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Avabahuka chikitsa dr prashanth a s

Avabahuka chikitsa dr prashanth a s

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Avabahuka chikitsa dr prashanth a s

  1. 1. SHAMANA CHIKITSA IN AVABAHUKA DR.PRASHANTH.A.S Professor Department of Post Graduate Studies in Kayachikitsa Ayurveda Maha Vidyalaya Hubli, Karnataka – 580024 Telephone: 0836-2335575 Mob: +91-94481-35575 Mail: drprashanthas@gmail.com © COPYRIGHT RESERVED, Dr.Prashanth.A.S, Professor, Dept. of PG studies in KC, AMV, Hubli, KA
  2. 2. INTRODUCTION • Avabahuka - affects Amsa Sandhi. • Avabahuka - not mentioned in the Nanatmaja Vata Vyadhi. • Acharya Susruta, Vagbhata - Avabahuka a Vata Vyadhi. • Madhava Nidana - Amsa Shosha and Avabahuka. • Amsa Shosha - preliminary stage - Sleshaka Kapha Sosha in Amsa Sandhi. • Avabahuka - Shleshaka Kapha Sosha + Shoola during movement, restricted movement etc. • Madhukosha Teeka: – Amsa Shosha - Dhatu Kshaya i.e., Sudha Vata Janya – Avabahuka - Vata Kapha Janya.
  3. 3. MODERN VIEW • Aches and pains related to musculo-skeletal system are common and the incidence of such illness increases with age. • Avabahuka can be compared to the musculo skeletal disorders of the shoulder girdle and brachial plexus neuropathy. • In allied sciences the therapeutic aspect of management of these disorders still remain in infancy.
  4. 4. LITERARY REVIEW • Charaka – Bahusirshagata Vata • Sushruta – Avabahuka • Vagbhata – Avabahuka • Dalhana, Arunadatta, Hemadri – analyzed Avabahuka in detail. • Madhava Nidana, Yoga Ratnakara – Avabahuka. • Madhavakara is the first to differentiate it from bahushosha. • Bhavamishra, Sharangadhara etc. – Rasoushadhis in this context. • Vangasena – Chikitsa with different Yogas. • Gadanigraha, Brihat NighantuRatnakara, Nidana Sara etc. – Avabahuka with its management.
  5. 5. NIRUKTI AND PARIBHASHA • Avabahuka comprises of two words 'ava' and 'bahuka'. – Ava means ‘Viyoga’ or ‘Vikratou’ which means dysfunction or separation. – It can be taken as deterioration or dysfunction. – Bahuka - (at the end of a compound) - bahu - the arm. – Bahuka - Muscular gender. • Thus Avabahuka can be defined as, – Bahustambho Avabahuka – Bad arm, stiffness in the arm joint
  6. 6. AMSA SANDHI VIVECHANA • This is a major joint of upper limb. • This is one type of chala and Ulookhala sandhi. • This is formed by the combination of Pragandasthi, Akshakasthi and Amsaphalakasthi. • Pratanavati type of Snayu cover this sandhi. • Shleshaka Kapha present in this joint acts as lubricant and helps in protection and movement of the Sandhi.
  7. 7. AMSA SANDHI & MARMA • The Amsa Marma - head (Murdha), neck (Greeva) and the arm (Bahu). • Formed by the union of Amsa Peetha (glenoid) and the Skanda (acromio clavicular joint). • This is a Snayu Marma to a length of half finger's width (1 cm). • Amsa Marma consists of Mamsa, Sira, Snayu, Sandhi and Asthi. But it is a Snayu Marma. • It is one of Vaikalyakara Marma, any trauma to this will produce disability or deformity of the shoulder joint.
  8. 8. NIDANA • Bahya Hetu – causing injury to the Marma or the region surrounding that. • Abhyantara Hetu – indulging in Vata Prakopaka Nidana leading to vitiation of Vata in that region. – This may be again of Bahya Abhigataja (External cause) which manifest Vyadhi or disease first and the other is Dosha Prakopajanya (Samshraya) which in turn leads to Karmahani of Bahu.
  9. 9. SAMANYA SAMPRAPTI Nidana Mithya Ahara Vihara Old Age Provocation of Vyana Vata Sthanasamsraya in Amsa Pradesa Sleshaka Kapha Sosha Affliction of Sira, Snayu, Mamsa, Asthi, Kandara Bahu Cheshta Hara Avabahuka
  10. 10. MARMABHIGHATA SAMPRAPTI Abhyantara Marmabhighata Bahya Marmabhighata Amsa Marmabhighata Affliction of Mamsa, Sira, Snayu, Asthi, Kandara Provocation of Vata Bahu Chesta Hara Avabahuka
  11. 11. SAMPRAPTI GHATAKA Udbhavasthana Amapakwashaya Sancharasthana Rasayanis Adhisthana Amsa Pradesha Vyaktastana Bahu Pradesha, Amsasandhi Dosha Vata predominant : (Vyana and Prana) Anubandha Dosha : Kapha (Sleshaka), Pitta Dooshya Pradhanataha: Asthi, Majja, Rakta, Mamsa. Upadhatu Sira, Snayu, Kandara. Agni Jataragni and respective Dhatwagnis Ama Jatraagni mandyajanya Ama and respective Dhatwagni Mandyajanya Ama Srotas Asthivaha, Majjavaha srotas Srotodusti Prakara Sanga Roga marga Madhyama Roga Avastha Chirakari
  12. 12. DOSHA INVOLVEMENT  Vata Vyana: Chalagunataha Kshaya. Vyanavayu Ruksha Gunataha Kshaya. Prana: Karmataha Kshaya.  Kapha Sleshakha: Dravyataha Kshaya. Avalambaka: Supports the srotas of the kapha by virtue of its Ambukarma Dravyataha kshaya.  Pitta Pitha dushti because of Asraya- Asrayi bhava of Rakta, due to Sira, Snayu vishosha.
  13. 13. ROOPA • Bahu Praspandida Hara (impaired or loss of movement of the upper limb) • Amsa Bandhana Shosha (Muscle waisting) (Sushruta) • Shoola (Pain)
  14. 14. • Avabahuka: (A.H) • Viswachi: (A.H) • Manya Stambha: (C.S) • Ekanga Vata: (C.S) • Amsa Sosha: (S.S) SAPEKSHA NIDANA
  15. 15. • Ashtanga Hrudaya – Avabahuka Chikitsa: • Sushruta Samhita – Avabahuka Chikitsa: • Charaka Samhita – Bahusirsha Gata Vata: CHIKITSA SUTRA
  16. 16. SAMANYA CHIKITSA • Vatavyadhi – Snehana, Swedana, Mrudusamshodhana, Vasti, Sirovasti, Nasya, etc. • Charaka – Sthana, Dushya - Specific therapies. • Vagbhata - Jatroordhva Vatavikaras – Nasyakarma. • Three major approaches are made in the management of Vatavyadhi. – Treatment of Kevala Vata – Treatment of Samsrusta Vata – Treatment of Avruta Vata
  17. 17. VISHESHA CHIKITSA • Ashtanga Hrudaya - Nasya and Uttarabhaktika Snehapana. • Astanga Sangraha - Navana Nasya and Sneha Pana. • Sushruta - Vatavyadhi Chikitsa except Siravyadha. • Chikitsa Sara Sangraha - Nasya, Uttara bhaktika Snehapana and Sweda. • Vagbhata - Brumhana Nasya. • Chakradatta - Nasapana.
  18. 18. LINE OF TREATMENT Samanya • Nidana parivarjana • Abhyanga • Swedana • Uttarabhaktika Snehapana • Nasyakarma • Nasaapaana • Shamanoushadhi Vishesha • Marmabhighata Chikitsa ‘Samprapti Vighatanameva Chikitsa’
  19. 19. SHAMANA CHIKITSA SIDDHANTA • Vata Hara Oushadha Sevana • Uttara Bhaktika Sneha Sevana • Marmabhighata Chikitsa • Brumhana Nasya • Lepa • Abhyanga • Sweda • Seka
  20. 20. Mahatwa of Uttara Bhaktika Snehapana • Acts on Vyana and Prana Vata Shamana • Acts as Brumhana • Acts on Urdhwa Jatru Gata Roga • Does Snehana effect on Sandhi • Acts on Sleshaka Kapha • Acts as Snehana on Shoshita Sira, Snayu, Mamsa, Asthi, Kandara.
  21. 21. MARMABHIGHATA CHIKITSA • When there is Marmabhighata of Amsa Marma leading to Avabahuka prime importance is given for Marmabhighata Chikitsa. • Lepa – Marma Gulika mixed with Murivenna. • Lepa – Karuttha Gulika mixed with Murivenna. • Gandha Taila 10-20 drops internally at bed time with Prasarinyadi Ksheera Kashaya or with Ushna Ksheera Anupana.
  22. 22. BRUMHANA NASYA • Same like Uttara Bhaktika Sneha Pana • Acts as Brumhana which is Vatahara in nature • Acts on Urdhwa Jatru Gata Roga • Does Snehana effect on Sandhi • Acts as Snehana on Shoshita Sira, Snayu, Mamsa, Asthi, Kandara.
  23. 23. LEPA • Vatahara Lepa which are having Brumhana, Ushna can be used. • Vruddhadarvadi Lepa – Vatahara, Brumhana, Ushna. • Dasamoola Ksheera Lepa – Brumhana, Vatahara.
  24. 24. ABHYANGA • Abhyanga with Various Taila mentioned for Avabahuka like • Mahamasha Taila • Parinatakeriksheeradi Taila • Karpasasthyadi Taila • Prasarinyadi Taila • does the action of Vatahara, Brumhana, brings Snehana effect to the Sandhi
  25. 25. SWEDANA • Various kind of Swedana like • Jambeera Patrapinda Sweda • Shastika Shali Pinda Sweda • Kukudanda Sweda • Dasamoola, Bala Kashaya Nadi Sweda • acts as Vatahara, Rujahara, Brumhana • Vasodilator, Improves the circulation.
  26. 26. SEKA • Seka with various Vatahara Kashaya and Taila are used in Avabahuka. • Acts as like Abhyanga.
  27. 27. Specific Shamanoushadhi in Avabahuka
  28. 28. • Dasamoola Bala Masha Kwatha – Chakradatta • Ashtavarga Kwatha – Sahasrayogam • Maharasnadi Kwatha – Sahasrayogam • Prasarinyadi Kwatha – Sahasrayogam • Ekanga Veera Ras – Rasarajasundara • Vata Gajankusha Ras – Bhai.Rat • Prasarinyadi Taila – Ash.Hru • Ketakyaadi Taila – Sahasrayogam • Parinatakeri Ksheeraadi Taila – Sahasrayogam • Kaarpaasasthyaadi Taila – Sahasrayogam • Mahaakukkudamaamsa Taila – Bhai.Rat • Bruhat Masha Taila – Chakradatta
  29. 29. Dasamoola Bala Masha Kwatha • Chakradatta, Vatavyadhi.25 • - • Indicated as Pana and Nasya. • Indicated in Avabahuka, Viswachi. • Acts as Brumhana, Vatahara, Balya. • Adding Sneha / Ajya in it facilitates the action of the Kwatha.
  30. 30. Maharasnadi Kwatha
  31. 31. Maharasnadi Kwatha • Sahasrayoga, Kashaya Prakarana • Anupana – Sunti Ch, Pippali Ch, Yogaraja Guggulu, Ajamodadi Ch, Eranda Taila • Indication – Sarvanga kampa, Kubja, Pakshaghata, Avabahuka, Grudrasi, Amavata, Sleepada, Apatanaka, Antravrudhi, Adhmana, Janugatavata, Ardita, Sukramaya etc. • Acts mainly as Vatahara, Soolahara, Srotoshodhana.
  32. 32. Ashtavargam Kwatha • Sahasrayoga, Kashaya prakarana • - • Vatahara, Ushna • Can be given with Ksheerabala (101) • Acts as Vaso-dilator
  33. 33. Prasarinyadi Kwatha • Sahasrayoga, Vishista Kashaya prakarana • - • Vatahara, Ushna, Teekshna, Brumhana, Balya • Has vaso-dilator property.
  34. 34. Ekangaveera Ras • Rasarajasundara, P-458 • - • Anupana – Ardraka swarasa • Indication – Pakshaghata, Ardita, Apabahuka, Viswachi, Gridrasi, Vata roga, Dhanurvata
  35. 35. Vatagajankusha Ras
  36. 36. Vatagajankusha Ras • Bhaishajya Ratnavali, Vatavyadhi.488-492 • Anupana – Pippali Ch, Manjishta Kwatha • Indication – Gridrasi, Kroshtukasirsha, Avabahuka, Manyastambha, Urustambha, Pakshaghata
  37. 37. Prasarinyadi Taila • Ashtanga Hrudaya. Chi.21/65-66 • - • Vatahara, Ushna, Teekshna, Brumhana, Balya • Has vaso-dilator property.
  38. 38. Parinatakeri Ksheeraadi Taila • Sahasrayoga, Taila Prakarana • - • Used for Abhyanga • Vatahara, Ushna, Brumhana • Indicated in Avabahuka.
  39. 39. Kaarpaasasthyaadi Taila • Sahasrayoga, Taila Prakarana • - • Indicated for Pana, Nasya, Abhyanga • Indicated in Avabahuka, Pakshaghata, Ardita • Vatahara, Ushna, Teekshna, Balya • Prabhava – Acts on Urdhwa Jatru Vikaras.
  40. 40. Ketakyaadi Taila • Sahasrayoga, Taila Prakarana • - • Vatahara, Ushna • Indicated in Asthigata Vata • Useful in Marmabhighata Janya Avabahuka
  41. 41. Mahaakukkudamaamsa Taila Ingredients Indications
  42. 42. Mahaakukkudamaamsa Taila • Bhaishajya Ratnavali, Vatavyadhi.511-520 • Indicated in almost all Vatavyadhi • Brumhana, Balya, Vatahara
  43. 43. Bruhat Masha Taila
  44. 44. Bruhat Masha Taila • Chakradatta, Vatavyadhi.192-196 • Used as Vasti, Abhyanga, Nasya • Indication – Hastakampa, Shirakampa, Bahusosha, Avabahuka, Badirya, Karnanada, Karnasula, Visvachi etc. • Brumhana, Vatahara, Ushna • Prabhava – Acts on Urdhva Jatrugata Roga
  45. 45. Shamanoushadhi’s in other conditions
  46. 46. Chakradatta • “Moolam balaayaastvatha paaribhadraat tathaa aatmaguptaa swarasam pibed vaa Nasyantu yo maamsarasena kuryaan maasadasou vajra samaana baahu” (Vatavyadhi.26) • “Baahushoshe pibet sarpir bhuktvaa kalyaanakam mahat” (Vatavyadhi.28) • Trayodasanga Guggulu – Gridrasi baahu prishte hanu grahe... (Vatavyadhi.69-73) • Narayana Tailam – Hanusthambe Manyaasthambe... (Vatavyadhi.120-130) • Mahanarayana Tailam – Hanugraham... (Vatavyadhi.131-140) • Swalpamaasha Tailam – Baahuseersha gata vata... (Vatavyadhi.154-155)
  47. 47. Bhaishajya Ratnavali • Balaadi Kashayam – Baahushosha... (Bha.Rat.26/67) • Yogarajaguggulu Vati – Sarvaan Vataamayaan... (Bha.Rat.26/102-113, Sarngadhara) • Brihat Vaata Chintaamani Ras – Vaata Rogam... (Bha.Rat.26/141-144) • Vaata Vidwamsa Ras – Manyaa Sthambam... (Bha.Rat.26/178-184, Rasendra Sara Sam) • Maashabalaadi Tailam – Hanusthambham Manyaasthambam... (Bha.Rat.26/551-556) • Vishagarbha Tailam – Hanusthambham Manyaasthambham... (Bha.Rat.26/560) • Balarishtam – Sarva Vata Roga hara... (Bha.Rat.26/572-574)
  48. 48. Ekamoolika Prayoga
  49. 49. Guggulu • Rasa : Katu, Tikta, Kashaya • Guna : Laghu, Sara, Vashada • Virya : Ushna • Vipaka : Katu • Karma : Balya, Rasayana, Varnya, Vatakaphahara, Bhagnasandhanakrut,Medoh ara • DOSE - 2- 4 g of the drug.
  50. 50. Rasna • Rasa: Tikta • Guna : Guru • Virya : Ushna • Vipaka : Katu • Karma : Amapacana, Kaphavatahara • Dose : 25 - 50 g. (Decoction)
  51. 51. Lashuna • Rasa: Madhura, Katu • Guna: Guru, Picchila, Sara, Snigdha, Teekshna • Virya: Usha • Vipaka: Katu • Karma: Balya, Deepana, Hrudya, Kaphavatahara, Raktadoshahara, Bhagnasandhanakara, Rasayana, Asthimamsa Sandhankara • Dose: 3 g of drug
  52. 52. Prasarini • Rasa: Tikta • Guna: Guru, Sara • Virya: Ushna • Vipaka: Katu • Karma: Vatahara, Vrushya, Balakrut, Sandhanakrut • Dose: 2 - 4 g of drug in powder form
  53. 53. Ashwagandha • Rasa: Tikta, Kashaya • Guna: Laghu • Virya: Usha • Vipaka: Madhura • Karma: Rasayana, Vatakaphahara, Balya, Vajikarana • Dose: 3 - 6 g of the drug in powder form
  54. 54. Bala • Rasa: madhura • Guna: laghu, snigdh, pichhil • Virya: sita • Vipaka: madhura • Karma: balya • Dose: 25 - 50 g (Decoction)
  55. 55. Other Shamanoushadhi’s
  56. 56. • Kwatha : Bhadradarvadi Kwatha (S.Y) Dhanadanayanadi Kwatha (S.Y) Mahamanjishtadi Kwatha (S.Y) • Rasoushadhi : Ardhangavatari Ras (R.R.S) Amruta Sanjeevani Rasayana (R.R.S.S) Kalakandaka Ras (R.Y.S.S.) Mallasindoora (R.T.S.) Yogendra Ras (B.R.) Rasaraja Ras (B.R.)
  57. 57. • Guggulu : Shadasheeti Guggulu (Y.R.) Simhanada Guggulu (B.R.) • Ghrita yoga : Brihat chagaladi ghrita (B.R.) Indukanta ghrita (S.Y.)
  58. 58. • Taila Yoga : Triteeya Prasarani Taila (Ch.D.) Niramisha Masha Taila (B.R.) Bala Taila (B.R.) Madhyama Narayana Taila (B.P.) Maha Saindavadi Taila (B.P.) Laghu Vishagarbha Taila (Y.R.) Visha Tinduka Taila (R.T.) Ksheerabala Taila (S.Y.) Balaswagandhadi Taila (S.Y.) Dharwantharam Taila (S.Y.)
  59. 59. PERSONAL DATA OF THE PATIENT Name : Mr. shivaputrappa.gurappanavar Age : 42 Yrs. Sex : Male Religion : Hindu Occupation : farmer Economic status : poor Educational status : 10th std Marital status : Un Married Habitat : Rural Address : atpost yaraguppi tal kundagol dist dharawad OPD No. : 9862 Date : 23 – 11 - 09
  60. 60. PRADHANA VEDANA: • Severe Pain in the right shoulder joint (Amsa Sandhi Shoola) since – 3 months • Pain radiating to RUL • Difficulty in range of movements (Stambha) • Numbness • Unable to carry on his daily regimen (Karmakshayakari) ANUBANDH VEDANA: • Chest Pain • Bilateral knee jts pain
  61. 61. ADYATANA VYADHI VRUTTANTA: Patient was apparently normal 3 months ago. One fine day patient fell down with outstretched hand when he went to procure water from the well, he had an injury to rt shoulder joint, chest, both knees etc. he had lacerations over knees and elbow. Initially pt was administered with nsaids and his rt shoulder jt was immobilized with figure of 8 bandage by a local vaidya . After 4 days the condition worsened and he developed swelling of the affected part and above mentioned complaints for which he consulted the same person. again he was immobilized in their own method for 20 days by which he had minimal relief. But Since from last 20 days the symptoms aggravated and pt was unable to carry on his daily regimen for which he came to our hospital.
  62. 62. VAYUKTIKA VRUTTANTA: Aahara : Vegetarian Rasa satmy : Katu, Tikta, Kashaya rasa pradhana Vihara Nidra :poorvakalina Prakruta ( 6 – 7 hrs) now adhyatanakalina disturbed due to pain Vyasana : occasional smoker TREATMENT HISTORY: NSAID’s Immobilization PURVA VYADHI VRUTTANTA: h/o Fall.
  63. 63. SAMANYA PAREEKSHA: Ashta Sthana Pareeksha; Nadi : 80/min. Mala : Malabaddata Frequency: once a day, imcomplete evacuation Characteristics: Hard, Dry Mootra : Prakruta, Frequency: day – 2-3 times, Night –1-2 times Characteristics: Normal coloured, non turbid Jihwa : Prakruta Shabdha : Prakruta Sparsha : Prakruta Drik : Prakruta Aakruti : Madhyama
  64. 64. Dashavidha Pariksha: Prakruti : Vatapittaja Vikruti : Vata pradhana kapha anubanda Sara : Madhyama Samahanana : Madhyama Pramana : Madhyama ( Ht: 5’2” wt – 46 kg) Satmya : Katu, tikta, Kashaya rasa satmya Satwa : Madhyama Ahara shakti : Avara Vyayama shakti : Madhyama (Now reduced) Vayaha : Madhyama (Parihani) (42 years)
  65. 65. Vitals Examination: Temperature : 98o F Pulse : 80/min. Respiration Rate : 18/min. Blood Pressure : 140/90 mmHg Height : 5’2” Weight : 46 Kgs
  66. 66. II. Motor System : Muscle Strength : Weak on right upper extremity Bulk of muscles : Reduced in right upper extremity Tone of muscles : Hypotonia (Decreased in rt upper limb) Gait : Normal III. Sensory System: Pain : Pricking type of pain present Touch : No signs of Inflammation Joint Position : Normal
  67. 67. 2. Respiratory system O / I : Respiration Rate – 18/min.(Regular) O / A : Normal vesicular Breath sounds 3. C.V.S. O / I : Pulse–80 / min,BP – 140/90 mm Hg O / A : S1 S2 heard 4. GIT P / A O / I : Normal Contour O / A : Normal Bowel sounds heard O / P : No Organomegaly
  68. 68. SROTAS PAREEKSHA: • Pranavaha Srotas : Prakruta • Udakavaha Srotas : Prakruta • Annavaha Srotas : Prakruta • Rasavaha Srotas : Karshya • Raktavaha Srotas : Ruja, Karshya • Mamsavaha srotas : Atiruja • Medovaha srotas : Prakruta • Asthivaha Srotas : Asthi Shoola • Majjavaha Srotas : Ruja, Stabdata • Mutravaha Srotas : Prakruta • Purisavaha Srotas : Malabaddata •Swedhavaha srotas : Prakruta
  69. 69. LOCAL EXAMINATION: 1. Tenderness Rt. Shoulder : Present Rt. Upper Ext : Present Chest Region : Mild ( right side) Cervical Region : Absent 2. Numbness Rt. Upper Ext. : Present 3. Grip Strength : Reduced 4. ROM Rt shoulder jt : Painful Adduction & Abduction GM Readings : Flexion 60 Elevation 50 Hyperextension 40
  70. 70. ROGA PAREEKSHA: •Nidana : Abhighata, Vatakara Ahara, Vihara • Roopa : Karmahaani Shoola Stambha Vedana in uraha, amsa, bahu • Upashaya : Madhura amla lavana rasa yukta ahara Alpa Vyayama. • Anupshaya : Vata vardhaka ahara ( ruksha, sheeta, laghu, katu, tikta, kashaya) Vata vardhaka vihara (atijagarana, vyayama, vegavidharana)
  71. 71. DIAGNOSIS: Apabahuka SADHYA-ASADHYA: Kastha Sadhya VYAVACHEDAKA NIDAN: - Ekangavata (Monoplegia) - Vishvachi (Radio Ulnar Neuritis) - Apabahuka (Frozen shoulder) - Amsa shosha
  72. 72. TREATMENT GIVEN: Amapachana with Panchakola churna 10 gms twice daily with hot water for 2 days 1) Jambeera pinda sweda 2) Nasapaana with dasamooli balamaasha kwath 7 Days SHAMANA: 1) Yogaraja Guggulu 500mg, Thrice daily after food along with 2) Prasarinyadi Ksheera Kashaya 40ml as Anupana for 45 Days.
  73. 73. PATHYA: • Abyanga, svedana, mardana • Madhura amla, lavana, snigdha padartha APATHYA: • Vata vardhaka ahara vihara
  74. 74. RESULT: • Patient felt 85% improvement after 7 days of procedures. Assessment GM ROM readings Right shoulder joint : BT AT Adduction Painful Normal Abduction Painful Normal Flexion 60 180 Elevation 50 180 Hyperextension 40 90
  75. 75. Dr. PRASHANTH. A. S. M.D. (Ay), (Ph.D.), PROFESSOR DEPARTMENT OF POST GRADUATE STUDIES IN KAYACHIKITSA AYURVEDA MAHAVIDYALAYA, HUBLI (KARNATAKA) Cell: 09448135575 drprashanthas@gmail.com For further details: Ayurveda Mahavidyalaya, Hubli
  76. 76. Ayurveda Mahavidyalaya, Hubli Ayurveda Mahavidyalaya, Hubli

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