About Physical Therapy: A Patient’s Guide

Abt Physia Theapy: A Patient’s Gide
Depatment f ehabiitatin Theapies
nivesity f Iwa Hspitas and inis
[SIZE=-1]Pee eview Stats: Intenay Pee eviewed
[SIZE=-1]eatin Date: Nvembe 2002
[SIZE=-1]ast evisin Date: Nvembe 2002
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Physia theapy heps pepe este and maintain ptima physia fntin. Physia theapists se examinatin and teatment t hep pepe impve thei abiity t mve and fntin as best they an t enabe them t pefm thei neessay daiy ativities.
Physia theapists pvide sevies t assist pepe in peventing injy and iness, wsening an existing injy. Theapists wk with pepe f a ages wh eqie assistane de t iness, injy, devepmenta deay.



Physia Theapy f Hspitaized Patients
Physia theapists wking with ate inpatients stive t impve thei mbiity and t pepae them f dishage fm the hspita. Inpatients with a wide vaiety f heath nens benefit fm physia theapy. The inpatient aeas in whih physia theapists wk, inde bns, adia, digestive diseases, genea mediine, nenatgy, negy, nesgey, ngy, thpedis, psyhiaty, hematgy, tanspant, and tama.
Physia theapists evaate patients and wk as pat f a team t detemine apppiate dishage pans inding hme, inpatient ehabiitatin skied nsing, and tpatient sevies.
Evaatin pedes inde:


* ange f Mtin
* Stength
* SensatinPain
* Bed Mbiity
* Tansfes
* Gait
* Baane
* dinatin
* Exeise Teane
* Pstheti eqiements
* Assistive and Adaptive Eqipment eqiements
Physia theapists se the findings f thei evaatin t detemine apppiate inteventins and devep a teatment pan t impve patient’s mbiity and fntina skis.


Inteventins inde:



* Theapeti Exeise
* Baane Taining
* Mbiity Taining
* Gait Taining
* Patient and Famiyaegive Edatin
Aqati Theapy


Patients that may benefit fm aqati theapy:
* bese
* Pe-existing thpedi nditins
* ange f mtin imitatins
* mpmised baane
* Patients with ngestive bsttive pmnay disease (PD)
* Patients with eating disdes
Ppeties f wate that ae benefiia f patients:

* Hydstati pesse heps with beathing and edes heat ate espnse t exeise, whih wes the ate f peeived exetin
* Byany makes exeise pimaiy nn-weight beaing
* Vissity pvides esistane thgh jint ange f mtin
* Tempeate 92-94 degees F heps t ede jint and mse seness and stiffness
Pepe patiipating in aqati theapy may benefit fm the fwing:

* Enhanement f the adiespiaty system
* Impvement f jint and mse fexibiity
* Impvement f msa stength
* Impvement f msa endane
* Impvement f baane
* Impvement f psyhsia aspets
Hand Theapy



Hand theapists teat patients with sh divese diagnses as:




* Fates

Tendn aeatins



Neve damage

Spains
apa tnne
Tendnitis
ngenita defets

Amptatins

hematid athitis

etified hand theapists wi pefm a thgh examinatin f the msskeeta and negia fntin, fm whih they design individaized pgams f patient management.





Hand ehabiitatin may inde stmized spinting t ptet heaing tisses, btain desied psitins and mtin, sbstitte f deeased fntin.




Exeise pgams addess speifi needs sh as jint stiffness, mse weakness imbaane, nditining f patins atheti demands, and maximizing fntin. A theapist may emmend adaptive devies and mdifiatins in the hme wk envinment t aw patients t fntin as effetivey and safey as pssibe.




Spts Theapy




Tpiay, spts theapy speiaizes in the ae f thpedi injies t the extemities and spine, sh as:




* Msa stains
Jint spains



Menisa injies

vese injies
Bsitis
Pe- Pst-p ehabiitatin f jint igament ensttin
Fates
Amptatins
Athitis

Theapists tiize thei knwedge f eseah fm the iteate and thei inia expeiene t devep inia teatments f spts-eated injies. These pts ae then individaized f a patient’s patia pbem and may inde:


* Eetia stimatin
Bifeedbak
mpteized stength testingtaining
Theapeti p
Mana tehniqes

Vestiba ehabiitatin

Vestiba ehabiitatin is an individaized, mpehensive evaatin and teatment appah f pesns with vestiba disdes. Vestiba ehabiitatin ses an exeise appah t:




* Deease dizziness
Impve gaze stabiizatin



Impve baane by etaining sensy and mt aspets f psta nt

Inease vea ativity eve

Mst exeises ae designed t faiitate enta nevs system (NS) mpensatin athe than ateing the ndeying vestiba pathgy.



Wmen’s Heath-eated Theapy



bstetis


* Diagnsis and teatment f msskeeta disdes in pegnany inding apa tnne, w bak pain, ppe-bak and nek pain, knee pain, tasa tnne syndme, abdmina weakness
Tanstanes Eetia Neve Stimatin insttin f se ding ab f pain eief



-setin evey- pevi f exeises, abdmina exeise, psitining f mft, sa mbiizatin

adivasa exeise insttin f gestatina diabetes meits
Penata exeise insttin in ppe pste, bdy mehanis, peventin f diastasis, peventin f inay inntinene
ae ding high-isk pegnanies—bed est inding ange f mtin, bed mbiity and tansfes, peventin f denditining, psitining

Gynegy


* Exeise f pevi f msate t pevent and teat inay inntinene
Bifeedbak and myfasia teatment f pevi pain
Pe- and pst-p edatin n safe exeise and ppe bdy mehanis

Fibmyagia

* Insttin in se f pain-nting mdaities
* Insttin in safe and pgessive exeise pgam

Ht vs. Ham: ndestanding Pain

[SIZE=-1]May Faihid, PT
[SIZE=-1]nivesity f Iwa Hspitas and inis
[SIZE=-1]Depatment f Physia Theapy

Knwedge is pwe!This is the pimay easn f edating pepe abt bak pain. We want y t ndestand and aept bette what is ging n with y athe than iving in fea f thinking y ae ding smething that ases y me damage and me ham.
Mst pepe d nt ndestand that thee ae tw kinds f pain. Ate pain is the kind that we say identify with injies, f exampe, when y t y finge, beak eg, and s fth. With ate pain, afte y have heaed, y pain ges away, as we. hni pain pesists even when the stims f pain is n nge thee. hni pain an happen f a pe f easns. Y an have a pbem that is nt “fixabe” with taditina media teatments sh as epida injetins. The the kind f pain s when the neves n nge ae being stimated, bt they ntine t send messages f pain. A gd exampe f this is phantm eg pain. An individa may se a eg bt tw yeas dwn the ad sti fees the eg is thee. Sh individas may mpain, “my te hts, I’m having pain in my eg,” and s fth. Hw an this be?This is simia t the hni pain that sme pepe get. Bt jst bease thee may be n identifiabe pbem, this des nt mean y dn’t ht.
hni pain s in 3-5% f the wd’s ppatin. Thee aen’t vey many f y t thee, and y ae misndestd pepe. hni pain is nt ny misndestd by the ay ppatin, f exampe famiy and fiends, bt as is nt we ndestd by media pfessinas. Y may fee that media pfessinas, inding physiians and physia theapists, k at me fnny afte I say I’ve tied eveything inding PT and I knw it has heped the pepe. Y may fee ike they k at y as smene wh is a “wimp” as smene wh is miking the system. Y may have even been td that y pbem is “a in y head.”
These kinds f mments may have ested in y feeing angy and fstated. When y ae in this state, y mses tighten and y have me pain. It eates a big ye. hni pain eates nsideabe stess—jst bease it is nt identifiabe, desn’t mean y dn’t have genine hni pain.
Ht vess ham—is thee a diffeene? Yes. et s expain. We an se a spts anagy. An athete an be ht whie patiing mpeting, his he eg is pt in an immbiize ast, and we dn’t expet that athete t etn t his spt the next day. He has t g thgh heaing and ehabiitatin. At end f the ehabiitatin, the athete has a deisin t make: d I etn t athetis and pssiby ht mysef, des the athete deide it’s nt wth it t me t fae the pspet f haming mysef again and faing nstant pain.
The same thing happens t pepe wh ae nt athetes. Amst eveyne eqies ehabiitatin afte an injy. Y may aways have dismft and pain. Bt y have a deisin: d I et it stp my ife d I “pay” thgh it. et’s give y an exampe f ht assiated with daiy ife ativities. It is sping, y get exited, and y g tside and enthsiastiay stat pepaing y gaden. This is nt smething y have dne f a whie. Y ae sing diffeent mses and y vey we may get se aftewad. Many pepe may find that they “ht” when they d things they have nt f a whie ( at a). They may ask themseves: is this jst an expeted “ht” is it smething me?We ae taght as hiden that pain is a waning. We pay attentin t pain and ty t d smething abt it. This happens with what we a “ate pain” bt nt f thse with hni pain. When y have bak pain, y say bak ff f a whie and esme y ativities afte a few days. This is the same thing that pepe with hni pain d. They d thei pesibed exeises, ht a t, bak ff and dn’t d them f a few days ny t etn and find that the same ye s. It ften fees ike y hit a wa. Y neve get past that wa bease y fea y ae asing ysef ham damage. This fea stps mst pepe.
Afte y ae mediay evaated by a spine dt and the dt has td y that it is safe t patiipate in ehabiitatin, then y need t beieve and tst that nthing y wi be asked t d in a ehabiitatin pgam administeed by a iensed physia theapist is ging t ham damage y. This des nt mean that we dn’t beieve y ht.
A mmitted physia theapist an give y the ts t beme as fntina as y an be physiay and emtinay, bt y wi sti have sme dismft. We d nt pmise t “e” y f a f y bak pain.



Fats Abt Bak and Nek Pbems
* Many f s wi expeiene signifiant bak pain at sme time in ives. Mst f s eve and mve n with ives with itte n pbem.
* ess than 5% f pepe with bak pbems eqie sgey.
* Bak pain an be sepaated int tw maj ategies:

* Ate eent bak pain that is ess than six mnths fm the nset
* hni bak pain that pesists nge than six mnths

* Teatment f hni pain diffes fm teatment f ate pain. (Ht vs. Ham)
* Patients with hni pain ept that they have nt espnded we t:

* Taking pain mediatin f extended peids f time
* Extended peids f nn-physia ativity
* Passive theapies sh as tatin, stimats (TENS), hipati, and massage
* Exessive se f d heat paks
Teatments sh as these ae ften nt engh t hep impve a hni pain nditin.
* In genea, pepe with ate bak pain epesent the vast majity f thse wh expeiene bak pbems. Pepe with hni bak pain, athgh a vey sma gp f pepe with bak pain, epesent by fa the mst fstating and sty bak pbems.
* ften patients with pesistent bak pain see many diffeent media pfessinas, hea nfsing and, smetimes, nfiting sties abt the ase f thei pain and ften fee that thes think it is “a in thei head.” ndestandaby, individas with ng-standing bak pain may beme angy, depessed, fstated and stessed by the pesna and finania isis ng-tem pain an ase.
The fist step in ppe teatment f a bak pbem is t ndestand the diffeene between hni and ate pain and then wk with membes f a etified ehabiitatin team n deveping an effetive teatment pan.

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