Physiotherapy, also known as physical therapy, is the use of techniques to improve movement and function and restore the overall well-being of the body through rehabilitation, exercise, and advice. Physiotherapists work in conjunction with clinicians to facilitate recovery in the event of illness, disability, or injury.
Physiotherapy can help in reducing pain, preventing injury, and increasing freedom of movement. It is applicable in a wide range of neurological, neuromuscular, cardiovascular, and respiratory conditions.
Physiotherapy for familial amyloid polyneuropathy
Familial amyloid polyneuropathy (FAP), also known as transthyretin amyloid polyneuropathy (TTR-FAP) is a progressive, life-threatening, genetic disease that usually affects the nervous system and the heart. FAP is caused by mutations in the TTR gene and is inherited in an autosomal dominant manner. The normal form of the TTR protein, which the TTR gene encodes for, is responsible for the transport of vitamin A and thyroxine hormone in the body. Abnormal TTR protein, on the other hand, forms aggregates called amyloids in the nervous system, heart, kidneys, and eyes, causing damage.
In FAP, both the peripheral and autonomic nervous system are affected. Depending on the stage of the disease, symptoms are seen in the upper and lower limbs.
Treatments for FAP largely depend on the extent of symptom progression and organ damage. Physiotherapy can help alleviate some of the pain and restricted movement associated with peripheral neuropathy.
Depending on their needs, patients may be prescribed both physical therapy and occupational therapy. Physical therapy focuses on the ability to perform movement; occupational therapy helps improve activities of daily living, such as taking care of oneself or interacting with others at home or at work.
Physiotherapy exercises
Improving muscle strength and reducing pain are some of the objectives of physiotherapy. The patient might be advised and trained in several exercises to help with nerve function. It is important to perform these exercises under the supervision of a qualified physiotherapist. The exercises are summarized below.
Aerobic exercises
Aerobic exercises increase muscular activity, heart rate, and breathing. Aerobic exercises include brisk walking (either outside or on a treadmill), swimming, low-impact aerobics sessions, stationary cycling, or a combination of these. The exact duration and type of aerobic exercises are determined by the physiotherapist after evaluating the patient’s physical fitness.
Flexibility exercises
Flexibility exercises, also known as stretching, help in flexing joints to reduce the risk of injury. Stretching is a good warm-up activity before starting aerobic exercises and can be done at home or under the guidance of a physiotherapist in a clinic.
Stretching targets specific muscles, including the calf muscles (back portion of the lower leg), hamstring muscles (backs of the thighs), and plantar fascia (fibers that connect the heel to the toe).
Strength training
Strength training targets muscles to make them stronger and resistant to injury. It can also help a person regain lost muscle strength. Strength training involves lifting weights or transferring the body’s weight onto the target muscle. Generally, the physiotherapist first focuses on core, hip, knee, and ankle strength training before moving on to other areas.
Strength training carries a risk of injury and must be done under supervision to ensure proper posture and an adequate number of repetitions.
Balance exercises
Joint pain and weak muscles as a result of polyneuropathy can result in poor balance. Balance exercises can help restore balance and alleviate the feeling of stiffness or unsteadiness. Older people benefit immensely from balance training, as muscles tend to get weaker with age.
Other information
Based on need, the physiotherapist might also prescribe braces to protect injured nerves or muscles and help in safe movement. Education is also an important aspect of the physiotherapy regime and often involves finding alternate methods of carrying out daily activities to minimize the risk of muscle injury.
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