Know about stroke Prevention and Post Stroke Physiotherapy Role


Preventive healthcare services walk extra mile to ensure the overall health of individuals. The whole program is based on two basic components: preventive measures and restorative treatments.

Stroke is the condition where the plaque formation interrupts the blood supply to brain cells. Blood serves to carry nutrients and oxygen required for functioning of the brain. Stroke causes paralysis or loss of function of one leg and arm. Modern stagnant lifestyle, unhealthy eating habits, heredity, use of drugs increase the chances of stroke even in young individuals (less than 50years old).

Preventive measures aim to maintain the health by adopting healthy life style and eating habits using behavior changing strategies. It includes educating people about risk factors of stroke at young age as posed by smoking, junk food, alcohol consumption and stagnant life style. Various wellness programs for school children and corporate world are organized to inculcate the healthy habits in early life and to educate professionals about the risk factors respectively.
Smoking increases the chances of stroke by narrowing of vessels. Behavioral therapy to make the smokers quit it includes personal or even the telephonic counselling. Adopting healthy diet habits reduces to blood sodium level, maintain normal range of blood pressure and thereby reduces the risk of getting stroke. Diet rich in fruits and vegetables is recommended for the same. Obesity is one of the foremost risk factor for stroke. Regular physical activities, active life style, yoga, exercise, walk and of course, healthy diet keep the person away from obesity. Wellness programs to educate the people about increased risk of stroke by alcohol consumption as well as the counselling help to quit or at least, reduce the alcohol consumption.

Blessed people get the preventive care in time and stay away from life threatening stroke. But this is not the case with all!

Rehabilitation is the holistic approach that aims to regain the physical activities (sitting, standing, and walking) through exercise with focus on required proper diet and restoration of cardiorespiratory fitness.

Physiotherapy helps the stroke survivors to keep these nonfunctional muscles toned. Once the muscles regain their function, physiotherapy makes the patients to relearn everyday skills and retrain their healthy brain cells to control the affected body parts. The objective is to regain the lost functions of the muscles through mild but regular exercises followed by achieving the normal body movement using that function. In worst cases, even if the function cannot be restored due to severity of damage caused by stroke, physiotherapy helps the patient to regain the best of it using several equipments; sometimes with help of stick or other devices. Patients are recommended to start the physiotherapy at earliest even when they are in bed. The passive movements of limbs and the suggested correct posture to lie in prevent the possible stiffening of muscles and joints. This ensures quick regain of movement once functions of the muscles are restored.

Stroke survivors have reduces ability to manage the day to day life activities. Integral wellness and  self-management programs and counselling help them to adopt with the impact of stroke and to become actively engaged in daily life despite the long term effects of stroke on body.


Gastrointestinal Problems And Nutrition Therapy

Gastrointestinal problems / digestive disorders include a number of disorders such as constipation, irritable bowel syndrome, haemorrhoids, anal fissures, perianal abscesses, anal fistulas, perianal infections, diverticular diseases, colitis, colon polyps and cancer. Out of these disorders, constipation and irritable bowel syndrome are known as functional disorders and are generally attributed to an unhealthy lifestyle, among other things, leading to eating disorders and nutritional deficiencies. Thus, they can be reversed by way of nutrition therapy.

Functional Gastrointestinal Disorders – Causes

Functional gastrointestinal disorders such as constipation and irritable bowel syndrome are caused due to issues that affect the motility of the gastrointestinal tract causing it to lose motility. It is a result of low fiber diets, insufficient exercise, travelling, routine changes, excessive dairy products in diet, stress, resisting bowel movements (either from haemorrhoid pain, or otherwise), overuse of laxatives, taking antacid medications that contain calcium / aluminium, taking medications such as antidepressants and iron pills and pain killers, and pregnancy.

  1. Constipation: Constipation is a condition characterized by symptoms including difficulty to pass stools, bowel movement becomes irregular and infrequent / incomplete. It causes strain during bowel movements and often leads to fissures and haemorrhoids.

Nutrition Therapy: Since constipation is directly attributed to lack of fiber (roughage) in a diet, it is pertinent to have a diet that is rich in fiber. Foods include a number of fruits and vegetables, lentils, beans, whole grains and dark chocolates.

  1. Irritable Bowel Syndrome (IBS): Irritable bowel syndrome, also known as spastic colon, irritable colon, or nervous stomach, is where the colon muscles contract frequently. There are foods and medications that often trigger IBS. It is characterized by symptoms such as abdominal cramps, pains, gas problems, bloating, irregular bowel movements and an alternate phase of constipation and diarrhoea.

Nutrition Therapy: IBS is often triggered by certain foods and it can be reversed using nutrition therapy. To reverse IBS, a diet plan needs to be rich in fiber, which can be added through a number of fruits and vegetables, lentils, beans, whole grains, etc. Additionally, diet must not include caffeine, and monitored foods that trigger the IBS.

Most common gastrointestinal problems are a direct result of an unhealthy lifestyle and proper nutrition therapy can successfully reverse these conditions. We at Eva Physiocare have developed an integrated wellness programme designed specifically for patients with gastrointestinal disorders. The programme includes nutrition and diet therapy where the therapists make a diet chart well-suited to the patient and his or her lifestyle. In addition, we stress on physical therapy. Our physical therapist sets down an exercise regimen for the patient so as to let out the toxicity accumulated in the body and manage weight, both of which contribute to gastrointestinal disorders.

Diabetes Is A Reversible Disorder

Diabetes Is A Reversible Disorder


Diabetes, also known as Diabetes mellitus, is a medical condition where blood sugar (glucose) levels are abnormally high. Glucose is added to the body by virtue of the food we eat. The hormone ‘insulin’ is responsible for breaking down the glucose so that it can enter the body cells and energise the body. It results in symptoms such as fatigue; increased hunger, thirst and need for urination; infections; blurred visions; unnatural weight gain / loss; and dark patches on the body, to name a few; whilst leading to other associated risks.

There are two types of diabetes – type 1 and type 2. Type 1 diabetes is when the body fails to produce insulin. Type 2 diabetes is when the body doesn’t produce enough insulin and the little that it does produce, it fails to use. Type 2 diabetes is more common and is commonly thought to be irreversible. However, recent studies have proven that diabetes, even Type 2 is reversible.

Reversing Diabetes

Professor Roy Taylor of Newcastle University, UK has presented his findings (the Twin Cycle Hypothesis) that type 2 diabetes is found to be a common occurrence in people who consume excess calories leading to fatty liver, as a result of which it fails to respond to insulin hormone whilst producing excessive glucose. Additionally, the excessive fat in the liver passes on to the pancreas forcing the failure of the insulin production cells. According to the research that was presented, if one manages to lose less than 1 gram of fat from the pancreas, by means of diet, then it will start functioning properly once again, thereby, in essence making type 2 diabetes reversible. It was further added that diabetes remains reversible for almost 10 years after its onset.

Thus, diabetes reversal essentially requires a change in lifestyle. Fat accumulation in the liver and fat is a direct result of the unhealthy lifestyle that has become the norm of the fast paced society. Reversing diabetes requires two things – a diet plan and an exercise / work out regime.

  1. Diet Plan – The diet plans to reverse diabetes should be carefully planned out, thus, it is advisable to consult a diet and nutrition therapist. A typical diet plan to help reverse diabetes includes food that have low calories with an overall low calorie intake, equal amount of carbohydrate intake at each meal, healthy fats (i.e., saturated fats and trans fats are to be avoided, a variety of fresh or frozen fruits and vegetables (including leafy greens), whole grains and food made with whole grains, and lean protein (fish, poultry, low-fat dairy, soy, and beans). Additionally, one must let go of alcohol while sweets must be limited.
  2. Exercise Regime – The exercise regime will vary from person to person and will be set out by the physical therapist. It is important to be active every day and this typically includes walking, jogging / running, and exercising. Certain precautions are to be taken such as carrying snacks to avoid sudden falls in blood sugar.

We at Eva Physiocare have developed an integrated wellness programme to help our patients reverse diabetes through diet and nutrition therapy alongside physical therapy. With our programme patients can successfully reverse diabetes and let go of additional health risks that come with it, as well as curing themselves of disorders the underlying cause of which is diabetes.

Food and Nutrition Play a Major Role in Rheumatoid arthritis

Food And Nutrition Play A Major Role In Managing Rheumatoid Arthritis


Rheumatoid arthritis is a chronic medical condition where the joints of a person are affected, particularly in the hands and the feet, and other body parts including skin, eyes, heart, lungs, blood vessels, etc. It is of huge concern in India as there are over a million instances of rheumatoid arthritis in the present scenario.


As mentioned earlier, rheumatoid arthritis is an autoimmune disorder. It occurs when the immune system of the body starts to attack its own self, particularly in the synovium lining of the membranes that surround the joints. The inflammation of the synovium stretch, weaken and destroy the tendons, ligaments, cartilages and the bone that it encompasses.

The factors that generally are seen to contribute to rheumatoid arthritis are the gender (men are more prone to it), ageing persons (mostly after 40 years of age), obesity in ageing persons, family history of the disorder, lifestyle problems such as smoking, and exposures to harmful elements in the environment. In short, the rheumatoid arthritis circles back to the effects of built up nutritional deficiencies due to a generally unhealthy lifestyle.

Symptoms & Diagnosis

Symptoms of rheumatoid arthritis include – tender, inflamed and warm joints; stiffness in joints particularly in morning and after any kind of prolonged periods of inactivity; loss of function in joints; unnatural weight loss; fatigue and inability to work or concentrate; and fever. Initial symptoms affect the smaller joints in the hands and feet. As the condition progresses, the symptoms spread to other parts of the body.

In case rheumatoid arthritis remains unattended, it can cause deformity in joints. It also increases risk of developing osteoporosis, rheumatoid modules, dry eyes and mouth, infections, abnormal body compositions, carpal tunnel syndrome, heart disease, lung disease and lymphoma.

Rheumatoid arthritis is diagnosed through a physical exam where the joints, reflexes and the muscle strength are studied. In addition to this, blood tests (for ESR, CRP, anti-CCP, etc.) and imaging tests (X-ray, MRI, and ultrasounds) may also be required.


Rheumatoid arthritis is not completely reversible. It can only be managed through medications, alternative treatments and in worst case scenarios, surgeries.

Physical therapy is the best way to manage pain and restore flexibility and mobility in joints for rheumatoid arthritis patients in a therapeutic and holistic manner. The physiotherapist works on the joint flexibility, mobility, strengthening of muscles, etc., in order to ensure that the patient can lead a normal lifestyle.

What is important in addition to physical therapy is food and nutrition therapy since the immune system of the body needs restoration. The dietitian and nutritionist typically recommend an anti-inflammatory diet for a rheumatoid arthritis patient:

  • Foods rich in omega-3 fatty acids such as fatty fishes (salmon, tuna, herring, and mackerel), chia seeds, flax seeds, and walnuts find a place in the diet.
  • In addition to this, antioxidants are necessary, i.e., food rich in vitamins A, C, E and selenium. Such antioxidant rich foods include berries (blueberries, cranberries, strawberries and goji berries), dark chocolate, spinach, kidney beans, pecans, artichokes, and so on.
  • Fiber forms another essential part of the diet as they help reduce C – reactive protein levels. Foods rich in fiber include whole grains and food made from whole grains, fresh fruits and vegetables.
  • Another important part is the addition of flavonoids to the diet through soy products (tofu, miso, etc.), berries, green tea, broccoli and grapes.
  • Foods to be completely avoided include processed carbohydrates, saturated fats and trans fats.

We at Eva Physiocare have developed a comprehensive wellness programme for rheumatoid arthritis patients that include physical therapy, exercise therapy and diet-nutrition therapy in order to manage it.

Detox Diet & Fatty Liver

Detox Diet & Fatty Liver



Fatty liver, also known as hepatic steatosis, is a reversible medical condition where too much triglyceride fat is built up in the liver. The liver has vital bodily functions where it processes and filters anything a human body intakes and the excessive fat interferes with these processes. The fat in the liver is medically considered as ‘too much’ when the fat comprises of 5 to 10 percent of the liver’s weight. Fatty liver is at a rising rate in India due to changing lifestyles. About 30-40% of Indians are reported to have early stages of fatty liver, and this is an alarming statistic.


The primary causes of fatty liver are mainly attributed to changing lifestyles that lead to obesity, rapid weight loss, insulin resistance, type 2 diabetes, nutrition deficiency, metabolic syndrome, hypertension, dyslipidaemia, high cholesterol levels, high levels of triglyceride fat in the blood, polycystic ovary syndrome, sleep apnoea, underactive thyroid (hypothyroidism), and underactive pituitary gland (hypopituitarism). Some factors that aid these causes are age (above 50), genetic inheritance, pregnancy, and side effect of certain medications, including aspirin, steroids, tamoxifen (Nolvadex), and tetracycline (Panmycin), and lifestyle factors such as smoking and consumption of alcohol.

Stages, Symptoms & Diagnosis

There are four stages of fatty liver –

  1. Simple fatty liver (steatosis) / alcoholic fatty liver – This is potentially harmless and generally show no symptoms, however, one may have fatigue or vague abdominal discomfort.
  2. Non-alcoholic steatohepatitis (NASH) / Alcoholic steatohepatitis – A very minimal portion of the population with simple fatty liver move to this stage. It is an aggravated stage where the inflammation of the liver is a notable symptom along with dull or aching pain in the top right of the abdomen. Other symptoms include a poor appetite, weight loss, physical weakness, fatigue and confusion.
  3. Fibrosis (scarring of the liver) – In this stage there is a persistent inflammation in the liver and fibrous scar tissues show around the blood and liver cells by replacing some of the healthy tissues.
  4. Cirrhosis (chronic liver disease) – This is the final stage that leads to liver failure and requires a transplantation. It usually affects those above 50-60 years of age and is characterized by the liver shrinking and becoming lumpy. Symptoms include an enlarging, fluid-filled abdomen, jaundice of the skin and yellowing of the eyes, confusion, and a tendency to bleed more easily.

Diagnosis is done through blood tests and imaging tests such as CT scan, MRI, transient elastography, magnetic resonance elastography, and liver tissue examination, and also through physical exam.

Treatment: Detox Diet

As mentioned earlier, fatty liver, at its early stages (except the third and fourth stages) is reversible by way of simple changes in lifestyle. If the fatty liver is due to alcohol, the main change in lifestyle involves avoiding alcohol completely for 6 weeks. Apart from this, fatty liver can easily be reversed through detoxification that includes a detox diet and exercise regimen. The detox diet typically includes foods that are cholesterol free and enable the lowering of triglyceride levels in the blood. For instance, mono- and poly-unsaturated fats should be substituted for saturated and trans fats by using olive oil instead of butter and eating fish such as salmon instead of red meat. The detox diet should also be designed in a manner that fights or controls or prevents obesity, type 2 diabetes, insulin resistance and metabolic syndrome. In addition, certain drugs, smoking, etc., are to be avoided. Alcohol is also to be avoided even if the fatty liver is not attributed to it. There should be a carefully planned exercise regimen for 30 mins each day so as to control weight and rejuvenate the body.

We at Eva Physiocare have developed an integrated wellness programme containing diet therapy, nutrition therapy and exercise therapy for fatty liver patients, enabling them to completely reverse the condition and get back to the normal life within weeks.

Hypothyroidism and Nutrition

Hypothyroidism and Nutrition Therapy


Hypothyroidism is a medical condition where the thyroid glands do not produce enough thyroid hormones. The thyroid gland, a small butterfly-shaped gland located in the base of the neck is responsible for producing hormones that regulate metabolism and other bodily functions in heart, brain, muscles and skin. Hormonal changes in the body are natural, but those induced by hypothyroidism are detrimental to the human body as bodily functions are slowed down. About 11% of the Indian population is reported to have been affected by hypothyroidism. Owing to the changing lifestyle hypothyroidism is a fast growing issue.

Causes and Types

Hypothyroidism is generally attributed to unhealthy lifestyles of the modern human being that leads to a nutrient deficient diet, particularly iodine. Other causes include – radiation therapy in neck; radioactive iodine treatments; use of drugs such as amiodarone (Cordarone, Pacerone), lithium, interferon alpha, and interleukin-2; thyroid surgery; deficiencies or problems at birth, during pregnancy; pituitary gland damage or disorder; and hypothalamus disorder.

There are certain other factors that puts one at a risk of hypothyroidism, such as race (particularly white or Asian); gender (women are mostly affected); ageing; premature greying of hair; autoimmune disorders such as type 1 diabetes, multiple sclerosis, rheumatoid arthritis, celiac disease, Addison’s disease, pernicious anaemia, or vitiligo; bipolar disorder; down syndrome; and turner syndrome.

Hypothyroidism can be of three types – primary, where the gland is affected directly; secondary, where the gland is affected due to other disorders such as pituitary gland problem or hypothalamus problem; and tertiary, where sometimes hypothalamus problems result in hypothyroidism.


Hypothyroidism can affect different age groups and symptoms in each of these groups vary a little.

  • Women, Teens – Basic symptoms in women and teens include changes in the menstrual cycle; delayed puberty (in teens); muscle cramps; constipation; depression; dry hair and skin; hair loss; fatigue; increased sensitivity to cold; slowed heart rate; swelling of the thyroid gland; unexplained weight gain; high cholesterol, difficulty in concentrating; pain and swelling of joints; sleeping problems; and carpal tunnel syndrome.
  • Infants, Children – The symptoms in infants often include no symptoms at all but sometimes may show cold limbs; constipation; extreme sleepiness; hoarse cry; little or no growth; low muscle tone; persistent jaundice; poor feeding habits; puffy face; stomach bloating; and swollen tongue. Children may be affected by delayed mental development and slow reaction time.


Hypothyroidism is to be diagnosed through a comprehensive physical test to check for thyroid inflammation, imaging scan such as thyroid scans and thyroid ultrasounds to check for nodules, and blood tests to check for TSH levels like T4, and total or free T3.

Treatment: Nutrition Therapy

While hypothyroidism is generally treated through supplements and medications, nutrition therapy plays a big part in its treatment since hypothyroidism is caused by nutrient deficiencies in most of the cases. Proper nutrition is responsible for the maintenance of the thyroid gland. Nutrients responsible for this include iodine, selenium, zinc, iron, copper, Vitamins A, E, D and B12, and DHEA and Pregnenolo-sulphate. All of these are to be effectively complemented through a proper diet. Additionally, a common problem in hypothyroidism is an unexpected weight gain and difficulty in losing weight. Nutrition therapy along with an exercise therapy helps in losing and controlling weight. Additionally, physiotherapy and physical therapy help ease symptoms of pain in joints and other body parts. We at Eva Physiocare have an integrated wellness programme comprising of nutrition therapy, exercise therapy and physiotherapy to manage hypothyroidism in patients holistically and therapeutically.

Treating Diabetic Neuropathy with Physiotherapy and Nutrition Therapy

Treating Diabetic Neuropathy with Physiotherapy and Nutrition Therapy


Diabetes, a metabolism disorder, is mostly attributed to unhealthy eating habits and a generally unhealthy lifestyle. Various complications can arise in the human body due to its overbearing and elongated presence. Diabetic neuropathy is one such complication where diabetes for a long period results in nerve damage, usually affecting the patient’s leg and feet. Patients with type 1 or type 2 diabetes often run the risk of developing diabetic neuropathy.


There may be several causes that lead to diabetic neuropathy. However, all of those causes circle back to diabetes being the core issue. As a direct result of diabetes, high levels of blood sugar in the blood for long periods injure nerves in every portion of the body, and kidneys damaged by diabetes send toxins into the blood that in turn cause nerve damage. Additionally, usage of Metformin drugs to manage diabetes can lead to a Vitamin B12 deficiency and this in turn can cause nerve damage. Apart from this, a diabetic patient may develop diabetic neuropathy if his blood vessels are damaged by high levels of cholesterol, mechanical injuries (such as carpal tunnel syndrome), and unhealthy lifestyle factors including overweight, alcohol consumption and smoking.

Symptoms and Types

The common symptoms for diabetic neuropathy include sensitivity to or loss of feeling of touch, trouble with coordination when walking, numbness or pain in the extremities, muscle weakness, nausea and indigestion, diarrhoea or constipation, unsteadiness upon standing, intemperate sweating, vaginal dryness in women and erectile dysfunction in men, to name a few. These symptoms may, however, vary depending on the type of diabetic neuropathy.

Diabetic neuropathy is of four kinds – peripheral, autonomic, proximal, and focal.

  • Peripheral neuropathy is the most common of all that affects the legs, hands and arms, necessarily in that order.
  • Autonomic neuropathy occurs when diabetes affects the autonomic nervous system that controls the heart, bladder, stomach, intestines, sex organs and eyes.
  • Proximal / radiculoplexus / femoral neuropathy, also known as diabetic amyotrophy, affects the nerves in the thighs, hips, buttocks or legs, commonly observed in type 2 diabetes and older patients.
  • Focal neuropathy / mononeuropathy is when a specific nerve in the face or torso or leg is damaged, usually in older patients.

Diagnosis and Treatment: Physiotherapy and Nutrition Therapy

Diabetic neuropathy can be effectively managed through the holistic and therapeutic non-intrusive alternative treatment of physiotherapy. The physiotherapist uses methods such as gross light touch and pinprick sensation to conduct a comprehensive physical test to check the core and muscles strength, sensitivity, reflexes, etc., in order to diagnose and assess the diabetic neuropathy condition. Other tests include filament test, quantitative sensory testing, nerve conduction studies, electromyography (EMG) and autonomic testing.

Techniques such as transcutaneous nerve stimulation (TENS), static magnetic field therapy, low-intensive laser therapy, and monochromatic infrared light therapy, have been shown to have positive effects in the management of diabetic neuropathy, by slowing down the condition, relieving the patient of pain, manage further or associated complications and restore the functionality of the affected regions. There is also an exercise regimen particularly for patients with peripheral and proximal neuropathy, such as aerobic exercise, flexibility exercise, strength training exercise and balance exercise, and generally to manage weight. In addition, nutrition therapy becomes pertinent in order to manage diabetic neuropathy because diabetic conditions call for a massive alteration in food intake. There might be certain nutritional deficiencies that are best managed through food intake. In addition, it also aids in weight loss and maintaining a generally healthy lifestyle.

We at Eva Physiocare have developed an integrated wellness programme comprising of physiotherapy and nutrition therapy in order to effectively manage diabetic neuropathy in our patients.