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  Physiotherapy  
 
 
Physiotherapy
 
Physiotherapy may be defined as a science that seeks to improve movement dysfunction, promote optimal health and functions of the human body.  It involves the assessment, maintenance, restoration of the physical function and performance of the body.  It is practiced in India since the last fifty years. It plays a big role in preventive aspects.
Physiotherapy is "tending to the cure or providing relief from disease or injury." It involves rehabilitating the patient from "bed to job".
Be it acute or intensive care, respiratory and cardiac rehabilitation, pain management, Arthritis, headache, post-operative pain, heel pain, fitness, or sports injury, physiotherapy has a role to play in restoring the patient to normal or at least a functional capacity.
Physiotherapy today is an independent health care profession for all the age groups from neonatal to geriatrics. (From birth to old age.)
 
 
Physiotherapy Includes
 
  • Electro Therapy
  • Exercise Therapy
  • Cryotherapy
  • Hydrotherapy
 
Electro Therapy
Electrical Modalities:
 
 
 
Commonly used electro modalities are,
Short Wave Diathermy:
 
 
Short Wave diathermy current is a high frequency alternating current. The heat energy obtained from the wave is used for giving relief to the patient. Its frequency is 27,120,000 cycles per second and the wavelength is 11 meter. 
Types of Applications:
 
The condenser field method (commonly used).
Cable method
 
 
 
 
 
 
 
 Ultra-Sound Therapy
 
Ultrasonic involves the use of sound waves. It is useful for localized pain and helps to reduce pain, muscle spasm, and loosens adhesions. 
 
It is also useful in neuralgic pain like Post-herpetic neuralgia. Care should be taken for the dosage.
 
Generation of Ultrasonic waves
Ultrasonic waves are generated by vibration of a Crystal mounted on a special head.
 
 
Treatment Time
 
Initial Stage - 3 to 4 min
Severe Stage - 6 to 8 min
 
 
Interferential Therapy (I.F.T)
 
Interferential Therapy is an analogue interferential stimulation device which is used for symptomatic relief and management of post surgical and post traumatic acute and chronic pain.
 
This type of stimulation is characterized by the crossing of two electrical medium, independent frequencies that work together to effectively stimulate large impulse fibers. These frequencies interface with the transmission of pain messages at the spinal cord level. Because of the frequency, the interferential wave meets low impedance when crossing the skin to enter the underlying tissue.
This deep tissue penetration can be adjusted to stimulate parasympathetic nerve fibers for increased blood flow. Interferential Stimulation differs from TENS because it allows a deeper penetration of the tissue with more comfort (Compliance) and increased circulation.
 
Common Uses
 
Pre and Port Orthopedic Surgery, Joint Injury Syndrome, Cumulative Trauma Disorders, Increasing Circulation & Pain Control of Various Origins.
 
Electrical Stimulation
 
Galvanic Current:
 
Can be used for Diagnostic and Therapeutic purposes, Direct Galvanic current is mainly used for Ionization i.e. transference of ions of drugs into the tissues through the skin for pain relief. It is also used for stimulation of weak muscles. 
Faradic Current: 
Faradic Current is surged with different wave forms. It is used for pain & swelling eg post operative knee surgery-it is given to improve muscle strength, prevent atrophy, & reduction of muscle swelling.
 
 
 
 
 
 
 
 
 
 
Paraffin Wax Bath
 
Paraffin wax is used for the treatment.
The temperature of the wax is in the range between 40° to 44°c.
The heat energy obtained from the hot wax is used to relieve pain and stiffness of the joints. 
Paraffin wax has a low melting point. A special wax is used for small joints of hands and feet. Skin acts as an insulator. It is used for stiff joints (post-plaster, fracture of hands, feet) , Arthritic cases of small joints. It should not be given in certain skin conditions.
 
 
 
 
 
 
 
 
 
T.E.N.S (Trans Cutaneous Electrical Nerve Stimulation)
 
This instrument has a simple theory "gate control" i.e. Pain can be blocked by non destructive means. 
A gentle application of electrical stimulation (with special rate, width, & voltage control) helps to close the gate, thereby blocking the pain message to the brain at the spinal cord level giving immediate pain relief in certain conditions. Using of T.E.N.S. since 1979 and is found good results in chronic back pain and neck pain. It is biologically safe to use. (Except when pacemaker is implanted)
 
 
 
 
 
 
 
 
 
Other Electrical Modalities:
 
Traction,
Continuous Passive Motion (C.P.M),
Infra Red (I.R),
LASER,
Hydro Collateral Packs,
 
Importance of exercise
Proper exercises promote joint and muscular nutrition. Be it arthritis, back pain, neck pain, calf muscle pain, Depression, shoulder pain or cancer, exercises have been proved effective.
 
Exercises help to improve the range of motion. Breathing and relaxation exercises must be done twice a day. Repetition of exercises varies with the individual and the condition of the patient.
 
Too much exercising can damage joints or cause fatigue.
 
Exercises must be done under the supervision of the physiotherapist.
 
Common Conditions for Physiotherapy
 
Orthopedic Conditions:
 
  • Mainly includes muscular and joint pain eg. Arthritis-Osteo or Rheumatoid, Ankylosing Spondylitis (Bamboo Spine) etc.
  • Pain in heel, elbow or shoulder due to arthritis, injury, or infection.
  • Sports Injuries: Ligament, muscular or fractures, or sprain.
  • Neck pain, back pain, due to injury, infection, wrong posture, or muscular soft tissue Injuries, eg. ankle sprain.
 
All the above mentioned conditions are treated by physiotherapy.
 
Geriatric Conditions: 
 
Aches and pains are more common in old age. Osteoporosis, muscles fatigue, stiffness of the joints, frequent falls, imbalance, difficulty in walking, lack of concentration, impaired vision etc. are the common problems where physiotherapy plays an important role.
 
Early Physiotherapy is beneficial. Daily exercises of arms legs, back, neck, and breathing exercises are a must.
 
Computer related problems:
 
Computer hazards are increasing these days. 
They include Arm, Elbow, Shoulder and Neck pain, which may be associated with tingling and numbness in the arm or fingers.
Sitting in one position for long hours can cause Back, Knee, Calf muscle, and Foot pain.
Headache is another problem.
All such Problems can be minimized or nullified by Physiotherapy.
 
Ergonomics i.e. work postures is very important,
Warm up exercises for neck, back, Shoulder, elbow, wrists & fingers, knees; foot etc. must be done. 
Do not sit for more than 45 minutes at a stretch in one position.
If ergonomics is given importance and priority in offices and industries, then work output will be more and healthy with less absenteeism.
 
Obesity:
 
Obesity is the root cause of many ailments and such persons can be benefited by Physiotherapy.
 
Neurological Cases:
 
In Neurological cases Physiotherapy should be started as early as possible. Conditions where physiotherapy can help:
 
  • Facial Palsy: paralysis of one side of face.
  • Paralysis - Hemiplegia (one arm & one leg),
Paraplegia (paralysis of both legs),
Monoplegia, (paralysis of one extremity),
Tetraplegia (paralysis of all four limbs) etc.
 
  • Muscular Dystrophy - weakness of muscles
  • Parkinson's disease
  • Migraine and Tension headache
These conditions are treated by exercises and electrotherapy, If physiotherapy is started in time, then disabilities can be minimized.
Chest Physiotherapy: Asthma, Bronchitis, air pollution, allergic conditions etc.
Pre and post - operative Bronchial hygiene care, special breathing exercises and postural drainage helps to reduce medications and get better life.
 
Pediatric cases: 
 
Pediatric cases like Cerebral Palsy, Poliomyelitis, Talipes Equinus Varus (Foot deformities), Flat feet, Meningitis, Asthma etc.
 
Gynecology & Obstetric cases: 
 
Pelvic inflammation cases can be treated by the Physiotherapist. 
In Obstetrics cases it has now been established that ante-natal and post-natal exercises play an important role in the toning up of the pelvic floor muscles and posture.
 
  • Pre (From 5th month) and Post natal (From 2nd day if no complications) exercises (before & after delivery),
  • Incontinence of urine-dribbling of urine,
  • Pelvic Inflammation,
  • Special exercises for women above 45years for osteoporosis etc.
 
E.N.T Conditions:
 
Physiotherapy may help to treat frontal and maxillary sinus cases. 
Chronic allergic rhinitis is also treated by physiotherapy.
 
Skin Conditions:
 
  1. Vitiligo (White Patches).
  2. Burns.
  3. Wounds are treated by special modalities