JIIU’S

INDIAN INSTITUTE OF MEDICAL SCIENCES & RESEARCH.

Warudi, Talq.Badnapur, Dist.Jalna.

N O O R H O S P I TA L

DEPARTMENT OF PHYSIOTHERAPY CME BASICS OF PHYSIOTHERAPY 02 TH April 2014

What is Physical Therapy?

Prevents, identifies, corrects, and alleviates acute or prolonged movement dysfunction of anatomic or physiologic origin. The primary objective of physical therapy is to promote optimum human health and function.

The APTA

Physical therapy

or

physiotherapy

(sometimes abbreviated to

PT

) is a health care profession primarily concerned with the remediation of impairments and disabilities and the promotion of mobility, functional ability, quality of life and movement potential through examination, evaluation, diagnosis and physical intervention. It is carried out by

physical therapists

(known as

physiotherapists

in most countries) and

physical therapist assistants

(known as

physical rehabilitation therapists

or

physiotherapy assistants

in some countries).

Our Beginnings

Establishment of the Profession

• • • Established by the Surgeon General in 1917 Founded by Mary McMillan Called “Reconstruction Aides”

Present Academics

Bachelor of Physiotherapy 4-1/2 years Masters of Physiotherapy 2 or 3 years Ph.D.

Fellow ship programmes 4-6 years

Where is Physical Therapy Practiced?

Treatment

• • • • • Hospitals Private offices Nursing homes Schools Out Patient clinics • Private Homes

Prevention

• Schools • Sports Centers • Workplaces • Public facilities • Health Clubs

What do PTs do?

• • • Movement Specialists Restore function Improve mobility Physical therapists are experts at analyzing human movement. They help restore and enhance normal movement patterns following injury and disease using a variety of techniques, procedures and modalities.

Misperceptions about Physical Therapists  Just give massages  Aerobics instructors  Never see blood  Only treat healthy people who are injured.

Future Outlook for the profession Life expectancy People living longer, healthier lives Greater number of older people – more cases of arthritis, stroke, heart disease, etc…

A Systems Approach

PT: A Systems Approach

Musculoskeletal

The musculoskeletal system includes:  Bones  Muscles   Joints Tendons  Ligaments  And other soft tissue

 Cervical (PIVD, Spond. etc.)  Frozen shoulder, TOS, Sprains, Strains  Tennis & Golfers elbow  Wrist pains  Rheumatoid Arthritis  Thoracic (BP, PIVD, #, etc.)  Lumbar (LBP, PIVD, Spond. etc.)  Sacroiliac joint dysfunctions  Hip dysfunctions

 Knee Osteoarthritis  Ankle Sprain, Strain  ACL, PCL, reconstruction surgeries  Various fractures of Head, Trunk, Upper & Lower limbs  Sports trauma  Oral fibrosis  Bed sores  Wound healing

PT: A Systems Approach

Neurological

This systems includes:  Brain  Spinal cord  Nerves Movement, sensation, balance.

Patients treated within this system include:  Head injuries  Strokes  Parkinsonism  Carpal Tunnel Syndrome  Peripheral neuropathies  Multiple Sclerosis  Muscular Dystrophy  Cerebral Palsy  Polio

PT: A Systems Approach

Cardio pulmonary

The system includes:  Heart  Lungs  Blood vessels Patients treated within this system include:  Heart disease  Bronchitis  Heart Transplants

PT: A Systems Approach

Integumentary System

This systems includes the skin   Patients treated within this system includes  Burns Wounds Diabetes

Role of the Physical Therapist

Evaluation & Treatment

Evaluate  Patient History

Types of tests

 Examination  Perform Tests Types of Tests  Range of motion  Strength  Balance  Coordination  Posture  Respiration

Treatment strategy

Treatment Identify purpose/outcomes  Pain reduction  Swelling reduction  Range of Motion

   Interventions Electrical stimulation Adaptive devices (crutches, wheel chairs/prosthetics) etc..

Modalities: To reduce pain and inflammation including electrical stimulation (IFT, TENS), heat superficial (IRR, Hydro collator packs, Heating Pads), deep heat (SWD, Ultrasound, Laser) and icing, etc… Manual therapy: Including joint and soft tissue mobilization. Exercise programs: To improve flexibility, strength, endurance, power and coordination.

MODALITIES

Electrotherapy

          Short Wave Diathermy Interferential Ultrasound TENS Electrostimulation IRR Hydrocollator Packs Whirlpool Bath Paraffin Bath Combination therapy

Shortwave Diathermy It penetrates up to 2 inches.

Indications

 Bursitis  Capsulitis  Osteoarthritis  Deep muscle spasm and strains  Spondylosis, etc.

SWD Electrode placement

Low Level Laser Therapy

L

ight

A

mplification by

S

timulated

E

mission of

R

adiation.



Indications

 Pain and inflammation reduction  Collagen synthesis  Control of microorganisms  Increased vascularization  Equipment  Helium-neon and gallium-arsenide lasers are used.

Ultrasound Therapy

Ultrasound Therapy   Modality which stimulates repair of soft tissue and pain relief Form of acoustic energy used for deep tissue heating

Indications

 Tendinitis  Bursitis  Sprain  Strain  Trigger points  Heel pain  Osteoarthritis  Neck pain  Back pain  Burn contracture  Scars

Interferential therapy

It acts on pain gate mechanism.

Indications

 Lumber spondylosis  Cervical spondylosis  Back pain  Neck pain  Shoulder pain  Knee pain  Rheumatoid arthritis  Ankylosing spondylitis

Transcutaneous Electrical Nerve Stimulation (TENS).

Indications

 Cervical Radiculopathies  Lumbar Radiculopathies  Trapezius myalgia  Tingling, Numbness in Upper and lower limbs  Myofascial pain syndrome  Trigger pain  Pregnancy It acts on pain gate mechanism.

TENS for pain over different parts of the body.

Hydrocollator Packs  It maintains heat for 20-30 minutes  Silicate gel pads submersed in 160-170 o F water

Indications

 Reduction of pain, spasm, hypoxia and ischemia  General superficial muscle relaxation.

Whirlpool Bath Equipment  Tank with turbine that regulates water flow  Agitator controls amount of movement of water by emitting air  Varying sizes of tanks used to treat respective body parts.

Indications

 Swelling, muscle spasm and pain  Provides conduction and convection .

Paraffin wax Bath  Equipment  A paraffin wax and mineral oil combination, heated to 126-130 o F, paper towels and towels.



Indications

 Useful in treating chronic injuries  Effective for angular areas of body such as hands, wrists, elbows, ankles and feet.

   Application Body part is cleaned and dried Soak technique  Body part remains in wax 20-30 minutes without moving it.

Dip and wrap technique  Hand dipped 6-12 times, wrapped in a plastic bag and then draped with a towel to maintain heat for 30 minutes.

Cryotherapy   Used as first aid treatment for on field trauma in sports and in other musculoskeletal system conditions.

RICE (rest, ice compression, elevation) may be used for the initial days of and injury and continue up to 2 weeks after injury.

Mechanical Modalities

Traction

 Drawing tension applied to a body segment 

Indications

 Spinal nerve root impingement  Decrease muscle guarding, treat muscle strain  Treat sprain of spinal ligaments  Relax discomfort from normal spinal compression

 Physiological Effects  Produces separation of vertebral bodies impacting ligaments, capsules, paraspinal muscles  Increases articular facet separation, and relief of nerve root pain  Decreases central pressure of vertebral disks  Increases proprioceptive changes  Relief of joint compression.

Intermittent Compression Units

Equipment  Utilizes nylon inflatable sleeve  Sleeve is inflated to specific pressure using either water or air  Utilized to facilitate movement of lymphatic fluids Parameters Able to adjust on-off time, pressure and treatment time

Indications

 Used for controlling or reducing swelling after acute injury  Good for pitting edema, which develops several hours after injury  Elevation of extremity is critical to effective treatment  With electrical stimulation, muscle pumping can be incorporated to facilitate lymphatic flow

 Cryo-Cuff  Uses both compression and cold simultaneously  Elevation of cooler results in increased cuff pressure  Also allows for circulation of cooler water  Portable and easy to use  Game Ready System  Circulates water with compression.

 Can be adjusted for various time, temperature and compression settings.

Time for some Musculoskeletal conditions

Frozen Shoulder

 Frozen shoulder (adhesive capsulitis) is a disorder characterized by pain and loss of motion or stiffness in the shoulder.

 It affects about two percent of the general population.

 It is more common in women between the ages of 40 years to 70 years old.

 Cause: Idiopathic

Frozen Shoulder

Various exercises for frozen shoulder

Strengthening exercises for shoulder

Strengthening exercises for shoulder

Osteoarthritis

What is osteoarthritis?

Osteoarthritis is a form of arthritis that features the breakdown and eventual loss of the cartilage of one or more joints. Cartilage is a protein substance that serves as a "cushion" between the bones of the joints

Risk Factors You Can Control

This includes sports that have a high rate of injury and jobs that require repetitive motion, such as bending the knees to install flooring. Obesity is another risk factor – it has been linked specifically to osteoarthritis of the knees and hips.

Hamstring Stretch

Calf Stretch

Straight Leg Raise

Quadriceps Set

Seated Hip March

Pillow Squeeze

Heel Raise

Side Leg Raise

Sit to Stand

One Leg Balance

Step Ups

Walking

Low-Impact Activities

 Being active may also help you lose weight, which takes pressure off joints.  Other exercises that are easy on the knees: biking, swimming, and water aerobics.

 Water exercise takes weight off painful joints.

Supportive Devices

Various Exercises for Neck pain

Various Exercises for Low back pain

Exercises with Theraball

Aquatic Physical Therapy

 Aquatic Physical Therapy includes but is not limited to treatment, rehabilitation, prevention, health, wellness and fitness of patient populations in an aquatic environment with or without the use of assistive, adaptive, orthotic, protective, or supportive devices and equipment.

 The buoyancy, support, accommodating resistance and other unique properties of the aquatic environment enhance interventions for patients/clients across the age span with musculoskeletal, neuromuscular, cardiovascular or pulmonary, and integumentary diseases.

Chest Press Resistance training Weights Exercises Shoulder Press Seated Row

Lateral Pull Down Squat Lunge

Back extension Abdominal crunch

Triceps and Upper Back Stretch

Flexibility

Rear Deltoid and Upper Back Stretch

Pectoral and Upper Back Stretch Quadriceps Stretch

Hamstring Stretch Adductor Stretch Calf Stretch

GENERAL PHYSICAL FITNESS PROGRAMME

 Mon - steady run  Tue - weights  Wed - fartlek  Thu - flexibility  Fri - steady run  Sat - weights  Sun - flexibility

What is Physical Activity..?

Any thing that keep you moving..!

Making Physical Activity a Part of Your Life.

There are 1440 minutes in every day Schedule 30 of them for physical activity.

THANK YOU

Any Questions. . . ??