Rehabilitation Medicine

Dr. Faiq Isho

Professor & Consultant Rheumatologist

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Objectives

• Definition
• Terms
• Components
• Program
• Rehabilitation of Pain
 Rehabilitation medicine
• a branch of medicine
• enhance and restore functional
ability and quality of life of patients
with physical impairments or
disabilities

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Physical Therapy (PT)
• Physical therapy involves exercising and
manipulating the body.
• It can improve joint and muscle function, helping
people stand, balance, walk, and climb stairs
better.

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Occupational therapy
• Occupational therapy is intended to enhance a
person's ability to do basic self-care activities,
useful work, and leisure activities.

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Rehabilitation team

Treatment involves a team work & continued

sessions of training for many weeks

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 Physical
therapist
Other Occupational
Systems therapist

Dietitian Orthotist

Physician
Recreational
Prosthetist
therapist

Psychologists
Audiologists

speech social
therapists workers
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 Rehabilitation program:

To initiate a formal rehabilitation program: A doctor

writes a referral letter to a rehabilitation center.
1. Diagnosis
2. Goals of therapy
3. Type of therapy needed, such as ambulation
training (help with walking) or training in
activities of daily living.
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• Setting:
-outpatient : in a therapist's office.

• Inpatient: in hospital

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 1) Education

• Avoid predisposing factor

• Weight reduction
• Habits: smoking, drinking
• Diet

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2)Excercises

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 Treatment of Pain and Inflammation

Techniques include:
1) Heat therapy,
2) Cold therapy, cryotherapy
3) Electrical stimulation,
4) Traction
5) Massage
6) Assistive devices

• Cold therapy seems to be more effective for acute pain.

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1)Heat Therapy
• Heat:

- Increases blood flow

- Makes connective tissue more flexible

- Decreases joint stiffness, pain, and muscle spasms

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Indications:

1. Inflammation (including various forms of arthritis)

2. Muscle spasm

3. Injuries such as sprains and strains.

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 Types of Heat Therapy
A) Heat applied to the body's surface

1. Infrared heat
• Indication: Arthralgia, Arthritis, Back pain,
Fibromyalgia, Muscle spasm, Myositis,
Neuralgia, Sprains, Strains, Tenosynovitis, and
Whiplash injuries
• C/I severe heart, liver, or kidney disorder,
peripheral vascular disease, or reduced skin
sensation, infection, malignancy

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2. Hot packs

• Cotton cloth containers filled with silicate gel,

usually warmed in a microwave oven

• Uses: Same as for infrared heat

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3. Paraffin bath

• Dipping in, or painting with wax

• Usually applied to small joints, such as those of

the hand, knee, or elbow

• Not used for open wounds

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4. Hydrotherapy

• Immersion in agitated warm water

In a large industrial whirlpool

• Enhances wound healing by stimulating blood

flow and helping clean out burns and wounds

• Relaxes muscles and relieves pain

• Helps with range-of-motion exercises

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B) Heat applied to deep tissues

1. Shortwave Diathermy
Uses: Mechanical pains, Pain due to kidney stones,
or sinusitis (short-term or chronic).

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2. Microwave diathermy

• Heat produced by microwaves

• Simpler to apply and more comfortable than

shortwave diathermy

• Evenly warms deep tissues (such as muscles)

without heating of the skin

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

3. Ultrasound

Penetrate deep into tissues

• Uses: Bone injuries, Bursitis, Complex regional pain
syndrome , Contractures, Osteoarthritis , Tendinitis

C/I in : ischemia, infected areas, healing bones, or

eyes, brain, spinal cord, ears, heart, or reproductive
organs, tendency to bleed or cancer

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2) Cold Therapy (Cryotherapy):

• Applying cold may numb tissues

• Uses: muscle spasms, acute low back pain, and
acute inflammation.

• C/I in :tissues with a reduced blood supply

(peripheral arterial disease).

• Types: ice bag, a cold pack, or fluids (as ethyl

chloride that cool by evaporation).

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3) Electrical Stimulation:

• Indications: peripheral nerve injury, spinal cord disorder,

or stroke muscles atrophy, chronic back pain, RA , a
sprained ankle, shingles, or a localized area of pain.

• C/I a severe heart disorder or a pacemaker (arrhythmias)

or near the eyes.

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4) Traction:

Neck (cervical) traction may be used to treat chronic

neck pain due to:
• Cervical spondylosis
• Disc prolapse
• Whiplash injuries
• Torticollis.

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5)Massage:

Massage may relieve pain, reduce swelling, and help loosen

contracted tissue.

Uses
• Arthritis, bursitis, periarthritis, Fibromyalgia
Sprains(lig.inj), Strains ( m. or tendon inj), contracted
tissues, Fractures, Joint injuries
Hemiplegia, Paraplegia, Quadriplegia
Low back pain
Neuritis, Peripheral nerve injuries 36
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6) Assistive Devices:

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Summary
Rehabilitation is important to restore normal
function & quality of life of patients
Physical therapy: skills for LL( excercises)
Occupational therapy: skills UL (ADL)
Rehabilitation: team, program
Physical agents: Heat Tx( superficial: IR, Hot
pack, paraffin, hydroTx; deep: diathermy SWD,
MWD, US), Cold ( Cryo Tx), ElectroTx, Traction,
Massage, Assistive devices

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 Quiz
Q1. A 25 -year old football player presented to the rheumatologist with
right knee pain after two days of trauma during playing football. O/E there
was tenderness on the lateral side of right knee and stress test was
positive. MRI revealed lateral meniscal injury of left knee. Which one of the
following physical agents is the most effective therapy for this patient pain?
A. Traction
B. Cryotherapy
C. Heat therapy,
D. Electrical stimulation
E. Massage

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Q2. All of the followings are examples of heat applied to the body's surface
except:

A. Infra-red therapy
B. Hot packs
C. Paraffin bath
D. Short-wave diathermy

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Thank you

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