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الموضوع: About Physical Therapy: A Patient’s Guide

  1. #1
    تاريخ التسجيل
    Jan 2007
    الدولة
    الأردن-فلسطين
    المشاركات
    2,252

    About Physical Therapy: A Patient’s Guide

    About Physical Therapy: A Patient’s Guide
    Department of Rehabilitation Therapies
    University of Iowa Hospitals and Clinics
    Peer Review Status: Internally Peer Reviewed
    Creation Date: November 2002
    Last Revision Date: November 2002
    -------------------------
    Physical therapy helps people restore and maintain optimal physical function. Physical therapists use examination and treatment to help people improve their ability to move and function as best they can to enable them to perform their necessary daily activities.
    Physical therapists provide services to assist people in preventing injury and illness, or worsening an existing injury. Therapists work with people of all ages who require assistance due to illness, injury, or developmental delay.
    [IMG]//www.uihealthcare.com/topics/medicaldepartments/orthopaedics/physicaltherapy/cover_art.jpg[/IMG]


    Physical Therapy for Hospitalized Patients
    Physical therapists working with acute inpatients strive to improve their mobility and to prepare them for discharge from the hospital. Inpatients with a wide variety of health concerns benefit from physical therapy. The inpatient areas in which physical therapists work, include burns, cardiac, digestive diseases, general medicine, neonatology, neurology, neurosurgery, oncology, orthopedics, psychiatry, rheumatology, transplant, and trauma.
    Physical therapists evaluate patients and work as part of a team to determine appropriate discharge plans including home, inpatient rehabilitation or skilled nursing, and outpatient services.
    Evaluation procedures include:

    • Range of Motion
    • Strength
    • Sensation/Pain
    • Bed Mobility
    • Transfers
    • Gait
    • Balance
    • Coordination
    • Exercise Tolerance
    • Prosthetic Requirements
    • Assistive and Adaptive Equipment Requirements
    Physical therapists use the findings of their evaluation to determine appropriate interventions and develop a treatment plan to improve patient’s mobility and functional skills.


    Interventions include:

    • Therapeutic Exercise
    • Balance Training
    • Mobility Training
    • Gait Training
    • Patient and Family/Caregiver Education
    Aquatic Therapy

    Patients that may benefit from aquatic therapy:
    • Obese
    • Pre-existing orthopedic conditions
    • Range of motion limitations
    • Compromised balance
    • Patients with congestive obstructive pulmonary disease (COPD)
    • Patients with eating disorders
    Properties of water that are beneficial for patients:
    • Hydrostatic pressure helps with breathing and reduces heart rate response to exercise, which lowers the rate of perceived exertion
    • Buoyancy makes exercise primarily non-weight bearing
    • Viscosity provides resistance through joint range of motion
    • Temperature 92-94 degrees F helps to reduce joint and muscle soreness and stiffness
    People participating in aquatic therapy may benefit from the following:
    • Enhancement of the cardiorespiratory system
    • Improvement of joint and muscle flexibility
    • Improvement of muscular strength
    • Improvement of muscular endurance
    • Improvement of balance
    • Improvement of psychosocial aspects
    Hand Therapy




    Hand therapists treat patients with such diverse diagnoses as:


    • Fractures
    Tendon lacerations




    Nerve damage

    Sprains
    Carpal tunnel
    Tendonitis
    Congenital defects

    Amputations


    Rheumatoid arthritis

    Certified hand therapists will perform a thorough examination of the musculoskeletal and neurological function, from which they design individualized programs for patient management.





    Hand rehabilitation may include customized splinting to protect healing tissues, obtain desired positions and motion, or substitute for decreased function.




    Exercise programs address specific needs such as joint stiffness, muscle weakness or imbalance, conditioning for occupations or athletic demands, and maximizing function. A therapist may recommend adaptive devices and modifications in the home or work environment to allow patients to function as effectively and safely as possible.




    Sports Therapy




    Tpically, sports therapy specializes in the care of orthopedic injuries to the extremities and spine, such as:


    • Muscular strains

    Joint sprains




    Meniscal injuries

    Overuse injuries
    Bursitis
    Pre- or Post-op rehabilitation for joint or ligament reconstruction
    Fractures
    Amputations
    Arthritis

    Therapists utilize their knowledge of research from the literature and their clinical experience to develop clinical treatments for sports-related injuries. These protocols are then individualized for a patient’s particular problem and may include:
    • Electrical stimulation
    Biofeedback
    Computerized strength testing/training
    Therapeutic pool
    Manual techniques

    Vestibular Rehabilitation


    Vestibular rehabilitation is an individualized, comprehensive evaluation and treatment approach for persons with vestibular disorders. Vestibular rehabilitation uses an exercise approach to:


    • Decrease dizziness

    Improve gaze stabilization




    Improve balance by retraining sensory and motor aspects of postural control

    Increase overall activity level

    Most exercises are designed to facilitate central nervous system (CNS) compensation rather than altering the underlying vestibular pathology.




    Women’s Health-related Therapy



    Obstetrics

    • Diagnosis and treatment of musculoskeletal disorders in pregnancy including carpal tunnel, low back pain, upper-back and neck pain, knee pain, tarsal tunnel syndrome, abdominal weakness
    Transcutaneous Electrical Nerve Stimulation instruction for use during labor for pain relief




    C-section recovery- pelvic floor exercises, abdominal exercise, positioning for comfort, scar mobilization

    Cardiovascular exercise instruction for gestational diabetes mellitus
    Prenatal exercise instruction in proper posture, body mechanics, prevention of diastasis, prevention of urinary incontinence
    Care during high-risk pregnancies—bed rest including range of motion, bed mobility and transfers, prevention of deconditioning, positioning

    Gynecology
    • Exercise for pelvic floor musculature to prevent and treat urinary incontinence
    Biofeedback and myofascial treatment for pelvic pain
    Pre- and post-op education on safe exercise and proper body mechanics

    Fibromyalgia
    • Instruction in use of pain-controlling modalities
    • Instruction in safe and progressive exercise program
    التعديل الأخير تم بواسطة Dr.isra ; 03-28-2008 الساعة 09:31 PM

  2. #2
    تاريخ التسجيل
    Jan 2007
    الدولة
    الأردن-فلسطين
    المشاركات
    2,252

    افتراضي

    Hurt vs. Harm: Understanding Pain

    Mary Lou Fairchild, PT
    University of Iowa Hospitals and Clinics
    Department of Physical Therapy

    Knowledge is power!This is the primary reason for educating people about back pain. We want you to understand and accept better what is going on with you rather than living in fear of thinking you are doing something that causes you more damage and more harm.
    Most people do not understand that there are two kinds of pain. Acute pain is the kind that we usually identify with injuries, for example, when you cut your finger, break leg, and so forth. With acute pain, after you have healed, your pain goes away, as well. Chronic pain persists even when the stimulus for pain is no longer there. Chronic pain can happen for a couple of reasons. You can have a problem that is not “fixable” with traditional medical treatments such as epidural injections. The other kind of pain occurs when the nerves no longer are being stimulated, but they continue to send messages of pain. A good example of this is phantom leg pain. An individual may lose a leg but two years down the road still feels the leg is there. Such individuals may complain, “my toe hurts, I’m having pain in my leg,” and so forth. How can this be?This is similar to the chronic pain that some people get. But just because there may be no identifiable problem, this does not mean you don’t hurt.
    Chronic pain occurs in 3-5% of the world’s population. There aren’t very many of you out there, and you are misunderstood people. Chronic pain is not only misunderstood by the lay population, for example family and friends, but also is not well understood by medical professionals. You may feel that medical professionals, including physicians and physical therapists, look at me funny after I say I’ve tried everything including PT and I know it has helped other people. You may feel like they look at you as someone who is a “wimp” or as someone who is milking the system. You may have even been told that your problem is “all in your head.”
    These kinds of comments may have resulted in your feeling angry and frustrated. When you are in this state, your muscles tighten and you have more pain. It creates a big cycle. Chronic pain creates considerable stress—just because it is not identifiable, doesn’t mean you don’t have genuine chronic pain.
    Hurt versus harm—is there a difference? Yes. Let us explain. We can use a sports analogy. An athlete can be hurt while practicing or competing, his or her leg is put in an immobilizer or cast, and we don’t expect that athlete to return to his sport the next day. He has to go through healing and rehabilitation. At end of the rehabilitation, the athlete has a decision to make: do I return to athletics and possibly hurt myself, or does the athlete decide it’s not worth it to me to face the prospect of harming myself again and facing constant pain.
    The same thing happens to people who are not athletes. Almost everyone requires rehabilitation after an injury. You may always have discomfort and pain. But you have a decision: do I let it stop my life or do I “play” through it. Let’s give you an example of hurt associated with daily life activities. It is spring, you get excited, and you go outside and enthusiastically start preparing your garden. This is not something you have done for a while. You are using different muscles and you very well may get sore afterward. Many people may find that they “hurt” when they do things they have not for a while (or at all). They may ask themselves: is this just an expected “hurt” or is it something more?We are taught as children that pain is a warning. We pay attention to pain and try to do something about it. This happens with what we call “acute pain” but not for those with chronic pain. When you have back pain, you usually back off for a while and resume your activities after a few days. This is the same thing that people with chronic pain do. They do their prescribed exercises, hurt a lot, back off and don’t do them for a few days only to return and find that the same cycle occurs. It often feels like you hit a wall. You never get past that wall because you fear you are causing yourself harm or damage. This fear stops most people.
    After you are medically evaluated by a spine doctor and the doctor has told you that it is safe to participate in rehabilitation, then you need to believe and trust that nothing you will be asked to do in a rehabilitation program administered by a licensed physical therapist is going to harm or damage you. This does not mean that we don’t believe you hurt.
    A committed physical therapist can give you the tools to become as functional as you can be physically and emotionally, but you will still have some discomfort. We do not promise to “cure” you of all of your back pain.



    Facts About Back and Neck Problems
    1. Many of us will experience significant back pain at some time in our lives. Most of us recover and move on with our lives with little or no problem.
    2. Less than 5% of people with back problems require surgery.
    3. Back pain can be separated into two major categories:
      1. Acute or recent back pain that is less than six months from the onset
      2. Chronic back pain that persists longer than six months
    4. Treatment for chronic pain differs from treatment for acute pain. (Hurt vs. Harm)
    5. Patients with chronic pain report that they have not responded well to:
      1. Taking pain medication for extended periods of time
      2. Extended periods of non-physical activity
      3. Passive therapies such as traction, stimulators (TENS), chiropractic, and massage
      4. Excessive use of cold or heat packs
      Treatments such as these are often not enough to help improve a chronic pain condition.
    6. In general, people with acute back pain represent the vast majority of those who experience back problems. People with chronic back pain, although a very small group of people with back pain, represent by far the most frustrating and costly back problems.
    7. Often patients with persistent back pain see many different medical professionals, hear confusing and, sometimes, conflicting stories about the cause of their pain and often feel that others think it is “all in their head.” Understandably, individuals with long-standing back pain may become angry, depressed, frustrated and stressed by the personal and financial crisis long-term pain can cause.
    The first step in proper treatment of a back problem is to understand the difference between chronic and acute pain and then work with members of a certified rehabilitation team on developing an effective treatment plan.

  3. #3

    افتراضي

    شكرا لك د. إسراء .. .. ....

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    وإلى الأمام .

  4. #4
    تاريخ التسجيل
    Jan 2007
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    الأردن-فلسطين
    المشاركات
    2,252

    افتراضي

    انت اللي نورت بمرورك

    شكرا جزيلا علي على تواجدك القوي

    الى الامام


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