Good posture projects confidence
Author: Dr. Deepak Sharan
Bangalore Times, The Times of India, May 24, 2001
"Stand up straight!" "Pull your shoulders back!"
"Stop slouching" As children, some of us were reprimanded
to maintain good posture. Yet we were seldom taught effective
ways to accomplish this. Most of us remain blissfully unaware
of the harmful consequences of postural neglect.
As we start to grow older and worry, our posture deteriorates.
We have a series of reflexes throughout the body that support
us against the force of gravity and naturally co-ordinates our
movements. Inappropriate muscular tension creates an interference
with these reflexes and many of us end up moving in ways that
are awkward and inefficient.
The consequences of poor posture can be seen all around us: stiff
necks, shoulders hunched forward or pulled tightly back, restricted
breathing, and tightness in the thighs, legs and ankles. The result
is headaches, neckaches, backaches, and sciatica.
So what is 'good' posture? Posture is essentially the position
of the body in space. The correct posture is one in which the
body segments are balanced in the position of optimal alignment
and maximum support, with full pain-free movement with a minimum
of energy expenditure. The key to this low-tension position is
balance: your upper torso and head are balanced over the mid-torso
and lower back so that they rest on top of one another and don't
require muscle tension to hold things in place.
Nature has aligned us so our center of gravity falls through
our body and moves through specific bony landmarks: Earlobe over
the middle of the shoulders, over the hip joint, and over a point
about an inch in front of the ankle joint. In the correct position,
your spine has the natural curvature, your chest is 'open', meaning
that they are centered on the plane of the torso. With correct
muscle flexibilities and strength balances, proper posture can
be maintained without conscious effort. However, when you are
fatigued or stressed, you tend to revert to your relaxed posture
and alignment. You will then fatigue even more quickly and perform
less efficiently.
But how is poor or faulty posture developed? Children stand or
sit in a hunched over position for a variety of reasons: habitually;
psychological factors, especially low self-esteem (adolescent
girls may slouch to hide developing breasts), laziness, to irritate
their parents, or to express their growing independence; muscle
spasm; respiratory conditions; excess weight; and high-heeled
shoes/boots, tight clothing and wide belts.
Poor posture often worsens during the adolescent growth spurt,
when a child may assume a more pronounced round back. Other common
postural problems are when the spine curves inward, slouching
and side-to-side curving. The aggravating cause of a significant
number of modern injuries related to posture is computer use,
which will be discussed in a subsequent column.
Many think straightening up is important only for appearances.
Although good posture does project confidence, strength and poise,
it is important because it contributes to our health and capabilities.
An awareness campaign to promote the importance of good posture
in students is the need of the hour, and is an important activity
of "Open Door". Good postural habits must be instilled
at an early age. Get your school or college to organize lecture-demonstrations
in Postural Correction. Treatment of postural problems includes
individualized assessment, exercises and practice. A special method
called Alexander Technique is popular in the west, though largely
unheard of in India. Muscle relaxation techniques, biofeedback,
manipulation, massage and stretching exercises are also used to
relieve pain and muscle tension. Regular non-jarring exercises,
such as swimming, and maintaining high levels of activity are
recommended. Appropriate supportive furniture (e.g., firm beds
and chairs) may be required. Posture can be improved, and the
sooner the better. Pulling back into alignment may feel awkward
and uncomfortable at first, but we adjust to it quickly.
You can let your posture get worse and suffer the consequences,
or you can improve it NOW. The choice is yours.
Rage Spills Over Into Sporting Arenas
Author: Asha Chowdary
Bangalore Times, The Times of India, July 27, 2001
Fury, as in a fire in the chest and a burn in the gut, is no
longer restricted to high pressure work areas or bad roads. In
a malady now on the rise in the city, anger is erupting on the
sports field, not always during a national level match but even
during friendly club events. Sports rage, as the disorder is often
termed, has led to grave injuries caused by a moment of fury or
fleeting carelessness.
Today, anything can precipitate a physical attack- losing a match
or even anger spilling over from an earlier grudge. Whatever the
cause, the victims who suffer, do so in silence, often too scared
to even tell their doctors what caused the mishap.
"We are always trying to find excuses for this," says
Malini N (name changed) who was deliberately injured during a
badminton match and is now suffering from a serious eye wound.
"In my case, I was playing badminton with this club member
who was annoyed by women being included in the club. In a moment
of anger, he smashed the shuttlecock with unnecessary force and
it hit my eye. I was rushed to the hospital with a haemorrhage
in my eye and though that was treated in some weeks, a cataract
has developed and I now suffer from blurred vision. I now require
an operation that can cost over Rs. 40,000."
According to Malini, these events happen all the time, but most
people do not bring them to light. "I had a friend who had
her contact lens smashed, another person had his eyelids crushed
in a club match. I don't see why we should be the target of someone
else's personal angst."
"People will do anything to win," says national level
hockey player, Ashish Ballal. "In some matches, a lot of
people get hurt because some of them begin hitting each other
on the field. You see, in an important match, you train a lot
and you want to taste success. Sometimes in hockey, a person can
be hooking you and your blood pressure shoots up and you react
in anger. I've seen it happen. One of my teammates had to have
several stitches and I have had some bruises myself. The frustration
levels and the desire to win is definitely on the increase."
Dr. Hemanth Kalyan, consultant in orthopaedic surgery and sports
medicine at Lakeside Medical Centre says, "This usually happens
in the informal level of sports. In the interschool hockey match,
I once saw a student who scored a goal being hit with a hockey
stick and the bones of his wrist were damaged. Only education,
protective gear and healthy sporting attitudes can help in any
sport."
Dr. M Venu, senior registrar, orthopaedics, at HOSMAT says, "
There has been an increase in injuries due to foul play. People
have come to me with knee injuries and severe bleeding, especially
after a football match. The amount of competition is on the increase
which could be reason behind this." Dr. Deepak Sharan, head
of pediatric orthopaedics department, Bangalore Children's Hospital
adds, "Pent up emotions and hidden psychological problems
can surface during a game. In many countries, there are sports
counsellors who can help out."
In foreign countries, sports rage extends to parents and coaches
who often resort to violence on the sports field. Press accounts
describe a youngster actually beaten to death and others who were
viciously beaten. Many countries are even enacting laws increasing
penalties for sports violence and to curb sports rage.
Obesity: Kids at Health Risk
Author: Kanak Hirani
Bangalore Times, The Times of India, August 23, 2002
A five-minute run tires him out. He can put away two packets
of chocolate at a go. He feels drowsy in school and has low self-esteem.
His cholesterol is high and he complains of frequent backaches.
If this sounds like a description of your child, it's possible
that he counts among the 20 per cent of students who suffer from
obesity.
A recent study by doctors from the Bangalore Children's hospital
(BCH), showed 20 per cent of pre-school children surveyed to be
suffering from obesity. Of that, five per cent were at risk of
cardiac diseases.
Dr. Nandini Mundkur, CEO, BCH says this survey is just an indication
of increasing obesity among young children. Right from the time
they're in the womb, babies are at risk. However, signs of obesity
can be detected from the age of three.
"Factors like breast-feeding, nutrition, exercise and eating
habits play an important role," says Dr. Mundkur. She adds
that exercise isn't on the agenda of either parents or schools.
"How many schools insist that their students exercise every
morning? How many children eat healthy meals? Schools conduct
health camps but don't focus on these issues. It's essential that
every child should have an annual health check up. They should
be taught that they are responsible for their body."
Obesity can hinder a child's development in various ways: They
are at the risk of heart diseases, orthopaedic and joint problems.
"Obese children also get isolated and are called names. Their
weight makes it impossible for them to participate in sports and
they get tired fast," adds Dr. Mundkur.
Children and adolescents with obesity keep Dr. Deepak Sharan
active professionally. "I've just seen an obese 12-year-old
with slipped capital femoral epiphysis (the head of the femur
slips away from the rest of the femur)," says the head, department
of pediatric orthopaedics and rehabilitation, BCH.
He explains that the tensile strength of bone and cartilage in
children doesn't adapt well to excess loading due to being overweight,
causing a variety of orthopaedic and joint problems.
Dr. Kavita Bhat, pediatric endocrinologist, Manipal Hospital
and BCH says, "Up to 60 per cent of the children who are
checked for obesity have elevated cholesterol as young as four
to five years. Sometimes, obese children snore a lot at night,
causing respiratory problems and hindering their performance in
school."
You can check if your child is obese by finding out his Body
Mass Index, by calculating his weight in kg divided by height
(squared) in metres. A BMI of over 29 indicates obesity and a
BMI between 20 to 25 is ideal. The Bangalore Children's Hospital
also has an obesity clinic with a panel of doctors at their Rajarajeshwarinagar
center on Monday mornings, and at their Malleswaram center on
Wednesday mornings from 10 am to 1 pm. For details call 8600252
or 3347794, or email bchrc@vsnl.com.
Backpacks Make for Bad Backs
Author: Seth Swift
October 23, 2002
Easterneronline.com
(USA), October 23, 2002
Recent studies have shown that backpacks, especially in adolescents,
may be the cause of an increase in cases of bad backs. Some results
of students shouldering a load that at times exceeds a quarter
of their bodyweight are chronic back, neck, and shoulder pain.
In a way, it's almost like a perpetual pregnancy that students
wear on their back for five to eight hours a day, five days a
week, in excess of nine months a year for upwards of 18 years.
As students, we practically live out of our backpacks.
While backpacks may be an improvement over the hand held book
satchels of the past as far as organization and such are concerned,
it may be that the cons outweigh the pros.
This is not just an American phenomenon either. In India, Dr.
Deepak Sharan, who is the head of the Department of Pediatric
Orthopedics & Rehabilitation at Bangalore Children's Hospital,
has documented cases of people with back pain that he believes
are related to the use of backpacks. "The immediate result
of carrying too much unbalanced weight for too long is muscle
soreness and strained ligaments. Backpacks lead to restricted
movement of the spine and alter the fluid content of discs."
This makes backpack wearers prime targets for herniated discs
and arthritic spines later in life.
The imbalance in one's center of gravity created by lugging the
books around on one's back is one of the easiest things that can
be corrected, according to some. One way to counteract this imbalance
is to carry the load higher on the back, because, according to
Dr. Randolph Trowbridge, who specializes in the science and medicine
of biomechanics, "The shape of our backs makes it easier
to carry a load there."
With some people, however, this piece of advice does not mesh
with their own personal experience. Tim Wooddy, a graduate student
in the History and High Tech Communications programs, said, "The
weight in a backpack is going down, so the bottom vertebrae are
taking (the brunt of) the load. That's why the military uses backpacks
(that rest) low on the backs. It's pretty effective."
Another way to help counteract the center of gravity created
by too many books in a backpack is by rearranging the books. Researchers
recommend that students pack the heavier items nearest to the
back, and when they do pack the items do it so the weight is evenly
distributed. That way the weight doesn't shift to one side and
place even more stress on just one side of the spine.
One thing for students to beware of is that the weight of the
backpack should not exceed 10-15 percent of one's bodyweight.
The number and weight of books is not something most students
have much control over, since books regularly weigh 5-7 pounds,
but some doctors recommend carrying a book or two in your arms
if the weight exceeds the maximum safe weight.
One petite sophomore student, who prefers to remain anonymous,
remarked, "I never knew that (too much weight) could be so
bad for your back. I always wondered why my back always hurt."
Students should also beware of the saddlebag single strap backpacks.
The major problem with these is that it puts all the weight and
stress on one side only and doesn't distribute it. Another thing
to be wary of is only wearing one strap of a backpack. This can
cause even more undue stress on one's back and, besides, is a
remnant of the ultra crappy 1980s.
The backpacks that have numerous compartments for storage can
be a good investment for students. According to researchers, this
allows for a more even distribution of the weight. Students should
avoid overpacking their backpack. Instead of bringing the kitchen
sink, first find out whether it is really needed in class that
day. Wide shoulder straps and backpacks made of lighter material
are also recommended.
A useful tip that Dr. Sharan gives to backpack wearers is that,
"If the backpack forces the wearer to move forward to carry
(it), it's overloaded." He also stresses that postural problems
"Do not go away with time if nothing is done about them.
Remember," he said, "as the twig is bent, so grows the
tree."
Wooddy remarks of backpacks and their users, "Backpacks
are designed for light loads, but still people pack 20-30 pounds
in there. This is unhealthy because most people aren't fit enough
(to carry that load)." The president of Jansport was not
available for comment for this issue.
'Rs. 40 cr. a month for schemes for
the disabled'
Bangalore, The Hindu, January 22, 2003
Doctors and government officials met here on Tuesday to try correct
the handicaps in the State's disabled care system. The programme,
organized by the Commissionerate for Persons with Disabilities,
had doctors from Bangalore Children's Hospital (BCH) addressing
orthopaedic surgeons from government hospitals state-wide.
The Assistant Commissioner from the Commissionerate, B.C. Pradeep
Kumar, regretted that very few parents or doctors knew that the
State Government gave a maximum of Rs. 15,000 for corrective surgeries.The
money was given regardless of the level of disability or the age
of the disabled person, but was subject to income levels-for children
of parents below poverty level who earned less than Rs. 24,000
a year.
"The State Government spends Rs. 40 crore a month on pensions
and other schemes for disabled people," he said. The money
could be better used on post-operative care, etc.
The BCH doctors - Nandini Mundkur and Deepak Sharan - asked government
doctors not to give "permanent" disability certificates
for children below five. "Such a certificate will hamper
the child for life," Dr. Mundkur pointed out. Besides, without
proper counselling, parents would prefer to let children remain
disabled, as corrective surgery would cut off government aid.
If the parents are in the below poverty line category, a disabled
child gets Rs. 125 a month for life.
Dr. Sharan spoke of identifying patients for surgery. "For
cerebral palsy, most doctors warn against surgery. But lower limb
surgery can be successful for children between four and six years
while those between six and eight years can have upper limb surgery,"
he said. Doctors had to operate only in cases where benefits outweighed
the risks, he stressed.
The government doctors said they worked in severely understaffed
hospitals (one nurse for three wards) with ill-equipped operating
theatres. "Though the government has said that those with
45 per cent disability need only one ID, disabled people come
asking for certificates for job applications, travel concessions,
pension, etc.," the doctors said. Mr. Kumar said the commissionerate
would organize another workshop to discuss assessment of disability.
Those who wanted to know more about the corrective surgery scheme
can contact the District Disability Welfare Officer or the commissionerate
(phone: 548 2639/41) or Mr. Kumar (phone: 548 2659).
Doctors inept to treat disabled
Author: Paawana Poonacha
Bangalore, Sunday Times, February 2, 2003
An estimated eight million disabled persons in Karnataka need
to undergo surgeries to correct/reduce deformities resulting from
polio, cerebral palsy, limb deformities and post burns contractures.
But sadly, government orthopaedic surgeons with postgraduate qualifications
are not "technically skilled or adequately exposed"
to conduct these corrective surgeries, a recent study by the State
Commissionerate of Disabilities found out.
This is certainly bad news for those with locomotor disabilities.
Though the Karnataka government has allocated Rs. 15,000 per person
per year for surgical correction of locomotor disability, there
are no good surgeons or hospitals available to see the project
through. As of today, surgeries are conducted in just a couple
of hospitals and most rural patients do not have access to them.
"The government incurs an expense of Rs. 36 crore, just
to provide maintenance allowance to the disabled. Of this, Rs.
12 crore could be saved if the disabled undergo corrective surgeries,"
Chief Resource Person, State Corrective Surgery Scheme for Locomotor
Disabilities, Dr. Deepak Sharan, said.
Another discouraging trend is that some of the disabled, who underwent
surgeries for free at camps, have been crippled due to complications
caused by the lack of technical expertise. "Therefore, most
disabled believe that it is better to suffer disability than face
complications of a failed surgery," Dr. Sharan says.
Ironically, locomotor disability is handled by the Department
for the Welfare of Disabled under Women and Child Welfare, with
absolutely no involvement of the health department.
At a recent orientation program for government orthopaedic surgeons,
willing doctors were given a comprehensive training programme
at all regional levels by the health department, before being
asked to carry out corrective surgeries independently.
The Commissionerate of Persons with Disabilities, which conducted
the programme, has a long list of recommendations, including a
multi-disciplinary team approach, on-the-spot assessment and documentation,
and expert postoperative care.
"Rajasthan has earmarked Rs. 7 crore for such surgeries
and set a target of 25,000 cases for 2002-03. The state Health
department too should launch a drive in setting targets and earmarking
budgets to this exercise," Assistant Commissioner (Disabilities)
B.C. Pradeep Kumar said.
‘Handicapped’
on medical certificate
Author: Paawana Poonacha
Bangalore, The Times of India, March 11, 2003
Shocking but true. An estimated 25 lakh disabled persons in the
state do not possess medical certificates conforming to GOI guidelines
to avail of benefits of various schemes. Reason: Doctors are unaware
of the procedure to issue such certificates as no one possesses
the copy of guidelines.
In a letter to Chief Minister S.M. Krishna last week, the Union
Ministry for Social Justice and Empowerment directed the government
to take immediate steps to set up a medical board to issue certificates
as per guidelines.
“Unfortunately, the health department has not yet circulated
copies of the guidelines to government hospitals to issue medical
certificates as required under the Disabilities Act,” laments
Assistant Commissioner for Disabilities, B.C. Pradeep Kumar.
While there is alarming rise in number of cases before courts
where the disabled weren’t provided GOI-approved medical
certificates, large-scale discrepancies have been noticed in issuing
certificates.
As a result, a very negligible section of the disabled have so
far availed of concessions for reservation in employment, education,
allotment of houses and sites, issuance of bus passes, travel
tickets, etc. All those who suffer from any kind of disability
beyond 40 per cent are entitled to receive certificates.
At a recently held orientation programme on corrective surgery,
orthopaedic surgeons felt the reasons for lack of interest to
receive guidelines to issue certificates was the procedure was
exhaustive and time consuming.
“The guidelines to issue certificates run into 100 pages.
The one-day camps being organized by the Department of the Welfare
of the Disabled expects surgeons to issue certificates to about
2,000 disabled in a spa of a few hours,” doctors complained,
adding that calculations to find out whether patients suffer from
40 per cent disability was complicated.
Software. Two Bangalore-based Orthopaedics- Dr. Prabhakar Murthy,
medical superintendent of Bangalore Children’s Hospital,
and Dr. Deepak Sharan, HOD, Pediatric Orthopaedics and Rehabilitation-
have been asked to evolve a software package to simplify the procedure
for issue of certificates.
Quack, quack: beware of ‘docs’
Author: Paawana Poonacha
Bangalore, The Times of India, March 27, 2003
"I'll get to the root of your problem and swear painless,
speedy treatment," a quack operating near Shantinagar assured
anxious parents of nine-month-old Arfa K. who recently suffered
a dislocated elbow. Several sessions of massage, applications
of splints and herbal pastes followed, but the trauma only increased.
A week later, the infant’s upper limb swelled up like a
balloon and she went into a coma. Doctors attending on Arfa drained
out half a litre of pus from the elbow. She had also developed
septic arthritis of the hips requiring another surgery.
In another case reported recently, doctors found a girl of the
same age suffering from septicemia and septic arthritis of the
hip because of "branding" (using hot iron rods) treatment
administered by quacks.
Following conducting a series of assessment camps, Karnataka's
Corrective Surgery Programme for Locomotor Disability, has reported
a sudden rise in the popularity of quacks in the city.
Incidents where "fixing the bones" by quacks and delay
in proper treatment by a couple of weeks, has led to a lifetime
of disability. In extreme cases limbs have even had to be amputated.
"Orthopaedic Surgeons encounter numerous limb deformities
resulting from failed folk healing and bone-setting," the
report reads. Quacks are found to be operating in the by lanes
of Shivajinagar, Kalasipalya, Yashwantpur, Cubbon Park and surrounding
areas.
"Injudicious massage for injuries around the elbow leads
to stiffness because of extra bone formation or to joint instability
due to ligament damage following forcible manipulation. This is
in addition to the risks of infection, gangrene (due to damage
of blood supply), deformities or fractures that fail to join,"
warns Dr. Deepak Sharan, chief Resource Person, State Corrective
Surgery Programme.
"Many educated and well-to-do people rationalise such treatment
by stating that disciplines such as Osteopathy and Chiropractic,
based on manipulation of spine and joints, are very popular in
the west. Unfortunately, native practitioners undergo no systematic
training and ply obscure techniques secretly handed down the ages.
They have no knowledge of anatomy and they can damage nerves and
blood vessels by blind manipulation," Dr. Sharan feels.
Although both children described above, made complete recoveries
from a life-threatening condition, parents admitted that they
sought the help of quacks due to poverty. Radhika Mandal, a charitable
organisation has sponsored over 20 successful operations, including
these two cases, in the last one year.
Save your child's back
Author: Kanak Hirani Nautiyal
Bangalore Times, The Times of India, May 26, 2003
Forget about how it looks and don't choose the pink schoolbag
with the Mickey Mouse. When you buy a bag for your child this
year, make sure that when he packs it with his books, it's easy
on his back.
Ideally, a child shouldn't carry a bag more than 10 per cent of
his or her body weight. And there's a good reason. The top of
the shoulder where the straps of a backpack rest is rich in nerves
and blood vessels that serve much of the rest of the body- head,
arms and hands, neck and back.
Excessive weight of a backpack can lead to several health problems
for a child.
Seema Shah's son Manek who weighs 22 kg carries at least five
kg to school. "I feel my poor boy has developed a hunch because
he carries such a heavy bag. He has to carry all his textbooks
and notebooks to school every day," she says.
Sseema says that she'd rather buy a sensible school bag that's
easy on her son's shoulders, he won't let her. "Kids also
want their bags to be fun." She suggests that schools can
make things simple and have a cupboard where the students can
store their textbooks. According to Dr Deepak Sharan, department
of pediatric orthopaedics and rehabilitation, Bangalore Children's
Hospital (BCH), next month BCH is conducting a workshop for children,
teachers and parents titled Kids, Computers and Backpacks. "We
have a visiting US faculty for this workshop. I believe that we
need a forum to address this issue where everyone can take a concrete
decision."
In schools like the Gear Foundation, things are different. According
to their head, M Srinivas, children do not carry bags weighing
more than a kg. "They leave most of their books in school.
They only carry a small file with some papers and a comment card
for the parents. Most children in other schools carry 200 page
notebooks when they need just one or two pages," he says.
Ravi Ladha, local distributor for Genius bags, says since the
past two years his company has manufactured bags that are easy
on a child's shoulder and back. "The Orthofit bag remains
on the shoulder and doesn't shiftthe stress on the vertebral column.
It also fits against the curve of the back as it has been ergonomically
designed." Ladha says another bag, Orthogrip, has good padding,
shape and grip so that the bag straps don't dig into the skin.
"Since the bag weight is a serious issue we also have school
bags with trolleys," he adds.
If your child is buckling under his school bag, this is how he
or she may feel: an aching in the shoulders, neck and back; tingling
in the arms, wrist and hands, especially at night; noticeable
imbalances in posture, including tilting of the head and neck
to one side and an uneven gait; frequent headaches and poor voice
quality.
Weight and watch
o Use a knapsack with well-padded straps and use both straps
when carrying the knapsack
o Buy a knapsack with several compartments to better distribute
the weight
o Pack heavier items near the top of the pack. That way, the
legs are carrying most of the weight. Heavy items packed at
the bottom of the pack put more stress on the back
o Both straps should be worn across the shoulders and upper
back to equalize the weight
Back to links.
'Heavy
backpacks affecting children'
By Staff Reporter
Bangalore, The Hindu, July 5, 2003
Backpacks, bad postures, and computers can do enough harm to
children if proper care is not taken while carrying bags to school
and while working on the computer, according to experts from Bangalore
Children's Hospital.
Speakers at a workshop on "Kids, backpacks and computers,"
organized by The Hindu under the Newspaper in Education (NIE)
programme and Bangalore Children's Hospital here on Friday expressed
concern over the fact hat most schoolchildren suffered from backaches,
neck pains, and other musculoskeletal problems due to heavy backpacks
and bad sitting postures. Around 300 children from 16 schools
in Bangalore, 35 teachers, and 45 parents participated in the
programme, which also discussed computer-related injuries (CRI)
in children. Nandini Mundkur, Paediatrician, Bangalore Children's
Hospital, stressed the need for schoolchildren to be seated in
the correct posture in the classroom. She said chairs in the classroom
should be of the appropriate size according to the age of the
child. Students should rest their backs on the seat and the feet
should touch the ground while seated.
"Schoolchildren are posed with the problem of carrying bulky
backpacks to schools, and Indian students are not alone in facing
this problem," Shruthi R. Iyer, Researcher from Houston,
said.
According to a study conducted by her, around 49 percent of the
Indian students complain of pain in the upper back, lower back,
neck, and shoulders. She said there was a need to implement "pain
prevention screening" in schools so that children were not
subjected to the torture of carrying heavy backpacks.
Deepak Sharan, Orthopaedic Surgeon, said a lot of IT professionals
suffered from CRI or repetitive strain injury (RSI), which was
caused due to bad postures while sitting in front of the monitor.
Children were at a high risk of developing CRI or RSI, which might
cripple them at a later stage, he cautioned.
Back to links
Rehabilitate cerebral
palsy patients
Author: Paawana Poonacha
Bangalore, The Times of India, November 22, 2003
What does it take to bite, chew and swallow food or what synchronises
our speech as we breathe? Ask thew country's estimated 40-80 lakh
children suffering from cerebral palsy (CP), a disorder causing
lack of control over one's movements.
The disorder causes inter-connected disabilities due to a 'minor
problem' in the brain, which could occur before, during or after
birth.
Even as there are signs of phasing out polio, CP is emerging
as the most common disability in the country, health experts warn.
As there is no complete cure for CP, multiple corrective surgeries
and neuro rehabilitation can help patients lead a better life,
a concept doctors in India are largely unaware of, they say. A
report compiled for the Bangalore Children's Hospital for the
state health department states that 75 per cent out of 1000 cases
of locomotory disabilities evaluated in 2002-03 were found to
be that of CP.
In a residential school for the disabled in Tumkur, 90 per cent
of the children were found to be suffering from it. None were
ambulant with or without locomotory assistive devices and many
were bed-bound or wheelchair-bound.
"Most children had the potential to walk but despite promise
of government funding, parents of these patients refuse to seek
adequate treatment," says Dr Deepak Sharan, HoD, pediatric
orthopaedics and rehabilitation, Bangalore Children's Hospital,
who conducted the study.
According to him, a common advice given by most doctors is that
nothing can be done medically for these children.
"Many CP patients are bluntly referred to physiotherapists
who are not equipped to handle CP patients with disabilities like
speech, vision, swallowing, epilepsy, mental retardation, behavioral
and learning disabilities," he says.
Shortage of medical professionals trained in rehabilitation trends
seems to be the reason why treatment of CP patients is lagging
behind in India. "There are corrective surgeries based on
current international recommendations which have shown encouraging
results," says Dr Sharan.
Neuro rehabilitation of CP patients is equally dismal, if not
worse, says, Dr A.S. Hegde, HoD, neurosurgery at Satya Sai Hospital.
"NIMHANS offers neuro rehabilitation, while Vittal Medical
College in Vellore, Armed Forces Medical College at Pune, Dr Ahluwalia's
Institute of Rehabilitation at Delhi and St. John's Hospital at
Bangalore offer succour to CP patients on both neuro and ortho
fronts," Dr Hegde details.
Ajay Vijayaraghavan (photo) before and after surgery. On Saturday,
Ajay and 30 other CP patients who have been operated upon by Dr
Deepak Sharan, will have a get-together at Bangalore Children's
Hospital to set up a support group.
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Heavy school bags cause musculoskeletal
disorders: Study
Kochi, Daily Excelsior, August 13th, 2004
KOCHI, Aug 12: Three out of four computer professionals in India
develop musculoskeletal disorders after working continously on
computers and history of most of these cases are traced to their
school days, a study by the Indian Academy of Paediatrics Shows.
According to the survey conducted among 3,500 professionals at
Bangalore alone, 75 per cent of them reported disorders and the
academy was now on a massive drive to collect data from across
the country. For most of them, the disorder began from their school
days when they had to carry heavy backpacks, according to Dr Deepak
Sharan who has been on an intense campaign for the last two years
to reduce the load of school bags.
Dr Deepak, who is the head of the Department of Paediatric Orthopaedics
at Bangalore Children’s Hospital and Research Centre, was in the
city to conduct study among the students, parents and others.
"If the current trend persists, it will be a rarity to find a
pain-free adult when the present generation of school children
grows up to enter the work force," he warned. According to a study
in 2001, which is the only one available on Indian students, 50
per cent of them were tested positive for chronic pain due to
carrying heavy backpacks. "Half of them go through a severe episode
of pain at least once before they enter adulthood," he poined.
Adolescents with back, neck and shoulder pain were at increased
risk of experiencing chronic musculoskeletal pain, he said citing
different studies abroad. "All this will have a serious impact
on the productivity and thereby the economy of the nation," Dr
Deepak said.
The academy had launched a national-level drive to collect data
on the ill-effects of heavy backpacks and is into a campaign across
the country to get the weight of bags reduced, national executive
member Dr Sachidananda Kamath said. As per their findings, carrying
of backpacks would change the centre of gravity in the body and
would affect stability. It causes the body to lean forward and
baseline oxygen consumption increases. Tiredness or muscle fatigue,
swelling, pain in the head or neck, back or shoulders, muscle
spasms or stiffness, numbness, curved or rounded back and altered
gait could be some of the results of carrying heavy baggage. The
academy had also come out with some suggestions to the schools,
parents and the manufacturers of bags in this regard. The cochin
chapter had recently made some schools accept their suggestions,
including bags with less weight. (UNI)
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Workshop on cerebral palsy
By Staff Reporter
Kochi, The Hindu, October 19, 2004
The high cost of new technologies in medicine prevents ordinary
people access to modern medical treatment, said the District Collector,
A.P.M. Mohammed Hanish. Inaugurating a free surgical workshop
for managing cerebral palsy in children, Mr. Hanish said it was
difficult for the Government to evolve welfare schemes in the
health sector because of the lack of funds. But the Government
would ensure an environment for such enterprises to flourish.
The Bangalore-based expert in orthopaedics and rehabilitation,
Deepak Sharan, will lead the four-day surgical camp at the Welcare
Hospital. Organised by the Adarsh Institute for Cerebral Palsy
and Childhood Development Disorders, the camp will select about
six children below 15 years for surgery. According to the organisers,
the surgery would help children with cerebral palsy to a great
extent in going about their daily activities without external
help.
At the inaugural function, paediatrician Abraham K. Paul, vice-chairman
(Tech.) of Adarsh, introduced the team which would conduct the
surgery and take follow-up action. The technical director of Adarsh,
S. Ramakrishnan, welcomed the gathering. Senior orthopaedic surgeon,
Sudheer Thomas, and the director of Adarsh, P.N. Narayanan, spoke
on the occasion. Paediatrician Sachidananda Kamath proposed a
vote of thanks.
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New surgical procedure to treat
cerebral palsy
By Shyama Rajagopal
Kochi, The Hindu, October 31, 2004
There is no programme yet to manage cerebral palsy in spite
of the fact it accounts for the maximum number of cases of disability
in the country, said Deepak Sharan, Bangalore-based consultant
in Orthopaedics and Rehabilitation. Talking to The Hindu here,
Dr. Sharan said there were no parameters to measure disability
in a person. Disability certificates were issued quite arbitrarily,
he said. Many a time, it was noticed that disability of a person
measured at one centre differed with the result from another centre,
he said.
Setting parameters
Dr. Sharan, who is consultant to the Union Ministry of Social
Justice and Empowerment and also the Disability Commissioner of
Karnataka, said the Government had appointed a team of specialists,
including developmental paediatricians, paediatric neurosurgeon,
paediatric orthopaedic surgeon, physio therapist, occupational
therapist and other specialists, to set parameters to define disability.
The Childhood Disability Group of the Indian Academy of Paediatricians
would provide the basic structure to define disability and provide
a measuring yardstick. The Government also has plans to modify
the definition of cerebral palsy, said Dr. Sharan, who is part
of a five-member expert committee on cerebral palsy and autism
under the Union Ministry. There are about 5-8 million people in
the country afflicted with cerebral palsy, he said. The Spastic
Society of India and other NGOs provided more of vocational training
to cerebral palsy-afflicted children. Medical treatment of cerebral
palsy was non-existent, he said.
He said the perception of an attack of cerebral palsy had been
linked to difficult labours. But, now the theory has been extended
to say that a child with disabilities could also lead to difficult
labours, he added. The incidence of cerebral palsy has been measured
at 2-2.5 out of 1,000 births. At a disability screening camp held
in Bangalore in 2002-03, it was found that out of 1,000 disabled
cases, 75 per cent of locomotor disabilities were due to cerebral
palsy.
Advanced surgery
Conventional methods of correcting cerebral palsy through surgery
were not generally successful, said Dr. Sharan, who has a Fellowship
in Paediatric Orthopaedics from the U.K. and is also a member
of the American Academy for Cerebral Palsy and Developmental Medicine.
According to him, a poorly done operation is worse than no operation
at all. After a five-year training in the U.K. in the most advanced
technique in managing cerebral palsy called Orthopaedic Selective
Spasticity Control Surgery (OSSCS) using an advanced computer
aided three-dimensional analysis of muscle function, Dr. Sharan
has performed about 45 surgeries in the last three years in Bangalore,
all of which have boosted his confidence to make available such
surgery to more people. OSSCS is not a technique but a principle
devised by the Japanese orthopaedic surgeon, Takashi Matsuo, explains
Dr. Sharan. About 30 muscles are involved in taking one step.
In the case of a cerebral palsy-afflicted person, a few muscles
fail to function. All the dysfunctional muscles in a limb need
to be identified and should be corrected in a single operation,
he said. It also reduces the trauma of going through a number
of surgeries, he said.
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