Miran - Neurophysiotherapy and Pilates

During my first few years as a physiotherapist, I worked in private setups that relied heavily on electrotherapy. Treatment mostly involved machines and maybe three or four exercises for the knee or shoulder, depending on what the patient came in for. I really thought physiotherapy was all about that. But what puzzled me was seeing the same patients coming in every day, with maybe a 20-30% reduction in pain—at best. We kept doing the same treatment every day, with no real change. Even more puzzling was how much patients loved passive therapy, even though the relief it gave was only temporary. Eventually, when I did my master’s and started working more closely with patients, I realized how crucial patient education was. Introducing them to exercise therapy and a more holistic approach made all the difference. When patients started feeling stronger and saw how long-term this kind of therapy could be, they began to trust us. So when we built MIRAN , we made a conscious decision— we w...

When I used to accompany my parents to doctor’s appointments, we often had to wait for hours and sometimes up to three. It was frustrating and disruptive, requiring an entire day just for one visit. When I became a physiotherapist, I was determined to create a better experience for my patients. My practice is designed to be patient-centric, ensuring timely appointments, clear communication, and a structured, goal-oriented approach to therapy. I believe healthcare should be efficient, transparent, and focused on patient well-being. Key Principles: - Punctuality – No long wait times, appointments start on time. - Efficiency – Optimized scheduling to respect patients' time. - Clear Communication – Simple, understandable explanations. - Accessibility – Always available for patient queries. - Goal-Oriented Therapy – Set and review treatment goals regularly. - Family Involvement – Encourage family participation in recovery. - Feedback-Driven – Adjust treatments based on patient input...

  1️⃣ Create a Safe Environment Falls are the biggest risk with ataxia. Make your space safe: Remove loose rugs, wires & clutter. Install grab bars in bathrooms & hallways. Use sturdy, non-slip footwear (even at home). Keep rooms well-lit & furniture stable. Use a walker or cane if needed — safety first! 2️⃣ Prioritize Physiotherapy, Pilates & Speech Therapy Regular physiotherapy helps maintain strength & balance. Modified Pilates (under expert guidance) builds core stability & body awareness. If speech is affected, speech therapy improves communication & confidence. 3️⃣ Use Assistive Devices (Without Hesitation) Walkers, canes, braces — use what works for you . Use apps or tools if speech/writing is difficult. Assistive devices = independence tools , not a step back. 4️⃣ Take Mental Health Support Seriously Living with ataxia is emotionally challenging. It’s okay to feel overwhelmed. Talk to a counselor or join a support group. Caregivers — you need sup...

  There are countless blogs and vlogs guiding us on how to choose the right dress, lipstick, shoes, or even a university. Yet, when it comes to selecting a physiotherapist, we often assume that every professional is equally skilled. However, just as the world evolves, so does our understanding of the human body. Scientific research and evidence-based practices are constantly advancing, and a good physiotherapist should adapt accordingly. So, how do you choose the right physiotherapist? Here are some key factors to consider: ✅ Specialization Matters Not all physiotherapists treat every condition effectively. Choose a therapist who specializes in your specific issue—whether it's neurological rehabilitation, sports injuries, post-surgical recovery, women's health, or chronic pain management . A specialist will have advanced training, experience, and a deeper understanding of your condition. ✅ Thorough Assessment & Clear Communication A good physiotherapist should conduct a det...

Neuropilates combines Pilates principles with neurological rehabilitation, customizing exercises to address specific cognitive and physical challenges in patients.  For example, with Parkinson’s patients, the focus is on improving coordination, mobility, and awareness. The exercises are designed to enhance both motor skills and cognitive control, empowering patients to actively engage in their recovery. It’s not just about strengthening muscles but also about improving brain-body connection, leading to better overall function and quality of life. Neuropilates can improve memory and focus. Here's how: Mind-Body Connection : Neuropilates encourages patients to engage both the body and mind, promoting cognitive awareness during physical exercises. This dual focus can improve attention and concentration. Cognitive Stimulation : Exercises involving coordination, balance, and multi-step movements challenge the brain, enhancing cognitive functions like focus, problem-solving, and memory. ...

 Taking care of your feet is especially important if you have diabetes, as the condition can lead to complications such as nerve damage (neuropathy) and poor circulation, increasing the risk of foot infections or ulcers. Here are 5 essential ways to care for your feet and reduce the risk of serious issues: 1. Inspect Your Feet Daily Why: Diabetes can cause nerve damage (neuropathy), which may reduce your ability to feel pain or notice injuries, infections, or other foot problems. What to Do:     Check your feet every day for cuts, blisters, redness, or swelling.                                         Look between your toes and on the soles of your feet for any signs of injury or infection.     Use a mirror if you can’t reach all parts of your feet. If you notice anything unusual, contact your doctor mmediately to prevent complications. 2. Keep Your Feet Clea...

The duration of physiotherapy for individuals with Parkinson's disease can vary widely based on individual needs and disease progression. Generally, ongoing physiotherapy is recommended to maintain mobility, flexibility, and strength. Research suggests continuing therapy for at least six months after diagnosis, but long-term engagement is often beneficial. Patients may initially attend sessions multiple times a week, gradually transitioning to less frequent visits as they progress. The focus may shift to maintaining gains achieved in therapy and adapting exercises to changing abilities and functional needs.We have a patient who started with 4 sessions a week and finally in the 2nd year came down to twice a week post achieveing functional goals (cooking and moving about on her own with no risk of fall) and now continuing physiotherapy for fitness (Pilates at Miran) and agility training.  Regular reassessment by a physiotherapist is crucial to tailor the program as symptoms evolve. U...

As an intern, managing a spinal cord injury patient often required three physiotherapists for transfers and standing, which was uncomfortable and slowed progress. The lack of equipment delayed key milestones like unsupported sitting and weight-bearing, impeding the patient's recovery and their ability to experience and adapt to weight on their legs. When I began at Miran, I was committed to implementing body weight support (BWS) for weight-bearing exercises. The impact on patients was profound; the joy they experienced when they stood and felt their legs for the first time was truly unmatched. This breakthrough not only boosts their confidence but also plays a crucial role in their overall recovery. BWS systems significantly improve rehabilitation outcomes by providing a safer environment for patients to practice standing and walking. The support reduces the risk of falls, allowing patients to engage more fully in their exercises without the constant fear of losing balance. For the...

 Accepting the new normal after a brain stroke involves adapting to changes and focusing on rehabilitation and recovery. As a physiotherapist, my role is to guide patients through this transition with a compassionate, individualized approach. First, we assess the extent of physical impairments and functional limitations caused by the stroke. This helps us set realistic goals and develop a personalized therapy plan. Emphasis is placed on improving mobility, strength, and coordination through targeted exercises and activities. We also address any adaptive techniques or assistive devices needed to enhance daily living activities. We focus on adaptive devices like walker or stick as a safety measure more than a supportive device if possible. Encouraging patients to embrace their new routines, while celebrating progress and small victories, is crucial. Support from family and caregivers is integral, as they play a vital role in the recovery process. By focusing on gradual improvement an...

  Have you met anyone saying, I can do a lot of work in the house, I walk for 45 minutes everyday but walking on slippery surface is scary. Now what is this? We fail to admit that we are losing balance while walking on slippery grounds, down the stairs or uneven grounds. We find it normal with ageing. But is it normal? NO, it isn’t normal and lets shed light on why it isn’t.   As you age, a lot of degeneration and system changes happen that are normal. But loosing balance isn’t a normal change. We have three systems in the body that control balance: Vision (major one), somatosensory (your sensory and musculoskeletal system) and vestibular system (the system in between your ears). All of this goes through ageing but if one of the systems is affected more than the normal ageing process, it will affect in increasing the risk of fall. So what are the signs to know that I am at a risk of fall?? When there is fear of fall on a particular surface which was normal at first. Walki...

I  was at a family gathering, and I was approached by an elder who was about 60 years old and she told me looking at her trembling hand, do you think I have Parkinsons? Its not the first time I have been approached at a party, family function or even a funeral with symptoms and asking for an instant solution or that one exercise that can solve the problem. But this time it was far more shocking, as she thought her hand tremors was Parkinsons. Just to make it clear, Tremors are not equal to Parkinsons. Its best to get diagnosed with a neurologist and have a chart planned out instead of self diagnosis.  But after positive diagnosis, is it the end of the world? No, even if its a progressive movement disorder , we can slower the progress, plateau it and a lot of times reverse the symptoms. But does Parkinsons go away? A very common question asked to us, when we tell them we need minimum 3 months with them to get them functionally better. Parkinsons is like Diabetes or any other...

  Have you ever witnessed some one wearing handcuffs walk towards you? Have you noticed their distress ? Have you taken a moment to think how we simply take the ability to move for granted? Thats what i see as a Neuro Physiotherapist when a patient with Parkinsons walks towards me . I see invisible handcuffs around their hands and their feet , which makes it impossible for them to move . The weight of which pull them into a stooped or slouched posture . Their anxiety and depression experienced is almost tangible. How challenging simply turning in bed can be. How all of these factors simply paralyse the patient and bring their morale down to point they feel absolutely helpless. Although being a physiotherapist i do see a silver lining since we do have a key to those handcuffs " MOVEMENT"  simple rhythmic large movements and i almost see the handcuffs click open. Neuro-pilates acting as a catalyst, helping them not only to move better but also carry out their basic daily tasks ...

We have been trained to believe that if one is affected with a neurological disorder, it’s the complete end of the world and they have to resort to living with the disability that it brings along, as if it’s one of the many irreversible changes of life. I have met numerous patients with such conditions, all having different perspectives on their conditions which has a direct effect on the outcome of therapy.  ‘ Am I going to be normal, again?’  ‘Will I be how I was before I got this disease?’ ‘ Will I ever be able to play my favourite sport?’ ‘Am I always going to be dependent for my day to day activities?’ These are the most common questions asked by patients when they first learn about their condition. The answer to all these questions is a very straightforward yes. They will be independent, but with a mindset shift in what is considered normal. A new normal is established and it comes with different abilities. A patient with an Incomplete Spinal cord injury used to ...

I have been a neurophysiotherapist since more than 13 years, and I have seen a lot of changes and improvement in the way we see patients with neurological conditions and their life. After my bachelors, I started working in a reputed hospital, I saw patients with stroke, Parkinsons and other neurological conditions being treated the same way as patients with knee pain, back pain and ankle injuries. The focus was achieving the range of motion, getting them pain free or getting the tone normalised. At that moment I questioned myself , is our body made only for being pain free and moving freely? I didn’t get any answer at that time until I completed my masters. The treatment protocol wasn’t wrong, but according to me it wasn’t fulfilling or achieving the goal fully.  I went for my masters in 2012, and had a great exposure to research, clinical applications and patient centred care. It changed my perspective to physiotherapy and its application. When I came back in 2013, there was no Ne...