Sunday, February 13, 2011

The Modalities of Physical Therapy

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Physical therapy is the treatment of neurological, musculoskeletal, circulatory, and skin disorders using various physical therapy modalities. The goal of physical therapy intervention is for patients to regain maximum potential and to have a productive life with or without the presence of disability.

Physical therapists may use a number of different modalities for your problem(s) or condition for a variety of reasons, including:
  • Reduction of pain
  • Increasing range of motion
  • Decreasing swelling
  • Increasing the rate of healing
  • Stabilizing areas needing support

“Four basic modalities are employed in physical therapy, each applied where and when it will do the most good. Not all of the modalities are used in every case.


Cold therapy

Cold therapy or cryotherapy is an effective means of reducing inflammation following an accident or injury. Cold therapy is applied in the form of ice packs, sometimes combined with massage, cold water bath of the injured area, and other methods. The reduced temperature will quell the firing of the nerve-muscle units and reduce muscle spasms, and that along with the anesthetic effect of the cold temperature will ease pain. Also, the cold reduces blood flow into the injury and reduces any bleeding that may be present and reduces oxygen demands of the injured tissue, thus preserving the muscle cells. An ice pack often is applied with a compression wrap to reduce swelling, and with elevation of the injured extremity above heart level for maximal reduction in swelling.


Heat therapy

Heat or thermotherapy may be employed only after the active swelling of the injury has abated, 24-48 hours following the injury. Heat is conveyed into the injured area by the use of moist heat packs, hot paraffin, hot air or hot water as in a whirlpool bath, by infrared lamp, and by conversion. Conversion is the development of heat brought about by the passage of sound waves or electric current through tissue. Diathermy is an example of electrical waves directed into tissue and converted into heat. Ultrasound, very high-frequency sound waves, bring about the vibration of the tissues, which increases the temperature within them. A form of application of sound waves called phonophoresis consists of application of a medication to the injured area followed by ultrasound to drive the medication deep into the tissues.
Heat increases blood flow to an area, so should not be used when internal bleeding accompanies an injury. However, like cryotherapy, heat reduces muscle spasms by increasing the blood flow to an area, which helps to wash out metabolic waste products and increase the amount of oxygen reaching the tissues.


Electrical stimulation

Application of electrical stimulation can restore muscle tone by stimulating muscles to contract rhythmically. This method is used often when an injured person has been confined to bed for a long period of time. Over time, muscles will atrophy and the patient will require long, arduous periods of exercise once he is mobile. The use of electrical stimulation can prevent muscle atrophy and reduce the necessary physical therapy regimen required later. Electricity is also used to drive molecules of medication through the skin into the tissues. This is called iontophoresis. A special machine called a TENS machine (transcutaneous electrical nerve stimulation) beams electric current through the skin (transcutaneously) into the injured area specifically to stop pain. Why TENS has this ability to assuage pain remains open to question, but it is thought that it prevents pain perception by the sensory nerves in the injured area. That is, the nerves that normally would detect pain and carry the impulse to the spinal cord do not sense pain. The electrical signal from the TENS machine can be adjusted for frequency and strength to achieve its effect without patient discomfort. All electrical stimulation is delivered by placing pads on or around the injured area to conduct the electrical current.


Mechanical manipulation

The use of massage, manipulation of the injured limb, traction, and weight lifting are part of the mechanical form of physical therapy. Massage is the rubbing, tapping, or kneading of an injured area to increase blood circulation and relieve pain. Manipulation consists of putting an injured joint through its movements from one extreme to the other. This is designed to restore full range of motion to the joint and eliminate pain from movement. Traction is the application of weight to stretch muscles or to help increase the space between vertebrae and relieve nerve compression. Manipulation may be carried out by a trained technician or by using a machine especially constructed to exercise the injured joint. Resistance can be altered in the machine to make joint extension or flexing more difficult, thus helping to build the muscles that control the joint movement.

Many forms of physical therapy can be carried out at home, but the exercises must first be carefully explained by a trained therapist. Incorrect application of a physical therapy modality can be as harmful as any traumatic injury. Most modalities are applied two or three times daily over a period of time to help restore movement, flexibility, or strength to an injured area.

Through the use of tests, evaluations, exercises, treatments with modalities, screening programs, as well as educational information, physical therapists:
  • increase, restore or maintain range of motion, physical strength, flexibility, coordination, balance and endurance
  • recommend adaptations to make the home accessible and safe
  • teach positioning, transfers, and walking skills to promote maximum function and independence within an individual's capability
  • increase overall fitness through exercise programs
  • prevent further decline in functional abilities through education, energy conservation techniques, joint protection, and use of assistive devices to promote independence
  • improve sensation, joint proprioception and reduce pain


Common Conditions

A vast number of conditions are treated effectively with physical therapy intervention. Examples of specific diseases and conditions that may be improved with physical therapy include:
  • arthritis
  • sports/orthopedic injuries
  • joint replacements
  • cerebral vascular accident (stroke)
  • coordination and balance disorders
  • Alzheimer disease

To ensure the best treatment outcome for the patient, the physiatrist and the physical therapist must ensure that the correct physical therapy modalities are prescribed.

Many researches supported that treatment outcome differ from patient to patient depending upon the severity and extent of the disability, methods used, and also the level of cooperation of the patient to rehabilitation.

Monday, February 7, 2011

The Power of Physiotherapy Exercises - Why Are They So Beneficial?

Health care providers referred to as physical therapists or physiotherapists are qualified in giving assessments and treatments on different conditions. They are more focused in providing relief and wellness through a more physical approach such as manual therapy, acupuncture and physiotherapy exercises.

Physiotherapists or "PT's" are highly trained professionals who can identify weaknesses or imbalances in the body. Physical therapists can help in targeting specific areas in the body where weakness or pain is felt and then prescribe the suitable treatment plan. Physiotherapy exercises are methods that can truly help relieve and soothe stress, as well as help the body function without pain and limitation.

How Exercise Helps the Body

When you incur an injury, the pain felt should serve as a guide to where the sensitive areas are located. Physiotherapists stress that there are two major types of pain: first is the pain due to stiffness and the second is pain due to damage. Pain due to stiffness may be quite bearable when you are doing exercise, and may be relieved gradually once you finish an exercise. The pain basically means that your muscles are a bit out of sync, and need to be eased back into working condition. Pain due to damage can be unbearable, which is an obvious indicator that your muscles are damaged, and are not ready for any exercise yet.

Once your physiotherapist determines the extent and cause of your pain, he or she will ask you to perform an array of physiotherapy exercises. There are practically hundreds of PT exercises for different injuries, from injuries to the neck, lower back, shoulders, spinal cord, legs, and feet. Your Physiotherapy clinician may also specify additional personalized stretching exercises for you. Stretching, as you should know, is important for maintaining proper range of motion of the joins, and also promotes flexibility of muscles.

For example, if you have tight muscles or stiff joints, performing normal activities like climbing the stairs or reaching for items above the cupboard may be tough to do. With proper stretching exercises, the normal body functions can either be preserved or enhanced. Scar tissue is formed and soft tissue becomes contracted as a result of an injury or a surgery. It's important that you regularly perform physical therapist-assisted stretching exercises, to ensure that the scar formation does not impair your movements.

How Prescription Exercises Help to Improve Muscle Strength

Prescription physiotherapy exercises are generally employed to specifically target muscle deficiencies, and also to help rehabilitate patients after an injury or after undergoing surgery. Therapeutic or prescription exercises are often used to improve the patient's strength, function and mobility, as well as to significantly lessen pain and swelling in the affected part of the body. Family doctors and PT practitioners often prescribe simple and easy home-based physiotherapy exercises, and also provide their patients with handouts and easy-to-understand instructional manuals or guides. Many agree that supervised physiotherapy exercises are more effective than home-based exercises, especially in patients who have osteoarthritis of the knee, low back injury and intermittent claudification. Still, physiotherapy exercises performed at home have their own advantages as well, more so for the post-operative recovery of anterior cruciate ligament.

Exercise is truly vital for the treatment and management of a wide array of chronic health conditions and injuries. Supervised physical therapy exercise programs consist of individualized prescription exercises that are specifically designed by trained physiotherapists, and are done in conjunction with the patient's condition and fitness level. Physical therapists are specialists in movement impairments, and are effective in developing or designing therapeutic exercise programs and modalities which suit a patient's specific needs.

One past study by a group of physicians from The Netherlands concluded that supervised physiotherapy exercises also result in less pain and improved function for tested patients, both in short term and long term durations.
Resources on Physiotherapy Exercises and other Information
A number of helpful physiotherapy resources are available online, to give you more helpful information on new and improved modalities for easing pain and improving strength and mobility. The American Family Physician's website offers relevant information related to physiotherapy exercises. Another authority site when it comes to information and resources about any specific therapy program, such as physiotherapy exercises, is the Canadian Physiotherapy Association.

Discover the benefits of physiotherapy exercises - for a healthy lifestyle, safe weight loss and effective injury rehab - you are sure to be on the path to wellness. Learn more about Exercise Prescription with the help of the PT Health Team. Get in touch with one of the competent health professionals today. 

Book your free consultation with PT Health now!

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