Pulmonary rehabilitation is a comprehensive intervention based on a thorough patient assessment followed by patient tailored therapies that include, but are not limited to, exercise training, education, and behavior change, designed to improve the physical and psychological condition of people with chronic respiratory disease and to promote the long-term adherence to health-enhancing behaviors”
Pulmonary rehabilitation is a comprehensive intervention based on a thorough patient assessment followed by patient tailored therapies that include, but are not limited to, exercise training, education, and behavior change, designed to improve the physical and psychological condition of people with chronic respiratory disease and to promote the long-term adherence to health-enhancing behaviors”
physiotherapy management for chronic obstructive pulmonary disease Sunil kumar
role of physiotherapy in chronic obstructive pulmonary disease, principles of physical therapy management in copd, physiotherapy assessing and treatment for copd
Neurophysiological Facilitation of Respiration is a treatment technique used for respiratory care of patients with unconscious or non-alert, and ventilated, and also with a neurological condition
NPF is the use of external proprioceptive and tactile stimuli that produce reflex respiratory movement responses and that increase the rate and depth of breathing
Application of PEP devices in Cardiorespiratory physiotherapy.
It includes types of PEP devices and their uses in physiotherapy..
It stands for positive expiratory pressure.
It includes spirometry, flutter, rc cornet, acapella, etc.
useful in various cardiorespiratory disorders like COPD, asthma , cystic fibrosis, respiratory failure etc.
Inspiratory Muscle Training or Respiratory Muscle Training or Ventilatory Muscle Training. IMT is the physiotherapy technique, with the help of different breathing exercises.
Manual ventilation, or ‘bagging’, is the use of a manual resuscitator bag (MRB) for the ventilation of a patient via either a facemask or an endotracheal tube.
Types of techniques:
Airway clearance techniques
Facilitating airway clearance technique with effective coughing techniques
Technique to facilitate ventilation pattern
Mobilization and Exercises
Airway clearance technique:
Postural drainage
Percussion
Vibration/shaking
Manual hyperinflation
Active cycle of breathing technique
Autogenic drainage
Positive expiratory pressure
High frequency chest compression
Exercises for airway clearance
Indications and cautions:
Cystic fibrosis
Atelectasis
Asthama
Respiratpry muscle weakness
Bronchiectasis
Mechanical ventilation
Neonatal respiratory distress syndrome
Contraindications:
Intracranial pressure (ICP) > 20 mm Hg
Head and neck injury until stabilized
Active hemorrhage with hemodynamic instability
Recent spinal surgery (e.g .• laminectomy) or acute spinal injury
Active hemoptysis Empyema
Bronchopleural fistula
Large pleural effusions
Pulmonary embolism
Aged, confused, or anxious patients
Rib fracture. with or without flail chest
Surgical wound or healing tissue
physiotherapy management for chronic obstructive pulmonary disease Sunil kumar
role of physiotherapy in chronic obstructive pulmonary disease, principles of physical therapy management in copd, physiotherapy assessing and treatment for copd
Neurophysiological Facilitation of Respiration is a treatment technique used for respiratory care of patients with unconscious or non-alert, and ventilated, and also with a neurological condition
NPF is the use of external proprioceptive and tactile stimuli that produce reflex respiratory movement responses and that increase the rate and depth of breathing
Application of PEP devices in Cardiorespiratory physiotherapy.
It includes types of PEP devices and their uses in physiotherapy..
It stands for positive expiratory pressure.
It includes spirometry, flutter, rc cornet, acapella, etc.
useful in various cardiorespiratory disorders like COPD, asthma , cystic fibrosis, respiratory failure etc.
Inspiratory Muscle Training or Respiratory Muscle Training or Ventilatory Muscle Training. IMT is the physiotherapy technique, with the help of different breathing exercises.
Manual ventilation, or ‘bagging’, is the use of a manual resuscitator bag (MRB) for the ventilation of a patient via either a facemask or an endotracheal tube.
Types of techniques:
Airway clearance techniques
Facilitating airway clearance technique with effective coughing techniques
Technique to facilitate ventilation pattern
Mobilization and Exercises
Airway clearance technique:
Postural drainage
Percussion
Vibration/shaking
Manual hyperinflation
Active cycle of breathing technique
Autogenic drainage
Positive expiratory pressure
High frequency chest compression
Exercises for airway clearance
Indications and cautions:
Cystic fibrosis
Atelectasis
Asthama
Respiratpry muscle weakness
Bronchiectasis
Mechanical ventilation
Neonatal respiratory distress syndrome
Contraindications:
Intracranial pressure (ICP) > 20 mm Hg
Head and neck injury until stabilized
Active hemorrhage with hemodynamic instability
Recent spinal surgery (e.g .• laminectomy) or acute spinal injury
Active hemoptysis Empyema
Bronchopleural fistula
Large pleural effusions
Pulmonary embolism
Aged, confused, or anxious patients
Rib fracture. with or without flail chest
Surgical wound or healing tissue
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.
Topic : Introduction to Physical Therapy
By : Dr. Kaiynat Shafique PT
Contents
▪️ Definition and History of Physiotherapy
▪️ The Profession of Physical Therapy - Current practice
▪️ Pain assessment and Outcome measures
▪️Medical Terminologies
▪️Introduction of Physiotherapy Modalities
▪️Introduction to Therapeutic Exercises
▪️Patient Positioning and bed mobility
▪️Gait Training and assistive devices ▪️Musculoskeletal disorders presentation
▪️MSK disorders and Treatments
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this power point presentation provides main emphasis on the phases of the rehabilitation post op. it will enhance the knowledge about do's and dont's during the rehabilitation phases in brief. U may ask the questions if you have in your mind in the comment section. this ppt includes upper extremity as well as lower extremity exercises and also provides easy understanding with the help of suitable and intresting diagrams
4. Physiotherapeutic approach of management in mechanically ventilated patient.ShagufaAmber
Mechanical ventilation (MV) is one of the most common interventions in the intensive care unit (ICU). Physical therapy includes early mobilisation to improve functional outcomes. Physical therapy interventions include passive movements of the extremities for deeply sedated patients, in-bed and out-of-bed mobility, active or passive cycling ,neuromuscular electrical stimulation and ambulation.Chest physiotherapy facilitates removal of retained or profuse airway secretions aiming to reduce airway resistance, optimize lung compliance, and decrease the work of breathing. Multimodality respiratory physiotherapy appeared to reduce mortality in ICU patients.
Flu Vaccine Alert in Bangalore Karnatakaaddon Scans
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Title: Sense of Taste
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 structure and function of taste buds.
Describe the relationship between the taste threshold and taste index of common substances.
Explain the chemical basis and signal transduction of taste perception for each type of primary taste sensation.
Recognize different abnormalities of taste perception and their causes.
Key Topics:
Significance of Taste Sensation:
Differentiation between pleasant and harmful food
Influence on behavior
Selection of food based on metabolic needs
Receptors of Taste:
Taste buds on the tongue
Influence of sense of smell, texture of food, and pain stimulation (e.g., by pepper)
Primary and Secondary Taste Sensations:
Primary taste sensations: Sweet, Sour, Salty, Bitter, Umami
Chemical basis and signal transduction mechanisms for each taste
Taste Threshold and Index:
Taste threshold values for Sweet (sucrose), Salty (NaCl), Sour (HCl), and Bitter (Quinine)
Taste index relationship: Inversely proportional to taste threshold
Taste Blindness:
Inability to taste certain substances, particularly thiourea compounds
Example: Phenylthiocarbamide
Structure and Function of Taste Buds:
Composition: Epithelial cells, Sustentacular/Supporting cells, Taste cells, Basal cells
Features: Taste pores, Taste hairs/microvilli, and Taste nerve fibers
Location of Taste Buds:
Found in papillae of the tongue (Fungiform, Circumvallate, Foliate)
Also present on the palate, tonsillar pillars, epiglottis, and proximal esophagus
Mechanism of Taste Stimulation:
Interaction of taste substances with receptors on microvilli
Signal transduction pathways for Umami, Sweet, Bitter, Sour, and Salty tastes
Taste Sensitivity and Adaptation:
Decrease in sensitivity with age
Rapid adaptation of taste sensation
Role of Saliva in Taste:
Dissolution of tastants to reach receptors
Washing away the stimulus
Taste Preferences and Aversions:
Mechanisms behind taste preference and aversion
Influence of receptors and neural pathways
Impact of Sensory Nerve Damage:
Degeneration of taste buds if the sensory nerve fiber is cut
Abnormalities of Taste Detection:
Conditions: Ageusia, Hypogeusia, Dysgeusia (parageusia)
Causes: Nerve damage, neurological disorders, infections, poor oral hygiene, adverse drug effects, deficiencies, aging, tobacco use, altered neurotransmitter levels
Neurotransmitters and Taste Threshold:
Effects of serotonin (5-HT) and norepinephrine (NE) on taste sensitivity
Supertasters:
25% of the population with heightened sensitivity to taste, especially bitterness
Increased number of fungiform papillae
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16. CONTRAINDICATIONS
Intracranial pressure (ICP) > 20 mm Hg
Head and neck injury until stabilized
Active hemorrhage with hemodynamic instability
Recent spinal surgery (e.g .• laminectomy) or
acute spinal injury
Active hemoptysis Empyema
Bronchopleural fistula
Large pleural effusions
Pulmonary embolism
Aged, confused, or anxious patients
Rib fracture. with or without flail chest
Surgical wound or healing tissue
17. Trendelenburg Position is Contraindicated for
the Following: .
Patients in whom increased ICP is to be avoided
Uncontrolled hypertension
Distended abdomen
Esophageal surgery
Recent gross hemoptysis related to recent lung
carcinoma
Uncontrolled airway at risk for aspiration
18. Subcutaneous cmphysema
Recent epidural spinal infusion or spinal anesthesia
Recent skin grafts, or flaps, on the thorax
Burns.
open wounds. and skin infections of the thorax
Recently placed pacemaker
Suspected pulmonary tuberculosis
Lung contusion
Bronchospasm
Osteomyelitis of the ribs
Osteoporosis
Coagulopathy Complaint of chest-wall pain
19. TREATMENT PRESCRIPTION.
Motivation
Patient’s goals
Physician/caregiver’s goals
Effectiveness ( of considered technique
Patient’s age
Ease (of learning and of teaching)
Skill of therapist/teachers
Fatigue or work required
Need for assistants or equipment
Limitations of technique based on disease type and severity
Costs (direct and indirect)
Desirability of combing methods
20. FACILITATING AIRWAY CLEARANCE WITH
EFFECTIVE COUGHING TECHNIQUE
What is cough….???
Stages of cough
Techniques of teaching effective coughing
self assisted coughing
manual coughing
26. TECHNIQUE TO FACILIATE VENTILATION
PATTERN
Body positioning
Breathing technique
Mobilizing the thorax
Facilitating the accessory muscles of respiration
27. BODY POSITIONING
Standing upright position
Erect sitting (self supported or with assist) with feet
moving (e.g., active, active assisted or passive cycling
motion)
Erect silting (self-supported or with assist) with feet
dependent
Lean forward sitting with arms supported and feet
dependent
24S degree sitting with legs dependent
Erect long sitting (legs non dependent)
< 4S degrees sitting (legs non dependenl)
Prone and semi prone/side lying
Supine
36. MOBILIZATION AND EXERCISES
What is mobilization.?
Mobilization is defined as the therapeutic and
prescriptive application of low-intensity exercise
in the management of cardiopulmonary
dysfunction usually in acutely ill patients.
Primarily, the goal of mobilization is to exploit
the acute effects of exercise to optimize oxygen
transport.
Even a relatively low intensity mobilization
stimulus can impose considerable metabolic
demand on the patient with cardiopulmonary
compromise.
37. In addition, mobilization is performed in the
upright position, that is the physiologic position,
whenever possible,
to optimize the effects of being upright on central
and peripheral hemodynamics and fluid shifts.
Thus mobilization is prescribed to elicit both a
gravitational stimulus and an exercise stimulus
38. EXERCISE
What are the exercises given
Exercise is the term used to describe the
therapeu tic and prescriptive application of
exercise in the management of subacute and
chronic cardiopul monary and cardiovascular
dysfunction. Primarily, the goal of exercise is to
exploit the cumulative ef fects of and adaptation
to long-term exercise and thereby optimize the
function of all steps in the oxy gen transport
pathway.
39. TREATMENT PRESCRIPTION FOR
MOBILIZATION AND EXERCISES
It depends on the patient’s condition
Whether the patient is in patient or in out
patient department
Also it depends on the functionality of the patient
at the present stage
It is decided on the basis of the exercise testing
protocol
Also on the basis of METs
40.
41. Step 1
Identify all the factors underlying the pathology causing
deficits in oxygen supply.
Step 2
Determine whether mobilization and exercise are indicated
and if so, which form of either will specifically address the
oxygen transport deficits identified in Step I.
Step 3
Match the appropriate mobilization or exercise stimulus to
patient's oxygen transport capacity.
Step 4
Set the intensity within therapeutic and safe limits of the
patient's oxygen transport capacity.
Step 5
Combine the various body positions especially in the erect
position with the following maneuvers:
42. Step 6
Set the duration of the mobilization sessions based on the
patient's responses (i.e., changes in measures and indices of
oxygen transport) rather than time.
Step 7
Repeat the mobilization session as often as possible based on
its beneficial effects and on is being safely tolerated by the
patient.
Step 8
Increase the intensity of the mobilization stimulus. duration of
the session, or both comml!l1surate with the patient's
capacity to maintain optimal oxygen transport when
confronted with an increased mobilization stressor, and in
the absence of distress; monitored variables to remain within
predetermined threshold range.
43. HEIARCHY OF TREATMENT FOR OXYGEN
SUPPLY TREATMENT
PREMISE: Position of optimal physiological
function is being upright and moving.
Mobilization and Exercise
Body Positioning
Breathing Control Maneuvers
Coughing Maneuvers
To minimize the work of breathing. of the heart.
and oxygen demand overall
ROM Exercises (Cardiopulmonary indications)
Postural Drainage Positioning
Manual Technique
Suctioning
44. PARAMETERS FOR TREATMENT PRESCRIPTION
IN THE MANAGEMENT OF CARDIOPULMONARY
PATIENTS
Define parameters of treatment based on history,
laboratory investigations, tests, and assessment
Treatment type
Intensity (if applicable)
Duration
Frequency
Instruct patient in "between treatment"
treatment, and if applicable the nurse. a family
member. or both
Reassessment every treatment
Modify as necessary within each treatment
Progress between treatments as indicated
45. Define treatment outcomes
Determine when treatment is to be discontinued
Request for additional supportive information. tests, and
investigations as indicated
Predict time course for optimal effects and course of
treatment to determine treatment efficacy; modify as
necessary
In conjunction with other interventions (e.g., medical,
surgical, nursing, respiratory therapy (weaning oxygen
supplementation.
sympathomimetic drugs, ADLs, balance with sleep and rest
periods. peak of nutrition and feeds. Peak energy times. peak
of drug potency and effects (e.g., pain, reduced sedation.
reduced neuromuscular blockade)
47. REFERENCES
Principles and practice of cardiopulmomary
physical therapy 3rd edition Donna Frownfelter
Tidy’s physiotherapy
Physiotherapy for respiratory and cardiac
problems 3rd edition by Jenifer A Pryor