Physiotherapy plays an important role in the pre and post operative stages of abdominal surgery to prevent pulmonary and circulatory complications. Preoperative physiotherapy includes assessment, education, and training patients in breathing and coughing exercises. Postoperative physiotherapy focuses on further exercises and mobilization to aid recovery and reduce complications like pneumonia, pain management, and scar tissue prevention. Studies show preoperative training and post operative chest physiotherapy can reduce hospital stays and improve outcomes for surgery patients.
Neurodynamics, mobilization of nervous system, neural mobilizationSaurab Sharma
This is the presentation which was delivered to third year Bachelor of Physiotherapy students at Kathmandu University School of Medical Sciences (KUSMS), Dhulikhel, Nepal. Different schools of thoughts in manual therapy are the part of curriculum for the undergraduate students at KUSMS.
This is the presentation which was delivered to third year Bachelor of Physiotherapy students at Kathmandu University School of Medical Sciences (KUSMS), Dhulikhel, Nepal. Different schools of thoughts in manual therapy are the part of curriculum for the undergraduate students at KUSMS.
Establishing the need for a surgical intervention
Confirmation of relevant physical findings and review of the clinical history and laboratory investigations that support the need of surgical intervention
Type of approach- Benefits & Risks of surgical procedure
The incision site- ease of surgery as well as cosmetic considerations
Type of anesthesia
radical mastectomy is a disabling condition, the side effects and post surgical complications of the conditions affect the patient both physically, psychologically and socially. in this presentation, an attempt to cover problem list, do's and don'ts, assessment, management is explained in detail.
THE URINARY INCONTINENCE AND IT'S MANAGEMENT DETAILS WITH APPROPRIATE EXPLANATION
Introduction of urinary incontinence,
Etiology of urinary incontinence,
Risk factors associated with urinary incontinence,
Types of urinary incontinence,
Pathophysiology of Urinary incontinence,
Clinical manifestations of urinary incontinence,
Diagnostic evaluations of urinary incontinence,
Management of urinary incontinence- Behavioural techniques, Drug therapy, surgical management, medical devices and Physiotherapy assessment and management in details with appropriate explanation with the help of the SlideShare .
Telegram channel - https://t.me/bhuneshwarmishra08/4?single
Facebook page - https://m.facebook.com/Bhuneshwarmishra08/
Instagram page - https://www.instagram.com/the_perfect_physio_tutorial/?r=nametag
YouTube channel - https://youtube.com/channel/UCCIEa_xDe3B-6BLfQaJb8PQ
Neurodynamics, mobilization of nervous system, neural mobilizationSaurab Sharma
This is the presentation which was delivered to third year Bachelor of Physiotherapy students at Kathmandu University School of Medical Sciences (KUSMS), Dhulikhel, Nepal. Different schools of thoughts in manual therapy are the part of curriculum for the undergraduate students at KUSMS.
This is the presentation which was delivered to third year Bachelor of Physiotherapy students at Kathmandu University School of Medical Sciences (KUSMS), Dhulikhel, Nepal. Different schools of thoughts in manual therapy are the part of curriculum for the undergraduate students at KUSMS.
Establishing the need for a surgical intervention
Confirmation of relevant physical findings and review of the clinical history and laboratory investigations that support the need of surgical intervention
Type of approach- Benefits & Risks of surgical procedure
The incision site- ease of surgery as well as cosmetic considerations
Type of anesthesia
radical mastectomy is a disabling condition, the side effects and post surgical complications of the conditions affect the patient both physically, psychologically and socially. in this presentation, an attempt to cover problem list, do's and don'ts, assessment, management is explained in detail.
THE URINARY INCONTINENCE AND IT'S MANAGEMENT DETAILS WITH APPROPRIATE EXPLANATION
Introduction of urinary incontinence,
Etiology of urinary incontinence,
Risk factors associated with urinary incontinence,
Types of urinary incontinence,
Pathophysiology of Urinary incontinence,
Clinical manifestations of urinary incontinence,
Diagnostic evaluations of urinary incontinence,
Management of urinary incontinence- Behavioural techniques, Drug therapy, surgical management, medical devices and Physiotherapy assessment and management in details with appropriate explanation with the help of the SlideShare .
Telegram channel - https://t.me/bhuneshwarmishra08/4?single
Facebook page - https://m.facebook.com/Bhuneshwarmishra08/
Instagram page - https://www.instagram.com/the_perfect_physio_tutorial/?r=nametag
YouTube channel - https://youtube.com/channel/UCCIEa_xDe3B-6BLfQaJb8PQ
This is the presentation which was delivered to third year Bachelor of Physiotherapy students at Kathmandu University School of Medical Sciences (KUSMS), Dhulikhel, Nepal. Different schools of thoughts in manual therapy are the part of curriculum for the undergraduate students at KUSMS.
Physiotherapy in MND
Dr. Quazi Ibtesaam Huma (MPT)
Dr. Suvarna Ganvir (Phd, Prof & HOD)
Dept. of Neurophysiotherapy
DVVPF’s College of Physiotherapy
Content
Introduction
Types of MND
Clinical Features of MND
Diagnostic Procedure
Management: 1) Pharmaceutical
2) Physiotherapy
Motor Neuron Disease
Motor Neuron Disease are a group of neurodegenerative disorders that affects the nerves in the spine and brain to progressively lose its function.
Motor neuron diseases (MND) include a heterogeneous spectrum of inherited and sporadic (no family history) clinical disorders of the upper motor neurons (UMNs), lower motor neurons (LMNs), or a combination of both.
Types of MND
Amyotrophic Lateral Sclerosis
Amyotrophic lateral sclerosis (ALS) is a neurodegenerative disease, characterized by progressive degeneration of motor neurons in the spinal cord, brain stem, and motor cortex, leading to progressive muscle atrophy and weakness.
Clinical Features
UPPER MOTOR NEURON
Loss of Dexterity
Muscle Weakness
Spasticity
Hyperreflexia
Pathological reflexes
LOWER MOTOR NEURON
Muscle Weakness
Muscle Atrophy
Hypotonicity
Hyporeflexia
Fasciculation
Muscle Cramp
Impairment related to LMN
Other clinical features
Diagnostic Criteria
Diagnostic Procedure
EMG-
It include signs of active denervation, such as fibrillation potentials and positive sharp waves;
Signs of chronic denervation, such as large motor unit potentials (increased duration, increased proportion of polyphasic potentials, increased amplitude)
Unstable motor unit potential
Nerve Conduction Velocity Studies,
Muscle And Nerve Biopsies,
Neuroimaging Studies - MRI
Management- Multidisciplinary Approach
Physical Therapy Examination
Cognition
Pain
Psychosocial Function
Joint integrity, ROM and Muscle strength.
Motor Function: Gross motor and Fine motor
Muscle tone and reflexes
Cranial nerve integrity
Sensations
Gait
Respiratory Function
Physiotherapy goals in MND treatment.
Pain reduction
Prevention for contractures
Maintenance of joint mobility
Regular review of posture
Positioning to relieve discomfort
House Modification and ergonomic advice.
Management of Sialorrhea and Pseudobulbar Affect
Management for Dysphagia
PEG procedure.
A PEG may be recommended as the disease progresses.
A PEG is a type of gastrostomy tube inserted via endoscopic surgery that creates a permanent opening into the stomach for the introduction of food.
Studies have found that PEG insertion may prolong survival. Patients with PEG were found to live 1 to 4 months longer than those individuals who refused it.
Management of Dysphagia
A palatal lift prosthesis may be prescribed for individuals with good articulation but who have a breathy voice quality or decreased loudness because of excessive air loss through the nose.
The device, a dental appliance designed to attach to the existing teeth and to elevate the soft palate, is custom-made by a prosthodontist.
Brian Mulligan described novel concept of the simultaneous application of therapist applied accessory mobilizations and patient generated active movements
This is the presentation which was delivered to third year Bachelor of Physiotherapy students at Kathmandu University School of Medical Sciences (KUSMS), Dhulikhel, Nepal. Different schools of thoughts in manual therapy are the part of curriculum for the undergraduate students at KUSMS.
Physiotherapy in MND
Dr. Quazi Ibtesaam Huma (MPT)
Dr. Suvarna Ganvir (Phd, Prof & HOD)
Dept. of Neurophysiotherapy
DVVPF’s College of Physiotherapy
Content
Introduction
Types of MND
Clinical Features of MND
Diagnostic Procedure
Management: 1) Pharmaceutical
2) Physiotherapy
Motor Neuron Disease
Motor Neuron Disease are a group of neurodegenerative disorders that affects the nerves in the spine and brain to progressively lose its function.
Motor neuron diseases (MND) include a heterogeneous spectrum of inherited and sporadic (no family history) clinical disorders of the upper motor neurons (UMNs), lower motor neurons (LMNs), or a combination of both.
Types of MND
Amyotrophic Lateral Sclerosis
Amyotrophic lateral sclerosis (ALS) is a neurodegenerative disease, characterized by progressive degeneration of motor neurons in the spinal cord, brain stem, and motor cortex, leading to progressive muscle atrophy and weakness.
Clinical Features
UPPER MOTOR NEURON
Loss of Dexterity
Muscle Weakness
Spasticity
Hyperreflexia
Pathological reflexes
LOWER MOTOR NEURON
Muscle Weakness
Muscle Atrophy
Hypotonicity
Hyporeflexia
Fasciculation
Muscle Cramp
Impairment related to LMN
Other clinical features
Diagnostic Criteria
Diagnostic Procedure
EMG-
It include signs of active denervation, such as fibrillation potentials and positive sharp waves;
Signs of chronic denervation, such as large motor unit potentials (increased duration, increased proportion of polyphasic potentials, increased amplitude)
Unstable motor unit potential
Nerve Conduction Velocity Studies,
Muscle And Nerve Biopsies,
Neuroimaging Studies - MRI
Management- Multidisciplinary Approach
Physical Therapy Examination
Cognition
Pain
Psychosocial Function
Joint integrity, ROM and Muscle strength.
Motor Function: Gross motor and Fine motor
Muscle tone and reflexes
Cranial nerve integrity
Sensations
Gait
Respiratory Function
Physiotherapy goals in MND treatment.
Pain reduction
Prevention for contractures
Maintenance of joint mobility
Regular review of posture
Positioning to relieve discomfort
House Modification and ergonomic advice.
Management of Sialorrhea and Pseudobulbar Affect
Management for Dysphagia
PEG procedure.
A PEG may be recommended as the disease progresses.
A PEG is a type of gastrostomy tube inserted via endoscopic surgery that creates a permanent opening into the stomach for the introduction of food.
Studies have found that PEG insertion may prolong survival. Patients with PEG were found to live 1 to 4 months longer than those individuals who refused it.
Management of Dysphagia
A palatal lift prosthesis may be prescribed for individuals with good articulation but who have a breathy voice quality or decreased loudness because of excessive air loss through the nose.
The device, a dental appliance designed to attach to the existing teeth and to elevate the soft palate, is custom-made by a prosthodontist.
Brian Mulligan described novel concept of the simultaneous application of therapist applied accessory mobilizations and patient generated active movements
Physiotherapy in wards
physiotherapy in ICU
physiotherapy in Cardiology
physiotherapy in Gynecology
post operative physiotherapy
physiotherapy in PICU
Palliative patients physiotherapy
Geriatric patients
Benefits of the chest physiotherapy in ward patients
Benefits of Exercise Specific to Breast Cancer
THIS PRESENTATION INCLUDES DEFINITION, INDICATIONS, CONTRAINDICATIONS, AIMS, GOALS, PR TEAM, AND COMPONENTS OF THE PULMONARY REHABILITATION. THIS PRESENTATION IS MADE ONLY FOR LEARNING AND GUIDANCE PURPOSE.
Fast Track surgery from the orthopedic point of view
How to apply FTS in orthopedics specially in Arthroplasty surgery. Evidence based practice in orthopedics
These lecture slides, by Dr Sidra Arshad, offer a quick overview of the physiological basis of a normal electrocardiogram.
Learning objectives:
1. Define an electrocardiogram (ECG) and electrocardiography
2. Describe how dipoles generated by the heart produce the waveforms of the ECG
3. Describe the components of a normal electrocardiogram of a typical bipolar lead (limb II)
4. Differentiate between intervals and segments
5. Enlist some common indications for obtaining an ECG
6. Describe the flow of current around the heart during the cardiac cycle
7. Discuss the placement and polarity of the leads of electrocardiograph
8. Describe the normal electrocardiograms recorded from the limb leads and explain the physiological basis of the different records that are obtained
9. Define mean electrical vector (axis) of the heart and give the normal range
10. Define the mean QRS vector
11. Describe the axes of leads (hexagonal reference system)
12. Comprehend the vectorial analysis of the normal ECG
13. Determine the mean electrical axis of the ventricular QRS and appreciate the mean axis deviation
14. Explain the concepts of current of injury, J point, and their significance
Study Resources:
1. Chapter 11, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 9, Human Physiology - From Cells to Systems, Lauralee Sherwood, 9th edition
3. Chapter 29, Ganong’s Review of Medical Physiology, 26th edition
4. Electrocardiogram, StatPearls - https://www.ncbi.nlm.nih.gov/books/NBK549803/
5. ECG in Medical Practice by ABM Abdullah, 4th edition
6. Chapter 3, Cardiology Explained, https://www.ncbi.nlm.nih.gov/books/NBK2214/
7. ECG Basics, http://www.nataliescasebook.com/tag/e-c-g-basics
micro teaching on communication m.sc nursing.pdfAnurag Sharma
Microteaching is a unique model of practice teaching. It is a viable instrument for the. desired change in the teaching behavior or the behavior potential which, in specified types of real. classroom situations, tends to facilitate the achievement of specified types of objectives.
Recomendações da OMS sobre cuidados maternos e neonatais para uma experiência pós-natal positiva.
Em consonância com os ODS – Objetivos do Desenvolvimento Sustentável e a Estratégia Global para a Saúde das Mulheres, Crianças e Adolescentes, e aplicando uma abordagem baseada nos direitos humanos, os esforços de cuidados pós-natais devem expandir-se para além da cobertura e da simples sobrevivência, de modo a incluir cuidados de qualidade.
Estas diretrizes visam melhorar a qualidade dos cuidados pós-natais essenciais e de rotina prestados às mulheres e aos recém-nascidos, com o objetivo final de melhorar a saúde e o bem-estar materno e neonatal.
Uma “experiência pós-natal positiva” é um resultado importante para todas as mulheres que dão à luz e para os seus recém-nascidos, estabelecendo as bases para a melhoria da saúde e do bem-estar a curto e longo prazo. Uma experiência pós-natal positiva é definida como aquela em que as mulheres, pessoas que gestam, os recém-nascidos, os casais, os pais, os cuidadores e as famílias recebem informação consistente, garantia e apoio de profissionais de saúde motivados; e onde um sistema de saúde flexível e com recursos reconheça as necessidades das mulheres e dos bebês e respeite o seu contexto cultural.
Estas diretrizes consolidadas apresentam algumas recomendações novas e já bem fundamentadas sobre cuidados pós-natais de rotina para mulheres e neonatos que recebem cuidados no pós-parto em unidades de saúde ou na comunidade, independentemente dos recursos disponíveis.
É fornecido um conjunto abrangente de recomendações para cuidados durante o período puerperal, com ênfase nos cuidados essenciais que todas as mulheres e recém-nascidos devem receber, e com a devida atenção à qualidade dos cuidados; isto é, a entrega e a experiência do cuidado recebido. Estas diretrizes atualizam e ampliam as recomendações da OMS de 2014 sobre cuidados pós-natais da mãe e do recém-nascido e complementam as atuais diretrizes da OMS sobre a gestão de complicações pós-natais.
O estabelecimento da amamentação e o manejo das principais intercorrências é contemplada.
Recomendamos muito.
Vamos discutir essas recomendações no nosso curso de pós-graduação em Aleitamento no Instituto Ciclos.
Esta publicação só está disponível em inglês até o momento.
Prof. Marcus Renato de Carvalho
www.agostodourado.com
Integrating Ayurveda into Parkinson’s Management: A Holistic ApproachAyurveda ForAll
Explore the benefits of combining Ayurveda with conventional Parkinson's treatments. Learn how a holistic approach can manage symptoms, enhance well-being, and balance body energies. Discover the steps to safely integrate Ayurvedic practices into your Parkinson’s care plan, including expert guidance on diet, herbal remedies, and lifestyle modifications.
Basavarajeeyam is a Sreshta Sangraha grantha (Compiled book ), written by Neelkanta kotturu Basavaraja Virachita. It contains 25 Prakaranas, First 24 Chapters related to Rogas& 25th to Rasadravyas.
Title: Sense of Smell
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the primary categories of smells and the concept of odor blindness.
Explain the structure and location of the olfactory membrane and mucosa, including the types and roles of cells involved in olfaction.
Describe the pathway and mechanisms of olfactory signal transmission from the olfactory receptors to the brain.
Illustrate the biochemical cascade triggered by odorant binding to olfactory receptors, including the role of G-proteins and second messengers in generating an action potential.
Identify different types of olfactory disorders such as anosmia, hyposmia, hyperosmia, and dysosmia, including their potential causes.
Key Topics:
Olfactory Genes:
3% of the human genome accounts for olfactory genes.
400 genes for odorant receptors.
Olfactory Membrane:
Located in the superior part of the nasal cavity.
Medially: Folds downward along the superior septum.
Laterally: Folds over the superior turbinate and upper surface of the middle turbinate.
Total surface area: 5-10 square centimeters.
Olfactory Mucosa:
Olfactory Cells: Bipolar nerve cells derived from the CNS (100 million), with 4-25 olfactory cilia per cell.
Sustentacular Cells: Produce mucus and maintain ionic and molecular environment.
Basal Cells: Replace worn-out olfactory cells with an average lifespan of 1-2 months.
Bowman’s Gland: Secretes mucus.
Stimulation of Olfactory Cells:
Odorant dissolves in mucus and attaches to receptors on olfactory cilia.
Involves a cascade effect through G-proteins and second messengers, leading to depolarization and action potential generation in the olfactory nerve.
Quality of a Good Odorant:
Small (3-20 Carbon atoms), volatile, water-soluble, and lipid-soluble.
Facilitated by odorant-binding proteins in mucus.
Membrane Potential and Action Potential:
Resting membrane potential: -55mV.
Action potential frequency in the olfactory nerve increases with odorant strength.
Adaptation Towards the Sense of Smell:
Rapid adaptation within the first second, with further slow adaptation.
Psychological adaptation greater than receptor adaptation, involving feedback inhibition from the central nervous system.
Primary Sensations of Smell:
Camphoraceous, Musky, Floral, Pepperminty, Ethereal, Pungent, Putrid.
Odor Detection Threshold:
Examples: Hydrogen sulfide (0.0005 ppm), Methyl-mercaptan (0.002 ppm).
Some toxic substances are odorless at lethal concentrations.
Characteristics of Smell:
Odor blindness for single substances due to lack of appropriate receptor protein.
Behavioral and emotional influences of smell.
Transmission of Olfactory Signals:
From olfactory cells to glomeruli in the olfactory bulb, involving lateral inhibition.
Primitive, less old, and new olfactory systems with different path
Ozempic: Preoperative Management of Patients on GLP-1 Receptor Agonists Saeid Safari
Preoperative Management of Patients on GLP-1 Receptor Agonists like Ozempic and Semiglutide
ASA GUIDELINE
NYSORA Guideline
2 Case Reports of Gastric Ultrasound
How STIs Influence the Development of Pelvic Inflammatory Disease.pptx
pre and post PT -kk 3.pptx
1. Physiotherapy
in
Pre and Post operative stage
Dr. Kaushik Patel (MPT. PhD scholar)
Assistant professor SPB Physiotherapy college
2. • The incidence of pulmonary and circular complications is
higher after abdominal surgery
• Physical therapy has a valuable role to play in prevention of
respiratory and circulatory complications as well as their
treatment
Key Concepts
• Principles /Aims of physiotherapy
• Preoperative assessment
• Preoperative training
• Postoperative assessment
• Post operative training
3. • Pulmonary complications were more frequent, were associated
with longer hospital stay, and occurred in combination with
cardiac complications in a substantial proportion of cases.
• Lawrence va, hilsenbeck sg, mulrow cd, dhanda r, sapp j, page cp. Incidence and
hospital stay for cardiac and pulmonary complications after abdominal surgery.
Journal of general internal medicine. 1995 dec 1;10(12):671-8.
4. Principles /Aims of physiotherapy
To maintain muscle power and joint ROM
To prevent pressure sore
To maintain good posture
To improve & enhance bed mobility
To gain cooperation & confidence
To educate the patient
To prevent chest complications
To prevent circulatory complications
5. Steps of physiotherapy in abdominal surgery
Preoperative
assessment
Postoperative
physiotherapy
Postoperative
assessment
Postoperative
training
Preoperative
physiotherapy Preoperative
training
6. Preoperative physiotherapy
Ideally patient should be admitted to the hospital 24 hours or
more before the operation
This allowed the patient to settle in and to meet those who are
responsible for the surgery
7. Preoperative assessment
a) Read the notes
b) Assess the respiratory functions
c) Check for circulatory problems
d) Detailed history of the patient
It include both subjective and objective assessment
Benefits
• To gain good rapport
• To know the functional status
• To understand patients goals
8. a) Clinical notes reading
• Causes for surgery
• Comorbid conditions – like asthma, obesity, diabetes etc.
• Any other notes by the surgeon/ physician
b) Respiratory assessment
• Chest deformities – Kyphosis, Kyphoscoliosis,
pectusexcavatum and pectuscarninatum
• Breathing pattern – Normal rate
Inspiration and Expiration ratio
• Abnormal breathing pattern – Pursed lip breathing
Apnoea, Hypopnea
Cheyne stokes respiration
Ataxic breathing
Apneustic breathing
9. • Chest movements – Symmetry of chest movements
Depth of respiration
Accessory muscle involvement
• Chest expansion – Both observational and palpation
• Dyspnoea/ Breathlessness – “The New York Heart Association
Scale Of Dyspnoea”
• Orthopnoea – Breathless when lying flat
“The New York Heart Association Scale Of Dyspnoea”
I - No symptoms with ordinary activity /Breathlessness with exertion
II – Symptoms with ordinary activity
III – Symptoms with mild exertion
IV- Symptoms at rest
10. d) Circulatory assessment
• Homan’s test
• oedema- qualitative and quantitative both
e) History taking
• Medical history
• Subjective history
11. Preoperative training
Teach the patient any exercise that will be started during the very
early postoperative period
These often include..
• Breathing exercise
• Cough reflex
• Arm and leg exercise
• Posture correction
Benefits
• To educate and train the patient about the post operative
exercise program and physiotherapy importance
12. a) Patient education
• Explain the general plan of care
• Pre operative instructions
b) Breathing exercises
• Diaphragmatic and local expansion exercises
c) Cough
• Teach huffing and coughing technique
13. d) Arm exercises
• Short lever exercises
• Long lever exercises
e) Leg exercises
• Ankle& toe movements
• Static Q’ceps & glutei
f) Posture correction
• Advices
• Ergonomic advantages
14. • Preoperative exercise therapy is effective for reducing both
postoperative complication rates and length of hospital stay
after cardiac or abdominal surgery (SR: valkenet, K. Et al.,
2010)
• Valkenet, K. et al. The effects of preoperative exercise therapy on postoperative
outcome: a systematic review. Clinical Rehabilitation, Volume: 25 issue: 2, page(s):
99-111
15. • Preoperative inspiratory muscle training reduced the incidence
of postoperative pulmonary complications (such as actelectasis
and pneumonia) and length of hospital stay compared with
usual care in adults undergoing cardiac and major abdominal
surgery(sr: katsura M, et al.,2015)
• Katsura M, kuriyama A, takeshima T, fukuhara S, furukawa TA. Preoperative
inspiratory muscle training for postoperative pulmonary complications in adults
undergoing cardiac and major abdominal surgery. Cochrane database of
systematic reviews 2015, issue 10
16. Post-operative physiotherapy
Aim
• To avoid respiratory and circulatory complication
• To prevent pressure sore
• To prevent muscle wasting and joint stiffness
• To prevent wound infection
• Scar management
• Postural awareness
• Complete rehabilitation in ADL
17. Post operative assessment
(SOAP assessment format should be followed)
• Surgery notes reading
• Vital signs checking
• Understating the attachments
• Objective assessment
• Inspection of the surgical incision
Benefit –
• To know the post operative problems of the patient
18. a) Surgery notes reading
• Type of incision
• Type of anaesthesia
• Duration of surgery
• Immediate complications/unwanted
events/management
b) Vital signs checking
• Pulse oximetry
• PR
• ECG
• Heart sounds
• Systemic arterial blood pressure
• CVP
• TPR chart
• Ventilator support
• Lungs volume
• ABG analysis
19. c) Understanding the attachments
• IV lines
• Nasogastric tube
• Catheter
• PCA- patient control anaesthesia
• Drains
d) Orientation assessment
• Communication ability
• Alertness
• Perceptual ability to follow instructions
23. Post operative training
Benefits
• Early recovery and less hospital stay
a) To prevent chest complication
• Breathing exercise (emphasis on lower segments)
• Coughing/cough support
• Inhalation, humidification & PD
• Breath control exercises with arm movements
24. b) To prevent circulatory complication
• Trendelenburg tilt (15 degree bed end elevation)
• Leg exercises
• Early ambulation
• Bed mobility
• Trunk &abs exercises
• Prevention by medical means
e) Prevention of bad posture
• Firm back support
• Chair with arms
• Over correction
25. f) To prevent muscle wasting and joint stiffness
• Strengthening exe to weak muscle
• Endurance training
• Encourage walking and increase distance gradually
• Stair climbing
• Ask the Patient to be as independent as possible.
• Immediately after surgery, encourage patient to move his
limbs freely in full ROM.
• Relaxed passive movements.
• Active assisted exe. in full ROM then active movments.
26. g) Scar management
• Friction massage
• Modality like us.
h) Complete rehabilitation in ADL
27. • Chest physiotherapy during the immediate postoperative
period following upper abdominal surgery are effective for
improving oxygen-hemoglobin saturation without increased
abdominal pain. Breathing exercises could be adopted at post-
anesthesia care units with benefits for patients.
• Manzano RM, Carvalho CR, Saraiva-Romanholo BM, Vieira JE. Chest
physiotherapy during immediate postoperative period among patients undergoing
upper abdominal surgery: randomized clinical trial. Sao Paulo Medical Journal.
2008 Sep;126(5):269-73..
28. • The various techniques of physiotherapy (chest physiotherapy,
incentive spirometry, continuous positive airway pressure
breathing) seem to be equivalent in efficacy; but intermittent
positive pressure breathing has no advantages, compared with
the other treatments and could even be deleterious. Chest
physiotherapy and incentive spirometry are the most practical
methods available for decreasing secretion contents of
airways, whereas continuous positive airway pressure
breathing is efficient on atelectasis.
• Rezaiguia S, Jayr C. [Prevention of respiratory complications after abdominal
surgery] Annales Francaises D'anesthesie et de Reanimation. 1996 ;15(5):623-646.
29. • Physiotherapy interventions are likely to have a positive
impact across a range of outcomes including pain, qol,
physical function and depression.
• Physiotherapy interventions are likely to be effective in the
management of adults with Persistent post-surgical pain
(PPSP).
• Robinson A, McIntosh J, Peberdy H, Wishart D, Brown G, Pope H, Kumar S. The
effectiveness of physiotherapy interventions on pain and quality of life in adults
with persistent post-surgical pain compared to usual care: A systematic review.
PloS one. 2019 Dec 13;14(12):e0226227.