Malaria Recovery Physiotherapy at Arunalaya

Best Malaria Treatment in Delhi

What is Malaria ?

Malaria is a life-threatening disease caused by parasites transmitted through the bite of infected Anopheles mosquitoes. While direct physiotherapy intervention during the acute, febrile stage of malaria is limited (focus remains on medical management), advanced physiotherapy plays a crucial role in managing the complications and facilitating recovery, especially after severe or complicated malaria.

How Malaria Can Impact Physical Function and thus require physiotherapy-

Malaria, particularly severe Plasmodium falciparum malaria, can lead to a range of complications that affect various body systems, creating a need for physiotherapy:-

Severe Fatigue and Post-Malarial Fatigue Syndrome: This is very common, lasting weeks or even months after the infection, and significantly impacts daily activities and quality of life.
Muscle Weakness and Atrophy (Muscle Wasting):
- Direct effects of the infection (inflammation, high metabolic demands).
- Prolonged bed rest, especially in severe cases, leads to significant deconditioning and muscle loss.
- Myalgia (muscle pain) and joint pain are also common.
Neurological Complications (Cerebral Malaria):
- Cerebral malaria is a severe form that can cause seizures, impaired consciousness, coma, and lead to long-term neurological deficits such as:
  - Hemiparesis (weakness on one side of the body)
  - Ataxia (lack of coordination)
  - Speech and swallowing difficulties (dysarthria, dysphagia)
  - Cognitive impairment
  - Sensory deficits
- These complications are more common in children.
Respiratory Complications:
- Acute Respiratory Distress Syndrome (ARDS) or pulmonary edema can occur, leading to breathing difficulties and prolonged ventilator support. This results in respiratory muscle weakness.
Anemia: The destruction of red blood cells by the parasite causes anemia, leading to reduced oxygen delivery to muscles and increased fatigue.
Joint Stiffness and Contractures: Prolonged immobility can lead to stiffness and shortening of muscles around joints.
Critical Illness Polyneuropathy (CIP) and Myopathy (CIM): In severe cases requiring ICU admission, patients can develop generalized weakness due to nerve and muscle damage.
Balance and Coordination Issues: Resulting from general weakness, fatigue, or neurological involvement.

Advanced Physiotherapy for Post-Malarial Recovery

Acute Phase (Hospitalization, if severe):
- Respiratory Physiotherapy: Crucial for patients with respiratory complications or on ventilators. This includes:
  - Chest percussion and vibrations to clear secretions.
  - Positioning for optimal lung expansion and secretion clearance.
  - Breathing exercises (e.g., deep breathing, diaphragmatic breathing) to improve lung capacity and strengthen respiratory muscles.
  - Assisted coughing techniques.
  - Early mobilization (e.g., bed exercises, sitting up) to prevent deconditioning.
- Passive Range of Motion (PROM) Exercises: Performed regularly by the therapist to prevent joint stiffness and contractures, especially in unconscious or critically ill patients.
- Positioning and Pressure Injury Prevention: Regular repositioning, use of pressure-relieving devices, and skin inspections to prevent bedsores.
Sub-Acute/Rehabilitation Phase (Once medically stable):
- Comprehensive Assessment: Evaluating muscle strength (often using manual muscle testing), range of motion, balance, gait, functional abilities (ADLs), respiratory function, and cognitive status.
- Fatigue Management: This is paramount.
  - Graded Exercise Therapy (GET): A carefully planned, progressive increase in physical activity, starting with very low intensity and gradually building up endurance without exacerbating fatigue.
  - Energy Conservation Techniques: Teaching patients to pace activities, take frequent rest breaks, and prioritize tasks.
  - Activity Modification: Advising on modifying daily tasks to reduce energy expenditure.
- Strengthening Exercises:
  - Progressive Resistance Training: Starting with bodyweight or light resistance bands and gradually increasing the load as strength improves. Focus on major muscle groups, especially those affected by disuse atrophy.
  - Functional Strengthening: Exercises that mimic daily activities (e.g., sit-to-stand, stair climbing, lifting light objects) to improve functional independence.
  - Avoid overexertion: Especially early on, to prevent muscle damage or exacerbation of fatigue.
- Mobility and Gait Training:
  - Transfers: Assisting patients with moving from bed to chair, etc.
  - Balance Training: Static and dynamic balance exercises (e.g., standing on one leg, tandem stance, walking on uneven surfaces) to improve stability and reduce fall risk.
  - Gait Re-education: Addressing any abnormal gait patterns (e.g., waddling gait from hip weakness, dragging feet from neurological deficits). This may involve assistive devices like walkers or canes initially.
- Neurological Rehabilitation (if cerebral malaria occurred):
  - Neuro-facilitation Techniques: Using specific handling and movement patterns to retrain movement and reduce spasticity or abnormal muscle tone.
  - Proprioceptive Neuromuscular Facilitation (PNF): Advanced stretching and strengthening techniques to improve range of motion, strength, and coordination.
  - Constraint-Induced Movement Therapy (CIMT): For patients with significant weakness on one side, restraining the stronger limb to force use of the weaker limb.
  - Sensory Re-education: If sensory deficits are present.
- Flexibility and Stretching: To address any joint stiffness or muscle tightness.
- Pain Management: Using modalities like heat/cold therapy, massage, and therapeutic exercises to alleviate muscle and joint pain.
- Splinting/Orthotics: If contractures are developing or if foot drop is present due to neurological damage, to maintain joint position and aid walking.

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Sunday: 9:30AM to 7:30PM

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+91 8090080907
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