for a full program of PT
a physician generally refers a patient to a licensed physical therapist
physical therapy
a medical specialty for the treatment of musculoskeletal, nervous, and cardiopulmonary disorders
physical therapist
uses a variety of treatments, including cold, heat, water, exercise, massage, and traction
PT benefits
restores and improves muscle function, builds strength, increases joint mobility, relieves pain, and increases circulation
PT uses
to treat various disorders, including arthritis, stroke, lower back pain, muscle spasms, muscle injuries or diseases, pressure sores, skin disorders, and burns
therapeutic team
physicians, nurses, medical assistants, and other specialists who work with patients dealing with chronic illness or recovery from major injuries
MA responsibilities
explaining a specialist's treatment approach to the patient; documenting the specialist's treatments and findings for the physician; answering the patient's questions
range of motion (ROM)
the degree to which a joint is able to move
goniometer
protractor device used to measure degree to which a joint is able to move
muscle strength testing
to determine the amount of force the patient is able to exert with a muscle or group of muscles
gait testing
includes an appraisal of the patient's length of stride, balance, coordination, direction of knees, and direction of feet
posture testing
doctor assesses posture by looking at the patient's spinal curve from the sides, back, and front. Dr. also notes the symmetry of alignment of the shoulders, knees, and hips
posture
body position and alignment
cryotherapy
applying cold to a patient's body for therapeutic reasons
thermotherapy
applying heat to a patient's body for therapeutic reasons
temperature tolerance
tolerance of temperature extremes varies greatly from person to person. Some people are unusually sensitive to cold or to heat. Listen carefully to patients for any indication of temperature intolerance during treatment. Cases of intolerance should be rep
principles of cryotherapy
limiting edema, constricting blood vessels, reduction of inflammation, an anesthetic effect for pain by reducing inflammation, reduction of pus formation, lowering of body temperature
dry cold applications
include ice bags, ice collars, and chemical ice packs
ice bag
a rubber or plastic bag with a locking lid
ice collar
rubber or plastic kidney-shaped bag, specially curved to fit around the back of the neck
chemical ice pack
usually a flat plastic bag containing a semifluid chemical
wet cold applications
include cold compresses and ice massage. The combination of the cold temperature and the motion of the massage can provide therapeutic relief for the localized pain resulting from a sprain or strain
principles of thermotherapy
relief of pain and congestion, reduction of muscle spasms, muscle relaxation, reduction of inflammation, reduction of swelling
erythema
redness
blanching
to become white or pale
dry heat therapy
include the use of chemical hot packs, heating pads, hot-water bottles, heat lamps with infrared or ultraviolet bulbs, and fluidotherapy
heating pad
physician should specify the temperature (low, medium, high) and length of time the pad should be applied; cover pad with a pillowcase or towel; make sure patient's skin is dry; patient should never lie on top of pad, as burns could result
ultraviolet rays are used
to kill bacteria and promote vitamin D formation
ultraviolet rays stimulate
epithelial cells and cause blood vessels to overfill, increasing the skin's defenses against bacterial infections
ultraviolet lamps
used to treat psoriasis, pressure sores, and wound infections
fluidotherapy
a technique for stimulating healing, particularly in the hands and feet. Patient places the affected body part in a container of glass beads that are heated and agitated with hot air
moist heat applications
include hot soak, hot compress, hot pack, and paraffin bath
paraffin bath
a receptacle of heated wax and mineral oil. It is used to reduce pain, muscle spasms, and stiffness in patients with arthritis and similar disorders; has added benefit of leaving the skin warm, flexible, and soft
diathermy
type of heat therapy in which a machine produces high-frequency waves that achieve deep heat penetration in muscle tissue
three types of diathermy
ultrasound, shortwave, and microwave
shortwave
do not use on a patient who has a pacemaker
microwave contraindications
use on patients with pacemakers, in combination with wet dressings, or in high dosages on patients with swollen tissue. Also, never use near metal implants because the reaction between metal and microwaves could cause burns
hydrotherapy
the use of water to treat physical problems
common forms of hydrotherapy
use of whirlpools and contrast baths and underwater exercises
regular exercise therapy
can help prevent problems caused by inactivity
lifting
always use muscles in thighs instead of back
active mobility exercises
self-directed exercises the patient performs without assistance
passive mobility exercises
physical therapists or a machine moves a patient's body part
aided mobility exercises
self-directed exercises that the patient performs with the aid of a device like an exercise machine or a therapy pool
active resistance exercises
the patient works against resistance (counter pressure) to increase muscle strength
reflexology
pressure is applied usually to hand or foot to help in healing
palpation
use of touch in exam
massage practice
uses pressure, kneading, stroking, vibration, and tapping to positively affect patients' health and well-being
massage
heart rate and blood pressure are lowered and blood circulation and lymph flow are increased
massage benefits
helps improve concentration, promotes restful sleep, and helps the mind relax
traction
the pulling or stretching of the musculoskeletal system to treat fractured bones and dislocated, arthritic, or other diseased joints
meridians
pathways for blood flow in body used in Chinese medicine
manual traction
PT performs this by using his hands to pull a patient's limb or head gently
static traction
also known as weight traction. PT places a patient's limb, pelvis, or chin in a harness which is then attached to weights through a pulley system
skeletal traction
performed in inpatient facilities on patients whose injuries require long traction time and heavy weights. A surgeon inserts pins, wires, or tongs into bones, after surgery, the pins, wires, or tongs are attached to pulleys and weights to provide continuo
mechanical traction
uses a special device that intermittently pulls and relaxes a prescribed body part, such as the neck
mobility aids (mobility assistive devices)
designed to improve patients' ability to ambulate, or move from one place to another. These include canes, walkers, crutches, and wheelchairs
canes
especially useful for patients with weaknesses on one side of the body (possibly due to a stroke), joint disability, or neuromuscular defects
standard cane
best for a patient who needs only a small amount of support
tripod cane
has three feet on bottom
quad-base cane
has four feet on bottom
walkers
lightweight, can be adjusted to various heights
walker use
older patients who are too weak to walk unassisted or who have balance problems. They give these patients stability
wheeled walkers
have brakes for safety
crutches
allow a patient to walk without putting weight on the feet or legs by transferring that weight to the arms
aluminum crutches
lighter and usually more expensive than those made of wood
two basic types of crutches
axillary and lofstrand
axillary crutches
reach from the ground to the armpit
lofstrand crutches
reach from the ground to the forearm, and each one has a rubber tip on the bottom to prevent slipping. This type has a handgrip and a metal cuff for long term use
crutch palsy
axillary crutches that are too long can put pressure on nerves in the armpit
crutch gaits
2-3 finger-widths between supports and armpits, elbow flexion 30*, patient wears walking shoes. Move crutches 4-6" at a time, support body weight with hands, stand erect-look forward, no heels
swing gaits
patients with severe disabilities, like leg paralysis or deformity, may use this or the swing-through gait
wheelchairs
before starting transfer, make sure it is in the locked position, don't let patients' legs dangle, back into & out of corridors if alone, stay to right side of corridor