JIIU’S

INDIAN INSTITUTE OF MEDICAL

SCIENCES & RESEARCH.
Warudi, Talq.Badnapur, Dist.Jalna.

N O O R H O S P I TA L
DEPARTMENT OF PHYSIOTHERAPY
CME

BASICS OF PHYSIOTHERAPY
02TH April 2014
What is Physical Therapy?
Prevents, identifies, corrects, and
alleviates acute or prolonged
movement dysfunction of anatomic or
physiologic origin. The primary
objective of physical therapy is to
promote optimum human health and
function.
The APTA
Physical therapy or physiotherapy (sometimes abbreviated to PT) is
a health care profession primarily concerned with the remediation of
impairments and disabilities and the promotion of mobility, functional
ability, quality of life and movement potential through examination,
evaluation, diagnosis and physical intervention.

It is carried out by physical therapists (known as physiotherapists in

most countries) and physical therapist assistants (known as physical
rehabilitation therapists or physiotherapy assistants in some
countries).
Our Beginnings
Establishment of the Profession

• Established by the Surgeon

General in 1917
• Founded by Mary
McMillan
• Called “Reconstruction
Aides”
 Present Academics
Bachelor of Physiotherapy 4-1/2 years

Masters of Physiotherapy 2 or 3 years

Ph.D. 4-6 years

Fellow ship programmes

 Where is Physical Therapy
Practiced?
Treatment Prevention
• Hospitals
• Private offices • Schools
• Nursing homes • Sports Centers
• Schools • Workplaces
• Public facilities
• Out Patient
• Health Clubs
clinics
• Private Homes
 What do PTs do?

• Movement Specialists
• Restore function
• Improve mobility

Physical therapists are experts at analyzing human

movement. They help restore and enhance normal
movement patterns following injury and disease using a
variety of techniques, procedures and modalities.
Misperceptions about Physical Therapists

 Just give massages

 Aerobics instructors

 Never see blood

 Only treat healthy people

who are injured.
 Future Outlook for the profession

Life expectancy

People living longer, healthier lives

Greater number of older people – more cases of arthritis,

stroke, heart disease, etc…
A Systems Approach
 PT: A Systems Approach
Musculoskeletal
The musculoskeletal system
includes:
 Bones
 Muscles
 Joints
 Tendons
 Ligaments
 And other soft tissue
 Cervical (PIVD, Spond. etc.)
 Frozen shoulder, TOS, Sprains, Strains
 Tennis & Golfers elbow
 Wrist pains
 Rheumatoid Arthritis
 Thoracic (BP, PIVD, #, etc.)
 Lumbar (LBP, PIVD, Spond. etc.)
 Sacroiliac joint dysfunctions
 Hip dysfunctions
 Knee Osteoarthritis
 Ankle Sprain, Strain
 ACL, PCL, reconstruction surgeries
 Various fractures of Head, Trunk, Upper &
Lower limbs
 Sports trauma
 Oral fibrosis
 Bed sores
 Wound healing
 PT: A Systems Approach
Neurological

This systems includes:

 Brain

 Spinal cord

 Nerves

Movement, sensation, balance.

Patients treated within this system include:

 Head injuries
 Strokes
 Parkinsonism
 Carpal Tunnel Syndrome
 Peripheral neuropathies
 Multiple Sclerosis
 Muscular Dystrophy
 Cerebral Palsy
 Polio
 PT: A Systems Approach
Cardio pulmonary

The system includes:

 Heart

 Lungs

 Blood vessels

Patients treated within this system include:

 Heart disease

 Bronchitis

 Heart Transplants
 PT: A Systems Approach
Integumentary System

This systems includes the skin

Patients treated within this system includes

 Burns
 Wounds
 Diabetes
Role of the Physical Therapist

Evaluation
&
Treatment
 Types of tests
Evaluate
 Patient History

 Examination

 Perform Tests

Types of Tests
Range of motion

Strength

Balance

Coordination

Posture

Respiration
 Treatment

Treatment strategy

Identify purpose/outcomes

 Pain reduction

 Swelling reduction

 Range of Motion
 Interventions
 Electrical stimulation
 Adaptive devices (crutches, wheel chairs/prosthetics)
etc..
Modalities: To reduce pain and inflammation including
electrical stimulation (IFT, TENS), heat superficial (IRR,
Hydro collator packs, Heating Pads), deep heat (SWD,
Ultrasound, Laser) and icing, etc…

Manual therapy: Including joint and soft tissue mobilization.

Exercise programs: To improve flexibility, strength, endurance,

power and coordination.
MODALITIES
 Electrotherapy
 Short Wave Diathermy
 Interferential
 Ultrasound
 TENS
 Electrostimulation
 IRR
 Hydrocollator Packs
 Whirlpool Bath
 Paraffin Bath
 Combination therapy
 Shortwave Diathermy
It penetrates up to 2 inches.

Indications

 Bursitis

 Capsulitis

 Osteoarthritis

 Deep muscle spasm and

strains

 Spondylosis, etc.
SWD Electrode placement
 Low Level Laser Therapy
Light Amplification by Stimulated Emission of Radiation.

 Indications
 Pain and inflammation reduction
 Collagen synthesis
 Control of microorganisms
 Increased vascularization

 Equipment

 Helium-neon and gallium-arsenide lasers are used.

Ultrasound Therapy
 Ultrasound Therapy
 Modality which stimulates repair of soft tissue and pain relief
 Form of acoustic energy used for deep tissue heating
Indications

 Tendinitis
 Osteoarthritis
 Bursitis
 Neck pain
 Sprain
 Back pain
 Strain
 Burn contracture
 Trigger points
 Scars
 Heel pain
 Interferential therapy
It acts on pain gate mechanism.

Indications

 Lumber spondylosis  Shoulder pain

 Cervical spondylosis  Knee pain

 Back pain  Rheumatoid arthritis

 Neck pain  Ankylosing spondylitis

 Transcutaneous Electrical Nerve Stimulation (TENS).

Indications It acts on pain gate mechanism.

 Cervical Radiculopathies

 Lumbar Radiculopathies

 Trapezius myalgia

 Tingling, Numbness in Upper

and lower limbs

 Myofascial pain syndrome

 Trigger pain  Pregnancy

TENS for pain over different parts of
the body.
 Hydrocollator Packs

 It maintains heat for 20-30

minutes

 Silicate gel pads submersed

in 160-170o F water

Indications

 Reduction of pain, spasm, hypoxia and ischemia

 General superficial muscle relaxation.
 Whirlpool Bath
Equipment
 Tank with turbine that regulates water flow

 Agitator controls amount of movement of water by emitting air

 Varying sizes of tanks used to treat respective body parts.

Indications
 Swelling, muscle spasm and pain

 Provides conduction and convection.

 Paraffin wax Bath

 Equipment
 A paraffin wax and mineral oil combination, heated to 126-130o F,
paper towels and towels.

 Indications
Useful in treating chronic injuries
Effective for angular areas of body such as hands, wrists, elbows,
ankles and feet.
Application
 Body part is cleaned and dried
 Soak technique
 Body part remains in wax 20-30 minutes without moving it.
 Dip and wrap technique
 Hand dipped 6-12 times, wrapped in a plastic bag and then
draped with a towel to maintain heat for 30 minutes.
 Cryotherapy
 Used as first aid treatment for on field trauma in sports and in
other musculoskeletal system conditions.
 RICE (rest, ice compression, elevation) may be used for the
initial days of and injury and continue up to 2 weeks after injury.
Mechanical Modalities
 Traction
 Drawing tension applied to a body segment

 Indications
Spinal nerve root impingement

Decrease muscle guarding, treat muscle strain

Treat sprain of spinal ligaments

Relax discomfort from normal spinal compression

 Physiological Effects

 Produces separation of vertebral bodies impacting

ligaments, capsules, paraspinal muscles

 Increases articular facet separation, and relief of nerve

root pain

 Decreases central pressure of vertebral disks

 Increases proprioceptive changes

 Relief of joint compression.

 Intermittent Compression Units
Equipment
 Utilizes nylon inflatable sleeve
 Sleeve is inflated to specific pressure using
either water or air
 Utilized to facilitate movement of lymphatic
fluids
Parameters
Able to adjust on-off time, pressure and
treatment time
Indications
 Used for controlling or reducing swelling after acute
injury
 Good for pitting edema, which develops several
hours after injury
 Elevation of extremity is critical to effective treatment
 With electrical stimulation, muscle pumping can be
incorporated to facilitate lymphatic flow
 Cryo-Cuff
 Uses both compression and cold simultaneously
 Elevation of cooler results in increased cuff pressure
 Also allows for circulation of cooler water
 Portable and easy to use

 Game Ready System

 Circulates water with compression.
 Can be adjusted for various time,
temperature and compression
settings.
Time for some Musculoskeletal
conditions
 Frozen Shoulder
 Frozen shoulder (adhesive capsulitis) is a disorder
characterized by pain and loss of motion or stiffness in
the shoulder.

 It affects about two percent of the general population.

 It is more common in women between the ages of 40

years to 70 years old.

 Cause: Idiopathic
Frozen Shoulder
Various exercises for frozen shoulder
Strengthening exercises for shoulder
Strengthening exercises for shoulder
 Osteoarthritis
What is osteoarthritis?
Osteoarthritis is a form of arthritis that features the breakdown and
eventual loss of the cartilage of one or more joints. Cartilage is a
protein substance that serves as a "cushion" between the bones of the
joints
Risk Factors You Can Control

This includes sports that have a high rate of injury and jobs that
require repetitive motion, such as bending the knees to install
flooring.

Obesity is another risk factor – it has been linked specifically to

osteoarthritis of the knees and hips.
Hamstring Stretch
Calf Stretch
Straight Leg Raise
Quadriceps Set
Seated Hip March
Pillow Squeeze
Heel Raise
Side Leg Raise
Sit to Stand
One Leg Balance
Step Ups
Walking
Low-Impact Activities
 Being active may also help
you lose weight, which
takes pressure off joints.
 Other exercises that are
easy on the knees: biking,
swimming, and water
aerobics.
 Water exercise takes weight
off painful joints.
Supportive Devices
Various Exercises for Neck pain
 Various
Exercises
for
Low
back
pain
Exercises with Theraball
 Aquatic Physical Therapy
 Aquatic Physical Therapy includes but is not limited to treatment,
rehabilitation, prevention, health, wellness and fitness of patient
populations in an aquatic environment with or without the use of
assistive, adaptive, orthotic, protective, or supportive devices and
equipment.

 The buoyancy, support, accommodating resistance and other unique

properties of the aquatic environment enhance interventions for
patients/clients across the age span with musculoskeletal,
neuromuscular, cardiovascular or pulmonary, and integumentary
diseases.
 Resistance training
Weights Exercises

Chest Press

Shoulder Press

Seated Row
Lateral Pull Down

Lunge

Squat
 Abdominal crunch

Back extension
 Flexibility

Triceps and Upper Back Stretch Rear Deltoid and Upper Back Stretch
Pectoral and Upper Back Stretch

Quadriceps Stretch
Hamstring Stretch Adductor Stretch Calf Stretch
 GENERAL PHYSICAL FITNESS
PROGRAMME
 Mon - steady run
 Tue - weights
 Wed - fartlek
 Thu - flexibility
 Fri - steady run
 Sat - weights
 Sun - flexibility
 What is Physical Activity..?

Any thing that keep you moving..!

 Making Physical Activity
a Part of Your Life.

There are 1440 minutes in every day

Schedule 30 of them for physical activity.
THANK YOU
Any Questions. . . ??