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for a full program of PT

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a physician generally refers a patient to a licensed physical therapist

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physical therapy

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a medical specialty for the treatment of musculoskeletal, nervous, and cardiopulmonary disorders

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physical therapist

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uses a variety of treatments, including cold, heat, water, exercise, massage, and traction

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PT benefits

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restores and improves muscle function, builds strength, increases joint mobility, relieves pain, and increases circulation

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PT uses

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to treat various disorders, including arthritis, stroke, lower back pain, muscle spasms, muscle injuries or diseases, pressure sores, skin disorders, and burns

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therapeutic team

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physicians, nurses, medical assistants, and other specialists who work with patients dealing with chronic illness or recovery from major injuries

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MA responsibilities

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explaining a specialist's treatment approach to the patient; documenting the specialist's treatments and findings for the physician; answering the patient's questions

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range of motion (ROM)

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the degree to which a joint is able to move

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goniometer

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protractor device used to measure degree to which a joint is able to move

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muscle strength testing

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to determine the amount of force the patient is able to exert with a muscle or group of muscles

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gait testing

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includes an appraisal of the patient's length of stride, balance, coordination, direction of knees, and direction of feet

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posture testing

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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

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posture

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body position and alignment

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cryotherapy

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applying cold to a patient's body for therapeutic reasons

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thermotherapy

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applying heat to a patient's body for therapeutic reasons

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temperature tolerance

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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 reported to the physician, who may decide to change the treatment

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principles of cryotherapy

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limiting edema, constricting blood vessels, reduction of inflammation, an anesthetic effect for pain by reducing inflammation, reduction of pus formation, lowering of body temperature

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dry cold applications

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include ice bags, ice collars, and chemical ice packs

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ice bag

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a rubber or plastic bag with a locking lid

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ice collar

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rubber or plastic kidney-shaped bag, specially curved to fit around the back of the neck

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chemical ice pack

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usually a flat plastic bag containing a semifluid chemical

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wet cold applications

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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

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principles of thermotherapy

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relief of pain and congestion, reduction of muscle spasms, muscle relaxation, reduction of inflammation, reduction of swelling

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erythema

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redness

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blanching

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to become white or pale

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dry heat therapy

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include the use of chemical hot packs, heating pads, hot-water bottles, heat lamps with infrared or ultraviolet bulbs, and fluidotherapy

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heating pad

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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

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ultraviolet rays are used

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to kill bacteria and promote vitamin D formation

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ultraviolet rays stimulate

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epithelial cells and cause blood vessels to overfill, increasing the skin's defenses against bacterial infections

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ultraviolet lamps

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used to treat psoriasis, pressure sores, and wound infections

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fluidotherapy

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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

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moist heat applications

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include hot soak, hot compress, hot pack, and paraffin bath

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paraffin bath

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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

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diathermy

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type of heat therapy in which a machine produces high-frequency waves that achieve deep heat penetration in muscle tissue

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three types of diathermy

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ultrasound, shortwave, and microwave

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shortwave

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do not use on a patient who has a pacemaker

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microwave contraindications

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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

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hydrotherapy

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the use of water to treat physical problems

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common forms of hydrotherapy

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use of whirlpools and contrast baths and underwater exercises

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regular exercise therapy

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can help prevent problems caused by inactivity

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lifting

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always use muscles in thighs instead of back

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active mobility exercises

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self-directed exercises the patient performs without assistance

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passive mobility exercises

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physical therapists or a machine moves a patient's body part

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aided mobility exercises

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self-directed exercises that the patient performs with the aid of a device like an exercise machine or a therapy pool

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active resistance exercises

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the patient works against resistance (counter pressure) to increase muscle strength

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reflexology

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pressure is applied usually to hand or foot to help in healing

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palpation

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use of touch in exam

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massage practice

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uses pressure, kneading, stroking, vibration, and tapping to positively affect patients' health and well-being

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massage

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heart rate and blood pressure are lowered and blood circulation and lymph flow are increased

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massage benefits

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helps improve concentration, promotes restful sleep, and helps the mind relax

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traction

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the pulling or stretching of the musculoskeletal system to treat fractured bones and dislocated, arthritic, or other diseased joints

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meridians

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pathways for blood flow in body used in Chinese medicine

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manual traction

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PT performs this by using his hands to pull a patient's limb or head gently

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static traction

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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

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skeletal traction

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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 continuous traction

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mechanical traction

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uses a special device that intermittently pulls and relaxes a prescribed body part, such as the neck

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mobility aids (mobility assistive devices)

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designed to improve patients' ability to ambulate, or move from one place to another. These include canes, walkers, crutches, and wheelchairs

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canes

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especially useful for patients with weaknesses on one side of the body (possibly due to a stroke), joint disability, or neuromuscular defects

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standard cane

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best for a patient who needs only a small amount of support

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tripod cane

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has three feet on bottom

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quad-base cane

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has four feet on bottom

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walkers

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lightweight, can be adjusted to various heights

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walker use

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older patients who are too weak to walk unassisted or who have balance problems. They give these patients stability

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wheeled walkers

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have brakes for safety

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crutches

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allow a patient to walk without putting weight on the feet or legs by transferring that weight to the arms

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aluminum crutches

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lighter and usually more expensive than those made of wood

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two basic types of crutches

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axillary and lofstrand

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axillary crutches

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reach from the ground to the armpit

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lofstrand crutches

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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

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crutch palsy

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axillary crutches that are too long can put pressure on nerves in the armpit

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crutch gaits

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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

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swing gaits

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patients with severe disabilities, like leg paralysis or deformity, may use this or the swing-through gait

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wheelchairs

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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

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