What is Shy Drager Syndrome?

Shy Drager Syndrome, which is known as multiple system atrophy, is a terminal phase of a neurological disorder which occurs rarely. It is a progressive disorder that affects the Central Autonomic Nervous System which kicks off during adulthood and worsens slowly. It also affects the person’s basal ganglia and brainstem. Basically it is the result of the autonomic nervous system’s failure to control the function of the body. It damages the person’s nerves which controls the involuntary function like heartbeat, blood pressure, breathing, and digestion. It is quite similar to the Parkinson’s disease since the persons with this syndrome manifest Parkinsonism like symptoms, which may be described further in this article. The main difference from Parkinson’s disease from this syndrome is that the damage in the person’s body is extensive when a person is diagnosed with this kind of syndrome.

Symptoms and Characteristics

Persons who have this syndrome may experience the following symptoms, signs and characteristics:

• Weakness of the muscles
• Ache in the neck
• Constipation
• Diarrhea
• Loss of libido
• Urinary incontinence or Inable to control bladder or bowel
• Dizziness
• Fatigue
• Dry skin
• Impotence
• Impairment of the temperature regulatory system
• Visual problems
• Slurred speech
• Poor balance
• Stiffness
• Movement is slow
• Facial expression is lost
• Dementia
• Bradykinesia
• Akinesia
• Rigidity
• Trouble swallowing
• Reduce ability to sweat
• Gasping
• Sleep apnea periods
• Abnormal posture
• Confusion
• Respiratory failure
• Lightheadedness
• Tremors (pill rolling tremors)
• Difficulty in walking
• Dementia
• Depression
• Shuffling
• Myalgia
• Mask appearance on the persons face
• Unable to close the mouth
• Frequent falling
• Mild mental functioning decline
• Nausea
• Monotone
• Slow speaking
• Voice is on low volume
• Orthostatic hypotension

Causes and Risk Factors

The exact causative agent or cause why this syndrome occurs is still unknown. However, recent studies show that it occurs on adulthood stage at around 50 years old and above. Also theories suggest that it may be related to the protein over production which is found in the person’s brain. While other theories suggest that it is primarily due to the degeneration of the nerve cell groups which is found in the person’s spinal column. Further more studies are conducted in determining the reason behind the said occurrences. That at risk for encountering or experiencing this syndrome falls to the ages in the middle to older persons. Aside from the age, the male gender is the one of greater risk to experiencing this syndrome. Rest assured that this syndrome is not of genetic cause and thus it can’t be inherited from one generation to the next.

Shy drager syndrome diagnosis:

In diagnosing the persons with Shy Drager Syndrome, physicians, who are either in the neurology or internal medicine experts, would require examinations such as:

• Medical history examination
• Physical examination
• Eye examination
• Neuromuscular examination
• Vital signs such as pulse and blood pressure is an important assessment
• Electroencephalogram examination
• MRI examination of the person’s head
• Barium Swallow examination
• Sleep studies examination
• CT scan examination
• Plasma norepinephrine level examination
• Blood examination
• Urine examination

Treatment

There is no known cure for this syndrome and the treatments which are prescribing to persons who are diagnosed with this syndrome are medications which will only control the symptoms that the person manifests. These kinds of medications that may be prescribed are as follows:

• Beta blockers such as propranolol which treats low blood pressure
• Fludrocortisones which treats low blood pressure
• MAOI which treats low blood pressure
• Vasoconstrictors which treats low blood pressure
• Vasopressin which treats low blood pressure
• Medications to treat spasms of the bladder such as oxybutynin
• Sildenafil which is a treatment for dysfunction of the male’s erectile
• Corticosteroids such as prednisone
• Immuno globulins which enhances the immune system

Aside from the medication, which is a form of dependent therapy, the persons with this syndrome are encouraged to follow independent therapy such as:

• Eating small and frequent meals and those which are easier to swallow
• Drinking caffeinated beverages every after meals
• Avoiding alcoholic beverages
• Moderate exercises
• Increasing fluid and salt to increase blood pressure
• Getting up slowly to avoid orthostatic hypotension
• Wearing elastic abdominal binders and support stockings
• Encouraging diet which are high in fiber and intake of fiber supplements

Aside from the ones that were mention, it is also advisable for the patient to undergo therapies such as:

• Speech therapies
• Tube feeding therapies for swallowing problems
• Intermittent catheterization therapy for problems with the urination
• Joining a support group therapy
• Implantation of the penile for treatment of impotence
• Breathing support therapy such as mechanical ventilation or oxygen therapy

Prognosis & Life Expectancy

The persons who are diagnosed with Shy Drager Syndrome have a poor outcome, hence a poor prognosis. Their physical functions as well as mental capabilities is loss in the long run and will eventually get even worse than before the disease started. There is a possibility of early death. The life expectancy with persons having Shy Drager Syndrome falls from the time and day she was diagnosed is from 7 up to 9 years.

Complications

The complications that are associated with these syndromes are as follows:

• Injuries that are result from fainting or falling
• Side effects of the medications such as hallucination or dizziness and the like
• Difficulty in performance of the ADLs or activity of daily living
• The loss of the ability to care or work which is seen progressively

Prevention

Since the cause of why Shy Drager Syndrome exists is still unknown, there are no known ways to prevent the occurrences of this kind of syndrome.

What is Vaginal Itching and Burning?

Vaginal itching and burning is one of the most common complaints of women especially during menstruation. Vaginal itching is generally a mild complaint; however, some may be caused by notorious infections that may aggravate once treatments are not instituted. The vagina is a sensitive tissue because of being a mucous membrane.

It is naturally acidic to fight infections such as yeasts. Changes in the normal pH of the vaginal can lead to problems such as itching because of possible irritation from microorganisms. Vaginal itching is usually associated with burning on the vaginal mucosa. This is because irritation may cause mild inflammation in the areas causing burning sensations in the area.

Associated Symptoms of Vaginal Itching and Burning

Vaginal burning and itching may also be associated with other symptoms that may be mild to severe. These include:

• Painful intercourse – Burning sensation in the vagina usually becomes intensified as the penis comes in contact with the vaginal wall.
• Difficulty urination – The presence of vaginal infections that lead to itching may also spread to the adjacent urethra. As a result, there is also itching and burning sensation as one tries to urinate.
• Presence of vaginal secretions – Vaginal secretions may also be observed, which may be non-purulent or purulent depending on the cause. Vaginal secretions may also be non-foul smelling or fishy in odor. Presence of fishy-odor in the secretions should be referred immediately because this may be caused by ongoing vaginal infections.

Vaginal itching during Pregnancy

Vaginal itching can also occur during pregnancy because of normal changes in the pH of the vagina. The vagina normally becomes slightly less acidic because of scant discharges. This produces minimal irritation. Pregnant women should ensure good perineal hygiene because the change in the pH can invite yeast infections.

Vaginal Itching without Discharge

Some vaginal itching may also be present without discharge. Absence of discharge is usually related to mechanical and chemical irritation rather than pathologic in nature. Vaginal itching without discharge can be due to irritation with clothing materials or feminine washes. Certain women develop allergy to certain fabrics used in underwear, tampons, napkins and even hygienic washes. It is important for these women to choose hypoallergenic soaps or washes to prevent vaginal itching. Cotton underwear is also beneficial to prevent allergies from silk or satin.

Vaginal Itching after periods

Women also usually experience vaginal itching after menses. This is because blood may not have fully escaped the vagina and some may still have attached to the vaginal wall. As a result, the blood becomes oxidized and may cause mild irritation in the vagina.

Causes of Vaginal Itching and Burning

Vaginal itching and burning may be caused by several factors. These include:

Yeast infections

Yeast infections are one of the most common causes of vaginal itching. It is caused by Candida albicans, an opportunistic microorganism. Yeast infections usually occur with the use of antibiotics, pregnancy, or weakening of the immune system. Lichen planus is also a fungal infection that causes white patches on the skin that may affect the vagina. The presence of yeast infections are largely dependent on the pH of the vagina and the immune system of the woman because fungal infections do not normally occur when there is normal pH and strong immunity because they do not support the growth of the fungi.

Sexually transmitted diseases

Sexually transmitted diseases can also cause vaginal itching. Most common STDs include Chlamydia, gonorrhea, herpes, genital warts and Trichomoniasis. These infections usually result in purulent vaginal discharges. Bacterial vaginosis may also occur as a result of increase in other microorganisms such as Escherichia coli in the vagina.

Chemical irritation

Substances such as detergents, condoms, soaps, creams, and contraceptive foams can also cause vaginal irritation and itching without discharges.

Menopause

Menopause causes the estrogen levels to decrease resulting in dryness and thinning of the vaginal wall. As a result, there will be irritation and itching from the dry mucosa.

Diagnosis

The diagnosis for vaginal itching and burning may include:

• Pelvic examination – Pelvic examination is usually done to assess the reproductive tract. It involves inspection and palpation of the vagina and other pelvic organs to determine any underlying conditions that may cause the itching.
• Vaginal Smears – Vaginal smears are also taken to determine possible presence of sexually transmitted diseases. It involves the collection of vaginal and cervical mucus and studying it under a microscope to detect the specific microorganism that causes the infection.

Treatment of Vaginal Itching and Burning

Treatments for vaginal itching depend on the causative factor. Treatments include:

• Antibiotic therapy – Cases of bacterial infection such as STDs require antibiotic treatment usually with doxycycline to kill the causative microorganisms. The therapy usually involves one week treatment. After the course of the antibiotics, a repeat vaginal smearing is done to determine effectiveness of therapy.
• Anti-fungal medications – Antifungal medications are also used in cases of yeast infections. Vaginal suppositories with anti-fungal medications as well as anti-fungal creams may be used. Oral anti-fungal treatments may also be used.
• Local anesthetics – Local anesthetics such as lidocaine may also be applied on the vagina to relieve burning and itching. Anesthetics are available in topical preparations so it can be used for local effects.
• Hormone Therapy – Hormone replacement such as estrogen therapy is also employed for menopausal women to relieve menopausal symptoms such as vaginal dryness.

Home Remedies for Vaginal Itching and Burning

Baking Soda Baths

Baking soda usually provides soothing effects in the vagina. However, baking soda should be used minimally because it can contribute to further change in the pH because of being alkaline.

Cold Compress

Cold compress can also be placed over the vulva to temporarily relieve burning and itching.

Wear Cotton Underwear

Cotton effectively absorbs vaginal secretions and prevents irritation of the vagina. Be sure to change undergarments every day.

Use Water-Based Lubricants

Water-based lubricants may also be used to relieve vaginal dryness that causes irritation and itching.

Other remedies include:

• Use warm water and unscented soap for perineal hygiene
• Never scratch the area to prevent further irritation
• Avoid scented toilet papers, pads, washes and douches
• Wipe the vulva from front to back to prevent infection from the anus going to the vagina
• Avoid tight under wear
• Wash hands every now and then to prevent contamination of the vulva

What is Dysgraphia?

Dysgraphia in children and adults is a learning disability that limits the writing capacity of a person. There is a disability in expressing thoughts through graphing and writing. Dysgraphia definition literally means an extremely poor writing ability from the Latin word dys- meaning impaired and graphia-meaning writing.

signs and symptoms of dysgraphia:

Dysgraphia learning disability symptoms does not involve intellectual impairment and occurs, despite the ability to read. The difficulty in writing results primarily from poor movement of muscle required for writing, poor orthographic coding (the storing and processing of letters in written words).

According to the Diagnostic Manual of Mental Disorders, dysgraphia occurs when the person’s writing skills are below the expected capabilities for his or her age, educational level and intellectual capacity.

Dysgraphia learning disability may involve impairment on the motor functioning. The disability in writing usually leads to writing fatigue because of inability to express thoughts through writing. Dysgraphia learning disability may be experienced both by children and adults.

Source – dyslexiaa2z.com

What are Signs, Symptoms of Dysgraphia?

Symptoms of dysgraphia are associated with the inability to write properly. Some dysgraphic children are regarded by people who do not have proper knowledge about dysgraphia as lazy or delayed in cognitive skills. Manifestations include:

• Lots of erasures
• Cramping of fingers during writing
• Creates an L shape with the arm while writing
• Mixing of lower and upper case letters in a word
• Improper use of lines and margins
• Unfinished letters or words
• Slow and labored copying skills
• Illegible handwriting
• Uses wrong words to express thoughts
• Pain during writing as a result of cramping
• Strong verbal skills but poor in writing
• Errors in spelling (some words are written in different spellings)
• Reversals in written numbers
• Inconsistent spaces between words
• Carefully watches hand while writing

What Causes Dysgraphia?

Dysgraphia is caused by disorders in the brain with genetic abnormalities. Intellectual abilities are not a factor for the development of dysgraphia, but most often than not, their intellectual abilities are not seen because of dysgraphia.

The following are the most common problems associated with dysgraphia.

Problems on the working memory

Specifically, there is a problem on the working memory which leads to poor connections between areas in the brain needed for writing. Because of this, there is a disturbance in recalling the sequence of motor movements needed to write a particular number or letter.

Problems on the orthographic loop

The orthographic loop is responsible with the storing of how a word is written based on hand-eye coordination. Sequencing problems also develop.

Problems on motor skills

There is a disturbance on the way a person writes because of problems on the motor area as affected by poor orthographic skills.

Other associated conditions

Conditions include ADHD and hearing problems. Attention Deficit Hyperactivity Disorder (ADHD) was seen to be an important contributor to dysgraphia. This is for the reason that children with ADHD have rapid thoughts that the fine motor skills are unable to adapt. In addition, there is an also poor organizing ability and the attention span is short.

Auditory problems are also factor for the development of dysgraphia because difficulties in hearing may also affect the language expression in general.

Visual problems may not be a strong reason for dysgraphia simply because they are just unable to see clearly, but the language formation may be intact.

Types of Dysgraphia

There are three types of dysgraphia and people who have dysgraphia learning disability may have one or more of these.

Spatial Dysgraphia

Spatial dysgraphia involves the disability in understanding space. Because of this, there is an illegible writing skill with problems on drawing skills. People with spatial dysgraphia are able to spell normally and they do not have fine motor disabilities.

Motor Dysgraphia

Motor dysgraphia involves problems on fine motor skills because of poor muscle tone and poor dexterity. People have difficulty in writing, despite normal verbal skills.

Dyslexic Dysgraphia

Dylexic dysgraphia have normal fine motor skills, but unable to write normally because of mixing of letters and words. Words may be written in a wrong way as a result of dyslexia.

Dysgraphia Test, Diagnosis, Assessment

Dysgraphia is difficult to diagnose because some people may have innate inability to write because of intellectual problem. It is also difficult to diagnose because people try to hide their disability. They have verbal fluency so it’s hard to tell whether the person has dysgraphia learning disability unless the person writes.

Varied educational evaluations and diagnostic tests are done to diagnose dysgraphia. Diagnostic writing tests are employed to assess the writing skills of the individual as compared to his developmental age. The output of writing is usually assessed by letting the person write or copy texts.

Observations of the posture and grip are also done to assess the writing patterns of the individual, which is usually done by occupational therapists.

Dysgraphia Treatment

Management of dysgraphia involves therapies and writing exercises. Treatment plans are categorized into three strategies:

Accommodations

• Alternatives to writing are employed in order for the patient to express his or her thoughts.
• Examples of this strategy include:
• Use of computers. Computers allow the child to express thoughts without writing.

Modifications

• Tasks are usually modified to prevent focusing on the area of weakness, which increase the anxiety of the child.
• Modification techniques include:
• Teaching the person to write in cursive form. Cursive writing has fewer letter reverses and prevents over spacing within words because they are written continuously.

Remediation

• Remediation involves teaching skills to the person to enhance the writing skills.
• Remediation strategies include educational therapy in the form of:
• Use of kinesthetic memory-The child is taught to write the letters or words and allowing to re-write them with the eyes closed. This technique enhances the memory on how to write a particular word.

Dysgraphia Exercises

Exercises are also done to improve the fine motor skills of the child such as:

• Rubbing hands together
• Shaking of the hands in a fast, non-violent manner
• Rubbing of hands against a clothing with a mild texture
• Using fingers in the dominant hand to click the top of a pen
• Performing push-ups on the chair while sitting. The child is instructed to place palms on the top of the chair or desk to push the body to stand.
• Therapists usually perform other measures to help the child improve the writing skills.

Dysgraphia Complications

Dysgraphia usually involves effects on the social relationships and emotional aspect of the child. The child or adult with dyspraxia learning disability oftentimes feel inferior to their peers. Some children feel frustrated by manifesting crying and refusal to do writing tasks. There is also high incidence of stress because of inability to express oneself through writing. Stress-related illnesses may occur such as headache, abdominal pain, fatigue and even conversion disorders (the child may feel pain without any underlying physiologic cause as a result of anxiety). Individuals with dysgraphia learning disability may also experience depression and may have low self-esteem. Alongside dysgraphia therapies, counseling must also be done to allow the person identify his or her strengths to increase self-confidence.

Dysgraphia Prognosis

People who undergo therapy and supported by their families eventually improve their writing skills. However, some people who did not develop confidence in writing may have the disorder for a lifetime.

What is Spigelian Hernia?

Spigelian Hernia or Lateral Ventral Hernia is a rare type of hernia that develops through the spigelian fascia. Spigelian fascia is a layer between the rectus abdominis muscle and the semi-lunar line laterally. It is also defined as a protrusion of peritoneal fat or sac of an organ which has a congenital defect or a weakness in the spigelian fascia. It is mostly seen at or below linea arcuata probably because of lack of posterior rectus sheath. It represents approximately 1-2% of all hernia and women are mostly affected and more likely to occur after the age of 50. Oblique hernia symptoms does not show any outward signs like swelling because it penetrates between the muscles of the abdominal wall. This type of hernia is usually small so it’s very difficult to diagnose. Compare to other hernias, because of its size there is a possible risk of strangulation. Predisposing factors that can cause spigelian hernia are increased intra-abdominal pressure, obesity, and trauma.

Abdominal Hernia

Source – sciencephoto.com

Location and Anatomy of Spigelian Hernia

Picture 2 – Different types of hernia

The location of Spigelian hernia is in the lateral edge of rectus muscle and semi-lunar line or below the level of the umbilicus.

Spigelian hernia is a hernia through spigelian fascia, which is the aponeurotic layer that is a layers of flat broad tendons that joins the muscles and it is located between the rectus abdominis muscle or also known as “six pack” medially and the semi-lunar line, it is a curved line placed on either side of rectus abdominis, laterally.

Diagram of Spigelian Hernia

This picture shows the common location of spigelian hernia inside the body.

Spigelian Hernia anatomy and location

Spigelian Hernia Symptoms and Signs

• Localized pain that comes and goes on a repetitive basis.
• Bowel obstruction it’s an obstruction in the intestines, preventing normal transit of products of digestion.
• Nausea and vomiting if there is a presence of bowel obstruction.

These are the only general signs of spigelian hernia. This rare type of hernia is usually small and doesn’t show any outward signs, so, it’s very difficult to determine its presence. The size of this hernia increase the risk for strangulation therefore it’s very necessary to be treated early once it’s detected and confirmed.

Spigelian Hernia Causes

Spigelian hernias usually occur in patients with:

(1) Increased intra-abdominal pressure in situations like having a

1. Heavy labor in women can cause pressure in the abdominal area that might result in having spigelian hernia.
2. Person who developed urinary retention. Urinary retention is characterized by having a poor, intermittent flow or a sense of incomplete voiding.
3. Severe coughing or severe vomiting
4. COPD or Chronic Obstructive Pulmonary Disease. COPD is a disease in the lungs in which the airways became narrowed normally due to tobacco smoking which they triggers the inflammatory response in the lung.

(2) Multiparous women or women who gave birth with 2 or more offspring and patients with recent significant weight loss. Clinical findings include focal tenderness or a mass along the linea semilunaris and because of this bowel incarceration and strangulation are common effects that result to spigelian hernia.
(3) Obesity is a medical condition where there is an excess body fat in the body. People that is obese carries an extra weight their muscle are often unable to handle this extra weight which increases the person to have a hernia. A patient that is obese will have a difficulty in determining the location of hernias as well as the recovery of the patient after surgery will become a problem.

Spigelian Hernia Diagnosis

• CT scan or Computed Tomography is considered as a most reliable technique to make sure of the diagnosis. A CT scan uses special x-ray equipment that produces multiple images with different dimension. It helps to identify abnormalities such as tumor and hernia inside the body.

• Ultrasound is recommended as a first line in detecting any presence of mass in the abdomen. Ultrasound is a procedure that uses high frequency sound waves to visualize internal organs and produces images of the body.
• MRI or Magnetic Resonance Imaging is a medical imaging technique that visualize internal organs. MRI can produce a good contrast between the different soft tissue of the body that is really helpful in determining problems in the body.
• Ultrasonography it is used for visualizing subcutaneous body structures such as tendons, muscles, joints, and internal organs.

*These diagnostic exam can help the doctors to detect any unrecognized cases of spigelian hernia. They can show any defect or abnormalities along the spigelian line in the lower abdomen, it can locate the presence of hernia sac, it can show how small the obstruction is and if strangulation is present.

Spigelian Hernia Treatment

There is no specific medical treatment for spigelian hernia because of the risk of strangulation most of the doctors recommend surgery. A surgical procedure in which hernia is repaired or removed and which the abdominal wall is strengthen with surgical mesh. Surgical Mesh is a woven fabric that helps to strengthen tissues, to treat surgical wounds and provide support to organs. Surgical mesh also prevents the hernia to go back.

What is Golfer’s Elbow?

Golfer’s elbow or also called as Medial Epicondylitis is a condition where there is a trauma and inflammation in the inner side of the elbow. In this condition, the pain radiates from the bump on the inside of the elbow to the forearm. It’s primarily due to overused muscles of the arm that can give an individual too much pain and it will limit their movements.

Golfer’s Elbow Image

Symptoms of Golfer’s Elbow

• Pain is the most common and obvious symptoms of Golfer’s Elbow that is experienced in the inside of the upper forearm and anywhere near elbow joint and wrist.
• Tenderness due to the inflammation cause by overusing muscles.
• Stiffness on the affected area.
• Muscle Weakness on the area that is overused.
• Numbness that radiates into one or more fingers.

Causes of Golfer’s Elbow

The main cause of Golfer’s Elbow is too much used of the muscles of the forearm accompanied by inadequate rest that will eventually make the muscles become strained and overwork. Over used can lead to straining the muscles that will interfere to an individual daily activities.

Activities that might lead in experiencing Golfer’s elbow:

• Golf : playing golf that gripping and swinging the clubs incorrectly can lead a damage in both muscles and tendons. The damage can lead in having Golfer’s elbow that medical professionals advised these patients to have at least 3-6 months rest in other to help or aid in faster recovery.
• Racket Sports : overdoing the “topspin” technique can lead in hurting your elbow and using rackets that are too small or big and heavy can lead in having an injury. Using inappropriate equipment can lead to additional force to be exerted by your arm so it is advised that you ask a professional regarding the right type of racket for you in order to avoid straining your muscles.
• Throwing Sports : during softball or baseball, improper pitching can lead in straining muscles. It is advised by the professionals that you should warm up first in any activity and have a basic knowledge in every sport and technique you will be using to avoid injury.
• Weight Training : Lifting weights improperly can make the elbow muscles and tendons to be overloaded. It is right to ask professionals to give you the appropriate type of weights especially if you are just a beginner to avoid injuries.
• Other activities : activities that have a repetitive arm, wrist, or hand movements can also lead in having Golfer’s elbow Syndrome.

Risk Factors of Golfer’s Elbow

• Most common in men
• Usually the affected age group are between 20-49 years old
• It can affect anyone who continually put stress on the arms, wrist and fingers.

Treatment for Golfer’s Elbow

• Complete rest is needed once you are diagnosed with Golfer’s Elbow to avoid more damage in your overuse muscles. Some medical professionals advise to put a splint or strap to avoid pulling the overused tendon.
• Iced the affected area in 10-15 minutes for four times a day to help to reduce the swelling and inflammation resulting by the injury. It will help you for your faster recovery.
• Physiotherapy
• 10 minute massage is usually recommended in order to help circulate the blood flow in the affected area
• Stretching Exercise that will help the affected arm to go back to its normal but it should be done gradually to avoid straining again the affected part. Medical professionals will give you a tennis elbow cure exercises or routine stretching exercise that is appropriate for you to aid you for faster recovery.
• Medication like NSAID’s (non-steroidal anti-inflammatory drug) to help reduce pain and swelling in the affected area. Medical professional will advised you specific dose of drug that you will take to avoid overdosing that might cause another problem. Do not Self-Medicated.
• Golfer’s exercise is a kind of exercise routine that is made and planned by your physical therapist to help for the recovery for your affected part.
• Surgery is applied when the rest of the treatment doesn’t help to improve the condition within 3-6 months span of time. The procedures will remove the damage tendon that will help to improve blood flow and will help in healing process.

Prevention for Golfer’s Elbow

Strengthen the muscles of your forearm like squeezing a stress ball to help your muscles be ready to absorb the pressure of the unexpected physical stress.

• Always stretch before any activity to warm up your muscles to avoid injuries. Usually stretching will make your muscle s be ready for the unexpected activity and it will help you to avoid creating injury in your body.
• Fix your form or technique in playing to avoid injuries. Ask a professional to help you in fixing your form in order to avoid straining the muscles to avoid having Golfer’s elbow.
• Lift smartly to avoid injuries to the muscle by using proper body mechanics. There are different ways and technique in lifting things that will not cause straining your muscles in the body like picking a book on the floor, instead you will pick it on a standing position and bending your back, it is advised you pick it on a sitting like position to avoid straining your arms and back in reaching the book.

Complications of Golfer’s Elbow

• It can cause chronic elbow pain
• There will be a limited range of motion that will cause a discomfort on the patient
• If not treated, it can have a fix contracture in the individuals elbow
• It can also lead to tendon or muscle rupture in the forearm

What is Dyspraxia?

Dyspraxia in children and adults is a learning disability involving difficulties in motor and speech – this is the main dyspraxia definition. An individual with dyspraxia may have difficulties in coordination and movement, language formation, thought and perception. The degree and type of disability depends on the classification of the condition. It should be understood that the condition does not affect the intelligence of a person, but may result in difficulty in learning during childhood.

Source – telegraph.co.uk

Dyspraxia learning disability also involves either a difficulty in planning action or executing it. Classifications of dyspraxia manifest these differences such as:

• Ideational Dyspraxia – Involves problems with planning the action (does not know how to do it).
• Ideo-Motor Dyspraxia– Involves problems with the action itself (cannot execute it even if the steps are known)
• Oromotor Dyspraxia– Involves problems on pronouncing words
• Constructional Dyspraxia- Involves problems on spatial tasks

Dyspraxia Signs and Symptoms

Symptoms of dyspraxia in children are learning disability which vary according to the developmental milestone of the person. The following outlines the most common signs and symptoms of dyspraxia as described according to developmental stage:

Infancy to Toddlerhood

A young child may experience mild dyspraxia problems such as delays in the following tasks:

• Sitting upright
• Crawling
• Walking
• Standing
• Vocalizing
• Establishing vocabulary
• Speaking (children are oftentimes not understood)

Preschool Age

The preschool child may experience the following difficulties:

• Problems with dressing own self
• Difficulty in tying shoelace or buttoning of clothes
• Unable to perform jumping, catching, hopping, kicking or skipping
• Difficulty in going up and down the stairs
• Lack of concentration
• Hesitant in playing with others
• Fidgets most of the time
• Clumsy
• Difficulty in holding a pencil properly
• Unable to understand common prepositions such as in, out, beside, on top, etc.

School age

• Early difficulties do not resolve
• Avoids sports and other school activities
• Best learns on a one-on-one teaching, unable to learn with other children
• Has difficulty in writing
• Reacts to all external stimuli (do not exhibit selective inattention to irrelevant stimulus) as a result of sensory integrative dysfunction
• Disorganized
• Unable to follow simple instructions and does not remember instructions.
• Unwilling to attend social activities because of speech difficulties.

Adolescence and Adulthood

• Poor grooming
• Clumsy
• Unable to write well
• Difficulties in speech (including pitch, volume and articulation)
• Difficulty learning how to drive
• Very sensitive to sensations such as touch, light, smell and taste
• Children should be assessed early for signs and symptoms to employ early management.

Causes of Dyspraxia

Dyspraxia learning disability was seen to be inherited although the exact cause of dyspraxia is unknown, but researchers speculate that the motor neurons are impaired. Because of this, it is likely that the brain will also process data longer.

Other studies have indicated that damage to the cerebellum during development may contribute to the occurrence of dyspraxia. Premature babies who have not developed the cerebellum fully have also higher risks for developing it.

Dyspraxia during adulthood is commonly caused by head traumas, brain attack (stroke) or illness affecting the neurologic system.

Types of Dyspraxia

1. Verbal dyspraxia

Verbal dyspraxia is an ideational dyspraxia learning disability wherein the person is not able to form words. There is a problem on the initiation of movements needed to form speech. It is also called articulatory dyspraxia or childhood apraxia. Verbal dyspraxia involves problems in making sounds, controlling the speech organs, controlling phonation and breathing, problems with feeding and a delayed language development.

2. Oral dyspraxia

Oral dyspraxia is an oromotor dyspraxia and involves problems on doing non-speech movements such as licking, sucking, blowing and any tongue or lip movement. Oral dyspraxia may affect speech as a result of motor problems. A child may manifest drooling as a result of problems on the tongue

3. Motor dyspraxia

Motor dyspraxia, also known as motor skills disorder involves difficulties in motor movements, including fine and gross motor activities. Motor dyspraxia is a result of problems on the motor neurons which affect the way the person moves. People having motor dyspraxia often exhibit clumsiness and falling.

4. Developmental dyspraxia

Developmental dyspraxia is a type of dyspraxia that develop starting at birth. Developmental dyspraxia may occur with all types of dyspraxia.

Dyspraxia Test

Testing for dyspraxia involves a checklist to be accomplished by a caregiver or the patient itself. This checklist contains demonstrations of dyspraxia to be evaluated from the patient. The testing is not an assessment tool for dyspraxia, but gives suspicion on the presence of the condition. A relevant number of manifestations present may suggest presence of the problem which requires definitive assessment and diagnosis from health practitioners.

Online testing is also available and results are presented in a few minutes or hours. Several mental health sites offer a free online testing for dyspraxia.

Dyspraxia Diagnosis and Assessment

Dyspraxia is oftentimes difficult to determine from other developmental disorders. Diagnosis and assessment of dyspraxia include:

• Detailed developmental history – Developmental milestones need to be examined to assess any difficulties in previous milestones such as walking, speaking or crawling.
• Cognitive Tests – Certain intellectual screening tests are performed by a trained examiner (usually a psychiatrist or psychologists) to assess learning and intellectual problems. Usually among patients with dyspraxia, the intellectual abilities are not affected.
• Motor Skill Test – Motor tests include gross motor and fine motor skills testing.
• Gross Motor Skills – Gross motor skills testing involve the examination of the use of large muscles during body movement such as walking, running, jumping, and balancing.
• Fine Motor Skills -This involves examining the use of small muscles during movement. The client may be asked to tie the shoelace, button clothes, write, or pick up small pieces.

Aside from these tests, the examiner will also assess reactions to stimuli such as touch, light and sound. Assessing dyspraxia is crucial as it is difficult to diagnose. Special education teachers are also trained to do assessments among students.

Dyspraxia Treatment

Treatment of dyspraxia learning disability aims at developing the speech and motor functioning for the patient. These include:

• Speech and Language Therapy – Speech and language therapy helps the patient in language formation. The therapy includes phonation and exercise of the speech organs.
• Occupational Therapy – Therapists usually allow clients to do home and school tasks and help clients in developing new skills that may be difficult for the client.
• Perceptual Motor Training – This therapy involves training the client develop movement, auditory, visual and language skills. The task advances as the development of the child improves.
• Dyspraxia Exercises – Exercises are instituted through active play. The child is allowed to explore things by themselves and play with other children to improve their language, motor skills, spatial skills and senses. Caregivers should ensure safety during these times. Caregivers may also be involved with the active play specially when inside the house.

Dyspraxia support groups are also helping in reassuring parents and providing therapies for clients. These treatments do not cure the condition, but improves the abilities of the client.

Dyspraxia Complications

Dyspraxia often do not lead to physical complications or side-effects. Problems arise with the social repercussions of the condition. A person may have low self-esteem and develop depression as a result of learning and motor problems. The person may also be socially isolated especially during school times.

Dyspraxia Prognosis

Dyspraxia is a lifelong disease; however it does not lead to medical conditions. Symptoms can be controlled or addressed using therapies and the person may experience optimum level of functioning. Some people with dyspraxia turn out to be talented individuals with the help of support groups.