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Rehabiltation.ppt

  1. 1. REHABILITATION MEDICINE Dr. Shamanthakamani Narendran M.D. (Pead), Ph.D. (Yoga Science)
  2. 2. <ul><li>Rehabilitation is a program that helps a person who is recovering from illness or injury to regain as much function as possible. </li></ul><ul><li>The aim is for clients to become as independent as possible despite his/her disabilities. </li></ul><ul><li>Rehabilitation also aims to teach strategies for ongoing disabilities. </li></ul>
  3. 3. Rehabilitation for Neurological Disorders <ul><li>The nervous system is vulnerable to various disorders. </li></ul><ul><li>It can be damaged by injuries, infections, degeneration, structural defects, and tumors, as well as disorders in the circulatory system. </li></ul><ul><li>Disorders of the nervous system, which may be helped by physical medicine and rehabilitation, may include, but are not limited to, the following: </li></ul>What conditions may benefit from neurological rehabilitation?
  4. 4. <ul><li>Vascular disorders - stroke, transient ischemic attack (TIA), subarachnoid hemorrhage, subdural hemorrhage and hematoma, and extradural hemorrhage </li></ul><ul><li>Infections - meningitis, encephalitis, polio, and epidural abscess </li></ul><ul><li>Structural, trauma, or neuromuscular disorders - brain, head, or spinal cord injury, Bell's palsy, cervical spondylosis, carpal tunnel syndrome, brain or spinal cord tumors, peripheral neuropathy, muscular dystrophy, myasthenia gravis, and Guillain-Barré syndrome </li></ul><ul><li>Functional disorders - headache, seizure disorder, dizziness, and neuralgia </li></ul><ul><li>Degenerative disorders - Parkinson's disease, multiple sclerosis, amyotrophic lateral sclerosis (ALS), Huntington's chorea, and Alzheimer's disease </li></ul>
  5. 5. The neurological rehabilitation team <ul><li>Neurological rehabilitation programs can be conducted while a person is a hospital inpatient, or on an outpatient basis. </li></ul><ul><li>The neurological rehabilitation team revolves around the patient and family. </li></ul><ul><li>The team helps set short- and long-term treatment goals for recovery and is made up of many skilled professionals, including the following: </li></ul><ul><li>Neurologist/neurosurgeon </li></ul><ul><li>Orthopaedist/orthopaedic surgeon </li></ul><ul><li>Physiatrist </li></ul>
  6. 6. <ul><li>Internist </li></ul><ul><li>Rehabilitation nurse </li></ul><ul><li>Dietitian </li></ul><ul><li>Physical therapist </li></ul><ul><li>Occupational therapist </li></ul><ul><li>Speech therapist/language therapist </li></ul><ul><li>Psychologist/psychiatrist </li></ul><ul><li>Recreational therapist </li></ul><ul><li>Audiologist </li></ul><ul><li>Chaplain </li></ul><ul><li>Vocational therapist </li></ul>
  7. 7. The neurological rehabilitation program <ul><li>The goals of a neurological rehabilitation program include helping the individual to return to the highest level of function and independence, and improving the overall quality of life for that individual - physically, emotionally, and socially. </li></ul><ul><li>A typical neurological rehabilitation program helps to accomplish and/or may include the following: </li></ul><ul><li>Assistance with activities of daily living (adls) such as eating, dressing, bathing, using the toilet, handwriting, cooking, and basic housekeeping </li></ul>
  8. 8. <ul><li>Speech therapy (to help patients who are having trouble speaking, expressing their thoughts, or swallowing; To improve speech patterns, enunciation, and oral communication, in general) </li></ul><ul><li>Counseling (to deal with anxiety and depression) </li></ul><ul><li>Bladder and bowel retraining </li></ul><ul><li>Activities to improve control and muscle balance in the trunk, pelvis, and shoulder girdle </li></ul><ul><li>An exercise program (to improve function, safety, and efficiency of movement; To prevent or postpone weakness caused by lack of use; To manage spasticity and pain; To maintain range of motion; To develop the maximum potential of muscle, bone, and respiration) </li></ul>
  9. 9. <ul><li>Social skills retraining </li></ul><ul><li>Gait and balance retraining </li></ul><ul><li>Nutritional counseling </li></ul><ul><li>Involvement in community support groups </li></ul><ul><li>Activities to improve cognitive impairments, such as difficulties with concentration, attention, memory, and poor judgment </li></ul><ul><li>Education regarding the disease and disease process </li></ul><ul><li>Goal setting (short- and long-term) involving the individual and family members </li></ul>
  10. 11. INTEGRATED YOGA MODULE FOR NEUROLOGIC DISORDERS <ul><li>Sithilikarana Vyayama (loosening exercises) </li></ul><ul><li>Jogging </li></ul><ul><li>Spinal twist and Spinal stretch </li></ul><ul><li>Knee stretch </li></ul><ul><li>Forward and Backward bending </li></ul><ul><li>Alternate toe touching </li></ul><ul><li>Suryanamaskar </li></ul><ul><li>Relax by walking </li></ul><ul><li>Tiger stretch </li></ul><ul><li>Alternate Bhujangasana and Parvathasana </li></ul><ul><li>Cycling </li></ul><ul><li>Pascimottanasana stretch </li></ul><ul><li>Side leg raising </li></ul><ul><li>Quick relaxation technique (QRT) </li></ul>
  11. 12. <ul><li>Yogasanas </li></ul><ul><li>Ardhakati cakrasana </li></ul><ul><li>Padahastasana </li></ul><ul><li>Ardha cakrasana </li></ul><ul><li>Bhujangasana </li></ul><ul><li>Salabhasana </li></ul><ul><li>Dhanurasana </li></ul><ul><li>Sarvangasana </li></ul><ul><li>Matsyasana </li></ul><ul><li>Halasana </li></ul><ul><li>Chakrasana </li></ul><ul><li>Sasankasana </li></ul><ul><li>Vakrasana/ Ardha-Matsyendrasana </li></ul><ul><li>Ustrasana </li></ul><ul><li>Deep relaxation technique (DRT) </li></ul>
  12. 13. <ul><li>Pranayama </li></ul><ul><li>Kapalabhati </li></ul><ul><li>Vibhaga pranayama (Sectional breathing) </li></ul><ul><li>Surya Anuloma pranayama </li></ul><ul><li>Nadi suddhi </li></ul><ul><li>Sitali/ Sitkari/ Sadanta </li></ul><ul><li>Bhramari </li></ul><ul><li>Meditation (Dhyana Dharana) </li></ul><ul><li>Nadanusandhana </li></ul><ul><li>OM meditation </li></ul><ul><li>Kriyas </li></ul><ul><li>Jala Neti </li></ul><ul><li>Sutra Neti </li></ul><ul><li>Vaman Dhouti </li></ul>
  13. 14. SPECIFIC PRACTICES
  14. 16. What is Cardiac Rehabilitation? <ul><li>A cardiac rehabilitation program takes place in a hospital or in the community. </li></ul><ul><li>“Rehab” is for patients who are getting better after heart problems or surgery. </li></ul><ul><li>One of the best things you can do for yourself is to get in a rehab program. </li></ul><ul><li>Everything you need to get and stay healthy is in one place, and medical staff is on hand at all times. </li></ul><ul><li>Rehabilitation can do a lot to speed </li></ul><ul><li>your recovery and reduce your chances </li></ul><ul><li>of future heart problems. </li></ul>
  15. 17. What happens in a rehabilitation program? <ul><li>Rehabilitation programs can help you change your lifestyle habits. </li></ul><ul><li>These programs often take place at a hospital with a rehabilitation team or with the help of your doctor, nurse or other healthcare professionals. </li></ul><ul><li>Many people find that rehab programs are very helpful after getting out of a hospital. </li></ul><ul><li>They allow people to join a group to exercise and to get special help in making lifestyle changes. </li></ul>
  16. 18. During your rehabilitation program you’ll… <ul><li>Exercise using a treadmill, bike, rowing machine or walking/jogging track. </li></ul><ul><li>Be monitored for a change in symptoms by a nurse or another health care professional. </li></ul><ul><li>Start slowly, following a safe exercise program that gradually helps you to become stronger. </li></ul><ul><li>Gradually move into a more intensive program that lets you work longer and harder. </li></ul><ul><li>Possibly begin strength training if your doctor says you can. </li></ul><ul><li>Have your heart rate, blood pressure and EKG monitored. </li></ul>After you’ve completed the program, you may feel better than ever. Make these lifestyle changes a part of your everyday life!
  17. 19. TREADMILL
  18. 20. How else does it help me? <ul><li>You may go to classes or get personal help to quit smoking and stay smoke-free. </li></ul><ul><li>A nutritionist will help you create a healthy eating plan to reduce your intake of foods high in saturated fat and cholesterol. </li></ul><ul><li>You’ll improve your cardiovascular fitness. </li></ul><ul><li>You’ll be weighed and taught ways to lose weight if you need to. </li></ul><ul><li>You can learn relaxation skills to help manage and reduce your stress. </li></ul><ul><li>You may meet others who’ve just been through a similar event. </li></ul>
  19. 21. What are the Warning Signs of Heart Attack and Stroke? <ul><li>Warning Signs of Heart Attack: </li></ul><ul><li>Some heart attacks are sudden and intense, but most of them start slowly with mild pain or discomfort with one or more of these symptoms: </li></ul><ul><li>Chest discomfort </li></ul><ul><li>Discomfort in other areas of the upper body </li></ul><ul><li>Shortness of breath with or without chest discomfort </li></ul><ul><li>Other signs including breaking out in a cold sweat, nausea or lightheadedness </li></ul>
  20. 22. <ul><li>Warning Signs of Stroke: </li></ul><ul><li>Sudden weakness or numbness of the face, arm or leg, especially on one side of the body </li></ul><ul><li>Sudden confusion, trouble speaking or understanding </li></ul><ul><li>Sudden trouble seeing in one or both eyes </li></ul><ul><li>Sudden trouble walking, dizziness, loss of balance or coordination </li></ul><ul><li>Sudden, severe headache with no known cause </li></ul><ul><li>Learn to recognize a stroke. </li></ul><ul><li>Time lost is brain lost. </li></ul>
  21. 23. INTEGRATED YOGA MODULE FOR HYPERTENSION & HEART DISEASE <ul><li>Suksma Vyayama (strengthening the joints) </li></ul><ul><li>Loosening of wrists </li></ul><ul><li>Shoulder rotation </li></ul><ul><li>Padasancalana </li></ul><ul><li>Drill walking </li></ul><ul><li>Breathing exercise </li></ul><ul><li>Hands stretch breathing </li></ul><ul><li>Ankle stretch breathing </li></ul><ul><li>Trikonasana breathing </li></ul><ul><li>Tiger breathing </li></ul><ul><li>Straight leg raising </li></ul><ul><li>Setubandhasana breathing </li></ul><ul><li>Quick relaxation technique (QRT) </li></ul>
  22. 24. <ul><li>Yogasanas </li></ul><ul><li>Ardhakaticakrasana </li></ul><ul><li>Vrksasana </li></ul><ul><li>Garudasana </li></ul><ul><li>Vakrasana/ Ardha-Matsyendrasana </li></ul><ul><li>Gomukhasana </li></ul><ul><li>Bhujangasana </li></ul><ul><li>Deep relaxation technique (DRT) </li></ul>
  23. 25. <ul><li>Pranayama </li></ul><ul><li>Vibhaga pranayama </li></ul><ul><li>Candra Anuloma pranayama </li></ul><ul><li>Nadi suddhi </li></ul><ul><li>Ujjayi pranayama </li></ul><ul><li>Sitali/ Sitkari/ Sadanta </li></ul><ul><li>Meditation (Dhyana Dharana) </li></ul><ul><li>Nadanusandhana </li></ul><ul><li>OM meditation </li></ul><ul><li>Kriyas </li></ul><ul><li>Jala Neti </li></ul><ul><li>Vamana Dhouti </li></ul><ul><li>Kapalabhati (20-40 strokes/minute) </li></ul>
  24. 26. SPECIFIC PRACTICES
  25. 27. Benefits of Cardiac Rehab <ul><li>Improved quality of life </li></ul><ul><li>Return to work </li></ul><ul><li>Improved Cardiorespiratory function </li></ul><ul><li>Increased endurance and strength </li></ul><ul><li>Enhanced performance at work, recreation, and sport activities </li></ul><ul><li>Decrease in blood pressure </li></ul><ul><li>Improved energy </li></ul><ul><li>Increased knowledge of disease </li></ul><ul><li>Improved risk factor management </li></ul>
  26. 28. <ul><li>Increase the threshold of symptoms </li></ul><ul><li>Reduced anxiety/decreased depression </li></ul><ul><li>Decreased hospitalizations </li></ul><ul><li>Reduced risk of future cardiac event </li></ul><ul><li>Enhanced sleep </li></ul><ul><li>Enhanced feeling of well-being </li></ul><ul><li>Is a support group with other heart survivors </li></ul>
  27. 30. What is musculoskeletal rehabilitation? <ul><li>A musculoskeletal rehabilitation program is a physician-supervised program designed for people with impairments or disabilities due to disease, disorders, or trauma to the muscles or bones. </li></ul><ul><li>Musculoskeletal rehabilitation programs can often improve functional capacity, reduce symptoms, and improve the well-being of the patient. </li></ul>
  28. 31. What conditions can benefit from musculoskeletal rehabilitation? <ul><li>Amputation </li></ul><ul><li>Trauma injuries such as sprains, strains, joint dislocations, and fractures </li></ul><ul><li>Back pain </li></ul><ul><li>Osteoporosis </li></ul><ul><li>Arthritis </li></ul><ul><li>Bone tumors </li></ul><ul><li>Repetitive stress injuries such as tendonitis and carpal tunnel syndrome </li></ul><ul><li>Joint injury and replacement </li></ul>
  29. 32. The musculoskeletal rehabilitation team <ul><li>Musculoskeletal rehabilitation programs can be conducted on an inpatient or outpatient basis. </li></ul><ul><li>Many skilled professionals are part of the musculoskeletal rehabilitation team, including any/all of the following: </li></ul><ul><li>Orthopaedist/orthopaedic surgeon </li></ul><ul><li>Neurologist/neurosurgeon </li></ul><ul><li>Physiatrist </li></ul><ul><li>Internist </li></ul><ul><li>Rehabilitation nurse </li></ul><ul><li>Dietitian </li></ul>
  30. 33. <ul><li>Physical therapist </li></ul><ul><li>Occupational therapist </li></ul><ul><li>Social worker </li></ul><ul><li>Exercise physiologist </li></ul><ul><li>Psychologist/psychiatrist </li></ul><ul><li>Recreational therapist </li></ul><ul><li>Case manager </li></ul><ul><li>Chaplain </li></ul><ul><li>Vocational counselor </li></ul>
  31. 34. The musculoskeletal rehabilitation program <ul><li>A musculoskeletal rehabilitation program is designed to meet the needs of the individual patient, depending upon the specific problem or disease. </li></ul><ul><li>Active involvement of the patient and family is vital to the success of the program. </li></ul><ul><li>The goal of musculoskeletal rehabilitation is to help the patient return to the highest level of function and independence possible, while improving the overall quality of life - physically, emotionally, and socially. </li></ul>
  32. 35. In order to help reach these goals, musculoskeletal rehabilitation programs may include the following: <ul><li>Fitting and care for casts, braces, and splints (orthoses), or artificial limbs (prostheses) </li></ul><ul><li>Exercise programs to improve range of motion, increase muscle strength, improve flexibility and mobility, and increase endurance </li></ul><ul><li>Gait (walking) retraining and methods of safe ambulation (including the use of a walker, cane, or crutch) </li></ul><ul><li>Help with obtaining assistive devices that promote independence </li></ul>
  33. 36. <ul><li>Patient and family education and counseling </li></ul><ul><li>Pain management </li></ul><ul><li>Stress management and emotional support </li></ul><ul><li>Nutritional counseling </li></ul><ul><li>Ergonomic assessments and work-related injury prevention </li></ul><ul><li>Vocational counseling </li></ul>
  34. 37. Calf stretch Hamstring stretch MUSCULOSKELETAL REHABILITATION Hip abductor strengthening Quadriceps strengthening
  35. 38. Hip adductor strengthening Hip and buttock stretch Iliotibial band and buttock stretch Iliotibial band stretch
  36. 39. INTEGRATED YOGA MODULE FOR MUSCULOSKELETAL DISORDERS <ul><li>Sithilikarana Vyayama </li></ul><ul><li>Passive rotation of toes </li></ul><ul><li>Toe bending </li></ul><ul><li>Ankle bending and Ankle rotation </li></ul><ul><li>Knee bending and Knee rotation </li></ul><ul><li>Half butterfly and Full butterfly </li></ul><ul><li>Waist rotation </li></ul><ul><li>Wrist rotation </li></ul><ul><li>Shoulder rotation </li></ul><ul><li>Neck bending and Neck rotation </li></ul>
  37. 40. <ul><li>Sithilikarana Vyayama (strengthening exercises) </li></ul><ul><li>Manibandha sakti vikasaka (wrist) </li></ul><ul><li>Kara tala sakti vikasaka (palms) </li></ul><ul><li>Anguli sakti vikasaka (fingers) </li></ul><ul><li>Kaphoni sakti vikasaka (elbows) </li></ul><ul><li>Bhujabhandha sakti vikasaka (arms) </li></ul><ul><li>Kati sakti vikasaka (back) </li></ul><ul><li>Jangha sakti vikasaka (thighs) </li></ul><ul><li>Pindali sakti vikasaka (calf) </li></ul>
  38. 41. <ul><li>Pranayama </li></ul><ul><li>Kapalabhati </li></ul><ul><li>Vibhaga pranayama (Sectional breathing) </li></ul><ul><li>Nadi suddhi </li></ul><ul><li>Sitali/ Sitkari/ Sadanta </li></ul><ul><li>Bhramari </li></ul><ul><li>Meditation (Dhyana Dharana) </li></ul><ul><li>Nadanusandhana </li></ul><ul><li>OM meditation </li></ul><ul><li>Kriyas </li></ul><ul><li>Jala Neti </li></ul><ul><li>Sutra Neti </li></ul><ul><li>Vaman Dhouti </li></ul>
  39. 42. SPECIFIC PRACTICES
  40. 44. What is physical rehabilitation? <ul><li>Physical rehabilitation is the process of physically recovering from your cancer and adjusting to any physical changes you may experience. </li></ul><ul><li>Cancer and its treatment affect some survivors’ bodies more than others. </li></ul><ul><li>You may have been able to physically recover from cancer on your own. </li></ul><ul><li>Or, you may have a hard time physically adjusting to life after cancer and want to seek help from a medical professional. </li></ul>
  41. 45. Medical professionals who can help you with physical rehabilitation focus on: <ul><li>Restoring your independence </li></ul><ul><li>Preventing other physical problems you may get from being inactive for so long </li></ul><ul><li>Assisting you with adjustments from physical changes and disabilities </li></ul><ul><li>Helping you physically handle day-to-day activities </li></ul><ul><li>For some survivors, life after cancer means learning how to live with major physical changes. </li></ul><ul><li>You may have to find new ways to do things or change the things you do on a daily basis. </li></ul>
  42. 46. <ul><li>It is perfectly understandable if adjusting to physical changes upsets you. </li></ul><ul><li>If you want to learn more about how physical changes can affect you emotionally, you should talk to a mental health professional. </li></ul><ul><li>A physical rehabilitation plan is something you can develop with the help of your health care team. </li></ul><ul><li>A part of your physical rehabilitation plan may be working with therapists who specialize in helping your body recover after cancer. </li></ul><ul><li>These therapists can help you with physical changes throughout your survivorship. </li></ul>
  43. 47. Who can benefit from physical rehabilitation? <ul><li>Recovering from cancer and its treatment is difficult for many survivors. </li></ul><ul><li>Getting back to work, regaining your independence and feeling like you have enough energy to get through the day may take time. </li></ul><ul><li>Physical rehabilitation is important for all survivors who feel that cancer or its treatment affected them physically. </li></ul><ul><li>It is important to give your body some time to recover, but if you are struggling with your physical recovery at any time during your survivorship, you can talk to your health care team about physical rehabilitation. </li></ul>
  44. 48. <ul><li>Working with a therapist on physical rehabilitation is usually recommended for survivors who have a leg or arm amputated, receive a prosthetic, or experience any other serious physical change that interferes with their mobility or ability to physically function. </li></ul><ul><li>It can also be helpful for survivors who experience minor physical changes but still have a hard time physically adjusting to life after cancer. </li></ul><ul><li>If you feel like the physical effects of cancer and its treatment are seriously interfering with your life after your treatment ends, you can ask a member of your health care team if you would benefit from help. </li></ul>
  45. 49. What are some signs that a survivor might benefit from help with their physical rehabilitation ? <ul><li>You feel weak all the time </li></ul><ul><li>You often lose your balance </li></ul><ul><li>You have difficulty moving your arms and legs </li></ul><ul><li>You don’t have enough energy to get through the day </li></ul><ul><li>You have muscular or orthopedic problems </li></ul><ul><li>You have difficulty walking and going up stairs </li></ul><ul><li>You have difficulty swallowing </li></ul><ul><li>You have difficulty talking </li></ul><ul><li>You are recovering from a major surgery </li></ul><ul><li>You're having a hard time adjusting to major physical changes </li></ul>
  46. 50. Who can help a survivor with physical rehabilitation? <ul><li>The type of physical rehabilitation therapist you should see will depend on your individual needs. </li></ul><ul><li>You may need to learn how to use your muscles again. </li></ul><ul><li>You may need to learn how to move around your home or conserve your energy so you can return to work. </li></ul><ul><li>You may have trouble communicating with people because of physical changes to your face, mouth or throat. </li></ul><ul><li>There are therapists who specialize in each of these areas. </li></ul>
  47. 51. <ul><li>A physical therapist can help you adjust to the physical changes in your body by teaching you exercises and physical activities that can help condition your muscles and restore strength and movement. </li></ul><ul><li>Examples of things a physical therapist may do: </li></ul><ul><li>Evaluate your muscle strength, mobility and how well you can move your joints </li></ul><ul><li>Teach you exercises that increase or maintain your range of motion, strength, flexibility, endurance, coordination, posture and balance </li></ul><ul><li>Help you manage aftereffects from treatment </li></ul><ul><li>Assist you in chronic pain management </li></ul><ul><li>Design a self-care exercise program that fits your recovery needs </li></ul>
  48. 52. <ul><li>An occupational therapist will help you learn to manage your daily activities and incorporate any physical changes caused by cancer into your home and work life. </li></ul><ul><li>Examples of things an occupational therapist may do: </li></ul><ul><li>Help you learn to use assistive devices like walkers, if needed </li></ul><ul><li>Discuss with you possible changes in your home or workplace to accommodate your physical changes </li></ul><ul><li>Show you ways to conserve your energy and plan your days </li></ul><ul><li>Examine your hand/eye coordination </li></ul><ul><li>Evaluate any cognitive changes cancer or treatment may have caused </li></ul>
  49. 53. <ul><li>A speech therapist will help you if you have difficulty talking or swallowing after your treatment for cancer. </li></ul><ul><li>Examples of things a speech-language pathologist (therapist) may do: </li></ul><ul><li>Evaluate and train you in areas where you may have difficulty communicating </li></ul><ul><li>Help you with difficulty swallowing </li></ul><ul><li>Teach you about voice preservation and treatment in voice restoration </li></ul><ul><li>Treat symptoms of memory loss and attention </li></ul>
  50. 54. How long should survivors work with therapists on their physical rehabilitation? <ul><li>Some of the physical side effects that survivors experience are only temporary. </li></ul><ul><li>You may want to participate in some kind of physical rehabilitation plan only while the temporary change affects your daily life. </li></ul><ul><li>There are also physical side effects that may not happen until years after treatment ends. </li></ul><ul><li>If these changes require adjustments in your daily life, you might benefit from physical rehabilitation. </li></ul>
  51. 55. <ul><li>A progressive and ongoing physical rehabilitation plan may enhance the quality of your life at any time during your survivorship. </li></ul><ul><li>Depending on your specific issues, the length of the physical rehabilitation process can vary. </li></ul><ul><li>Some insurance plans only cover a limited number of visits. </li></ul><ul><li>You should ask your insurance company about the number of visits allowed in your plan if getting financial assistance to pay for your physical rehabilitation is important to you. </li></ul>
  52. 56. PROMOTION OF POSITIVE HEALTH <ul><li>Breathing practices </li></ul><ul><li>Hands in and out breathing </li></ul><ul><li>Ankle stretch breathing </li></ul><ul><li>Tiger breathing </li></ul><ul><li>Rabbit breathing </li></ul><ul><li>Sasankasana breathing </li></ul><ul><li>Straight leg raise breathing </li></ul><ul><li>Sithilikarana vyayama (loosening exercise) </li></ul><ul><li>Jogging </li></ul><ul><li>Forward and Backward bending </li></ul><ul><li>Side bending </li></ul><ul><li>Twisting </li></ul><ul><li>Pavanamuktasana kriya </li></ul><ul><li>Suryanamaskar </li></ul>
  53. 57. <ul><li>Yogasanas </li></ul><ul><li>Standing </li></ul><ul><li>Ardhakati cakrasana </li></ul><ul><li>Ardha cakrasana </li></ul><ul><li>Padahastasana </li></ul><ul><li>Prone </li></ul><ul><li>Bhujangasana </li></ul><ul><li>Salabhasana </li></ul><ul><li>Dhanurasana </li></ul><ul><li>Supine </li></ul><ul><li>Sarvangasana </li></ul><ul><li>Matsyasana </li></ul><ul><li>Cakrasana </li></ul><ul><li>Sitting </li></ul><ul><li>Pascimottanasana </li></ul><ul><li>Vakrasana/Ardha Matsyendrasana </li></ul><ul><li>Sasankasana/ Yogamudra </li></ul><ul><li>Ustrasana </li></ul><ul><li>Deep relaxation technique (DRT) </li></ul>
  54. 58. <ul><li>Pranayama </li></ul><ul><li>Kapalabhati </li></ul><ul><li>Vibhaga pranayama (Sectional breathing) </li></ul><ul><li>Nadi suddhi </li></ul><ul><li>Meditation (Dhyana Dharana) </li></ul><ul><li>Nadanusandhana </li></ul><ul><li>OM meditation </li></ul><ul><li>Kriyas </li></ul><ul><li>Jala Neti </li></ul><ul><li>Sutra Neti </li></ul><ul><li>Vaman Dhouti </li></ul>
  55. 59. SPECIFIC PRACTICES
  56. 61. What is occupational rehab? <ul><li>Occupational rehabilitation is the process of returning injured workers to suitable employment. </li></ul><ul><li>Assess the needs of the injured worker and the workplace requirements to develop a rehabilitation plan of action, listing the services needed to return the injured worker to work </li></ul><ul><li>Employ different health professionals, such as occupational therapists, physiotherapists, psychologists and rehabilitation counsellors </li></ul><ul><li>Are referred to by the employer, insurer or the treating doctor to help in complex cases </li></ul><ul><li>Are nominated by the employer in the return-to-work program. </li></ul>
  57. 62. <ul><li>A health hazard is something that has the potential to cause an adverse health effect. </li></ul><ul><li>The Act defines an occupational illness as &quot;a condition that results from exposure in a workplace to a physical, chemical or biological agent, to the extent that the normal physiological mechanisms are affected and the health of the worker is impaired.&quot; </li></ul><ul><li>An adverse health effect might be a minor skin rash, or it might be a life-threatening disease like lung cancer. </li></ul>
  58. 63. The Act recognizes three major categories of agents which can be hazardous to health. They are chemical agents, biological agents and physical agents. <ul><li>Chemical agents take many forms. They can appear in the workplace as gases, liquids or solids. Chemicals may be the product being manufactured. They may be an input to a process. Or, they may be a byproduct of a process. </li></ul><ul><li>Biological agents are living things or products of living things. Most biological agents found in the workplace are microscopic organisms. They include bacteria, viruses and fungi, all of which feed on plant or animal tissue. </li></ul>
  59. 64. <ul><li>Physical agents are forms of energy or force. They include noise, vibration, electricity, heat and cold, pressure and radiation. Some, like electricity, are usually a deliberate part of a production process. Others, like noise and vibration, are most often unwanted byproducts of a process. </li></ul>
  60. 65. Hazard Control <ul><li>Recognition and assessment prepare the way for control or elimination of a hazard. </li></ul><ul><li>Where an assessment finds that a hazard is likely to adversely affect one or more workers, some form of control is needed. </li></ul><ul><li>The principles of hazard control are often described by the location of the control: at the source of the hazard; along the path between the hazard and the worker; or at the worker. </li></ul><ul><li>Control at the Source. </li></ul><ul><li>Control Along the Path. </li></ul><ul><li>Control at the Worker. </li></ul>
  61. 66. TEXTILE, APPAREL & FURNISHINGS <ul><li>High risk job tasks associated with this job: </li></ul><ul><li>Handle agents that cause allergic contact dermatitis or contact urticaria </li></ul><ul><li>Use n-hexane as a solvent in glues, inks, coatings, or degreasers </li></ul><ul><li>Work with glue solvents </li></ul>Job Tasks Related Information in Haz-Map Construct, decorate, or repair leather and leather-like products, such as luggage, shoes, and saddles.Causes of allergic contact dermatitis include formaldehyde resins, and rubber chemicals. Description Shoe and Leather Workers and Repairers Job Name
  62. 67. <ul><li>High risk job tasks associated with this job: </li></ul><ul><li>Dye fur with compounds containing amines </li></ul><ul><li>Grind, mix, or weigh dyes or apply dyes to textiles </li></ul><ul><li>Handle agents that cause allergic contact dermatitis or contact urticaria </li></ul><ul><li>Inhale or handle nitrogen compounds that can induce methemoglobinemia </li></ul><ul><li>Prepare, card, or spin natural vegetable fibers (a heavy exposure) </li></ul><ul><li>Produce silk (sericulture) </li></ul><ul><li>Repeatedly prepare, card, or spin natural vegetable fibers </li></ul><ul><li>Use chromates or dichromates in tanning </li></ul>
  63. 68. HEALTH Related Information in Haz-Map Administer anesthetics during surgery or other medical procedures Diagnose, treat, and help prevent diseases of women, especially those affecting the reproductive system and the process of childbirth. Description Anesthesiologists, Ob/Gyn and pediatricians Job Name
  64. 69. Related Information in Haz-Map <ul><li>High risk job tasks associated with this job: </li></ul><ul><li>Care for sick patients (bloodborne pathogens) </li></ul><ul><li>Care for sick patients (droplet/airborne pathogens) </li></ul><ul><li>Generate latex dust using latex products </li></ul><ul><li>Handle agents that cause allergic contact dermatitis or contact urticaria </li></ul><ul><li>Handle medical needles or surgical instruments </li></ul><ul><li>Work in mouths of patients </li></ul>
  65. 70. <ul><li>High risk job tasks associated with this job: </li></ul><ul><li>Care for sick patients (bloodborne pathogens) </li></ul><ul><li>Care for sick patients (droplet/airborne pathogens) </li></ul><ul><li>Care for sick patients (fecal-oral pathogens) </li></ul>Job Tasks Related Information in Haz-Map Care for ill, injured, convalescent, or disabled persons in hospitals, nursing homes, clinics, private homes, group homes, and similar institutions. May work under the supervision of a registered nurse. Licensing required. Description Licensed Practical and Licensed Vocational Nurses Job Name
  66. 71. <ul><li>Disinfect or sterilize medical equipment </li></ul><ul><li>Generate latex dust using latex products </li></ul><ul><li>Generate psyllium dust </li></ul><ul><li>Handle agents that cause allergic contact dermatitis or contact urticaria </li></ul><ul><li>Handle medical needles or surgical instruments </li></ul><ul><li>Mix and apply bone adhesives </li></ul><ul><li>Sterilize equipment with ethylene oxide </li></ul>
  67. 72. <ul><li>High risk job tasks associated with this job: </li></ul><ul><li>Generate latex dust using latex products </li></ul><ul><li>Handle agents that cause allergic contact dermatitis or contact urticaria </li></ul><ul><li>Handle medical needles or surgical instruments </li></ul><ul><li>Perform venipunctures with needles treated with bis(tri-n-butyltin)oxide </li></ul><ul><li>Work in a medical or research laboratory handling the pathogen </li></ul>Job Tasks Related Information in Haz-Map Perform routine medical laboratory tests for the diagnosis, treatment, and prevention of disease. May work under the supervision of a medical technologist. Description Medical & Clinical Laboratory Technicians Job Name
  68. 73. <ul><li>High risk job tasks associated with this job: </li></ul><ul><li>Generate latex dust using latex products </li></ul><ul><li>Handle agents that cause allergic contact dermatitis or contact urticaria </li></ul><ul><li>Handle medical needles or surgical instruments </li></ul>Job Tasks Related Information in Haz-Map Prepare, administer, and measure radioactive isotopes in therapeutic, diagnostic, and tracer studies utilizing a variety of radioisotope equipment. Prepare stock solutions of radioactive materials and calculate doses to be administered by radiologists. Subject patients to radiation. Execute blood volume, red cell survival, and fat absorption studies following standard laboratory techniques. Description Nuclear Medicine Technologists Job Name
  69. 74. <ul><li>High risk job tasks associated with this job: </li></ul><ul><li>Care for sick patients (bloodborne pathogens) </li></ul>Job Tasks Related Information in Haz-Map Assist in operations, under the supervision of surgeons, registered nurses, or other surgical personnel. May help set up operating room, prepare and transport patients for surgery, adjust lights and equipment, pass instruments and other supplies to surgeons and surgeon's assistants, hold retractors, cut sutures, and help count sponges, needles, supplies, and instruments. Description Surgical Technologists Job Name
  70. 75. Related Information in Haz-Map <ul><li>High risk job tasks associated with this job: </li></ul><ul><li>Care for sick patients (droplet/airborne pathogens) </li></ul><ul><li>Disinfect or sterilize medical equipment </li></ul><ul><li>Generate latex dust using latex products </li></ul><ul><li>Handle agents that cause allergic contact dermatitis or contact urticaria </li></ul><ul><li>Handle medical needles or surgical instruments </li></ul><ul><li>Mix and apply bone adhesives </li></ul><ul><li>Sterilize equipment with ethylene oxide </li></ul>
  71. 76. High risk job tasks associated with this job: Job Tasks Related Information in Haz-Map Take X-rays and CAT scans or administer nonradioactive materials into patient's blood stream for diagnostic purposes. Include technologists who specialize in other modalities such as computed tomography and magnetic resonance. Include workers whose primary duties are to demonstrate portions of the human body on X-ray film or fluoroscopic screen. Description Radiologic Technologists and Technicians Job Name
  72. 77. Related Information in Haz-Map <ul><li>High risk job tasks associated with this job: </li></ul><ul><li>Care for sick patients (droplet/airborne pathogens) </li></ul><ul><li>Generate latex dust using latex products </li></ul><ul><li>Handle agents that cause allergic contact dermatitis or contact urticaria </li></ul><ul><li>Handle medical needles or surgical instruments </li></ul><ul><li>Use formaldehyde or glutaraldehyde to develop x-rays in darkroom </li></ul>
  73. 78. High risk job tasks associated with this job: Job Tasks Related Information in Haz-Map Perform medical tests in a laboratory environment for use in the treatment and diagnosis of diseases in animals. Prepare vaccines and serums for prevention of diseases. Prepare tissue samples, take blood samples, and execute laboratory tests such as urinalysis and blood counts. Clean and sterilize instruments and materials and maintain equipment and machines. Description Veterinarian Technologists & Technicians Job Name
  74. 79. Related Information in Haz-Map <ul><li>High risk job tasks associated with this job: </li></ul><ul><li>Care for children or primates infected with hepatitis A </li></ul><ul><li>Generate latex dust using latex products </li></ul><ul><li>Handle agents that cause allergic contact dermatitis or contact urticaria </li></ul><ul><li>Handle infected animal carcasses or placental tissues </li></ul><ul><li>Handle infected chickens or birds </li></ul><ul><li>Handle infected dog or cat (bite or scratch) </li></ul><ul><li>Handle infected domestic animals (inhalation or percutaneous exposure) </li></ul>
  75. 80. <ul><li>Handle infected laboratory rats or mice </li></ul><ul><li>Handle infected macaque monkeys </li></ul><ul><li>Handle infected rodents (bite) </li></ul><ul><li>Handle infected rodents (inhalation or percutaneous exposure) </li></ul><ul><li>Handle infected skunk, raccoon, bat, fox, other carnivore, or woodchuck (bite) </li></ul><ul><li>Touch infected farm animals </li></ul>
  76. 81. <ul><li>High risk job tasks associated with this job: </li></ul><ul><li>Care for children or animals infected with cryptosporidiosis </li></ul><ul><li>Care for children or primates infected with hepatitis A </li></ul>Job Tasks Related Information in Haz-Map Attend to children at schools, businesses, private households, and child care institutions. Perform a variety of tasks such as dressing, feeding, bathing, and overseeing play. Exclude preschool teachers and teacher aides. Description Child Care Workers Job Name
  77. 82. FOOD SERVICING <ul><li>High risk job tasks associated with this job: </li></ul><ul><li>Handle agents that cause allergic contact dermatitis or contact urticaria </li></ul><ul><li>Handle limes, celery, parsnips, or figs </li></ul><ul><li>Prepare fruit salad using a solution of enzymes (pectinase and glucanase) </li></ul><ul><li>Prepare potatoes using metabisulfite powder </li></ul>Job Tasks Related Information in Haz-Map Direct the preparation, seasoning, and cooking of salads, soups, fish, meats, vegetables, desserts, or other foods. May plan and price menu items, order supplies, and keep records and accounts. May participate in cooking. Description Chefs and Head Cooks Job Name
  78. 83. <ul><li>High risk job tasks associated with this job: </li></ul><ul><li>Handle limes, celery, parsnips, or figs </li></ul>Job Tasks Related Information in Haz-Map Take orders and serve food and beverages to patrons at tables in dining establishment. Exclude workers who only work at counters. Description Waiters & Waitresses Job Name
  79. 84. ENGINEERING, SCIENCES & EDUCATION <ul><li>High risk job tasks associated with this job: </li></ul><ul><li>Generate latex dust using latex products </li></ul><ul><li>Inhale aspergillus in bakery, beet sugar refinery, or biotechnology plant </li></ul><ul><li>Inhale plant mold (greenhouse worker) or slime mold (microbiologist) </li></ul>Job Tasks Related Information in Haz-Map Investigate the growth, structure, development, and other characteristics of microscopic organisms such as bacteria, algae, or fungi. Include medical microbiologists who study the relationship between organisms and disease or the effects of antibiotics on microorganisms. Description Microbiologists Job Name
  80. 85. <ul><li>High risk job tasks associated with this job: </li></ul><ul><li>Apply organochlorine insecticides </li></ul><ul><li>Handle agents that cause allergic contact dermatitis or contact urticaria </li></ul><ul><li>Mix or apply organophosphates or work in fields after an application </li></ul>Job Tasks Related Information in Haz-Map Conduct research in breeding, physiology, production, yield, and management of crops and agricultural plants, their growth in soils, and control of pests; or study the chemical, physical, biological, and mineralogical composition of soils as they relate to plant or crop growth. May classify and map soils and investigate effects of alternative practices on soil and crop productivity. Description Soil and Plant Scientists Job Name
  81. 86. High risk job tasks associated with this job: Job Tasks Related Information in Haz-Map Conduct chemical and physical laboratory tests to assist scientists in making qualitative and quantitative analyses of solids, liquids, and gaseous materials for purposes such as research and development of new products or processes, quality control, maintenance of environmental standards, and other work involving experimental, theoretical, or practical application of chemistry and related sciences. Description Chemical Technicians Job Name
  82. 87. Related Information in Haz-Map <ul><li>High risk job tasks associated with this job: </li></ul><ul><li>Formulate, mold, or cure resins to produce advanced composite materials </li></ul><ul><li>Inhale or handle nitrogen compounds that can induce methemoglobinemia </li></ul><ul><li>Manufacture isothiazolinones </li></ul><ul><li>Manufacture lead products </li></ul><ul><li>Use anhydride compounds to manufacture chemical products </li></ul><ul><li>Use benzene to manufacture products </li></ul><ul><li>Use diazonium salts to manufacture photocopy paper or polymers </li></ul>
  83. 88. <ul><li>High risk job tasks associated with this job: </li></ul><ul><li>Generate plant-derived bioaerosols </li></ul><ul><li>Inhale aspergillus in bakery, beet sugar refinery, or biotechnology plant </li></ul><ul><li>Inhale insect allergens in the laboratory </li></ul>Job Tasks Related Information in Haz-Map All other biologists not classified separately above Description Biologists, All Other Job Name
  84. 89. INTERNATIONAL BUSINESS TRAVELERS <ul><li>High risk job tasks associated with this job: </li></ul><ul><li>Travel to endemic area with inadequate protection </li></ul>Job Tasks Related Information in Haz-Map The term &quot;international business traveler&quot; is not a specific occupational group in the Standard Occupational Classification System. Description International Business Travelers Job Name
  85. 90. COMPUTER RELATED R EPETITIVE S TRAIN I NJURY <ul><li>&quot;We pray with our hands and often communicate with them. We use them to eat, work, and make love. We employ them as marvelously sophisticated instruments of flexibility and strength, and when they are damaged, we anguish.&quot; </li></ul><ul><li>Keith L. Moore, </li></ul><ul><li>Clinically Oriented Anatomy </li></ul>
  86. 91. What is RSI? <ul><li>R epetitive S train I njuries occur from repeated physical movements doing damage to tendons, nerves, muscles, and other soft body tissues. </li></ul><ul><li>The rise of computer use and flat, light-touch keyboards that permit high speed typing have resulted in an epidemic of injuries of the hands, arms, and shoulders. </li></ul><ul><li>Cumulative Trauma Disorder can happen even more quickly as a result of typing technique and body positions that place unnecessary stress on the tendons and nerves in the hand, wrist, arms, and even the shoulders and neck. </li></ul><ul><li>Lack of adequate rest and breaks and using excessive force almost guarantee trouble. </li></ul>
  87. 92. <ul><li>C arpal T unnel S yndrome in connection with these injuries, but in fact CTS is only a small and dangerous percentage of typing injuries. </li></ul><ul><li>Tendinitis, Bursitis, Tenosynovitis/DeQuervain's Syndrome, Tendinosis, Thoracic Outlet Syndrome, Trigger Finger/Thumb, Myofascial Pain Syndrome, Cubital Tunnel Syndrome, and several other related conditions may also be involved. </li></ul><ul><li>All of these are serious and in advanced cases can cause great pain and permanent disability. </li></ul><ul><li>In addition, patients injured by repetitive strain sometimes develop R eflex S ympathetic D ystrophy (RSD), </li></ul>
  88. 93. SYMPTOMS <ul><li>Tightness, discomfort, stiffness, </li></ul><ul><li>soreness or burning in the hands, </li></ul><ul><li>wrists, fingers, forearms, or elbows </li></ul><ul><li>Tingling, coldness, or numbness in </li></ul><ul><li>the hands </li></ul><ul><li>Clumsiness or loss of strength and coordination in the hands </li></ul><ul><li>Pain that wakes you up at night </li></ul><ul><li>Feeling a need to massage your hands, wrists, and arms </li></ul><ul><li>Pain in the upper back, shoulders, or neck associated with using the computer. </li></ul>
  89. 94. HOW DO I PREVENT IT? <ul><li>Correct typing technique and posture, the right equipment setup, and good work habits are much more important for prevention than ergonomic gadgets like split keyboards or palm rests. </li></ul><ul><li>Note that the chair and keyboard are set so that the thighs and forearms are level (or sloping slightly down away from the body), and that the wrists are straight and level - not bent far down or way back . If the table is too high to permit this, you may do better to put the keyboard on your lap. </li></ul>
  90. 95. <ul><li>Anything that creates awkward reaches or angles in the body will create problems. </li></ul><ul><li>This isn't just about your hands and arms, either: the use or misuse of your shoulders, back and neck may be even more important than what's happening down at your wrists. </li></ul>
  91. 96. <ul><li>While you are actually typing your wrists should not rest on anything, and should not be bent up, down, or to the side. </li></ul><ul><li>Your arms should move your hands around instead of resting your wrists and stretching to hit keys with the fingers. (palm rests give you a place to rest your hands only when pausing from typing, NOT while you are typing.) </li></ul><ul><li>When you stop typing for a while, rest your hands in your lap and/or on their sides instead of leaving them on the keyboard. </li></ul><ul><li>Wrists also should not be bent to the side, but instead your fingers should be in a straight line with your forearm as viewed from above. </li></ul>
  92. 97. <ul><li>Wrong Correct </li></ul>
  93. 98. <ul><li>Increase your font sizes . </li></ul><ul><li>DON'T POUND on the keys : use a light touch. </li></ul><ul><li>Take lots of breaks to STRETCH and RELAX – This means both momentary breaks every few minutes and longer breaks every hour or so. Pace and plan your computer work. Fidget a lot! </li></ul><ul><li>Hold the mouse lightly – don't grip it hard or squeeze it. Place the pointing device where you don't have to reach up or over very far to use it; close to the keyboard is best. Better yet : learn and use keyboard equivalent commands whenever possible, as no pointing device is risk-free. Even trackballs have injured users. </li></ul>
  94. 99. <ul><li>Keep your arms & hands warm – Cold muscles & tendons are at much greater risk for overuse injuries, and many offices are over-air-conditioned. </li></ul><ul><li>Don't tuck the telephone between your shoulder and ear – so that you can type and talk on the phone at the same time. This common procedure is very aggravating for your neck, shoulders, and arms. </li></ul><ul><li>Take care of your eyes – Eyestrain is also a related, widespread problem that should be addressed at the same time you are setting up your computer for healthier use. </li></ul>
  95. 100. <ul><li>Pay attention to your body – Pain is your body yelling that it's in big trouble, but learning what is comfortable or awkward for your body before you're in pain may prevent injury. </li></ul><ul><li>Kids are at risk too – with increasing hours in front of the computer at home and school, using equipment that rarely is set up correctly for people their size. </li></ul>
  96. 108. SPECIFIC PRACTICES
  97. 109. THANK YOU

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