STEP TALK : “Don’t be just good, be great”

Posted on July 20, 2017July 20, 2017 by GajananBhalerao

“Don’t be just good, be great”

STEP TALK

By: Gajanan bhalerao

i have started STEP (sancheti Talent enhancement program) talk, based on TED talk concept for motivation and development of studnets.

This is a summery of STEP talk on 16/07/2017.

We are trained to be average! Why? When we can conquer the world, stand out and be different among the crowd and show the world that we are not just good but GREAT

In today’s Step Talk session we had discussion about the same. Remember these four principles always-

1. Decision making

2. Planning towards it

3. Problem finding

4. Problem solving

Follow these and see how you make everything happen the perfect way as you want.

When you feel like giving up, when you feel you are stuck up in a situation ask yourself 3 questions-

1. Ask yourself “why”

The moment you find the answer to your “why” you analyse yourself and get motivated to follow your dreams.

2. What is the purpose

Find the purpose as to why you want that particular thing and work in the direction towards getting it!

3. Why did I start

Remember when you feel like giving up, ask yourself why did I start. Give yourself a reason to make your dream come true.

Last but not the least “Believe in yourself and the world believes in you”

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.

images (4)

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

To do or not to do Masters Program in Physiotherapy

Posted on July 31, 2016August 11, 2017 by GajananBhalerao

Frequently Asked questions.

Que 1. To do or not to do masters program?

Ans: There are two parts to this answer

a. Yes, need to do master program.

Master program helps you to improve your knowledge, research & analytical skills. It will help to learn how to present your work.
More Education/training in a specialised field. This will give guidance and direction for your future clinical and academic work.
It defines your speciality of work field. “We are recognised by work we do, not our name! “.
Most of the budding therapist who want to join academics should do MPT, because in most of the universities the minimum criteria to join academics is MPT.
If want to join job in a corporate hospital then the salary structure is depends on the your degree. MPT gets 30-50% more than than BPT. Even annual increments are more for MPT, because annual increment is based on your basic pay. as BPT has less basic pay the annual increment is low

b. Not needed to do masters program.

There are few therapist who want to do only clinical practice and don’t want to do put their time and money in masters program. They choose to be only bachelor therapist.
Some of these therapist prefer to do highly specialised courses and workshops and get certification and use that it in clinical practice.
Not all masters program guarantee or improve your clinical skills. It may improve the knowledge but clinical skills may lack.

Que 2. Which speciality to do for masters program?
Ans: Choice of speciality in masters program is very important. Because this speciality and degree will last with you throughout your life. It will define your field of work and interest. So Choose very carefully.

How to to decide speciality? Just introspect your bachelor education and internship. Try to find the posting your enjoyed the most and spent more time beyond regular hour in that posting. If you enjoy it, you will like it, if you like it you will only be persistent in work interest and excel in that field.
You may ask guidance from your teachers and mentors.
Never comprise the speciality of your interest.
Try to find out which specificity is saturated or most preferred.
You may choose the branch less explored, which will give you more scope to develop it. ( In business trend never join when its growth is at he peak of the bell curve. because after peak there is a fall in the curve.)

Which college to join for masters program?

Most of the student prefer some colleges more than other and want join only that college at any cost. sometime they take the management seats and join the same college of interest. Please note before you decide college choose speciality of the course . If you are lucky to get the choice of speciality and college of interest then only join that college. But if you are getting the desirable college but not the speciality of interest, then i would suggest don’t compromise the speciality of masters program. Only degree will last with forever not the college.
There is significant differences in Undergraduate teaching in different colleges. Due to this there are multiple university toppers in some colleges than other. But there is not significant differences in master program training.
Note following points when you select he college
1. Your guide: guide plays a crucial role in master program. If you any preference of guide join that college.
2. Clinical case load for practice: Daily Case load is leading factor for your training and practice. If have more case load, your hands on skill will improve a lot.
3. Research and Publication. Some institute promote research and publication a lot. It help you to publish few scientific paper before and after you complete your post graduation.
4. Infrastructure of Institute: Some of the students give more importance to infrastructure. But instead of this give importance to the equipment and instruments they have in research and clinical practice
5. Give least importance to a. Proximity form your home/town. b. Accommodation/hostel facility, c. Stipend provided. (Stipend provided is not much, at the cost of compromising you speciality)
6. College /Tuition fees: In private college on an average the fees is ranging from 1-1.5 lacks of rupees. So depending on your affordability you can select college, but don’t compromise speciality of course.

Shall we go to US / UK/ abroad for Master program?

There are two part to this answer.

A. Go abroad for doing masters program

Masters Courses in UK are 1.5 -1.8 years courses. Because these course are not full time two years courses, students completed MPT in UK could not join Academics in some university (i.e. MUHS Nashik). Your requires minimum two years master program to be a academician.
Masters Courses in US are changing fast. only few universities are now providing 2-3 year masters program. Most of the universities are now offering DPT program. Sometime doing master program in US will not get you job in US because their recruitment systems are changing and they will take only DPT on job in near future. So spending 20 lakhs on rupees in doing masters program and then not getting job is a big problem. So think before you join masters program.
Masters Courses in Cananda, Australia, Newzealand, Germany. etc. These countries provide two years masters programs in some specialised fields especially sport, clinical biomechanics and musculoskeltal branches. If you are willing to go for these branches go to these countries. Even UK and US also provide same programs. So take your choice.

4. These program are well organised and well conducted

6. It will develop your literature review skills and culture research methodology

7. You may get job in their respective countries if you pass their licence exam to practice.

8. Good quality of lifestyle

9. worldwide exposure

10. Good salary and income

B. No need to go abroad for masters program

Non clinical courses: Most of the masters program are not fully clinical. Because you need to have practice licence to do clinical course. What is the use of masters programs if it lacks clinical exposure and hands on clinical skills.
MPT through Research courses: most of courses are non clinical and research based or academic/lab study based.
Settle abroad: One of the big reason people go abroad because to they want to go abroad work their and settle abroad. But day by day all countries are changing their rules and regulations of working licences and VISA. Politicians want their own people to get job in their country and want to stop immigrant for occupying their jobs.
Job satisfaction: Some of the people who settled abroad long years back they are satisfied with their job. But those joined few years back they are not satisfied with job and income.
Good opportunities in academics and Clinical practices in India: If you are in academics or good clinical business you can earn same amount of money in India.
Family : You can stay with your own family and culture
You Enjoy your life with here in India

At last i want to say that masters program is must, because in near future only these people will be in demand, and bachelor program therapist will face challenges unless they get specialised expertise in some specific clinical skills.

I highly respect, admire and congratulate all the Bachelor therapist who doing well their respective fields and making a good name in physiotherapy by their work than the degree.

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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

(follow this blog on facebook)

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.

https://m.facebook.com/story.php?story_fbid=10153526915724109&id=550684108

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

https://m.facebook.com/story.php?story_fbid=10153528771199109&id=550684108

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

IF YOU HAVE TALENT THEN SANCHETI IS RIGHT PLACE FOR YOU!

Posted on March 6, 2015May 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

I believe this world is full of opportunity, it is just that you need to be at right place in right moment of your life.

I feel Iam lucky I was at right place at right time in my life. The place is name as Sancheti institute. My life has changed from the day I joined Sancheti in 2004 for my Masters in Physiotherapy. I am from lower middle class family. My father was a teacher in high school. He dedicated his entire life with the minimal salary for education of his children. We are 4 brothers and 2 sisters. Being eldestamongst all I had to take inchargeof my living hood and education in early period of life. My dad paid my expenses till my graduation. After my Bachelors of physiotherapy I joined in DeenathMangeshkar hospital rehabilitation Centre in Kothrud Pune. I worked there for around 2 years then, I joined CMF College of physiotherapy as lecturer. I dint have any plans of doing Masters in physiotherapy. One day, one of senior Manoj Bora, advised to join Master in physiotherapy. He was doing masters in Sancheti after a gap of around 7-8 year after his graduation. He closed his 3 clinics and joined Masters. He told me the importance of master and advised me to join Sancheti. Today I am grateful to him for guiding at right moment. My batch in Masters was second batch after Pune University launched their Masters course.

Even though I was good in my studies, work and other skills I was not best. The period I spent in Sanchetihelped me take out best out of me. Here, I started believing that I am not just good but I am best among all. My confidence was pumped up which boosted my self-esteem. This made my dream come true. In my graduation days I could not even achieve 1^st position in my class and here I topped the Pune University. I feel honored to see my name on University toppers board as we enter Sancheticollege.

I got the opportunity to join as Lecturer in Sancheti college of Physiotherapy just after completion of my master program. I joined college as teacher on 2^nd April 2007. Being a teacher is itself a great honor for me. During my teaching experiences, I could also develop my clinical expertise. We developed neuro department in sancheti hospital. In the beginning we used to keep 2-3 hours dedicated for neuro patient. After a year we got a 200 sqft area dedicated for neuro rehab. In 2011 neuro rehab was expanded with 1500sqft area & 3 therapists for neuro and with more patients being referred for neuro rehab. Sancheti was started recognizing by good neuro rehabilitation too.

In this period,Sancheti institute believed in me and supported me in all my all ventures. It is with their support and security I was encouraged to take big steps in my life. I bought my own house within my 2 years of employment. You will be surprised to know that my salary was 19,000/- and my EMI was 15,000/-. At the back of the mind, I always had that, in case of any problem my institute will be always there.Its every man dream to own a house. To buy a house the most important think, is not money, home loan and security but just a small thing called a “guts”. This you get by the environment around you. This conducive environment was Sancheti Institute. Please note I had to work extra hours after the job in evening till eleven clocks in night to pay for my living expenses.

I read in books that to be successful either you invent everything from the scratch and work hard toward the excellence till you achieve it or be a part of successful system. Sancheti institute was already is successful system. So I decided to be a part of successful system and grow together with the institute instead of struggling alone.

I believe each one of has the burning and talent and desire to explain. This zeal of excellence is like a potentially active volcano. If this volcano bursts, it will throw out lot of rocks and debris. Rain is like world full of opportunity. Each drop of rain is a potential opportunity. It will wash away all the debris and rocks will start rolling down the hill. This flow of water creates a river which takes down all the rocks along with the water. This river is like a good system (sancheti institute). The uneven rocks of volcano starts taking good shapes as they roll down with the flow of water. So if you want to be in good shape then you need to flow with the river. So what you need to do is find a good river.

In last two year I got opportunity to serve as Head of Department of Physiotherapy and rehabilitation. It is with Manisha Madam’s support and guidance that I am able to serve the physiotherapy department. Today I am able to do so many activities and carry so many responsibilities just because of the belief and trust of Sancheti institute in me. I thank the entire management team and the institute for shaping me.

Today I can proudly say to all of you, if you have talent and zeal to excel then join the sancheti group.

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

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

Author of article:

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.

Neuro therapeutic approaches in neuro rehabilitation : Workshops Details

Posted on August 28, 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

We have to study all the Neuro therapeutic approaches in Neuro rehabilitation from BPT third year class, to fourth year and MPT. In these Approaches there are similarities and differences, advantages and limitations of each approaches need to be understood and studied during our graduation.

In third year and fourth year we need to discuss about it and show at least few techniques and do the demonstration on patients. It was very difficult for me to understand all these components and its was more difficult to apply these approaches in clinical practice.

Even though i was exposed to these approaches/technique it was very difficult to practice it. There was not enough opportunity to attend these kind of workshops or training. this thought process regarding this issue has been continuously thought-provoking in my mind. And i have experienced my students coming to me with the similar problem. they have been facing the similar problem like i use to.

There are so many approaches, What approach i suitable for my patient? This always a question with us all the time.

What is the technique i use for improving the desired control? The more try to answer this question we get more confused and we reach no where.

So i am planning to conduct a series of workshop on different approaches in neuro rehabilitation. These workshop will include practical demos on patients, clinical application of these approaches. These workshop will emphasis on similarities and differences, advantages and limitations approaches.

*Date*	*Topic*	*Participant Criterion*	*Participant fee INR*	*Resource*	*No. of days*
13/09/2014	Neuro therapeutic approaches in neuro rehabilitation :part I- Proprioceptive neuro Muscular facilitation. https://gajananbhalerao.wordpress.com/2014/08/28/workshop-of%E2%80%8B-proprioceptive-neuro-muscular-facilitation-pnf-in-neuro-rehabilitation-on13th-sept-2014-%E2%80%8B/	4^th year +, BPT, MPT30 students MAX	Indian –RS 1000/-International US $25/-	Dr. GAJANAN BHALERAO (PT)	1 DAY
18^th & 19^th October 2014	Neuro therapeutic approaches in neuro rehabilitation : Part II- NDT /Bobath approach in Adult hemiplegia	4^th year +, BPT, MPT30 students MAX	Indian –RS 2000/-International US $50/-/	Dr. GAJANAN BHALERAO (PT)	2 DAYS
27^th December 2014	Neuro therapeutic approaches in neuro rehabilitation : part III- Brainstorm & Roods approach	4^th year +, BPT, MPT30 students MAX	Indian –RS 1000/-International US $25/-	Dr. GAJANAN BHALERAO (PT)	1 DAY
3^rd & 4^th January 2015	Neuro therapeutic approaches in neuro rehabilitation : part IV- Motor relearning program	4^th year +, BPT, MPT30 students MAX	Indian –RS 2000/-International US $50/-	Dr. GAJANAN BHALERAO (PT)	2 DAYS
28^th February 2015	Neuro therapeutic approaches in neuro rehabilitation : part V- Recent advances with evidences.(CIMT, Mirror therapy, FES, BWSTT, mental imaginary training, strength training, robotic therapy etc)	4^th year +, BPT, MPT30 students MAX	Indian –RS 1000/-International US $25/-	Dr. GAJANAN BHALERAO (PT)	1 DAY

Other Workshops

November2014

Spinal cord injury rehab

4^th year +, BPT, MPT30 students MAX

Indian –RS 2000/-International US $50/-/

Dr. GAJANAN BHALERAO (PT)

2 DAY

13th & 14th December2014

2D and 3D gait analysis and management of gait deviation

4^th year +, BPT, MPT30 students MAX

Indian –RS 2000/-International US $50/-

Dr. GAJANAN BHALERAO (PT)

2 DAYS

14th & 15th March 2015

Neuro therapeutic approaches in stroke rehabilitation: part VI- Motor control & Strategies to improve motor control

4^th year +, BPT, MPT30 students MAX

Indian –RS 2000/-International US $50/-

Dr. GAJANAN BHALERAO (PT)

2 DAYS

Please give your suggestions 1akuzic3mu6ujpl6tedtew

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.

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

Posted on July 29, 2014July 29, 2014 by GajananBhalerao

SANCHETI HEALTHCARE ACADEMY Organizing
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.

Kindly send registration on anjalipradhan.sha@gmail.com

Hurry up! limited sits only.

For eligibility & programme details click attachment.

Please forward this information to the interested therapist and students.

Please click here for details.

MRP Workshop 2014 (1)