JIIU’S

INDIAN INSTITUTE OF MEDICAL SCIENCES & RESEARCH.

Warudi, Talq.Badnapur, Dist.Jalna.

NOOR HOSPITALNOOR HOSPITAL

DEPARTMENT OF PHYSIOTHERAPYDEPARTMENT OF PHYSIOTHERAPY

CMECME

BASICS OF PHYSIOTHERAPYBASICS OF PHYSIOTHERAPY

02TH 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. 4-6 years

Fellow ship programmes

Where is Physical Therapy Practiced?

• Hospitals

• Private offices

• Nursing homes

• Schools

• Out Patient clinics

• Private Homes

Treatment 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 ApproachCardio pulmonary

The system includes:

Heart

Lungs

Blood vessels

Patients treated within this system include:

Heart disease

Bronchitis

Heart Transplants

PT: A Systems ApproachIntegumentary System

This systems includes the skin

Patients treated within this system includes

Burns

Wounds

Diabetes

Role of the Physical Therapist

Evaluation &

Treatment

Types of tests Evaluate

Patient History

Examination

Perform Tests

Types of Tests

Range of motion

Strength

Balance

Coordination

Posture

Respiration

Treatment

Treatment strategy

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

Light Amplification by Stimulated Emission of Radiation.

Indications

Pain and inflammation reduction

Collagen synthesis

Control of microorganisms

Increased vascularization

Equipment

Helium-neon and gallium-arsenide lasers are used.

Ultrasound Therapy

Indications

Tendinitis

Bursitis

Sprain

Strain

Trigger points

Heel pain

Osteoarthritis

Neck pain

Back pain

Burn contracture

Scars

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

Interferential therapy

Indications

Lumber spondylosis

Cervical spondylosis

Back pain

Neck pain

Shoulder pain

Knee pain

Rheumatoid arthritis

Ankylosing spondylitis

It acts on pain gate mechanism.

Transcutaneous Electrical Nerve Stimulation (TENS).

Indications

Cervical Radiculopathies

Lumbar Radiculopathies

Trapezius myalgia

Tingling, Numbness in Upper and lower limbs

Myofascial pain syndrome

Trigger pain

It acts on pain gate mechanism.

Pregnancy

TENS for pain over different parts of the body.

Hydrocollator Packs

It maintains heat for 20-30 minutes

Silicate gel pads submersed in 160-170o F water

Indications

Reduction of pain, spasm, hypoxia and ischemia

General superficial muscle relaxation.

Whirlpool BathEquipment

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 126-130o F,

paper towels and towels.

IndicationsUseful in treating chronic injuriesEffective 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

ParametersAble 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-CuffUses both compression and cold simultaneouslyElevation of cooler results in increased cuff pressureAlso allows for circulation of cooler waterPortable and easy to use

Game Ready SystemCirculates 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

OsteoarthritisWhat 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.

Resistance training

Chest Press

Seated Row

Shoulder Press

Weights Exercises

Lateral Pull Down

Squat

Lunge

Abdominal crunch

Back extension

Flexibility

Triceps and Upper Back Stretch Rear Deltoid and Upper Back Stretch

Pectoral and Upper Back Stretch

Quadriceps Stretch

Adductor Stretch Calf StretchHamstring 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. . . ??