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Hans India
08-07-2025
- Health
- Hans India
PMR Day 2025 – Telangana Must Prioritise Early Neuro-Rehabilitation Within the Golden Window
As Telangana observes PMR Day, healthcare experts across the state are urging a fundamental shift in how recovery is managed after critical neurological events. From strokes to spinal cord injuries to traumatic brain injuries, the future of care must go beyond survival and focus on restoring quality of life—quickly, clinically, and completely. While stroke remains the second leading cause of death in India, it is now increasingly affecting adults in their 30s and 40s across Telangana. Districts like Hyderabad, Warangal, and Karimnagar are seeing a rise in cases triggered by hypertension, sedentary lifestyles, and undiagnosed chronic conditions. Despite improvements in emergency care and awareness, most patients are discharged without a recovery plan, especially in smaller towns. 'In most cases across Telangana, stroke survivors are sent home with general exercise advice and little direction,' says Dr. Aastik Bhatt, Physiatrist and PMR Consultant at HCAH Somajiguda. 'But the reality is, neuro-rehabilitation must begin as early as the first 72 hours after stabilisation. Physical Medicine and Rehabilitation (PMR) is a specialised medical discipline that drives the fastest and most functional recovery—not just physically, but cognitively, emotionally, and socially. At HCAH, our focus is not just on moving limbs—it's about helping people return to meaningful, independent living.' At HCAH's neuro-rehabilitation centres in Hyderabad, all recovery services are delivered under one roof. PMR doctors work closely with physiotherapists, occupational therapists, psychologists, speech therapists, and rehab nurses to ensure that every patient receives a seamless, personalised, and measurable recovery plan. 'We're seeing more young patients—some in their late twenties—who could recover fully with early, structured rehab,' adds Dr. Shiva, Consultant in Physical Medicine and Rehabilitation at HCAH Gachibowli. 'But recovery is not automatic. The brain and body must be actively guided through a process of neuro-restoration, especially within the golden window. PMR ensures that recovery is not left to trial and error—but designed and delivered with precision.' Despite growing need, access to high-quality neuro-rehabilitation remains limited outside major metro zones. To bridge this, HCAH (HealthCare atHOME) has built India's most advanced post-acute recovery network. With centres across Delhi NCR, Mumbai, Bengaluru, Hyderabad, and Kolkata, HCAH is among the only healthcare providers in the country offering end-to-end neuro-rehabilitation with structured protocols and robotic therapies designed for fastest recovery. 'Neuro-rehabilitation is not a luxury—it's a clinical necessity,' says Dr. Gaurav Thukral, Co-founder and Chief Operating Officer, HCAH. 'Patients who begin inpatient rehab within the golden window—especially the first 90 days—have far better outcomes. At HCAH, over 92 percent of such patients regain functional independence within three months. We've invested in high-end robotics, gamified therapy tools, cognitive labs, and milestone-based tracking to ensure that recovery is accelerated, personalised, and complete. Our goal isn't just to extend life—it's to restore the life people had before injury or stroke.' To honour PMR Day and strengthen its commitment to community health, HCAH's Hyderabad centre also hosted a blood donation camp, with participation from patient families, healthcare professionals, and local volunteers. The initiative was designed to promote the ethos of recovery and giving back. As the burden of stroke and neurotrauma grows across Telangana, public health leaders are being urged to act swiftly. Recommendations include: Establishing PMR-led neuro-rehabilitation centres in Tier 2 and Tier 3 districts Embedding early rehab pathways into non-communicable disease (NCD) programs Training GPs and frontline health workers to refer patients within the golden window On PMR Day, Telangana's medical community shares a unified message:The first 72 hours and the following 90 days are not just recovery time—they are decision points for a person's future. What we do in that window defines whether a life is stalled or rebuilt.
Time of India
07-07-2025
- Health
- Time of India
Experts call for integration of Physical Medicine and Rehabilitation into standard stroke care
New Delhi: On the occasion of National Physical Medicine and Rehabilitation (PMR) Day, neurologists and rehabilitation experts in the national capital called for urgent integration of Physical Medicine and Rehabilitation into India's stroke care protocols. With stroke now the second leading cause of death and the third leading cause of disability in the country, doctors stressed that rehabilitation within the first 90 days is essential - not just for survival but for full functional recovery. "Stroke is a race against time, not just during the attack, but long after hospital discharge," said Dr Man Mohan Mehndiratta, Principal-Director and Senior Consultant, Neurology, BLK-Max Centre for Neurosciences. "While emergency response has improved through ACT FAST awareness, post-stroke recovery remains poorly structured. Without targeted rehabilitation, patients may survive but lose their independence, speech, or memory," Dr Mehndiratta said. Stroke is increasingly affecting younger people in urban centres like Delhi, fueled by rising rates of hypertension, chronic stress and sedentary lifestyles. According to the India Hypertension Control Initiative (ICMR-WHO, 2023), one in four Indian adults is hypertensive, yet only 12 per cent have it under control. Experts are now calling for broader adoption of Physical Medicine and Rehabilitation (PMR), a multidisciplinary medical speciality that supports recovery after stroke, spinal cord injuries and head trauma. PMR combines robotic-assisted therapy, speech and occupational therapy, cognitive retraining and psychological support, all under a structured, evidence-based roadmap led by rehabilitation physicians. "Rehabilitation is not just exercise. It's a guided, clinical process," said Dr Amit Tomar, Lead Consultant - PMR, HCAH (HealthCare atHOME) said. "The brain's plasticity is highest in the first three months post-stroke. "Every day of delay narrows the window for recovery," he said. In a recent HCAH survey, only 40 per cent of respondents could identify stroke symptoms before hospitalisation. Yet among patients who received structured inpatient rehabilitation , 92 per cent regained core functional abilities within three months. In contrast, 70 per cent of those on unstructured home care took over four months to regain basic functions like speech and mobility. "These numbers reinforce the importance of timely, specialist-led rehab," said Dr Gaurav Thukral, Co-founder and Chief Operating Officer, HCAH. As stroke cases rise, experts called on national and state health authorities to take bold action to embed PMR into every stroke treatment protocol, expand insurance coverage for inpatient rehab, train more PMR specialists and rehab teams and establish dedicated neuro-rehabilitation centres in both public and private healthcare systems. "Survival should not be the end goal. Recovery with dignity must become the new standard," said Dr Mehndiratta. PTI
Hans India
22-05-2025
- Health
- Hans India
Structured rehabilitation is crucial in stroke care: Experts
The golden 90-day window after a stroke is when the brain's neuroplasticity is at its highest. Intervening during this time can significantly influence long-term recovery. Delaying rehabilitation risks losing that vital opportunity. When a 69-year-old woman slipped into a minimally conscious state after a major stroke last year, her family began preparing for the worst. Doctors across cities told her son, who had flown in from abroad, that her chances of recovery were slim to none. She was unresponsive, unable to move and showed faint signs of awareness. Today, she can sit up, track conversations and respond with gestures. It is not a miracle. It is the outcome of timely neuro-rehabilitation, scientific precision and relentless persistence. As India marks the World Stroke Awareness Month, the incident underscores a critical yet under-addressed truth in the country's stroke care. While emergency treatment can save lives, rehabilitation is what gives those lives meaning. After multiple hospitals expressed helplessness, the patient was admitted to Health Care at Home (HCAH), a chain of recovery and rehabilitation hospitals. There, she underwent a medically supervised, multidisciplinary neuro-rehabilitation programme led by specialists in Physical Medicine and Rehabilitation (PMR). Her treatment plan included Multimodal Sensory Stimulation, Hyperbaric Oxygen Therapy (HBOT) and advanced robotic and virtual therapies designed to activate dormant neural pathways and support functional recovery, said Dr Gaurav Thukral, co-founder and chief operating officer, HCAH. 'We see too many lives plateauing after emergency care simply because structured rehabilitation is not started in time,' said Dr Thukral. 'At HCAH, the PMR-led model ensures that every therapy is medically prescribed and clinically timed. Whether it is exoskeleton-based gait training, end-effector robotics, virtual reality therapy, or HBOT, these interventions require specialist oversight and infrastructure not available in standard physiotherapy settings,' he added. Dr Varun Rehani of BLK-Max Super Speciality Hospital, Delhi, said that in stroke care, urgency must also extend beyond the emergency room or ICU. The golden 90-day window after a stroke is when the brain's neuroplasticity is at its highest. Intervening during this time can significantly influence long-term recovery, said Dr Rehani, who is a neurology consultant at hospital's Centre for Neurosciences, Advanced Aneurysm Treatment, Epilepsy, Parkinson's Disease. 'Delaying rehabilitation risks losing that vital opportunity. Early, intensive, and scientifically guided care that includes neurostimulation and evidence-based therapies can dramatically improve outcomes,' he explained. The woman was diagnosed with a Disorder of Consciousness (DOC), a condition often misunderstood as irreversible. Her progress aligns with emerging global and Indian evidence highlighting the role of early neuroplastic stimulation in recovery, Dr Thukral said. Meanwhile, Dr Arunav Sharma, associate consultant, neurosurgery, Sir Ganga Ram Hospital, added, 'Patients with impaired consciousness are frequently written off. But the brain may still retain the ability to respond if the right areas are stimulated. Through Multimodal Sensory Stimulation, we engage various senses, including touch, movement, sound, smell, taste and vision to activate dormant neural networks. This approach can open up new possibilities in neuro-recovery.' Week by week, signs of improvement emerged. The patient blinked on command. She began to respond to voices with subtle movements. Eventually, she reached out for her son's hand, a gesture that once felt impossible. With more than 1.8 million stroke cases annually, India is witnessing a sharp rise in post-stroke disability. Yet, structured rehabilitation, particularly when led by PMR experts, remains underutilised in most parts of the country, Dr Thukral said.
Hans India
09-05-2025
- Health
- Hans India
Botox Therapy Helps Stroke Survivors in Hyderabad Regain Mobility and Independence
Stroke continues to be one of the major causes of long-term disability in India. A significant proportion of survivors go on to develop spasticity — a condition marked by painful muscle stiffness, involuntary contractions, and restricted movement. For many, this impairs day-to-day function and slows recovery. In Hyderabad, new hope is emerging through minimally invasive interventions such as Botox injections, when combined with specialist-led rehabilitation. These offer stroke survivors a renewed path to movement and independence. Botulinum toxin injections, popularly known as Botox, are increasingly being used to manage spasticity in stroke patients. In the medical context, Botox is injected directly into affected muscles to block overactive nerve signals, allowing the muscle to relax. This muscle relaxation is temporary, generally lasting around three months, but it provides a crucial window during which rehabilitation efforts can become far more effective. The temporary reduction in muscle tone allows patients to participate more actively in physiotherapy and occupational therapy, improving their chances of regaining lost function. In Hyderabad, HCAH stands out as the only centre offering a full-fledged Physical Medicine and Rehabilitation (PMR) specialist-led program for post-stroke spasticity. With structured Botox interventions as part of a multidisciplinary rehabilitation framework, HCAH is enabling better outcomes for patients across varying levels of disability. The expertise of PMR specialists (doctors trained specifically in restoring function and managing neurological disabilities) is central to this journey — from identifying which muscle groups need intervention, determining dosage, guiding injection technique, to integrating the procedure into a comprehensive rehabilitation plan. The Botox procedure itself is precise and specialist-driven. In clinical practice, it is often ultrasound-guided (USG) or nerve stimulator-guided, allowing accurate targeting of deep or small muscle groups. This enhances safety and efficacy, while minimizing discomfort and reducing the risk of missing the desired muscle. Botox injections are considered minimally invasive, especially when compared to more complex spasticity interventions such as intrathecal baclofen pumps. While the latter is suitable for severe generalised spasticity, Botox remains a preferred early-line option for focal spasticity — especially in the hands, arms, or legs. The relatively simple administration, low systemic side effects, and compatibility with ongoing therapy make Botox a valuable part of any modern spasticity management program. Crucially, Botox is not a cure — it is an enabler. By relieving abnormal muscle tone, it provides a critical window for therapeutic engagement. This includes physiotherapy, task-based occupational exercises, and use of assistive technologies. Recovery is not automatic — it is earned through targeted movement and repetition. Botox simply allows that work to happen more effectively. Early intervention with Botox within three to six months post-stroke can help prevent contractures and irreversible disability. At HCAH, this specialist-led approach has improved functional outcomes in patients who otherwise had plateaued in recovery. By combining targeted intervention with a broader rehabilitation model, patients and their caregivers are experiencing faster, more meaningful progress. The future of post-stroke spasticity care lies in precision, timing, and specialist integration. Botox, when used judiciously under PMR leadership, offers not just relaxation of muscle — but restoration of dignity, independence, and movement. (The writer is a MBBS, DNB (PM&R), leading Physical Medicine and Rehabilitation Specialist, HCAH Hyderabad)
