PHYSIOTHERAPY AND
REHABILITATION
Presenter : Dr. S.V.Hari krishnan(PGT ORTHO)
LEARNING OBJECTIVES
INTRODUCTION
ELECTROTHERAPY
CRYOTHERAPY
EXERCISE THERAPY
HYDROTHERAPY
REHABILITATION
CONCLUSION
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.
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
PHYSIOTHERAPY SPECIALTIES
CARDIO GERIATRIC
PHYSIOTHERAPY PAEDIATRIC PHYSIOTHERAPY
PHYSIOTHERAPY
ORTHOPAEDIC SPORTS NEUROLOGY
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.
• Thus rehabilitation includes prevention of
avoidable disabilities
Bed-sores
Venous thrombosis
Urinary infection
Renal stones
Muscle wasting
Joint stiffness and
Contractures
early mobilization
ELECTROTHERAPY
Interferential
Shortwave Microwave
Ultra sound Current Therapy (
Diathermy Diathermy
IFT)
Transcutaneous
Electrical Nerve Faradic & galvanic Cervical/ Lumbar
Wax bath
Stimulation ( muscle stimulator Traction
TENS).
Infrared rays LASER
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
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
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.
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
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
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
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
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
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
CRYOTHERAPY
Application of cold
Pain and muscle spasm
Reduction in flow of fluid in to
fibres
Stretching of collagen due to
tension(tear)
Reduces transmission of pain
impulses
Blood vessels are torn,invagination
of fluid in to muscle fibres
Reduces spasm (reduces ability of
muscle to maintain contraction)
Bruises in skin
Swelling and internal bleeding is
reduced
Advantages Disadvantages
Usually inexpensive. It is difficult to keep the ice in
Quick application with little place
preparation. Quickly melts
Faster muscle recovery No compression is applied.
Promotes healthier skin Can only be applied for short
complexion periods of time (10-20
Effective with chronic pain minutes).
management
Reduces stress & anxiety
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
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
EXERCISE THERAPY
Active & Passive Joint Mobilization Suspension
Resisted exercises
Exercises techniques. therapy
Proprioceptive
Relaxation
Hydrotherapy Stretching Neuromuscular
techniques
Facilitation. ( PNF)
Myo Fascial Muscle Energy Gait & Balance Posture
Release Technique Technique Training Correction.
Breathing Exercise Postural training
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
SHOULDER WHEEL EXERCISES FINGER LADDER EXERCISES
To improve the Range of
motion of shoulder joint
PARALLEL BARS
For gait training & posture correction
STAIRS & RAMP WOBBLE BOARD
Stair climbing training
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
SUSPENSION THERAPY
To improve range of movements
QUADRICEPS CHAIR AND STATIC
BICYCLE
For Quadriceps Strengthening
GYM BALL EXERCISE
For Back exercise , Neck & trunk control in Baby
OVERHEAD PULLEY & SUPINATOR/ PRONATOR
EXERCISE
FINGER EXERCISER
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
TYPES
TYPES
RIGID FRAMES AXILLARY / UNDER WALKING
FOLDING FRAMES ARM CRUTCHES STICKS(TETRAPOD
RECIPROCAL FRAMES ELBOW CRUTCHES AND TRIPOD)
FOREARM (LOFSTRANDS )
SUPPORTING FRAMES FOREARM
WHEELED FRAMES
(GUTTER
CRUTCHES)
ROLLATORs
AXILLARY CRUTCHES
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)
Gutter crutches
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
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
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
USES
• Long standing back ache
• Fibromyalgia
• Sports injuries
• Rotator cuff injuries
• Sciatica
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
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
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
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
EARLY continued during outpatient and
in patient department
• Aims at adaption to new
LATE environment of persons with
disabilities and employment
STAGES OF REHABILATION
• Immobilisation
ACUTE • Medications/surgery
• Specific exercises
RECOVERY • Neuromuscular
control
• Specific functional
FUNCTIONAL programes
• Exercises
SOCIAL REHABILITATION
• Goal:
– Recovery of skills in the affected for self catering
and living conditions
PROFESSIONAL REHABILITATION
• Goal :
– Restoration (full /partial) or nursing of new
professional skills allowing the sick and disabled
patients to return to work
PRINCIPLES OF REHABILITATION
Early beginning(hospital)
Succession(out patient basis)
Continuity
PERIODS OF REHABILITATION
HOSPITAL
OUTPATIENT POLYCLINICS
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
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)
THANK YOU
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and spiritual well-being. Think
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