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After studying this chapter you will be able to understand: Discuss the general principles of physical therapy, relate various cold and heat therapies to their benefits and contraindications, recall hydrotherapy methods, name several methods of exercise therapy,…
CHAPTER 54 Physical Therapy and Rehabilitation © 2014 by McGraw-Hill Education This is proprietary material solely for authorized instructor use Not authorized for sale or distribution in any manner This document may not be copied, scanned, duplicated, forwarded, distributed, or posted on a website, in whole or part 54-2 Learning Outcomes 54.1 Discuss the general principles of physical therapy 54.2 Relate various cold and heat therapies to their benefits and contraindications 54.3 Recall hydrotherapy methods 54.4 Name several methods of exercise therapy © 2014 by McGraw-Hill Education This is proprietary material solely for authorized instructor use Not authorized for sale or distribution in any manner This document may not be copied, scanned, duplicated, forwarded, distributed, or posted on a website, in whole or part 54-3 Learning Outcomes 54.5 Describe the types of massage used in rehabilitation therapy 54.6 Compare different methods of traction 54.7 Carry out the procedure for teaching a patient to use a cane, a walker, crutches, a wheelchair and 54.8 Model the steps you should take when referring a patient to a physical therapist © 2014 by McGraw-Hill Education This is proprietary material solely for authorized instructor use Not authorized for sale or distribution in any manner This document may not be copied, scanned, duplicated, forwarded, distributed, or posted on a website, in whole or part 54-4 Introduction • Medical assistant – Apply cold and heat – Assist with ambulation – Teach basic exercises – Demonstrate how to use a cane, walker, crutches, or wheelchair – Discuss with the patient specific therapies for home use © 2014 by McGraw-Hill Education This is proprietary material solely for authorized instructor use Not authorized for sale or distribution in any manner This document may not be copied, scanned, duplicated, forwarded, distributed, or posted on a website, in whole or part 54-5 General Principles of Physical Therapy • Physical therapy – Medical specialty treating • Musculoskeletal disorders • Nervous disorders • Cardiopulmonary disorders – Treatments – Patient benefits – Disorders © 2014 by McGraw-Hill Education This is proprietary material solely for authorized instructor use Not authorized for sale or distribution in any manner This document may not be copied, scanned, duplicated, forwarded, distributed, or posted on a website, in whole or part 54-6 Assisting Within a Therapeutic Team • Therapeutic team members • Medical assistant – Coordinate the patient’s schedule – Make referrals – Document treatments and findings – Reinforce instructions for the patient – Answer the patient’s questions © 2014 by McGraw-Hill Education This is proprietary material solely for authorized instructor use Not authorized for sale or distribution in any manner This document may not be copied, scanned, duplicated, forwarded, distributed, or posted on a website, in whole or part 54-7 Assisting with Patient Assessment • Joint mobility testing – Range of motion (ROM) – degree to which a joint is able to move – Goniometer – Degree of movement compared to a standard © 2014 by McGraw-Hill Education This is proprietary material solely for authorized instructor use Not authorized for sale or distribution in any manner This document may not be copied, scanned, duplicated, forwarded, distributed, or posted on a website, in whole or part 54-8 Assisting with Patient Assessment (cont.) • Muscle strength testing – Determines the amount of force exerted exert with a group of muscles – Compare each side of body • Gait testing – assessment of how a patient walks © 2014 by McGraw-Hill Education This is proprietary material solely for authorized instructor use Not authorized for sale or distribution in any manner This document may not be copied, scanned, duplicated, forwarded, distributed, or posted on a website, in whole or part 54-9 Assisting with Patient Assessment (cont.) • Posture testing – Body position and alignment – Checks spinal curves – Symmetry of alignment © 2014 by McGraw-Hill Education This is proprietary material solely for authorized instructor use Not authorized for sale or distribution in any manner This document may not be copied, scanned, duplicated, forwarded, distributed, or posted on a website, in whole or part 54-10 Apply Your Knowledge Match description with assessment type: ANSWER: _ D How a person walks A Joint mobility A Range of motion _ B Muscle strength C Body position and alignment _ C Posture B Force exerted with a group of muscles D Gait _ A Goniometer _ C Check spinal curves _ D Length of stride _ © 2014 by McGraw-Hill Education This is proprietary material solely for authorized instructor use Not authorized for sale or distribution in any manner This document may not be copied, scanned, duplicated, forwarded, distributed, or posted on a website, in whole or part 54-44 Crutches (cont.) • Measure to fit – Too long • Crutch palsy • Back pain – Too short • Back pain • Imbalance © 2014 by McGraw-Hill Education This is proprietary material solely for authorized instructor use Not authorized for sale or distribution in any manner This document may not be copied, scanned, duplicated, forwarded, distributed, or posted on a website, in whole or part 54-45 Crutches (cont.) • Crutch gaits – Tripod or standing position – Determine proper gait – Slow or fast gaits © 2014 by McGraw-Hill Education This is proprietary material solely for authorized instructor use Not authorized for sale or distribution in any manner This document may not be copied, scanned, duplicated, forwarded, distributed, or posted on a website, in whole or part 54-46 Crutches (cont.) • Four-point gait – Slow gait – Bear weight on both legs – Stable and save © 2014 by McGraw-Hill Education This is proprietary material solely for authorized instructor use Not authorized for sale or distribution in any manner This document may not be copied, scanned, duplicated, forwarded, distributed, or posted on a website, in whole or part 54-47 Crutches (cont.) • Three-point – Cannot bear weight on one leg – Must have good muscle coordination and arm strength © 2014 by McGraw-Hill Education This is proprietary material solely for authorized instructor use Not authorized for sale or distribution in any manner This document may not be copied, scanned, duplicated, forwarded, distributed, or posted on a website, in whole or part 54-48 Crutches (cont.) • Two-point • Swing gait Swing-to Swing-through © 2014 by McGraw-Hill Education This is proprietary material solely for authorized instructor use Not authorized for sale or distribution in any manner This document may not be copied, scanned, duplicated, forwarded, distributed, or posted on a website, in whole or part 54-49 Wheelchairs • Type of chair – Depends on patient’s disability – Length of time wheelchair needed • Always ensure patient safety during transfers • Use appropriate lifting techniques © 2014 by McGraw-Hill Education This is proprietary material solely for authorized instructor use Not authorized for sale or distribution in any manner This document may not be copied, scanned, duplicated, forwarded, distributed, or posted on a website, in whole or part 54-50 Referral to a Physical Therapist • Referrals – Provide physician’s order – Provide patient information • Therapists – Independent practitioners – Hospital or clinic – Home health © 2014 by McGraw-Hill Education This is proprietary material solely for authorized instructor use Not authorized for sale or distribution in any manner This document may not be copied, scanned, duplicated, forwarded, distributed, or posted on a website, in whole or part 54-51 Apply Your Knowledge When would a walker be an appropriate mobility device for use by your patient? ANSWER: Walkers are usually used by patients who are too weak to walk unassisted or who have balance problems Hurray! What is the role of the medical assistant related to referrals for physical therapy ANSWER: The medical assistant may be asked to contact the therapist directly or to give the patient a written order and information about contacting the therapist The referral must also be documented in the patient’schart © 2014 by McGraw-Hill Education This is proprietary material solely for authorized instructor use Not authorized for sale or distribution in any manner This document may not be copied, scanned, duplicated, forwarded, distributed, or posted on a website, in whole or part 54-52 In Summary 54.1 Physical therapy is a medical specialty for the treatment of musculoskeletal, nervous, and cardiopulmonary disorders using a variety of treatments, including cold, heat, water, exercise, massage, and traction © 2014 by McGraw-Hill Education This is proprietary material solely for authorized instructor use Not authorized for sale or distribution in any manner This document may not be copied, scanned, duplicated, forwarded, distributed, or posted on a website, in whole or part 54-53 In Summary 54.2 There are various types of cold and heat therapies, including dry and wet cold and heat applications Cold and heat therapy promote healing and increase patient comfort Contraindications to cold and heat therapies include circulation problems, pain, and hemorrhage © 2014 by McGraw-Hill Education This is proprietary material solely for authorized instructor use Not authorized for sale or distribution in any manner This document may not be copied, scanned, duplicated, forwarded, distributed, or posted on a website, in whole or part 54-54 In Summary (cont.) 54.3 Various types of hydrotherapy used to treat physical problems include whirlpools, contrast baths, and underwater exercises 54.4 There are several methods of exercise therapy, including active mobility, passive mobility, aided mobility, and active resistance © 2014 by McGraw-Hill Education This is proprietary material solely for authorized instructor use Not authorized for sale or distribution in any manner This document may not be copied, scanned, duplicated, forwarded, distributed, or posted on a website, in whole or part 54-55 In Summary (cont.) 54.5 The two major types of massage used in rehabilitation therapy are Swedish and neuromuscular Swedish massage uses basic strokes to manipulate soft tissues Neuromuscular massage is applied to specific muscles and helps release tension and knots, relieve pain and release pressure on nerves, and increase blood flow © 2014 by McGraw-Hill Education This is proprietary material solely for authorized instructor use Not authorized for sale or distribution in any manner This document may not be copied, scanned, duplicated, forwarded, distributed, or posted on a website, in whole or part 54-56 In Summary (cont.) 54.6 The different methods of traction used to treat physical problems include manual, static, skeletal, and mechanical 54.7 The various mobility aids include canes, walkers, crutches, and wheelchairs Specific instructions for each of these aids must be followed to reduce the possibility of patient injury during their use © 2014 by McGraw-Hill Education This is proprietary material solely for authorized instructor use Not authorized for sale or distribution in any manner This document may not be copied, scanned, duplicated, forwarded, distributed, or posted on a website, in whole or part 54-57 In Summary (cont.) 54.8 You may be asked to contact the specialist directly or to give the patient a written order and information about contacting the specialist Keep a file with information about the therapists your office uses, noting the forms and information each therapist requires © 2014 by McGraw-Hill Education This is proprietary material solely for authorized instructor use Not authorized for sale or distribution in any manner This document may not be copied, scanned, duplicated, forwarded, distributed, or posted on a website, in whole or part 54-58 End of Chapter 54 Disability is a matter of perception If you can just one thing well, you're needed by someone ~ Martina Navratilova © 2014 by McGraw-Hill Education This is proprietary material solely for authorized instructor use Not authorized for sale or distribution in any manner This document may not be copied, scanned, duplicated, forwarded, distributed, or posted on a website, in whole or part .. .54- 2 Learning Outcomes 54. 1 Discuss the general principles of physical therapy 54. 2 Relate various cold and heat therapies to their benefits and contraindications 54. 3 Recall hydrotherapy... website, in whole or part 54- 12 Cryotherapy and Thermotherapy (cont.) • Factors affecting use – Therapy' s purpose – Location and condition of affected area – Patient’s age and general health • Monitor... forwarded, distributed, or posted on a website, in whole or part 54- 5 General Principles of Physical Therapy • Physical therapy – Medical specialty treating • Musculoskeletal disorders • Nervous