananBhalerao

Article by: Dr. Gajanan Bhalerao (PT) MPT neuro PT , C/NDT (USA), Aquatic therapy (Kliniken Valens Switzerland)

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Physical Therapy is a constantly evolving field. There are many types and methods are adding as adjunct traditional physical therapy. Most of these therapies are performed on the land. There are multiple forces are always acting on our body in any given instant. the forces can be internal or external forces. Our muscles and body mechanics always have work against or with these forces to move. There is always one force acts on everything including our body is the constant force of gravity. Gravity acts on everything all the time. We move against or towards the force of gravity. We try to stabilize our body against the force of gravity. Amount of muscles work and effort depends on what is the body alignment with respect to gravity.

Benefit from Aqua therapy

Reduce weight bearing on lower limb – helps in partial weight bearing walking gradation

Assist in stability and balance
Makes Movement easy and assisted
Gives resistance to movements,
Easy to change the grading of resistance
High intensity training with less fatigue and injury to muscles and ligaments
Less stress on ligaments in closed chain positions
Helps in general body relaxation – stress management
Joint mobilization hip, knee, ankle, shoulder & elbow with less pain even with high intensity mobilization
Improving range of motion
Spinal joint mobilization
Muscle relaxation
Non weight bearing walking – deep water walking with floats
Strength training
Endurance training
Agility & plyometrics training
Balance training
Reduce tone/spasticity /rigidity/ tightness
Graded loading on labrum/ capsule and ligaments of joints
Coordination training

fig-311

Whom to contact for aquatic therapy?

Ans -Dr. Gajanan Bhalerao, 9822623701. schoolneurorehab@gmail.com

GB school of neuro rehab and aquatic therapy, Bungalow no 1. Gajanan Housing society Model colony Shivajinagar Pune 16. Direction and Maps

WHAT IS AQUATIC THERAPY?

There are multiple methods are developed to reduce the effect of gravity and using buoyancy.

Alterg

Body weight supported treadmill training

Dr Feng Youg and UTEP students work with patients at the Biomechanics Lab.

Robotic locomat

Space walk training simulator

edlu_wo3

Aqua treadmill
Aqua gym

Aqua cycling

All these method of training have advantage and disadvantages.

Most of these are targeted at only walking training (alter G, body weight supported treadmill training, aqua treadmill), cycling (aqua cycling) and strengthening ( aqua gym) individual muscles.
Body weight supported treadmill training is not very comfortable for patient (harness and un- weighing). it requires lots of effort by therapist to put legs forward during walking.

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Aqua treadmill : we can do limited exercises of walking forward, backward, sideways or running only.

There is need of therapy where there is more flexibility of selection of therapeutic exercises and activities. So Aquatic therapy play a major role is in this.

What is aquatic therapy?

Aquatic therapy refers to treatments and exercises performed in water for relaxation, fitness, physical rehabilitation, and other therapeutic benefit. Typically a qualified aquatic therapist gives constant attendance to a person receiving treatment in a heated therapy pool. Aquatic therapy techniques include Ai Chi, Aqua Running, Bad Ragaz Ring Method, Burdenko Method, Halliwick, Watsu, and other aquatic bodywork forms. Therapeutic applications include neurological disorders, spine pain, musculoskeletal pain, postoperative orthopedic rehabilitation, pediatric disabilities, and pressure ulcers.

Aquatic therapy refers to water-based treatments or exercises of therapeutic intent, in particular for relaxation, fitness, andphysical rehabilitation. Treatments and exercises are performed while floating, partially submerged, or fully submerged in water. Many aquatic therapy procedures require constant attendance by a trained therapist, and are performed in a specialized temperature-controlled pool. Rehabilitation commonly focuses on improving the physical function associated with illness, injury, or disability.^[1]^[2]

Aquatic therapy encompasses a broad set of approaches and techniques, including aquatic exercise, physical therapy,aquatic bodywork, and other movement-based therapy in water (hydrokinesiotherapy). Treatment may be passive, involving a therapist or giver and a patient or receiver, or active, involving self-generated body positions, movement, or exercise. Examples include Halliwick Aquatic Therapy, Bad Ragaz Ring Method, Watsu, and Ai chi.^[1]

For orthopedic rehabilitation, aquatic therapy is considered to be synonymous with therapeutic aquatic exercise, aqua therapy, aquatic rehabilitation, water therapy, and pool therapy. Aquatic therapy can support restoration of function for many areas of orthopedics, including sports medicine, work conditioning, joint arthroplasty, and back rehabilitation programs. A strong aquatic component is especially beneficial for therapy programs where limited or non-weight bearing is desirable and where normal functioning is limited by inflammation, pain, guarding, muscle spasm, and limited range of motion (ROM). Water provides a controllable environment for reeducation of weak muscles and skill development for neurological and neuromuscular impairment, acute orthopedic or neuromuscular injury, rheumatological disease, or recovery from recent surgery.^[3]^:1

Various properties of water contribute to therapeutic effects, including the ability to use water for resistance in place of gravity or weights; thermal stability that permits maintenance of near-constant temperature; hydrostatic pressure that supports and stabilizes, and that influences heart and lung function; buoyancy that permits floatation and reduces the effects of gravity; and turbulence and wave propagation that allow gentle manipulation and movement.^[4]

Techniques

Techniques for aquatic therapy include the following:

Halliwick Concept: The Halliwick Concept, originally developed by fluid mechanics engineer James McMillan in the late 1940s and 1950s at the Halliwick School for Girls with Disabilities in London, focuses on biophysical principles of motor control in water, in particular developing sense of balance (equilibrioception) and core stability. The Halliwick Ten-Point-Program implements the concept in a progressive program of mental adjustment, disengagement, and development of motor control, with an emphasis on rotational control, and applies the program to teach physically disabled people balance control, swimming, and independence.

Water Specific Therapy, WST: Halliwick Aquatic Therapy (also known as Water Specific Therapy, WST), implements the concept in patient-specific aquatic therapy.This concept is very good for rehabilitation of neurological and orthopedic impairment. This is tailer made approach for individual needs and problems. In this you can on the motor control as whole body & its movements in all direction and individual motor muscle control. You can do task specific training i.e. sit to stand, balance in walking, one leg stance, walking and balance again resistance of water, coordination exercises, core strengthening in task, postural control and motor control in various task.

Bad Ragaz Ring Method: The Bad Ragaz Ring Method (BRRM) focuses on rehabilitation of neuromuscular function using patterns of therapist-assisted exercise performed while the patient lies horizontal in water, with support provided by rings or floats around the neck, arms, pelvis, and knees. BRRM is an aquatic version of Proprioceptive Neuromuscular Facilitation (PNF) developed by physiotherapists at Bad Ragaz, Switzerland, as a synthesis of aquatic exercises designed by a German physician in the 1930s and land-based PNF developed by American physiotherapists in the 1950s and 1960s.
https://youtu.be/A0-DGEP4F1U

Ai Chi: Ai Chi, developed in 1993 by Jun Konno, uses diaphragmatic breathing and active progressive resistance training in water to relax and strengthen the body, based on elements of qigong and Tai chi chuan.

Aqua running: Aqua running (Deep Water Running or Aquajogging) is a form of cardiovascular conditioning, involving running or jogging in water, useful for injured athletes and those who desire a low-impact aerobic workout. Aqua running is performed in deep water using a floatation device (vest or belt) to support the head above water.

Watsu: Watsu is a form of aquatic bodywork, originally developed in the early 1980s by Harold Dull at Harbin Hot Springs, California, in which an aquatic therapist continuously supports and guides the person receiving treatment through a series of flowing movements and stretches that induce deep relaxation and provide therapeutic benefit. In the late 1980s and early 1990s physiotherapists began to use Watsu for a wide range of orthopedic and neurologic conditions, and to adapt the techniques for use with injury and disability.

Healing Dance

Aqua aerobics:

Top 6 reasons to use aqua aerobics for exercise:

1)Heart health. heart rate will be about 13 percent more slower – about 17 fewer heart beats a minute.

2)The enjoyment: If a workout is fun, I’m more likely to keep doing it.

3)The variety.

4)Stress relief.

5)Low impact.

6) Resistance of water

Benefit from Aqua therapy

Reduce weight bearing on lower limb – helps in partial weight bearing walking gradation

Assist in stability and balance
Makes Movement easy and assisted
Gives resistance to movements,
Easy to change the grading of resistance
High intensity training with less fatigue and injury to muscles and ligaments
Less stress on ligaments in closed chain positions
Helps in general body relaxation – stress management
Joint mobilization hip, knee, ankle, shoulder & elbow with less pain even with high intensity mobilization
Improving range of motion
Spinal joint mobilization
Muscle relaxation
Non weight bearing wallking – deep water walking with floats
Strength training
Endurance training
Agility & plyometrics training
Balance training
Reduce tone/spasticity /rigidity/ tightness
Graded loading on labrum/ capsule and ligaments of joints
Coordination training

fig-311

Who can benefit from Aqua therapy

A. Normal population for fitness and aerobic conditioning, weight loss

B. Orthopedic conditions

1)OA knee

2)Arthroplasty ACL,MCL repairs

3)Knee ligament injuries – conservative/ post op

4)Rheumatoid arthritis/ Ankylosing spondylitis/ Poly arthritis

5)Spine – conservative/ post operative, Low back pain

6) Fractures – conservative/post-op

C. Neurological conditions

1. Stroke rehab, Hemiplegic- upper limb, lower limb and trunk control training, and strengthening, balance and gait training

2. Paraplegic and quadriplegic – upper limb, lower limb and trunk control training and strengthening, balance and gait training

3. Balance disorders, Parkinson, Ataxia – strengthening, coordination, balance and gait training

4. Peripheral nerve injury and polyneuropathy -strengthening and gait training

5. Traumatic brain injury

D. Pedriatics – Cerebral palsy, DMD, Spina bifida, ataxia, developmental delay -strengthening, coordination, balance and gait training

What are the contraindication?

Frequently Asked questions about Aquatic therapy ?

Q: Is it necessary to know how to swim for aquatic therapy?

A: It is not necessary to know how to swim, during therapy you will be supported by your therapist or floats.

Q: Can patients without bladder control/ with a catheter participate in aquatic therapy?

A: Patients without bladder control must empty their bladder before aquatic therapy session. In order to participate, patients using a catheter must obtain prior permission from their physician. During therapy, the catheter must be blocked. Due to risk of infection, some public pools might not permit patients with a catheter to enter the pool.

Q: Can patients with bedsore/ open wounds receive aquatic therapy?

A: Yes, patients with bedsore/ open wounds can participate in aquatic therapy after the application of a wet dressing (specialized dressing which prevents water going into the wound). Permission from your physician or surgeon is required before coming for therapy. Risk – there are chances of cross infection and delayed wound healing in some cases if proper precaution is not followed.

Q: Do I need to wear a swimming costume or can I come in regular shorts?

A: Everyone who enters the pool is required to wear a swimming costume. Men shorts and T shirt, Women can use short length or full body costumes. Women or men with long hair are required to wear swimming cap during pool sessions. (It is advised to cover body in order to prevent suntan)

Q: How many sessions do I need to take?

A: There is no right answer to this question. It depends on multiple factors such as type/stage/progression of disease, severity/level of injury, neuroplasticity and learning ability of patient, compliance to therapy, training intensity and frequency of therapy.
10- 15 sessions is recommended in order to evaluate the rate of change and the effect/intensity of therapy. Depending on the results, more sessions may be necessary.

Q: Will aquatic therapy benefit me?

A: Aquatic therapy is one of the modalities of physiotherapy, if you need/are referred to physiotherapy then aquatic therapy will be beneficial as well. Compared to physiotherapy on land, it is easier to move in the water and exercises in water are more fun. You will be assessed on land first to find your impairment, activity and participation restriction. Based on the assessment your therapist will decide if you need aquatic therapy or not. Most of the time a combination of land and aquatic based exercises are beneficial for patients for strengthening, postural/trunk control, balance and gait training.

Q: Can a patient with cardiovascular diseases have aquatic therapy?

A: Cardiovascular disease is not a contraindication but a precaution. Patients with poor cardiovascular capacity, lower ejection fraction, under active/unstable angina should not attend aquatic therapy. When a body is immersed in water changes in blood pressure occur, patients with unstable hypertension of hypotension should to be monitored.

Q: Will I be taught/allowed to do exercises on my own in the pool during/after my aquatic therapy session?

A: Yes, after receiving appropriate training from your aquatic therapist and you are safe to perform exercises by yourself. Make sure that a life guard is on duty and aware of you when exercising alone.

Q: How should I prepare myself for aquatic therapy?

A: Please note the following:

Before aquatic therapy do not eat heavy food, light food or snacks are advised.
After a long session you might feel tired and hungry, therefore it is advised to bring a snack.
Keep well hydrated: Drink water before/during and after therapy.
Empty bladder and bowel before therapy.
Cover wounds with wet dressing before therapy.
Take bath/shower before entering the pool.
Check physical fitness and cardio vascular capacity, ability to tolerate exercises in water.
It is advised to observe other patients’ treatment session to get an overall idea about the therapy in water.
Bring moisturizer for use after pool session. Do not apply moisturizer before therapy otherwise it will be difficult for the therapist to maintain grip.
Bring essential showering toiletries and a spare set of clothes (if necessary bring a person/aid for assistance before and after session).

Q: Are there any changes that need to be observed/reported after completing the session?

A: Please report the following after the session:

How was the therapy experience?
How did you feel during and post session?
Did you notice any positive changes after the session?
For example: increased range of motion, strength, endurance, posture and movement
Did you notice any change in your functional ability, level of assistance or independence?
Presence of any adverse reactions to water or worsening of your present symptoms?
These issues may come up during the session as well, please report them to your therapist.
Are you getting any muscle cramps or delayed onset of muscle soreness? If so, please report to your therapist. He/she will advise you on what to do about it.

Whom to contact for aquatic therapy?

Ans -Dr. Gajanan Bhalerao, 9822623701. schoolneurorehab@gmail.com

GB school of neuro rehab and aquatic therapy, Bungalow no 1. Gajanan Housing society Model colony Shivajinagar Pune 16. Direction and Maps

My experience of 16th Post-Bachelor Aquatic Therapy Modular Course Package in Valens (Bad Ragaz), Switzerland

Posted on July 29, 2016August 3, 2016 by GajananBhalerao

My experience of aquatic therapy workshop Switzerland

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I was inspired by the C G Prashant’s 4 days aquatic therapy course in Pune. It was his teaching and training skill made me like the workshop. After completing the workshop i was enlightened with the new idea of aquatic therapy in neuro rehab. In NDT & neuro rehab we play with gravity as force to challenge, alter, assist or resist the motor control. In water we will get one more force along with “gravity” to play with motor control training, that is “buoyancy “. This concept has encouraged me to do the 14 days Aquatic therapy workshop Switzerland.

16th Post-Bachelor Aquatic Therapy Modular Course Package in Valens (Bad Ragaz), Switzerland

I have gone of Aquatic therapy course of 14 days in Kliniken Valens , Bad Regaz in Switzerland in month of May 2016. It was great learning experience. In Switzerland along with aquatic therapy I learned their culture, lifestyle and their teaching methods.

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Main building of Kliniken Valens

Valens is situated in valley. It is beautiful view from Valens.

Garden in front of the Kliniken Valens

Backyard of Clinic

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This intensive postgraduate aquatic therapy course (134.5 academic contact hours of 45 minutes) is unique in the world. The basis is “learningby-reasoning-and-doing” or “think-pair-share”: pool practice encompasses 86.9 hours. Preparatory and additional studying time needs about 20 hours. Five aquatic treatment concepts form the practical implementation of evidence based, and competence guided approach to therapy. ( Participants will experience a variety of patients during 5 hands-on sessions in the pool, supervised by the lecturers. Included are a (digital) course book, plus beverages during coffee/tea breaks.)

The concepts taught in the course
– Water Specific Therapy (WST) + login to http://www.halliwicktherapy.org
– The Bad Ragaz Ring Method® + http://www.badragazringmethod.org
– AquaT-Relax, passive relaxation including (spinal) joint mobilisation
– Clinical Ai Chi: addressing postural control and connective tissue
(e.g. neurodynamics) + http://www.clinicalaichi.org
– Aquatic Fitness (AT-Fit) introduction: focus on music, measuring
endurance and falls prevention

Contents are focused on adults with neuro-musculoskeletal impairments.
The red line in 2016 will be the individual with a neurological disease.

Case related contents provide students with a comprehensive picture of current research that supports decision making, clinical reasoning, problem-solving and goal-setting in aquatic therapy.

My instructors Johan Lambeck and his wife Anne Bommer (ClinicalAi Chi and Watsu)

Things that impressed me a lot

Teaching and training methods.

A. Didactic lectures

Planning: Course was very well planned and organized with details of daily lecture schedule.
Time management: time management was extremely good. Course schedule was not just written but each lecture schedule and timing of lecture delivery and completion of each session was dot on time.
Handout and notes: Whatever the didactic lecture were given in training all that was covered in all notes and hand out. This helped us to concentrate on the content of lecture that copying or writing note during lectures.
Evidence based lectures: All the lectures were evidence based with references of the content for each topic.
Best practices: during lecture they have discusses all the current practices throughout the world and in the end instructor emphasized on what best practices should be followed

B. Practical training in water: Lab session

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Hand on practice on models: instructors has given detailed and simple explanation for each treatment techniques and given plenty of time to practice on each other. They have instructed us to change partners frequently to avoid adaptation.
Individualized supervision and correction: we had 2-3 instructors in the group of 12-14 participants. During practice of techniques in water instructors used to come each participant and check our placement of hands, position and handling skills. They guided us all the correction whenever we were not doing appropriately. This individualized attention and correction helped to refine our handling skills.
Clinic is located at very beautiful place. Clinic is situated in the high hills with mountains covered with snow can be seen from our classrooms.
Simple and precise instructions of training.
Problem solving & Hand on practice on models: we got patients for assessment, problem solving, planning of optimized treatment plan according to their impairment and needs. We tried to solve their problems with different aquatic therapy techniques taught to us. We have observed the benefits of aquatic therapy in the single session as well. That was very encouraging and surprising for us.
Course schedule is hectic and lengthy but still inspiring: course is very hectic. It starts and 7.30 AM and will end by 6.00-6.30 PM, around 11 hours of training each day for 14 days. But it was well distributed in aquatic session and lecture session (1 aquatic and 1 land session in morning and 11 aquatic and 1 land session afternoon). Combination of aquatic and land training helped relaxation.
Expert instructors: This whole course in package of different modules, for each modules and different session there was expert panel of instructors in the respective field. Each instructor was great and expert clinician in their respective field and he/she was teaching and sharing their experiences with us. Lecturers
1. Johan Lambeck
  PT and Senior Lecturer IATF. He is director of Aquatic Rehab Consultants
  and is appointed as free research associate at Leuven University
  (Belgium), co-organizing the European Aquaoutcome/evidence Network
  (www.aquaoutcome.net), He is author of various books, book chapters and
  articles on AT in (peer reviewed) journals. He is a Cochrane member and
  former primary contact person for the WCPT aquatic physical therapy
  network.
2. Urs Gamper
  PT and Senior Lecturer IATF. Head of the Therapy Dept. at the
  internationally known Kliniken Valens, Switzerland. He has some 35 years
  of experience in Aquatic Therapy for adult patients with neurological,
  orthopaedic or rheumatologic diseases. He is an author of various books,
  book chapters and (peer reviewed) articles. Urs has a wide international
  teaching experience.
3. Anne Bommer.
  Senior Lecturer IATF. She is certified Ai Chi Lecturer and practitioner of
  Watsu and WST. Anne is specialized in working with clients with severe
  physical and intellectual disabilities and works in the Fondation Clair Bois,
  Geneva (Switzerland)
4. Bernd Anderseck
  PT, MSc in Neurorehabilitation, Kliniken Valens. Bernd is PNF Instructor
  IPNFA and lectures PNF over 15 years at a Swiss University of Applied
  Sciences. He has been faculty at various international conferences, e.g.
  about MS and gait rehabilitation
5. Jens Bansi
  PhD in sport sciences. Sports therapist and scientist at the Kliniken Valens.
  His research mainly focuses the impacts of (aquatic) training on cardiorespiratory
  fitness and immune functions in persons with MS and has
  authored various peer reviewed articles on this topic.
  He has 10 years of therapeutic experience involving conditioning for adults
  with orthopedic, rheumatological or neurological diseases in aquatic
  settings.
  Jens is member of RIMS and AQUA OUTCOME
6. Matthias Brunner
  Master of Sports, Aquatic Fitness Professional and owner of the
  Aquademie für Wasserfitness, Berne (Switzerland). He is specialized in
  aquatic programmes for golden age people.
7. Peter Oesch
  PhD, MSc in Health Ergonomics and PT. Head of the Research and the
  Ergonomics Department Kliniken Valens. Peter is author and co-author of
  peer reviewed articles and various books in Rheumatology and
  Assessments in Rehabilitation. He has 25 years teaching experience on
  graduate and postgraduate courses on national and international level.
Competency evaluation: at end of each module we have to go under competency evaluation of our planning and handling skills
Best infrastructure for aquatic therapy: I think it the best aquatic therapy infrastructure and facility in the whole world. This center is the role model for all others institutes. it has heated aquatic therapy pool. There are two pools only dedicated for treatment of patients in rehabilitation.
Experienced participant from different part of the world: There were highly experiences people were participant of course ranging from 5 -30 years of clinical and aquatic therapy experience. In spite of having such vast experience everyone was very cooperative and down to earth. I was surprised to see their zeal and hunger for knowledge at that age. It was commendable!

Participants of course.

There was participant from different countries. America 2, Holland 1, Spain 4, India 2, Philippines 2, Italy 1, England 1, Switzerland 2. We were frequently divided in group of 3-4 peoples fro group discussion for case based learning or problem based learning during didactic teaching and in aquatic session as well. Each time we kept in different groups. It was great learning experience interacting with all during group discussion of case based learning or problem based learning during the course.

I had good friendship with Emely & Alice from America, Nishita from India, Wendy from England and Claudate from Holland. At the end of every day we used sit together and discuss the daily teaching. it was Wendy’s idea to write down daily notes of techniques taught so that we will not forget it. We used discuss all the technique and I used to draw line diagrams of all the techniques taught. Then we used to put this drawing photos on our what’s up group. This daily discussion helped in better understanding and remembering the techniques well.

Emily and Claudate used to go for hiking. so one days I also joined with them. Usually in never go for hiking or walking in daily life. But they inspired me to walk up hill. We were walking in mountains trails from 7 -9 pm. In Switzerland day light is available till 9.30 pm. So it was quite bright till 9 pm. All the girls used to go for early morning walking /hiking or late evening walking. They were highly conscious about their fitness and health. This commitment to fitness health inspired me a lot. Now I am also working on my fitness. After coming back home from Switzerland I had participated in 25 Km cycling event with my staff in my hospital.

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How is the infrastructure?

Best infrastructure for aquatic therapy: I think it the best aquatic therapy infrastructure and facility in the whole world. This center is the role model for all others institutes. It has heated aquatic therapy pool, they get the hot water directly from hot springs in the mountains. There are two pools only dedicated for treatment of patients in rehabilitation. it has very well planned and user friendly changing rooms. Pool is very clean. They don’t use chlorine to clean and maintain pH of water, so it skin friendly and does not cause itching, dryness or rashes (common complication of chlorinated water in swimming pool).

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Who can apply for this course?

Qualified physiotherapist with few years of experience in neuro rehabilitation
interested in practicing aquatic therapy
has sound sufficient financial background support for course fees, accommodation, travel and food (food is very expensive in Switzerland)

How to take admission in this course?

This course packages happens once year in Kliniken valens Switzerland. You need mail to the study section .

Organization: Mrs. Gabriela Wyttenbach: study@kliniken-valens.ch with email id.

What is total expense to attend the course?

Course fees is 2400 CHF ( 2400x 70 (rate of INR to CHF) = INR 1,68,000)
Accommodation
- Suit room (with kitchen and toilet attached room) 60 CHF/per day 60x15days =900CHF ( 900×70=63,000INR).
- Staff room (with common kitchen and toilet outside room) 30 CHF/per day 30x15days =900CHF (450×70=31,500)
  INR).

This was the view from my Room’s Balcony

Common Kitchen with lockers & Freeze for each room.

Internet /wifi they provide wifi in clinic and accommodation area at rate 30 CHF each for 14 days, total 30+30=60CHF. (4,200 INR)

Food for each meal you will have to spend 25-40CHF (1750 -2800 INR). So you can carry your packed ready to use food with you for 15 days. We don’t get Indian food there and you may or may not like the local food, so it is better to carry your own food. I had my own food with me. on an average i had spent only 50 CHF (3500)on food and groceries.

Pune to Mumbai airport taxi and back 950 x 2= 1900 INR
Mumbai to Zurich and Zurich to Mumbai Swiss airways = 45000 INR

Mumbai to Zurich

Zurich to Mumbai

Valens to Bad regaz by bus 5CHF. Bad regaz to Kliniken valens 10×2=20 CHF (1400INR)

Zurich Bad Ragaz to and fro by train 38 x 2= 76 CHF (5320 INR)

Bad Ragaz Station

Swiss train. ticket checkers are always available in train. Don’t board without ticket in train.

Subway train from airport terminal A-B to C terminal

Zurich airport pass counter (all automatic)

Total expenditure = INR 2,55,500/- to 3,00,000/-

What is the entertainment source?

There is no TV in room. Only One TV is available in common hall, but it does not have any English/Hindi channels. Only source of entertainment is go for k=hiking and enjoy beauty of Switzerland or use WIFI/internet.

What is the arrangement of food?

Food for each meal you will have to spend 25-40 CHF (1750 -2800 INR). So you can carry your packed ready to use food with you for 15 days. I had carried readymade Daal, Pulav packets, Tea bag, tea powder, sugar, milk powder, chiwada, thephala, nuts and other small things. I had carried some utensils with me for cooking and eating. You will also get some cooking utensils in common kitchen or you can borrow from local staff living in staff rooms and using common kitchen. I used buy rice, eggs, bread, milk and sugar in their general store. There is only one general store in that village which opens at 8 am and closed by 6 pm. so you need to plan your shopping in this period only. it is closed on Sundays and Saturday it opens half day only. There is one restaurant in clinic and one commercial restaurant in that village.

Kliniken Valens Physiotherapy Department

Physiotherapy gymnasium

Advance Physiotherapy equipment

Robotic arm training

Leg Press

Locomat : Body wight supported treadmill training

Manipulation and therapy plinths

Rehab: cloth washing and drying training

Rehab: Carpentry training -vocational rehab

Adjustable Kitchen-Cooking rehab

Occupational therapy

All Cupboard shows what is inside that cupboards.

Climbing wall

How is the culture and people of Switzerland?

https://m.facebook.com/story.php?story_fbid=10153558294389109&id=550684108

I found people are very friendly and cooperative. Every passing by me used say hello and greet me in their language. Valens is a small village, there very few people found on the roads while walking daily.

Trip to Heidi hotel

Trip to other country without Visa

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My place of accomodation

Kliniken Valens, Switzerland is heaven of aquatic therapy, must visit place and learn from the best experts of the world in aquatic therapy!

Two days WORKSHOP ON”NEURO DEVELOPMENTAL TREATMENT (NDT) IN MANAGEMENT OF ADULT WITH STROKE AND BRAIN INJURY REHABILITATION” Date 17th 18th October 2015

Posted on October 1, 2015October 3, 2015 by GajananBhalerao

SANCHETI HEALTHCARE ACADEMY

Organizing

A Two days WORKSHOP ON

“NEURO DEVELOPMENTAL TREATMENT (NDT) IN MANAGEMENT OF ADULT WITH STROKE AND BRAIN INJURY REHABILITATION”

Date 17^th 18^th October 2015

Venue : Sacheti healthcare academy, Thube park Shivajinagar Pune

Course instructor

Dr. Gajanan Bhalerao (PT)

Master of Physiotherapy (Neurosciences)

Associate professor

Certified Adult NDT (C/NDT) Therapist

Sancheti Institute College of Physiotherapy

Shivajinagar, Pune.

Course Description:

This introduction to the management of adults with neurological dysfunction due to stroke or traumatic brain injury is based on the philosophy and basic principles of Dr. Karel and Mrs. Berta Bobath. The course utilizes lecture, lab practicums, and demonstration of patient treatment to teach participants a wide range of practical handling skills. Principles of NDT Basic clinical implications of Recovery of Function and Motor Learning research Components of normal movement in functional activities, such as transfers, dressing, and gait Discussion of typical patient impairments Practice of treatment handling skills Demonstration of patient treatment

This two day, “hands-on” course is designed for those who would benefit from a more in-depth understanding of the principles of NDT. Through the use of client videos you will be able to identify how each system influences motor control and understand the impairments in each system that impede your clients’ abilities to recover function. Your clinical reasoning will be improved through an understanding of neuroplasticity, resulting in your ability to select methodologies that match the etiology of CVA. Through self-experience labs you will learn how components of movement of the trunk influence each other, and understand how they influence the involved UE for active support and reach, the involved LE for the stance and swing phases of gait, as well as subluxation of the humerus. You will learn to provide effective interventions for your acute clients who are unable to control a symmetrical posture in sitting due to impairments causing poor head and trunk control. You will also learn what to expect and what to do when your clients attempt the transition from sit to stand. You will be provided with treatment ideas for achieving functional outcomes for your clients, including increased safety and independence. Using “hands-on”, you will learn how to access components of movement of the trunk and LE’s required for a symmetrical sit to stand, stand to sit, and for transfers. Facilitation of bed mobility will be demonstrated. You will gain an increased appreciation of the effect NDT can have on your clients’ recovery of function. You will also be provided with examples of documentation for achievable, reimbursable, discipline specific functional outcomes using NDT.

Learning Outcomes: Upon completion of the course, you will be able to:

Use the principles of NDT to provide your clients with opportunities for use of effective movement strategies to achieve functional outcomes
Identify how impairments in each system impede your clients’ abilities to recover function
Demonstrate an understanding of neuroplasticity and be able to select methodologies that match the etiology of CVA
Identify the components of movement of the trunk and understand how these components influence the involved UE and LE
Use effective interventions for your acute clients whose impairments cause poor head and trunk control in sitting
Use treatment ideas to achieve functional outcomes, including increased safety and independence
Use manual cues to access components of movement of the trunk and LE required for symmetrical sit to stand, stand to sit, and for transfers
Use examples to document achievable, reimbursable, discipline specific functional outcomes for use in all systems including a managed care environment, PPS and Medicare

Contact hours – 16

Eligibility – Clinical Therapist,

Registration fees: – Rs 3000/per candidate

Venue: – Sancheti Institute College of Physiotherapy Shivajinagar, Pune.

Limited Entries: 30 Only

Those who are interested please send mail for registration on following mail id.

gajanan_bhalerao@yahoo.com

contact Dr. Gajanan Bahelrao 9822623701, Dr. Dinesh Chavhan 8698261162

Registration from Registration Form ndt 2015

WORKSHOP ON 2D & 3D GAIT ANALYSIS AND MANAGEMENT Of GAIT DEVIATIONS

Posted on December 4, 2014May 9, 2015 by GajananBhalerao

Author of article:

DR. GAJANAN BHALERAO (PT), PhD Scholor, MPTH NEURO, Certified Adult NDT therapist. HOD Physiotherapy & Rehabilitation Dept in Sancheti Hospital Shivajinagar Pune. Associate Professor & HOD PT in Neuro Rehabilitation DEPT at Sancheti Institute College of Physiotherapy, Shivajinagar Pune

Sancheti college of physiotherapy is organizing

A WORKSHOP ON

2D & 3D GAIT ANALYSIS AND MANAGEMENT Of GAIT DEVIATIONS

On 20^th and 21 December 2014

Workshop details

S. No.	TOPIC
1.	Introduction
	Basics of human Gait Normal gait, Phases of gait Temporo-spatial parameters Gait traces and terminology Kinematics &Kinetics EMG and muscle function Physical examination Techniques Strength Testing
2.	Methods of gait assessment
2.a	Techniques in 2D video analysis
	Observational gait analysisFoot print method·Videographic/cinematographic analysis·Digital goniometric kinematic measurements
2.b	3D Gait analysis
	Set up of a lab Marker placement Force plates EMG Procedure
3.	Gait deviations
	Causes and factors affecting gait
	PT management of gait deviations
	Orthotic prescription
4.	Case Discussion

Venue: – Sancheti Institute College of Physiotherapy Shivajinagar, Pune.

Contact hours – 16

Eligibility – Clinical Therapist, Post Graduate, 3^rd & 4^th year students and Intern

Registration fees: – Rs 2500 per candidate.

Limited Entries-30 only

Those who are interested please contact for registration.

Contact: – anjalipradhan.sha@gmail.com, gajanan_bhalerao@yahoo.com

ABOUT THE RESOURCE PERSON

Dr. GAJANAN BHALERAO (PT)

Associate Professor

Masters in physiotherapy, Neurosciences,

Certified Adult NDT (C/NDT) Therapist

Sancheti Institute College of physiotherapy,

HOD Physiotherapy Dept Sancheti Hospital

Shivajinagar, Pune.

gajanan_bhalerao@yahoo.com

Credits : University Topper in Master of Physiotherapy 2007 Pune university

Work Shops Conducted (Continued Medical Education)

Workshop on Motor Relearning program for stroke

Rehabilitation at Youth Men Christian Association (YMCA), Pune, on 29^th & 30^th of March 2007.

A 2 day workshop under Indian Association of Physiotherapy Pune branch, on “Spinal Cord Injury Rehabilitation” in 2008
Resource person for the pre conference workshop and lecture during National Seminar On Multidisciplinary Approach To The Management Of Paediatric Disabilities organized by Faculty of Disability Management and Special Education Ramakrishna Mission Vivekananda University SRKV, Coimbatore, Tamil Nadu 641 020, INDIA. June 2010
A workshop on 2D & 3D Gait Analysis And Management Of Gait Deviations organized by Indian Association Of Physiotherapy Pune & Pimpri Chinchwad Branch on 27^th &28^th November 2010, at Sancheti institute college of physiotherapy.

A workshop Motor Relearning program for stroke Rehabilitation on October 2010, organized by Indian Association of Physiotherapy Pune & Pimpri Chinchwad Branch on 27^th &28^thNovember 2010, at Sancheti Institute College of physiotherapy.
A workshop on 2D & 3D Gait Analysis And Management Of Gait Deviations organized by Indian Association Of Physiotherapy Pune & Pimpri Chinchwad Branch on 27^th &28^th November 2010, at Sancheti institute college of physiotherapy.
A workshop Spinal cord injury Rehabilitation, organized by Indian Association of Physiotherapy Pune & Pimpri Chinchwad Branch on December 2010, at Sancheti Institute College of physiotherapy.
A workshop Spinal cord injury Rehabilitation, organized by Sancheti healthcare academy on December 2012, at Sancheti Institute College of physiotherapy.
A 2 day Workshop on Task specific training in neuro rehabilitation, on 30 -31 sept 2013, at Mission health physiotherapy center Ahmadabad, Gujarat.

Workshop on ” Neuro therapeutic approaches in neuro rehabilitation : part I- Proprioceptive neuro Muscular facilitation” on 13th Sept 2014

Posted on August 28, 2014September 1, 2014 by GajananBhalerao

On the occasion of word physiotherapy Day on in month of September

Sancheti Institute College of physiotherapy, Sancheti healthcare academy

organizing a one days work shop on

Neuro therapeutic approaches in neuro rehabilitation : Part I- Proprioceptive neuro Muscular facilitation

Date :- 13^th Sept 2014

Contact hours – 8hrs

Eligibility – Clinical Therapist, Post Graduate, 3^rd & 4^th year students and Intern

Registration fees: – Rs 1000 per candidate.

Venue: – Sancheti Institute College of Physiotherapy Shivajinagar, Pune.

Limited Entries: 30 Only

Course instructor

Dr. Gajanan Bhalerao (PT)

Master of Physiotherapy (Neurosciences)

Certified Adult NDT (C/NDT) Therapist

Associate professor Sancheti Institute College of Physiotherapy

HOD Physiotherapy Dept Sancheti Hospital

Shivajinagar, Pune.

Kindly send registration on

anjalipradhan.sha@gmail.com

PROGRAM HIGHLIGHTS.

Definition and neurophysiologic bases of PNF
Principals of PNF
Pattern of movement –D1 and D2
Pattern of movement in upper limb – unilateral pattern, bilateral pattern, symmetrical, asymmetric and reciprocal pattern of UL.
Pattern of movement in lower limb – unilateral pattern, bilateral pattern, symmetrical, asymmetric and reciprocal pattern of LL.
Training of use these patterns in patient treatment.
The approached PNF techniques will be: Slow Reversals (SR), Slow Reversal Hold (SRH), Repeated Contraction (RC), Timing for Emphasis (TE), Agnostic Reversals (AR), Hold-relax Active Movement (HRAM), Resisted Progression (RP), Rhythmic Rotation (RR), Hold-Relax (HR), Contract-Relax (CR), Rhythmic Stabilization (RS), Rhythmic Initiation (RI), Alternating Isometrics (AI),
Use of PNF for facilitation, inhibition or stability
Exercises for stability, mobility and coordination.
Training of activities of daily living, ambulation and transfers training using PNF.

ABOUT THE RESOURCE PERSON

Dr. GAJANAN BHALERAO (PT)

Associate Professor

Masters in physiotherapy, Neurosciences,

Certified Adult NDT (C/NDT) Therapist

Sancheti Institute College of physiotherapy,

HOD Physiotherapy Dept Sancheti Hospital

Shivajinagar, Pune.

gajanan_bhalerao@yahoo.com

Credits : University Topper in Master of Physiotherapy 2007 Pune university

Work Shops Conducted (Continued Medical Education)

Workshop on Motor Relearning program for stroke

Rehabilitation at Youth Men Christian Association (YMCA), Pune, on 29^th & 30^th of March 2007.

A 2 day workshop under Indian Association of Physiotherapy Pune branch, on “Spinal Cord Injury Rehabilitation” in 2008
Resource person for the pre conference workshop and lecture during National Seminar On Multidisciplinary Approach To The Management Of Paediatric Disabilities organized by Faculty of Disability Management and Special Education Ramakrishna Mission Vivekananda University SRKV, Coimbatore, Tamil Nadu 641 020, INDIA. June 2010
A workshop on 2D & 3D Gait Analysis And Management Of Gait Deviations organized by Indian Association Of Physiotherapy Pune & Pimpri Chinchwad Branch on 27^th &28^th November 2010, at Sancheti institute college of physiotherapy.

A workshop Motor Relearning program for stroke Rehabilitation on October 2010, organized by Indian Association of Physiotherapy Pune & Pimpri Chinchwad Branch on 27^th &28^th November 2010, at Sancheti Institute College of physiotherapy.
A workshop on 2D & 3D Gait Analysis And Management Of Gait Deviations organized by Indian Association Of Physiotherapy Pune & Pimpri Chinchwad Branch on 27^th &28^th November 2010, at Sancheti institute college of physiotherapy.
A workshop Spinal cord injury Rehabilitation, organized by Indian Association of Physiotherapy Pune & Pimpri Chinchwad Branch on December 2010, at Sancheti Institute College of physiotherapy.
A workshop Spinal cord injury Rehabilitation, organized by Sancheti healthcare academy on December 2012, at Sancheti Institute College of physiotherapy.
A 2 day Workshop on Task specific training in neuro rehabilitation, on 30 -31sept 2013, at Mission health physiotherapy centre Ahmadabad, Gujarat.

Hurry up! limited sits only.

For eligibility program & Registration from details click attachment.

PROPRIOCEPTIVE NEURO MUSCULAR FACILITATION

WORKSHOP REGISTRATION FORM PNF

Please forward this information to the interested therapist and students.

WORKSHOP ON MOTOR RELEARNING PROGRAM FOR STROKE REHABILITATION …..A Practical Approach On 16th and 17th August 2014

Posted on August 21, 2014August 28, 2014 by GajananBhalerao

SANCHETI HEALTHCARE ACADEMY Organized WORKSHOP ON

“MOTOR RELEARNING PROGRAM FOR STROKE REHABILITATION”

…..A Practical Approach

On 16th and 17th August 2014
Course instructor
Dr. Gajanan Bhalerao (PT)
Master of Physiotherapy (Neurosciences) Associate professor
Sancheti Institute College of Physiotherapy Shivajinagar Pune.

Contact hours – 16

Eligibility – Clinical Therapist,

Registration fees: – Rs 2000 per candidate.

MRP_Workshop_Cover

In this course 44 students, clinical therapist and teachers attended the work shop. The workshop included the motor control theories, different introduction approaches fours steps of MRP Assessment . Different activities of daily living and assessment and treatment in these activities is taught. activities such as Training of Supine to sit, Training of Sitting Balance, Training of Standing Balance,Training Of Standing Up & Sitting Down, Training of Upper Limb control, Shoulder hand syndrome, Gait Training, Orthotic prescription and management of Genu recurvatum.

Participant were taught how to set the goals according to task analysis and lifestyle, contextual and environmental factors in his own home/village/town/city.

Practical demos of treatment on patients was shown.

Workshop schedule

DAY ONE 16/08/14

Time	Topic
8 -8.30 am		REGISTRATION AND BREAKFAST
9.30 -1.00 am		INTRODUCTION
		Stroke anatomy and physiology
		Localization of lesion
		Theories of motor control
		Neurophysiological approaches(their differences and limitations)
		Muscle Re-Education Approach Neurotherapeutic approach Sensorimotor approach Movement therapy approach (Brunnstrom,) Bobath approach PNF approach (Knot and Voss) Task- specific approach system model of motor control Motor relearning program for stroke (1980s) Contemporary task-oriented approach (1990s)
		What is importance of the task specific approach? (Carry over, Neuroplasticity)
		General Assessment of stroke & common problems
1-2pm		LUNCH
1.00 – 5.00 PM		MRP Assessment
		Step 1	Analysis of task
		Step 2	Practice of missing component
		Step 3	Practice of task
		Step 4	Transfer of training
		GUIDELINES & STEPS FOLLOWED
		Training of Supine to sit
		Training of Sitting Balance
		Training of Upper Limb control
5pm		QUESTIONS & FEEDBACK

Day Two 17 /08/ 14

Time	Topic
8.00 AM	BREAK FAST
9AMTo1.00 PM	Training Of Standing Up & Sitting Down
	Training Of Standing Balance
	Orthotic prescription
	Gait Training
1.00 pm to 2.00 pm	LUNCH
2-3.30pm	Complications and its management
	Shoulder hand syndrome
	Spasticity
	Genu recurvatum
3.30 pm – 5.00 pm	Pool of Evidences of Stroke Rehab
3.30 pm – 5.00 pm	Case discussions
5.00 pm	QUESTIONS & FEEDBACK

The workshop focuses on practical demonstration & handling techniques in the Neuro rehabilitation. The workshop also aims at enhancing the skills of the participants & better understanding of problems commonly encountered in the management of stroke patients. Besides the workshop will emphasis on insight into unique case studies as well.

FEEDBACK OF MRP WORKSHOP

on 16^th & 17^th Aug 2014

POSITIVE POINTS –

The PPTS were short and precise, clinical assessment was long and required.
Excellent workshop; it was more beneficial because we had learnt things on the patients.
Food was good too.
Great workshop, teacher was good , and friendly workshop.
Preparations made by college were systemic.
Was the first workshop ever attended and really liked it, enjoyed a lot, got to know my mistakes while treating patients.
Explanation of theory was simplified.
Optimally arousing workshop.
Teaching methods and practical sessions.
Demo on patients was good.
Understood MRP for the first time.
Will help patients in Nanavati hospital .
Practical approach to treat hemiplegics.
Knowledge with fun workshop.
Regular attitude with patients of Sir.
More task-specific.
Excellent environment.
Motor control theories were made easier.
Interaction with students was good.
Not sleepy at all.
Learnt the importance of BOS in every movement.
Basic concepts got cleared today.
Totally new concept of rehab.
Biomechanics concept was taught again.

NEGATIVE POINTS-

The teaching speed bacem fast sometimes.
Got heavy post-lunch.
Include all participants in the activities.
More explanation of every specific activity, assessment.
Vast topics so slow bombardment of topics is advised.

WHAT I HAVE LEARNT TODAY?

Behavioral sciences.
The body follows the biomechanics and so should we while treating the patient.
Learnt to give task specific activities.
Assess functional activity directly without checking MMT, tone, reflexes.
How the treat the lateral slouch
Use of heel raise – sit to stand.
Without touching perform the activity.
Theories of motor control.
Constraint is not only resisting but preventing an abnormal, unnecessary movement.
Self confidence is important.
Communication with the patient
Task-specific
Postural components are important to target.
Analyse the function and treat.
Learnt how to treat patients without much energy expenditure.
‘What not to do’ in treatment.
Command to patients is important.
Line of gravity and centre of mass importance.
Tangent- bridge concept.
Analyse demand of task.
New phrases- invite muscles, create opportunities.

FEEDBACK FORMS DETAILS

INDIVIDUAL FEEDBACK OF PARTICIPANT ON DAY 1 AND DAY 2.

MRP WORKSHOP DAY 1

Participant 1.

GOOD POINTS –

The behavioral sciences was something new.
Each component of sit to stand , supine to sit was practically amazing .
In neurosciences not necessary that neural involvement makes an activity difficult but other system involvement should be considered also .
Doubts were cleared.

WHAT DID I LEARN TODAY ?

Theories of motor control
Alignment
Assessment
Biomechanics

Participant 2

Good points –

Understood well
Simple language
Functional assessment was taught well

What did I learn today ?

How to change behavior of the patient ?
Task specific activities

Participant 3.

Good points –

biomechanics
how to approach the patient

What I have learnt today ?

the bioemchanics and its use in treatment

Participant 4

Good points –

good food and tea
nice way of diverting from topic and keeping us awake in lecture

Bad points –

please explain basic terms
teach simple things after lunch

what I have learnt today ?

assessing functional activity and then treating like wise
lateral slouch technique
to give heel raise

Participant 5

Good points – ppts were good

Bad points –

practicals would’ve been more beneficial

What ive learnt today ?

Proper handling and commands beneficial
Theories of motor control
Practical sessions were good

Participant 6

Good points –

Biomechanics

Bad points –

2days is less duration

What ive learnt today ?

Motor control
Reflex theory was taught well
I learnt how to make others happy during therapy

Participant 7

Good points –

Misconceptions were cleared
Correlation with patients imeediately helped

What ive learnt today ?

Simple and easy techniques were taught
Energy expenditure was less

Participant 8 –

Good points –

Learnt new words
Concepts were cleared

What ive learnt today ?

Good rapo with patients
Behavioral attitudes of patients

Participant 9 –

Good points – handling was well taught

What ive learnt today ?

Communication with patient was well explained
Minimize therapist’s work by using proper biomechanics

Participant 10 –

Good points –

Understood what was taught and environment was good enough

Bad points –

Break of 5-5 mins in between

What ive learnt today ?

View of treating the patients changed
Functional tasks help patient
Patterns of activities

Participant 10-

Good points – nice and interesting seminar

Bad points – Food was ok

What ive learnt today ?

Treating the patient in a better way

Participant 11 –

Good points – interesting lecture and learnt many things

Participant 12 –

Good points –

liked the teaching method
question answer session

Bad points – Breakfast

What i have Learnt today ?

commands to the patients
how to emotionally handle the patients?

Participant 13 –

Good points-

Everything

Bad things –

food

What ive learnt today ?

totally new concept of treating patient
biomechanics
theories

Participant 14-

Good points –

Great workshop and it has helped a lot

What ive learnt today ?

Theories of motor control was taught really well

Participant 15 –

Good points –

Task specificity
BOS importance
Anatomy and physiology of nerve conduction

What ive learnt today ?

Satisfied with all the knowledge gained.

Participant 16 –

Good points –

Easy an inspiring workshop and great environment

Bad points –

Saturation after lunch .

What ive learnt today ?

Motor control theories

Participant 17-

Good points –

Practical sessions were great.

Bad points – Nothing as such .

What ive learnt today ?

Rehab of patient can be done with commands

Participant 18 –

Good points –

Practical sessions and food were great .

What ive learnt today ?

Assessment and treatment should be the same

Participant 19 –

Good points –

Interaction with students and question answer session wee good

Bad Points – time constraint

What ive learnt today ?

New words like constraint, alignment , postural adjustments .

Participant 20-

Good points –

Workshop content
Hand on training
Motor control theory
Mrp in daily tasks

What ive learnt today ?

Task oriented activities
Analysation of patient
Allowing patient to the prep phase and correcting it.

Participant 21

Good points –

Workshop was great

What ive learnt today ?

Approach is task oriented

Participant 22 –

Good points –

Workshop is excellent

Good interaction

Good food

Bad points –

Ppt

What ive learnt today ?

Informative session ,

Invite the muscle

Simple ways

Biomechanics

Participant 23-

Good points-

Practical sessions

Cleared common myths regarding stroke rehab.

Bad points –

Gets boring after lunch

What Ive learnt today ?

Old techniques were corrected.

Confidence was increased.

Create opportunities.

Participant 24-

Good points –

Great workshop.

New things .

Interaction was good.

Bad points- food

What ive learnt today ?

Task specific assessment .

Interaction with patient.

Commands to be given to patient.

Behavioral changes.

Participant 25 –

Good points –

Teaching method .

Good interaction.

On patient handling.

Bad points – more explanation on basics.

What ive learnt today ?

New concept of mrp.

Participant 26-

Good things-

Demo on patient

Bad things – food

What ive learnt today ?

Patient’s cooperation required in mrp.

Participant 27-

Good points-

Practical and handling of patient.

Keeping me focused on the lecture.

Bad points –

Slow bombarding about the topic.

What ive learnt today ?

New dimensions in patient – therapist sessions.

Behavior about learning and understanding problem-solving.

Participant 28 –

Good points-

Great understanding of the topic.

Interactive sessions.

Bad points –

Food.

What ive learnt today ?

Completely new dimension of neuro- assessment and treatment.

Participant 29 –

Good points –

Great interactive session.

Functional assessment .

Bad points –

Ppts.

What ive learnt today ?

Treatment is task – specific always which will help the patient .

Participant 30 –

Good points –

Practical approach to treat hemiplegics.

Simple approach to treat and assess too.

Bad points-

Ppts.

What ive learnt today ?

Excellent content about functional assessment and treatment.

Participant 31 –

Good points-

Assessment was great .

Analysis of the task was taught well.

Bad points –

Ppts.

What ive learnt today ?

Motor control theories .

Step wise analysis of the task.

Deep well and shallow well phenomenon.

Task specific approach.

Participant 32 –

Good points –

Knowledge with fun.

Attitude to talk to the patients.

Bad points –

Ppts.

What ive learnt today ?

Deeper knowledge of stroke and mrp.

Participant 33-

Good points –

Task-specificity.

What ive learnt today ?

Practical application which is usually required in day to day activities.

Participant 34-

Good points –

Presentation was great .

Knowledgable.

What ive learnt today ?

New approach towards rehab .

Participant 35-

Good points –

Practical- oriented .

Content was great.

What ive learnt today ?

My behavior with the patients was changed.

Participant 36-

Good points-

Good ppts.

Practical was better.

What ive learnt today ?

Totally new concepts and technique .

Participant 37 –

Good points –

Great way of teaching.

What ive learnt today ?

Lesser energy consumption techniques for the therapist .

Participant 38 –

Good points –

Friendly way of teaching .

On patient learning was great .

Good arrangement by the college.

What ive learnt today ?

Constraint and BOS topics were discussed.

Participant 39-

Good points-

Corrected my wrong ways of treating the patients.

What ive learnt today ?

Amazing experience.

Learnt how to develop rapport with the patient .

Participant 40 –

Good points-

I was optimally aroused.

Great on patient demo.

Less ppt.

Bad points-

Small batch of students should be there while treating and assessing the patient.

What ive learnt today ?

Analyse the demand of task of patient and then treat accordingly.

Participant 41-

Good points –

Learnt many things which ive not learnt in my ug .

Bad points-

Afternoon session went tangent.

What ive learnt today ?

Most of the basic concepts.

Pariticipant 42-

Good points –

Gait observation was great.

Assessment .

Great food.

Bad points-

Just go little slow.

What ive learnt today ?

Tangent – bridge concept.

Behavioral problems.

Participant 43 –

Good points –

Excellent environment.

On patient learning better.

Allowance to directly analyse patients by assessment.

Bad points –

Ppts.

Time constraint of only 2 days .

What ive learnt today ?

Basic approaches .

Handling of patients.

Task-oriented management .

DAY 2

STUDENT’S FEEDBACK

PARTICIPANT-1

Name-Shradhha Kodilkar

What I learnt-

-I liked the sentence ‘’Do not work on mobility if stability is not there… ’’Routinely we work on mobility first, so this will help me to see and prevent shoulder hand syndrome in stroke patients.

-WHAT WORKS FOR THE PATIENT IS TREATMENT, AND WHAT DOES NOT WORK IS ASSESSMENT! So I won’t force the patient to perform any activity which he is finding difficult.

-Hence forth my commands will change while treating patients. Also we should understand what patient wants him/her to improve and what we want him/her to do.

Good points-

. It was a great workshop

PARTICIPANT-2

Name-Rajashree

What I learnt-

-I learned how to mobilise adult with grade 0 control.

Good points-

-Good practical demo

-appreciate the efforts of calling patients on Sunday/holiday weekend.

-Custom made fast food provided.

Bad points-

-The calibre of participants should be at least graduates as the session becomes less interactive.

Participant-3

Name-Rashmi Kulkarni

What I learnt-

-Being neuro physiotherapist I used to think that I don’t have to read biomechanics to know dynamics. But it is very important.

Good points-

-I really liked the workshop and will definitely attend all the workshops in future.

Bad points-

NONE

Participant-4

Name-Dhanashree

What I learnt-

-Traditional approach of assessment is good to follow, but the new way task oriented approach of assessing range, function, strength, voluntary control is very interesting.

-Small biomechanical mal alignments result in major deviations.

-Eccentric lengthening is more appropriate to deal with spasticity.

-Weight bearing affects the moment arm of long finger flexors of hand and thus results in increase in flexor spasticity, so stretch the muscle to its optimal length.

-First to change the ‘’BEHAVIOUR OF THE PATIENT ‘’ we need to change ‘’BEHAVIOUR OF OURSELVES’’

Good points-

-Learnt about of the importance of knowledge of result and how observation is necessary before formulating any treatment protocol.

Bad points-

-Duration of workshop was less so practical session was for shorter duration.

Participant-5

Name-Pratibha Salkar

What I learnt-

-I found out the missing component in our practice. I will start applying it into my practice and make my skill stronger to improve functional ability.

-Transfer of learning-using this into various activities and treatment.

-It started the motor relearning in me!

Good points-

-Wonderful workshop

-Great work sir. Thanks for arranging this workshop.

Bad points-

NONE

Participant-6

Name-Sabah Jhaver

What I learnt-

-It has cleared a lot of concepts which were previously not well understood.

-I am very eager to go back and apply all the new things that I have learned.

-The workshop has broadened my view and has helped change my views about stroke management.

Good points-

-The entire workshop was very interesting

-It was conducted in a very student friendly manner.

-It has been a very nice experience overall and I am looking forward to attend more workshops conducted by sir.

Bad points-

-It was very long.

Participant-7

Name-Dhara Mehta

What I learnt-

-There is nothing like wrong treatment.’’ WHAT WORKS IS TREATMENT WHAT DOES NOT IS ASSESSMENT’’Dr.Gajanan.

Good points-

-I learnt how to able the patient functionally

-Correction of certain commonly made mistakes.

-It was not only motor relearning, but also how it can be used with other approaches.

Bad points-

NONE

Participant-8

Name-Rupa Gulani

Thanks for everything and sharing your ideas with us.

Participants-9

Name-Sumitra

What I learnt-

-Dual task training

-Bilingual task training

-Using tenodesis eccentric lengthening mfr to reduce spasticity.

-Gait training-Stance phase: Stability important, Swing phase: Initiation.

-Hand and upper limb task training.

-Hand grasp- Task training for fine motor skills.

-Path mechanics of hemiplegic shoulder and hand, and how to correct this alignment.

-Hurdle walking, Pelvic rotation, shifting of centre of mass.

Good points-

-More on patient explanation especially regarding preparatory postural adjustments, and going on postural adjustments during tasks.

Bad points-

NONE

Participant-10

Name-Shalmali Sulakar

What I learnt-

-I learnt that there is no fixed protocol. We can mix anything that can work on a patient.

-Love the sentence of sir ‘’ANYTHING THAT WORKS IS TREATMENT AND DOES NOT WORK IS ASSESSMENT’’

Good points-

-This 2 day workshop was very knowledgeable and got to know how to use tenodesis and active insufficiency in regular treatment.

-The videos shown are very useful.

-Sir taught how to get along with patients and how to make a friendly atmosphere in the opd.

-Thank you so much sir for sharing your knowledge.

Bad points-

NONE

Participant-11

Name-Radha Joshi

What I learnt-

-I learnt many new things and will surely apply it on our college’s patients

-I am sure I am going back with lots of new and interesting knowledge

Good points-

-today’s workshop was excellent and I had written yesterday on feedback paper that I used to treat in a wrong manner but when sir explained it, I realised and now I will also be optimistic.

-I really enjoyed the workshop and looking forward to attend more workshops in future. Everything was just PERFECT

Bad points-

NONE

Participant-12

Name- Priya bang

What I learnt-

-I learnt so many new things like on the first day I came with lots of questions about approaches and neurosciences but after this workshop I think I can treat stroke patients not as good as you but I will try my best

-One more thing I like which you tell us

“ANYTHING WHICH WORKS IS TREATMENT AND WHICH DOES NOT WORK IS ASSESSMENT”

-I like the word “ZIKZAK” which explains that ZIK is an output of patient (which can be normal or abnormal), where ZAK is a cause which is responsible for zik. If u beat the zak automatically zik is corrected

Good points-

-Thank you for teaching us.

Bad points-

NONE

Participant-13

Name-DeepikaBurman

What I learnt-

About mrp and other neuro techniques

Good points-

-This workshop on mrp was very knowledgeable and interesting.

-The environment he creates is simply mind awakening, actually it does not let you sleep at all, even for a second.

Bad points-NONE

Participant -14

Name-ChandaliDoshi

What I learnt-

-Good tapping techniques and videos

Good points-

-Workshop was very good, understanding the basic corrective treatment for walking.

-Hands on patient was outstanding, especially technique for releasing of hand of patient stephon

Bad points-

NONE

Participant-15

Name-MrunalHarle

What I learnt-

-About MRP, its benefits and limitations.

-MRP is useful in missing components like alignment, postural adjustments etc.

Good points-

-Since yesterday we are very attentive for lecture. I couldn’t distract my attention in fear of missing some important line which you have spoken… very interesting.

-Practical sessions were very good

Bad points-

-Though there were enough practical sessions, hands on for every person could have been improved.

-Some more instructors could have been there to help sir for practical sessions.

Participant-16

Name-KomalPawar

What I learnt-

-Many and various new concepts were learned

-Patient handling, communication, treating was taught

-Various exercises using different techniques

-Gait training, by actually doing it on each other was a good experience.

-Meaning of particular words/terms was understood

-Videos helped in tapping and exercises

Good points-

-The way of teaching was excellent

-All experience we got actually on patients

Bad points-

NONE

Participant-17

Name-KiranKarvarpatil

What I learnt-

-I have learned a lot of new things.

-The best thing u taught “what works is treatment and what does not work is assessment”

-I learned that correct the biomechanics the problem will automatically get solved

Good points-

-They provided good food

Bad points-

NONE

Participant-18

Name- Rasika athawale

What I learnt-

-Got to learn new concepts of treating stroke patients. Will surely help in the assessment and treatment of CVA patients.

-Learnt how to interact with patients very well

-Got to learn new meanings of words like postural control and alignment

– Frankly learnt biomechanics today in true sense. Will correct biomechanics henceforth

Good points-

-Good experience

-Thank you for such a great workshop

Bad points-

NONE

Participant-19

Name-Rasikakaittar

What I learnt-

-Taught us many new ways of treating the patient

-The sentences used by you are encouraging “whatever works is treatment and whatever does not work is assessment”

Good points-

-The time we spend was very valuable

-It was fun learning new things

Bad points-

NONE

Participant-20

Name-Ankita singh

What I learnt-

-right use of words at the right time was nicely taught by you.

Good points-

-Today’s session was again really new, innovative as well as creative.

-the friendly environment was created for the patient so that she/he becomes comfortable

-I didn’t feel “sleepy” even for a single minute.

Bad points-

NONE

Participant-21

Name-Sachin Pandey

What I learnt-

-One of the best experiences till now in neurology.

-Learn a lot from Dr Gaju Sir.

-One of the best things I got to know is how to treat a stroke or hemiplegic patient.

-Now I can treat the patient without using much support.

-It was the first time in the past year that I learned so many things about neurology in a day. That’s because of you sir.

-Today I learned how to manipulate in exercise via using environment things which is very important because all time provide all things.

Participant-22

Name-AnkitaParanjapee

What I learnt-

-The workshop gave mr an aim towards studying and taught me ways how to study…

-Learnt an important thing-When things can be done in a simple way, no need to complicate them.

-Would definitely like to attend more workshops and grasp knowledge from you sir.

-Thanks to Sancheti Healthcare Academy.

Good points-

-It was an excellent experience and surely got to know new things for handling patients which definitely added up in my learning.

-Great arrangements were made and I was mentally present throughout the session.

THANKS TO YOU SIR.

Participant-23

Name-Mehvish Mansuri

What I learnt-

-I was really tensed as I thought workshop would be as same as those lecture but this workshop was all worth it.

-I learnt not only MOTOR RELEARNING PROGRAMME but also the neuroscience behaviour, communication with the patient and how to assess and treat simultaneously.

-The gait pattern was well understood.

-Every minute details were explained practically well.

-Definitely the terms ‘’INVITE THE MUSCLES, ZIGZAG’’ ARE REGISTERED INTO MY BRAIN.

-Last but not the least what I learnt was ‘’THE BODY FOLLOWS BIOMECHANICS AND SO THE TREATMENT’’

THANK YOU SIR.

LOOKING FORWARD TO MANY WORKSHOPS WITH YOU.

THANK YOU ONCE AGAIN.

Participant-24

Name-Sunil Soni

What I learnt–

– I learnt a new approach to treat stroke patients. Numbers of new words were learnt like constrain, postural adjustments, anticipatory postural adjustments, on going postural adjustments.

Good points-

My overall experience of this workshop was good.
Presentation and arrangement were good
Thanks gajanan sir and thanks to Sancheti healthcare
Please inform about upcoming workshop

Bad points-

NONE

Participant-25

Name- Jui Bane

What I learnt-

Today’s PPT taught us that we have an integrated approach towards patient and include all approaches for the benefit of patient.
“ANYTHING THAT WORKS IS TREATMENT AND ANYTHING THAT DOESNOT WORK IS ASSESSMENT”

Good points-

-Sir you are my inspiration.

Entire MRP workshop was very informative and a wonderfull experience for me.
All the practical as well as ppt sessions were nice

Bad points-

NONE

Participant- 26

Name – Rochelle Rego

What I learnt-

-motor leaning with re education

– I learnt to how to approach any patient

Good points-

-today’s session was very excellent and motivating.

-The practical session was very good.

– I liked the fact that practical sessions were taken on the patients.

– I have understood the topic well

– Thank you for explaining so well and making the workshop light and funlearning.

-the lecture was very interactive

-good food

Bad points –

NONE

Participant- 27

Name – AaditiPanchwadkar

What I learnt-

-I got to learn newer ways of mobilisation also which can be used in ortho and neuro.

-I will definitely inculcate them.

Good points-

Today’s workshop was excellent.
There was more importance to practical session so I enjoyed it.
Overall workshop was very interactive and was a source of knowledge.
Thank you sir for sharing such knowledge with us.

Bad points-

NONE

Participant – 28

Name- RuchitaHajare

What I learnt-

I learned many new concepts.
I learned how to handle, communicate, re-educate the stroke patient
I learned new words like postural adjustments, constrain, “invite the muscle”
Also, “WHAT WORKS IS TREATMENT AND WHAT DOES NOT WORK IS ASSESSMENT”

Good points-

Workshop was excellent
The practical session was good.
You are so jolly that we don’t get bored in the workshop.
The way you teach is outstanding.
This made a behavioural change in me.
Thank you sir

Bad points-

NONE

Participant-29

Unnamed

What I learnt-

-The best thing I learned is that nothing or no treatment is wrong whenever or whatever we use becomes assessment, and the thing which is affective becomes treatment.

-As our patient always wants task accomplishment and MRP delay with the specific need of the patient mainly daily activities of life.

Good points-

-It was the best workshop I have ever been to.

Bad points-

NONE

Participant-30

Unnamed

What I learnt-

-I got to learn very difficult hand rehabilitation which was very task specific.

-Learnt the eccentric lengthening technique to reduce spasticity.

Good points-

-I loved the way hand grips were taught.

-I loved every moment of the workshop

-gait training was taught awesomely.

Bad points-

NONE

Participant-31

Unnamed

What I learnt-

-I got to know about a very difficult approach towards stroke patients.

-I understood how to communicate with them.

Good points-

-The seminar was outstanding.

Bad points-

NONE

Participant-32

Name-Prajakta Dingle

What I learnt-

-I got to learn many things and many concepts got cleared.

-I got to know about techniques that can also be used on orthopaedic patients and not only on stroke, in fact how to correct one’s posture and how to learn and correct one’s biomechanics.

-And main thing I learnt is whatever we do if it is beneficial to the patient than it becomes treatment and what we do is not beneficial becomes our assessment. So from next time whenever I deal with the patient, I won’t be afraid because I would be assessing him or treating him.

-Next was stability. I will concentrate more on stability then on mobility.

-Postural alignment, eccentric contraction of muscles proves to be very useful and powerful aspects while treating patients.

-Even with minimal assistance we can do wonders with the postures of patients which can help in postural correction.

Good points-

-I would love to attend more workshops of yours sir.

-Food was very nice.

Bad points-

NONE

Participant-33

Unnamed

What I learnt-

-Thank you sir, for giving this opportunity to learn so many good things about neurology and treatment of such patients.

-With this workshop I have learnt how to attend our patient, how to change the behaviour and make the environment so that we can make the patient to be more co-operative with us.

-I have also learnt about the neurological approaches, how they come into picture and how the biomechanics are important for every movement to take place and with the help of normal biomechanics, we form the treatment for patient.

-I also have learnt how the task specific activities help the patient to become functionally independent in their life.

-‘’If you can do a good analysis of the patient and can find out the missing component in them and correct it , you can a good therapist.’’

Good points-

-Thank you sir for sharing your great knowledge and exploring it.

Bad points-

NONE

Participant-34

Unnamed

What I learnt-

-I got to know more about the gait patterns.

-I also learned how to communicate and handle the patient.

Good points-

-The workshop was very good

-My thinking towards neurology has changed a lot.

-The best part about this workshop was the instructor was friendly, he was not teaching like a typical professor where most of the time we get bored and sleep.

-The college management was very systemic.

Bad points-

-The only boring part was the power point presentations, it was good that more of practical was demonstrated on patient itself so we get to know more easily.

Participant-35

Unnamed

What I learnt-

-Through this workshop I could learn new therapy of treating patients. And by this therapy we could improve quality of life of the patients as our main focus is to make patient functional. Due to which we are ultimately serving the society.

-So I am definitely going to use protocol and get fruitful results for my patients.

Participant-36

Unnamed

What I learnt-

-Today we have learnt about different phases of gait and its importance.

-I liked the practical session in the classroom about the gait initiation.

-Today we got to know about zigzag what it is actually.

-The practical session about hand treatment and shoulder treatment with the task specific treatment we learn and this will help us a lot.

-We got to know new idea of taping patient in hemiplegic patient.

-Behaviour changes are necessary that we know from you sir.

-We got to know about orthotics used in hemiplegic patients.

Good points-

-I liked the videos, practical sessions

-New techniques of giving bridging in hypotonic patients.

-We will apply the techniques of assessment and treatment in our daily clinical posting.

THANK YOU Sir.

Participant-36

Unnamed

What I learnt-

-I had many doubts regarding the various phases of gait cycle, but after today’s workshop the gait biomechanics is very much clear to me.

Good points-

-Excellent practical knowledge was provided.

-I would like to learn the hand biomechanics more in detail.

Bad points-

NONE

Participant-37

Unnamed

What I learnt-

WHAT ACTUALLY WORKS IS TREATMENT, WHAT DOES NOT WORK IS ASSESSMENT!!

Participant-38

Unnamed

What I learnt-

-Many things.

Good points-

-It was very good workshop.

-The best thing was practical sessions which cleared many doubts.

Participant-39

Unnamed

What I learnt-

-I feel myself very lucky to be part of this workshop.

-I will surely practice what techniques I have learnt today. I was never aware of such techniques.

You are a rally good teacher sir. You explain so well. I have become your teaching fan.

Thank you sir. Please conduct more workshops on other approaches.

Good points-

-The workshop was well organised including food.

-You are doing an excellent job sir. Please don’t stop it. You are one of my idols now. I am a neuroscience post graduate student and I would try to do my best the way you are doing.

Bad points-

-PPT was boring.

-Specially today in the morning session it was boring. Sorry I was sleeping.

Participant-40

Unnamed

What I learnt-

-I got to know taping technique. I used to know it but i

Now I know how exactly to do it.

-Biomechanics, lengthening, MFR, hand mobilisation and the way sir you make the environment useful for learning new techniques.

Good points-

-I like the task performance, before I was doing it very superficially but now I know assessing and treating too.

Bad points-

-PPT was a little boring and food was not good today.

Participant-41

I loved all the techniques you taught.

The workshop was all worth the efforts of coming to pune.

Spinal Cord Injury Rehabilitation workshop in Sancheti Institute college of Physiotherapy, Pune, August 2014

Posted on August 18, 2014August 19, 2014 by GajananBhalerao

Sancheti institute College Of Physiotherapy organized a workshop on SPINAL-CORD INJURY REHABILITATION on 2nd August 2014 for final year BPTh students of Sancheti institute College Of Physiotherapy .

Course instructor was Dr. Gajanan Bhalerao (PT) MPTH Neuro, Associate professor, Sancheti College of Physiotherapy & HOD Physiotherapy and Rehabilitation Sancheti Hospital, Pune.

Earlier We used to teach this in lecture format in regular class room teaching with didactic lecture. Last Few years we are doing in a workshop format where there get to learn the whole topic in 1 -2 days. This helps in continuity of lectures and practical demonstration, assessment and handling on patient.

In this course 42 students attended the work shop. The workshop included the neuro anatomy, mat exercises, transfer training, ambulation training etc. Participant were taught how to set the goals according to level, severity and available period of admission, OPD bases taking into account his lifestyle, contextual and environmental factors in his own home/village/town/city.

Practical demos of treatment on patients was shown. Different techniques of facilitation of control/strengthening was demonstrated on patients with incomplete cord injury TYPE B/C/D/E. Two quadriplegic who were showing type A in first few months were called in the workshop who are now high functioning walking independently. Indications and contraindication of different orthotics and prescription of orthosis taught .

Workshop details

Saturday – 2nd August 2014

Registration and breakfast

Introduction

Overview of anatomy of spinal cord
Incidences of SCI
Classification of SCI
Clinical syndromes
Physical effect of spinal cord injury
Levels of injury & functional abilities

Physical therapy evaluation and goal setting; ASIA scale

Functional goals & Strategies for functional rehabilitation

Case Studies

Evaluation

Treatment

Assessment, prescription & Wheel chair ambulation training

PWB Treadmill Training role of Central pattern generators(CPG)

Orthotic prescription

Stair case climbing training

Gait training.

Bladder and Bowel training

Bed sore prevention

Role Of Stem Cell Therapy

Participant’s Feedback on course content and training was taken at the end of both day. All the students like the detailed anatomy and its clinical apllication, differential diagnosis & classfication of different spinal cord injury. Every learned a lot from the lab session of ASIA assessment on patients. On post workshop feedback all the participaants reported that, they leanred lot of new techniques of faciltation, multiple alterantive methods for bed mobility, transfers and ambulation training, wheechair modification, Orthotic fixation, and Role of steam cell in SCI rehabilitation. Everone extreamely satisfied.

STUDENTS FEEDBACK

PRIYAMWADA HINGE

THE SCI WORKSHOP WAS VERY HELPFUL.I learnt how to have a positive perspective about treatment of SCI patients by looking at what we can make them do rather than what they can’t do at the given time.

The actual practicals done on the patient were good

I learnt how to formulate goals for the patient and what my actual goal should be i.e. making my patient functionally independent as much as possible.

I also learnt the scales how I would document the case.

WORKSHOP ADVANTAGES

Is conducted at a stretch, so the continuity link is helpful.

We got to be in a different atmosphere ,we had a feeling that we are here to learn something different and important, so I think we were more attentive.

DISADVANTAGES

If it is for a long time, it becomes tiresome.

RUDRI PUROHIT

ADVANTAGES

We got to know about the details of SCI, their mechanism, evaluation, assessment and management.

Most important thing was that we got assess patients and actually see how difficult it is and it isn’t the same to practice on normal individuals.

Plus it is important that if you are teaching a para or a quadri transfers, then you as a therapist must know to do it very well.

WORKSHOPS attract better participation of students than lectures.

Clinical exposure was there and the experience was great.

We got to prioritize the treatment methods.

BAD POINTS

Instead of one day, we could split it into 2 days.

SHARWARI MUTSADDI

I LEARNT:

Depending on the segmental level, there is a certain functional level of independence which can be attained.

Different types of orthosis which can be used.

Mat exercises

-Transfers

-Walking

-Bed mobilizations

Driving rehab.

Goal setting in different conditions.

Wheelchair mobility.

Advantages

Stimulated us to think.

Showed us practically on patients.

PPT and pictures were good.

Workshop environment was good.

Disadvantages

Workshop was too long

JAYDEEP SAMANT

ADVANTAGES.

We got to know about ‘what can we do’; rather ‘what is to be done’.

The inclusion of actual patients helped getting a hands on of the techniques demonstrated.

DISADVANTAGES

We could have had skipped accessory discussions like vehicle modifications rather made that discussion shorter to give more time to other topics.

We hope we can have such a workshop again after a certain fixed time so as to apply techniques learnt in lectures in that timeframe.

DEEPALI SHETH.

ADVANTAGES

One of the best method of learning is practically on the patient and is very helpful for understanding.

DISADVANTAGES

Just one day is not enough to learn about SCI

Becomes a bit saturating if tried to fit in one day.

THINGS I LEARNT

Function oriented Rx planning.

Gave us a more practical thinking.

HARDI SHAH

ADVANTAGES

Understood very nicely on seeing it on the patient.

Management was taught well.

Practicals shown on wheelchair and mat were well understood.

Workshop teaching is very interesting because it concentrates on powerpoint as a theory part and on patient evaluation and management as a clinical part.

I learnt to classify SCI and understand level of injury.

How to manage the patients Rx and meet his/her functional goals was taught well.

It was an interactive workshop which made us think a lot and put forward our ideas and doubts.

I didn’t find any bad points. I have learnt a lot.

UNNAMED

ADVANTAGES

Workshop pattern was very interactive.

Interesting than classroom lectures.

Learning on patients was the best way.

I LEARNT.

Proper assessment in paraplegics.

Short and long term goal management.

NENCY MEHTA

Todays workshop was of great benefit to us. Many wrong concepts were cleared and the most important part was the practical examination on the patient. Every topic should be covered in this manner only.

The main doubt was planning management for quadriplegics, which got cleared, and also going about outcome measures, priority for each patients, how it differs and functional training is the utmost important final step was understood.

It was well understood. It was very innovative and very different from regular classrooms.

I had wrong concepts for how to judge the level of injury, which I understand after this workshop, and I will now be able to assess patients in a better way.

Thanks a lot sir, it was of great help.

Looking forward to the next workshop.

ABOLI AJGAONKAR

ADVANTAGES

Very helpful workshop and got to learn about transfers and modifications which can be done to aid the

Patient needs.

Practicals on patients was a good teaching method. Please have many more like these.

Mat exercises done on normal people don’t tell us about its complexities, so doing so on patients helped us correct our techniques.

DISADVANTAGES

It was hectic.

NAFISA MOTIWALA

ADVANTAGES

Effective as it was patient based.

Pictures and ppt were effective.

Was a very interactive session.

Learnt management in a better way

DISADVANTAGES

Was conducted for a long time.

SONAL GHUGARDARE

ADVANTAGES

Learning practically on the patients was helpful

No need to refer books for basic management.

DISADVANTAGES

Assessment should’ve been also taken in detail ( along with functional scales)

SAYALI KHEDEKAR

GOOD POINTS

Interactive sessions, make learning easy, as questions asked by others clear doubts.

Less monotonous.

Patients took part in our session and helped us imply our knowledge. Hence, made us learn applicability of physiotherapeutic techniques.

Good hands on.

Made clear of short term and long term goals in para and quadri patients

Mat exercises helpful.

Would help in Rx, assessment and planning in future and also on patient.

BAD POINTS

The session could have been more topic and time oriented but in all was a good experience.

CHETNA VARMA

ADVANTAGES

Workshop pattern helped us understand better.

A classroom lecture before the workshop helped us grasp better,

Management of Rx with help of patient helped retain things better.

Additional points with ppts helped clear the picture about orthosis,etc

Now, assessing SCI patients is easier.

Mat exercises are now more thorough.

DISADVANTAGES

Time management was bad.

UNNAMED

GOOD POINTS

The workshop was very interesting and practical demos were helpful.

Was not boring due to interactions and my neuro doubts were cleared.

BAD POINTS

Was too long, I feel multiple shorter sessions would serve the purpose.

ABHISHEK GUJAR

Injury levels were explained and on patient demos were very good.

Very good demos on wheelchair transfers.

Different types of transfers well shown.

Self practice made us understand better.

KHUSHBOO TAHILRAM

GOOD POINTS

Workshop pattern is very good.

Environment change helps in learning.

Teaching method to include practical examples of patients helped us see approaches and problems. Was not ABSTRACT.

BAD

Was a little too stretched, by the end of the day, saturation.

WHAT I LEARNT

Practical ways to handle a patient

Handling skills

Open minded approach to Rx

Goal setting as per patient needs

Activity oriented goal setting

Positive attitude of therapist to goal outcomes

SUPRIYA DHADDHA

The workshop was more practical and management orientedwith hands on, on the patient

Practical knowledge on how to plan Rx of patient in relation to his or her need and not just focus on the objective management like ROM and strength training.

The ppt and viedos helped us understand more about actual patients and how they do ADLs even after this trauma

Various modes of management were taught in a patient and also setting Long and Short term goals was taught nicely.

Workshop training is more interesting and we pay more attention in it.

RUCHA DESHPANDE

GOOD POINTS

One of the best method to learn, practical on patients helps us understand better

Better than classroom lectures.

Practically used methods were focused upon rather than textbook methods

BAD POINTS

One day isn’t enough to learn about SCI. It becomes saturating and hectic.

THINGS I LEARNT

Function oriented Rx planning.

Practical thinking.

DIVYA DESAI

GOOD POINTS

Interactive and interesting.

The practical demonstrations on the patients and wheelchair demonstrations helped us learn better.

Understanding how to treat a SCI patient on the basis of patient’s current disabilities helped us learn better rather than learning it in a classroom by imagining a case.

Planning management of SCI patients is easier as we know what lies in short and long term goals.

More such sessions should be held.

ANAY DESAI

Sir, it was a marvelous experience.

I understood the Rx part which is more important than the theory part.

On patient eval and Rx was a good idea.

GOOD POINTS

Very good idea to change the place as classrooms give a monotonous feel.

Demos were helpful

Very well managed by sir and coordinators. No time wasted

BAD POINTS

I feel 9 to 5.30 is too much CNS on CNS load.

KINJAL SANGANI

GOOD POINTS

On patient skills.

Proper clinical exposure

To plan Rx as per patients activity and participation.

Don’t actually work on impairment.

Workshop is way better than classroom teaching or seminars.

Got to know assessment and using ASIA scale

Transfers, pre ambulatory training was helpful.

How to reduce therapist load with proper use of biomechanics.

How to give commands.

BAD POINTS

It is difficult to transfer patients in case therapist strength is less.

What should be the modification in relation to this?

MAYURI CHAUDHARI

GOOD POINTS

Explanation with a lot of examples.

On patient demos.

Management protocols

95% understanding

Proper understanding of wheelchair ambulation and transfer.

ASIA scale description

Change of environment helped understanding

Explanation of each goal

WHAT I LEARNT

I understood it better on the patient and also the wheelchair transfers and ambulation.

KRUPA DOSHI

The workshop was very effective, way better than classroom lectures.

Was effective as we learnt to assess the level of injury by myotomes and also what to expect from the patient.

We learnt that functional activities are more important than strengthening.

We learnt to look at the bigger picture rather than focusing on individual impairments.

BAD POINTS

It would be better if we got more patients and more groups so all of us could practice.

In the end, if you would have had given us a simulated case for us to assess and plan the Rx on a model it would’ve been better.

KALYANI SHIVARKAR

GOOD POINTS

Workshop format helped understand SCI better.

Theory and practical were both covered well

Functional independence, activity and participation should be the goals of Rx, I will never forget that

Learnt a lot of transfer methods.

Overall, workshop teaching was way better than classroom teaching.

GEETARANI MATURI

Patient management was taught very well

Education about orthosis and prosthesis was helpful

Theory was minimum

Learnt well about patient Rx,evaluation, handling and transfers very well

Workshop pattern was better than classroom pattern.

BAD POINT

Did not understand lecture towards the end as it was saturating.

WAGEESHWARI MADGULKAR

GOOD POINTS.

Really helpful workshop

Practical format helped understand better

Transfer methods and rehab part were taught well

Unclear concepts were cleared.

BAD POINTS

Many things were taught in a short time, so towards the end, it was less understood.

WHAT I LEARNT:

Methods of transfer and patient handling

Stepwise and easy rehab management of SCI patients.

RUJUTA RAUT

GOOD POINTS

Was a good learning experience and a good amount of demos were included.

Live practical on patient demos helped understand various problems faced while actually treating.

All doubts adequately cleared.

Was a better environment than a classroom

WHAT I LEARNT:

My doubts about orthotics were classified to great extent.

Goal setting was well classified.

Patient eval will now be easier

Learnt importance of patient interaction and proper commands

SAANIA KASLIWAL

GOOD POINTS

We liked the way it was conducted

Practical demos was the best part.

Many doubts were solved

Now we can go about with the management of SCI patients.

It will be really helpful for our future.

BAD POINTS

Time duration was very long

WHAT I LEARNT:

Management of SCI patients

Handling skills

Orthotics was taught

Wheelchair transfers were shown.

PRIYA GOGRI

GOOD POINTS

Workshops are a better way of teaching and I was more attentive throughout the workshop than I would be in the class and grasped very well.

We could practically see on patients and imply our learning directly on them.

Doubt solving played a great role in understanding the topic.

BAD POINTS

The workshop duration was a little too much, as in the end, it was a bit too over my head and couldn’t concentrate well in the end.

MEENAKSHI KADAM

ADVANTAGES

On patient learning is the best way of learning.

Hands on was better than classroom lectures.

Two way interactions were better than classroom lectures.

Change of environment.

DISADVANTAGES

Time limitation is a major setback.

WHAT I LEARNT:

80% of SCI doubts cleared.

Learning and interaction abilities improved

My goal of treating disabilities turned into making the patient independent.

neuro rehab

Physiotherapy management

Objective

Whom to contact for aquatic therapy?

WHAT IS AQUATIC THERAPY?

Techniques

What are the contraindication?

Frequently Asked questions about Aquatic therapy ?

Whom to contact for aquatic therapy?

Things that impressed me a lot

Sancheti college of physiotherapy is organizing

A WORKSHOP ON

2D & 3D GAIT ANALYSIS AND MANAGEMENT Of GAIT DEVIATIONS

On 20th and 21 December 2014

Workshop details

ABOUT THE RESOURCE PERSON

Dr. GAJANAN BHALERAO (PT)

Associate Professor

Neuro therapeutic approaches in neuro rehabilitation : Part I- Proprioceptive neuro Muscular facilitation

ABOUT THE RESOURCE PERSON

Dr. GAJANAN BHALERAO (PT)

Associate Professor

Work Shops Conducted (Continued Medical Education)

On 20^th and 21 December 2014