Physiotherapy role in handicap care

1. Handicap care
Mr. Muthuukaruppan M.

2. Handicap & Disability
 Disadvantage for a given individual in his or her
social context, that limits or prevents the
fulfillment of a role that is normal to an individual.
 Any restriction or lack of ability to perform an
activity in the manner normal to a individual.
 Physical, cognitive, mental, sensory, emotional or
combinations are noted.
 Disability prevents subjects from being
independent. Disabled persons are addressed
“Differently Abled” persons.

3. Rehabilitation
 Enhance and restore functional ability and quality
of life to those with physical impairments or
disabilities
 Primary prevention, Secondary prevention &
Tertiary prevention
 Goal is to “Add life to years, not years to life”

5. WHO Identified 6 Handicap’s
 Locomotor handicap: paraplegias
 Hearing & speech handicap: loss of hearing &
inability to speak
 Cardiopulmonary handicap: respiratory &
vascular disorders
 Visual handicap: blindness
 Mental handicap: Conditions like Down’s
syndrome, dyslexias
 Emotionally disturbed

6.  Primary disabilities are direct consequences of a
disease. eg-spinal cord injury, stroke
 Secondary disabilities are those which did not
exist at the onset of primary disability but develop
subsequently. eg-tight muscles, joints etc.

7. Result of Decreased Activity due to
handicap

8. Rehabilitation Team
 Doctor
 Physiotherapist
 Occupationaltherapist
 Speech pathologist
 Prosthetist – Orthotist
 Rehabilitation nurse
 Psychologist
 Music or play therapist
 Biomedical engineer
 Social worker
 Vocational counselor
 Special educator
 Government agencies

10. Delivery of Rehabilitation care
 Institutional based care (IBR)
 Homes
 Day care centers
 Outpatient clinic
 Camps
 Community based rehabilitation (CBR)

11. Therapeutic exercises
 Strengthening exercises
 Balance training
 Coordination exercises
 Gait training
 Mobilization exercises
 Re-education exercises
 Massage techniques
 Relaxation exercises

12. Strengthening exercises:
Set of exercises to improve the power of the
muscle or muscle groups
FITT principle – frequency, intensity, time & type
Types of contraction – concentric, eccentric or
isometric
Precautions needed to be taken care.
Balance training:
Procedures assisting in improving static & dynamic
balance are used in training

13. Coordination exercises:
For performing precise smooth and purposeful
movement using multiple muscles and a stable
posture
Volition - Ability to start, maintain or stop an
activity
Perception – intact centers and areas in brain to
retrieve the plans stored prior
Motor plans in central nervous system
Repetitive exercises, precision & attention are
important part of treatment

14. Gait training:
Gait or human locomotion is a translatory
progression of the body as a whole, produced by
coordinated movements of body segments.
Normal gait requires sensory inputs and proper
muscular activity.
Gait training can be given using assistive devices
such as crutches, walkers, sticks etc.

15. Mobilization exercises:
Mobilization is passive movement in such a
manner or speed that the patient can stop the
movement at his will.
It helps in restoring or maintaining joint movement
Massage techniques:
Manipulation of soft tissues and assisting in
circulation of extremities
Assists in treating pathological disorders.

16. Relaxation exercises:
Relaxation is a state in which the muscles of the
body are relatively free from tension
General relaxation & Local relaxation
Reeducation exercises:
Exercises taught to train a lost or new activity to
muscle groups after various pathologies.
Done in grades to increase the activity
subsequently

17. Summary
 Physical Activity/Exercise can improve disability
and handicap
 Improvement in quality of life

18. “Rehabilitation is clearly the only practical means of
significantly improving function in Handicap
patients”
George Kraft, MD
The Lancet, December 11, 1999