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Physiotherapy Basics
Physiotherapy Basics
knowledge of
Physiotherapy
By
Dr.B.Arun Kumar
M.D(Ay)
Introduction
This is a branch of health care science that mainly
concentrates on the physical aspects of an
individuals helath care, by treating their physical
ailments.
Physiotherapist must coordinate and work with the
other members, throughout rehabilitation period.
Physiotherapy practice
Movement management by:
Manipulative therapy
Electro therapy
Hydro therapy
MANIPULATIV
E THERAPY
Physiotherapy during
immobilization
1. Reduce edema2. Assist the maintenance of circulation to the area.
3. Maintains muscle function by active or static
contractions.
4. Maintain joint range where possible.
5. Maintain as much function as allowed by the
particular injury and the fixation.
6. Teach the patient how to use special appliances
ex;sticks,crutches.
Physiotherapy
techniques
1.Movement techniques:
passive,
assisted,
active,
free active,
resisted exercises can be given to facilitate
activity and to strengthen muscles.
Manipulative
therapy
It involves skillful restoration of mobility to soft
tissues and joints.
It consists of
Soft tissues techniques(massage)
Passive mobilization of joints
Passive streching of soft tissues
Auto stretching of soft tissues.
Stroking
Efflurage
Kneading
Picking up
Wringing
Skin rolling
Frictions
Stroking
Massage is the manipulating of superficial
and deeper layers of muscle and
connective tissue using various
techniques, to enhance function, aid in the
healing process, decrease muscle reflex
activity, inhibits motor-neuron excitability
and promote relaxation and well-being
Efflurage
a technique in massage in which
long, light, or firm strokes are
used, usually over the spine
and back. Fingertip effleurage
is a light technique performed
with the tips of the fingers in a
circular pattern over one part
of the body or in long strokes
over the back or an extremity.
Fingertip effleurage of the
abdomen is a technique
commonly used in the Lamaze
method of natural childbirth.
Kneading
The hands are placed
on the skin and
allowed to mould to
the part, then they
more in a circular
direction with pressure
gradually applied over
the top of the circle
and released towards
the bottom of the
circle.
Picking up
Similar to kneading
but it involves lifting
the tissues up at right
angles to the
underlyingbone,
sqeezing and releasing.
Wringing
It involves lifting the
tissues up as in
picing up and
applying a twist to
enchance the
stretching effect.
Skin rolling
It involves lifting and
stretching the skin
between thumbs and
fingers so that the
skin and
subcutaneous tissues
are moved on each
other and adhesions
are stretched.
Frictions
Small range
movements applied
with the thumb or
fingers starting
superficially and
working deeper.they
applied in one of two
ways tranverse or
circular.
Contraindications
Soft tissue manipulation
1.
2.
3.
4.
5.
Acute inflammation
Weeping conditions
Infection
Recent fractures
Patient preference
Indications
Soft tissue manipulation
1.
2.
3.
4.
5.
6.
7.
Scar tissue
Muscle spasm
Muscle tightness
Fascial tethering
Oedema
Pain
Slow healing scars or ulcers.
Connective Tissue
Massage
The term connective
Connective Tissue
Massage
Indications:
tendonitis
fibromyalgia
scoliosis
chronic fatigue syndrome
sciatica
multiple sclerosis
TMJ
ALS (Lou Gehrigs Disease)
arthritis
carpal tunnel syndrome
Passive mobilizaiton of
joints
Hydrotherap
y
Principles of
1.StengtheningTreatment
muscles:
They are strengthened by working progressively against
graded resistance.in the pool,resistance may be from
buoyancy, turbulence,unstreamlining.
2.Buoyancy:
movements downwards in the pool are resisted by
buoyancy.floats which may be of different densities may be
used to increase the effect of buoyancy.
3.Turbulence:
it is created by movement through water and is increased if
the rate of movement is increased.
Principles of
Treatment
4.unstreamling:
If a broad surface is presented when a body is moved through water
the resistance is greater than if the surface is narrow.
To progress exercises with a bat, for example, the movement is first
performed with the edge of the bat moving through the water and then
progressed so that the broad surface is going against the water.
5.Joint mobility:
Relief of pain and muscle spasm by the warmth of the water and by
support from buoyancy can restore free movement of joints.
6.Coordination and balance:
Patients can practice activites in standing,transference of weight,and
arm movements.
Methods of Heat
Transfer
Conduction
Convection
Radiation
Precautions:
Chilling
Sudden changes in blood
pressure
Infections
Falls inside and outside the pool
Fatigue of patients or staff.
Clinical Indications
Ankylosing spondylitis
Osteoarthritis
Rheumatoid arthritis
Juvenile chr.polyarthritis
Spondylosis
Capsulitis
Mechanical spinal disorders
Polymyalgia rheumatica
Major fractures (lower limbs/spine)
Ortopaedic surgery
Neurological disorders
Hydrotherapy
Contraindication
Contraindications:
Infected wounds
Acute skin conditions
Pyrexia
Incontinence
Cardiac disease
DVT
Recent pulmonary embolus
Recent CVA
GIT disorders
Tracheostomy
Epilepsy
Vertigo
Electro
therapy
Use of
Electrotherapy
1.Pain management
Use of
5. Acute Electrotherapy
and chronic edema
Sources of Heat
1.
2.
3.
4.
5.
6.
Paraffin wax
Infra red radiation
Heat pad
Hot moist packs
Short wave diathermy
Microwave diathermy
Paraffin wax
Paraffin wax refers to a white or colourless soft
solid that is used as a lubricant and for other
applications.
It consists of a mixture of hydrocarbon molecules
containing between twenty and forty carbon atoms.
It is solid at room temperature and begins to melt
above approximately 37 C (99 F).
Paraffin wax is an excellent material to store heat,
having a specific heat capacity of 2.14
2.9 J g1 K1 (joule per gram kelvin) and a
heat of fusion of 200220 J g1.
Infra red
Infrared (IR)radiation
light is electromagnetic radiation with
longer wavelengths than those of visible light, extending
Infra red
radiation
Heat Pad
They are plastic covered pads similar to but smaller
than electric blankets.
A pad has 3 levels of heat and is useful for treating
the neck or back.
Patient lies on it and heat passes to the tissues by
conduction.
Hot moist
packs
Short wave
diathermy
Microwave
Application diathermy
of
electromagnetic radiations
with a wavelength of
12.25cm & frequence of
2450MHz.
They are produced by a
megnetron,which is a
special type of thermoinic
valve.
Depth of penetration 3cm.
They are absorbed by fluid
tissues & less by bone,fat.
Degenrative joint disease&
joint lesions are better treat.
ICE
THERAPY
Ice Therapy
Ice Therapy
Cryotherapy, the use of ice or cold in a therapeutic
setting, has become one of the most common
treatments in orthopedic medicine.
The primary reason for using cryotherapy in acute
injury management is to lower the temperature of
the injured tissue, which reduces the tissue's
metabolic rate and helps the tissue to survive the
period following the injury.
It is well documented that metabolic rate decreases
by application of cryotherapy.