3. DEFINITION
PHYSICAL THERAPY - evaluating,
diagnosing, and treating a range of diseases,
disorders, and disabilities by physical means.
Diagnosis and treatment of physical source of
the problem; the injured tissues and
structures
He must cure himself is the doctrine of
physiotherapy.
4. HISTORY
• Hippocrates & later Galenus first
practitioner of physiotherapy (460
BC)
• Per hendrik ling – “father of
swedish gymnastics”
• Modern Physiotherapy was
established in Great Britain
• Emergence of physiotherapy :
World Wars
6. ROLE OF PHYSIOTHERAPIST
• Assess ,manage & treat a broad range of medical conditions
• Relieve physical pain & heal injuries.
• Increase mobility, build strength, improve balance & enhance
Cardiopulmonary performance.
• Use a variety of techniques to strengthen the muscles & joints.
• Make individual independent for his/ her activity of daily living.
• Provides gait training & Posture correction.
7. • Thus rehabilitation includes prevention of
avoidable disabilities
Bed-sores
Venous thrombosis
Urinary infection
Renal stones
Muscle wasting
Joint stiffness and
Contractures
early mobilization
9. SHORTWAVE DIATHERMY
• Frequency - 27.12 MHz
• wavelength -11 meters.
• Treatment of deep muscles and
joints that are covered with a
heavy soft-tissue mass.
• Utilizes two condenser plates that
are placed on either side of the
body part to be treated.
• Types:
– Continous
– pulsed
10. Microwave Diathermy
Frequency – 300 – 30,000mhz
Wavelength – 10-12cm(shorter
than short wave diathermy)
Strongly absorbed by tissues of
high water content(all joints)
Selective heat application
Not suitable for deeper tissues
11. ULTRASOUND
Uses high frequency sound
waves, greater than 20,000 Hz.
Frequency range of 1- 3 MHz
It has both thermal &
mechanical effect.
Used to heal soft tissue and
ligaments injury , scar
mobilization & edema
reduction.
12. INTERFERENTIAL CURRENT THERAPY
( IFT)
Placement of electrodes
two currents produced cross
each other in the affected area
Two currents 'interfere' with
each other
“INTERFERENTIAL”
This modality addresses the issues of
pain, spasm, and inflammation
13. TRANSCUTANEOUS ELECTRICAL NERVE
STIMULATION (TENS)
Most commonly used forms of electro
analgesia
Goal - block pain signals and to stimulate
the release of naturally produced pain
killers such as endorphin
Uses:
Low Back Pain (LBP)
Myofascial And Arthritic Pain
Sympathetically Mediated Pain
Bladder Incontinence
Neurogenic Pain
Visceral Pain
Postsurgical Pain
14. FARADIC & GALVANIC MUSCLE
STIMULATOR
Generation of impulse by a electic device
Delivered through electrodes on the skin in direct
proximity to the muscles
elicitation of muscle contraction using electric
impulse
stimulation of blood flow and pain reduction, as
well as ionization
15. CERVICAL/ LUMBAR TRACTION
short term relief of neck pain and
low back ache
relieve muscle spasm and nerve root
compression by stretching soft
tissues
Increases the spaces between
vertebrae reducing pressure on
intervertebral discs and nerve root
16. WAX BATH
Application of the molten
paraffin wax on the body part(40
– 44˚c)
Methods:
Dipping and Wrap,
Direct pouring method
Toweling or bandaging method
Reduces
pain,inflammation,edema and
muscle spasm
C/i in
ischaemia,haemoorhage,spinal
cord injuries, acute trauma
17. INFRARED RAYS
A band of light that we perceive as
heat
Decreases muscle spasm and
promote relaxation
Promoting healing of superficial
wounds
Faster ability to heal from soft
tissue injuries such as tears, pulls,
and sprains
May cause burns and electric shock
18.
19. CRYOTHERAPY
Pain and muscle spasm
Stretching of collagen due to
tension(tear)
Blood vessels are torn,invagination
of fluid in to muscle fibres
Bruises in skin
Application of cold
Reduction in flow of fluid in to
fibres
Reduces transmission of pain
impulses
Reduces spasm (reduces ability of
muscle to maintain contraction)
Swelling and internal bleeding is
reduced
20. Advantages
Usually inexpensive.
Quick application with little
preparation.
Faster muscle recovery
Promotes healthier skin
complexion
Effective with chronic pain
management
Reduces stress & anxiety
Disadvantages
It is difficult to keep the ice in
place
Quickly melts
No compression is applied.
Can only be applied for short
periods of time (10-20
minutes).
21. ICE BAGS:
simple plastic bags, chemical cold
packs or frozen vegetables.
The skin will pass through four stages of
sensation in 10-15 minutes.
These sensations in order are:
Cold
Burning
Numbness
ICE MASSAGE
DO NOT hold the ice in one area for more
than 3 minutes since this may cause
frostbite.
• Cold therapy should be stopped once the skin
feels numb
22. LASER
Light Amplification from the
Stimulated Emission of Radiation
(LASER)
Increases
healing rate in wounds and burns
healing response of fractures
regeneration of damaged nerve by
stimulating axon sprouting
Decrease inflammatory edema
Uses :
Osteoarthritis
Rheumatoid arthritis
Ankle sprain
Chronic Low back pain
Chronic ulcers and wounds
23. EXERCISE THERAPY
Active & Passive
Exercises
Resisted exercises
Joint Mobilization
techniques.
Suspension
therapy
Hydrotherapy
Relaxation
techniques
Stretching
Proprioceptive
Neuromuscular
Facilitation. ( PNF)
Myo Fascial
Release Technique
Muscle Energy
Technique
Gait & Balance
Training
Posture
Correction.
Breathing Exercise Postural training
24. ACTIVE AND PASSIVE EXERCISES
• Regain muscle power and then increase the
range of joint movement under muscle control
• Active exercise is the keynote of treatment
• It strengthen muscles and mobilize joints
• prevents bone atrophy, stimulate circulation,
improve co-ordination and restore function
28. SUSPENSION THERAPY
form of Assisted Exercises(continuous passive
motion)
to increase ROM, increase muscle power and
support body parts by using ropes and slings.
Aim : Muscle Strengthening Neuro-Muscular Co-
ordination
Types :
Axial
Pendular
vertical
34. WALKING AIDS
• A device designed to assist walking
• Improve the mobility of people
• Redistribute weight-bearing area
(decreasing force on injured or
inflamed part or limb)
• Can compensate weak muscles
• Decrease pain
• Improve balance
37. ADVANTAGES:
Convenience from temporary injuries
A large degree of support for the lower
body
Available at low cost.
perform a greater variety of gait
patterns , ambulate at a faster pace
DISADVANTAGES:
Limited upper body freedom
crutch paralysis(Radial N.and brachial
plexus injury)
39. PROPRIOCEPTIVE NEUROMUSCULAR
FACILITATION
Proprioceptive: sensory receptors
that give information concerning
movement and position of the
body
Neuromuscular: involving the
nerves and muscles
Facilitation: making easier
vital element in rehabilitation process of sports related injuries
40. USES
• To increase strength, flexibility,
coordination and functional mobility.
• The main goal of treatment is to
facilitate the patient in achieving a
movement or posture.
• used in orthopedic rehabilitation for
musculoskeletal injuries and in
neurological rehababilitation
41. MYO FASCIAL RELEASE THERAPY
Scarring or injury to network
of connective tissues produce
pain and impede motion
Gentle blend of streching and
massage
Uses hands on manipulation
of entire body
Technique to ease pressure in
the fibrous band of
connective tissue in the body
42. USES
• Long standing back ache
• Fibromyalgia
• Sports injuries
• Rotator cuff injuries
• Sciatica
43. HYDROTHERAPY
• Hydrotherapy, or water therapy, is the use of
water (hot, cold, steam, or ice) to relieve
discomfort and promote physical well-being
– Hot Water: relaxing, stimulate immune system.
– Tepid Water: stress reduction.
– Cold Water: reduce inflammation
• Alternating hot and cold water can stimulate the
circulatory system and improve the immune
system
44. External Hydrotherapy
– involves the immersion of
the body in water
Motion-based treatments
– uses water under pressure in
the form of jets, whirlpools or
aerated bubbles
– It is used to treat joint and
muscle injuries ,stress and
anxiety disorders.
Uses:
osteoarthritis
rheumatoid arthritis
fibro myalgia
sciatica
45. REHABILITATION
• Co ordinated usage of medical ,social
,educational and professional activities for
training(retraining) of individual for optimum
working ability
• Kinds of rehabilitation
Medical
Psychological
Home
Professional
Social
46. MEDICAL REHABILITATION
OBJECTIVE:
The restoration of health of the affected person in optimal
time
It starts from the place of accident, emergency room of
hospital,specialised rehabilitation centers
• From moment of trauma and
continued during outpatient and
in patient department
EARLY
• Aims at adaption to new
environment of persons with
disabilities and employment
LATE
47. STAGES OF REHABILATION
• Immobilisation
• Medications/surgeryACUTE
• Specific exercises
• Neuromuscular
control
RECOVERY
• Specific functional
programes
• Exercises
FUNCTIONAL
49. PROFESSIONAL REHABILITATION
• Goal :
– Restoration (full /partial) or nursing of new
professional skills allowing the sick and disabled
patients to return to work
50. PRINCIPLES OF REHABILITATION
Early beginning(hospital)
Succession(out patient basis)
Continuity
PERIODS OF REHABILITATION
HOSPITAL
OUTPATIENT POLYCLINICS
51. CONCLUSION
• Orthopaedic surgeon and a doctor of physiotherapy
should be “guides” for the patient during the
rehabilitation period
• Rehabilitation of patients rests on accurate diagnosis,
proper identification of roles, cooperation among the
different disciplines and a potent but practical goal
setting
• The patient is always the focus of treatment, and should
have a quality of life that is deemed most acceptable
52. BIBLIOGRAPHY
• Clayton's Electrotherapy - Theory and
Practice(8th edition)
• Principles of exercise therapy (M.Dena
gardiner)
• Watson – jones fractures and joint injuries (7th
edition)
• Orthopaedic physical therapy secrets(jeffrey
D.placzek)
53. THANK YOU
“Happiness is a state of mental,physical
and spiritual well-being. Think
pleasantly,engaged sport and read daily
to enhance your well-being.”
Editor's Notes
Physiotherapy in trauma and orthopaedics involves rehabilitation in
Elective surgeries including spinal surgeries
Trauma situations
=
continuous or pulsed (PSWD). o PSWD: application of series of short pulses of SWD so that short periods of SWD interrupted by gaps where there is no SWD. The pt. receives lower dose of SWD energy if compared with continuous SWD applied of the same time. The tissues will receive lower thermal load. o SWD: produce both deep and sup. Tissue heating, under certain controlled conditions it’s applied for 20 min at the max tolerable dose. SWD produced by an oscillating electric current of extremely high frequency.
Uses medium frequency current
Used in rheumatism
Arthritis
Muscle sprain
Neuralgia
Sports injury
Faradic current Flat Feet
To improve quadriceps power
Reeducation of muscle after tendon transfer
Galvanic current After nerve palsies to prevent fibrosis
The melting point of wax is 51-55°c. If the molten wax at 51-55°c is poured on the body part, its may cause burn. Some impurity like liquid paraffin or mineral oil is added to lower the melting point for safe application. Thus the temperature of the paraffin wax is maintained at 40-44°c
Dipping and Wrap, Direct pouring method
a band of light that we perceive as heat.
• Increase temperature causes increased phagocytic effects promoting healing of superficial wounds • Also in suppurating conditions such as carbuncles and abscess heat can help in drainage.
Muscle spasm is reduced due to decreased firing of secondary afferents of muscle spindle and increased firing of 1b GTO fibers reducing alpha
Heat causes pre-synaptic inhibition of A delta and C fibers via activation of A-beta fibers.
Easily available materials found in most homes
Place clean tap water into a foam cup and place in your freezer until it is completely frozen.
Peel back a small amount of the top of the cup and massage this onto area of pain using constant circular motion.
Motion that is uninterrupted for extended periods of time it is usually applied by a mechanical device that moves a desired joint continuously through a controlled range of moti on.
Axial Suspension - Joint is taken as point of suspension. Gravity eliminated.Limb is supported by the slings above the joint.Limb will move to both sides parallel to floor
Pendular-Point of suspension should be shifted away from the joint axis.Movement usually takes place against gravity.
Vertical - COG of the body part or the body is taken as point of suspension.Used to provide support to the body parts of the patient.