Chapter 11 - Assisting with cold and heat therapy and ambulation. In this chapter you will learn: Explain how medical assistants might assist with some forms of physical therapy; describe ways to test joint mobility, muscle strength, gait, and posture; discuss the benefits of cold and heat therapies; list contraindications to cold and heat therapies; identify various cold and heat therapies;...
CHAPTER 11 Assisting with Cold and Heat Therapy and Ambulation © 2011 The McGraw-Hill Companies, Inc All rights reserved 112 Learning Outcomes 11.1 Explain how medical assistants might assist with some forms of physical therapy 11.2 Describe ways to test joint mobility, muscle strength, gait, and posture 11.3 Discuss the benefits of cold and heat therapies 11.4 List contraindications to cold and heat therapies 11.5 Identify various cold and heat therapies © 2011 The McGraw-Hill Companies, Inc All rights reserved 113 Learning Outcomes (cont.) 11.6 Demonstrate how to perform cold and heat therapies 11.7 Describe hydrotherapy methods 11.8 Identify several methods of exercise therapy 11.9 Compare different methods of traction 11.10 Demonstrate how to teach a patient to use a cane, a walker, crutches, and a wheelchair © 2011 The McGraw-Hill Companies, Inc All rights reserved 114 Introduction • Medical assistant – Common duties • Apply cold and heat therapy • Assist patients with ambulation • You may also – Teach basic exercises – Demonstrate how to use a wheelchair – Demonstrate the use of cane, walker, and crutches – Discuss therapies with the patient © 2011 The McGraw-Hill Companies, Inc All rights reserved 115 General Principles of Physical Therapy • Physical therapy is a medical specialty that treats – Musculoskeletal disorders – Nervous disorders – Cardiopulmonary disorders © 2011 The McGraw-Hill Companies, Inc All rights reserved General Principles of Physical Therapy 116 (cont.) • Assisting the therapeutic team – Members • • • • Physicians Nurses Medical assistants Other specialists You must have a working knowledge of therapy techniques – Coordinate patient schedule – Make referrals – Explain treatment approach – Documentation – Reinforce instructions – Answer patient questions © 2011 The McGraw-Hill Companies, Inc All rights reserved General Principles of Physical Therapy 117 (cont.) • Specialized therapies – Art – Music – Dance – Writing – Crafts – Aquatic – Horticultural – Equestrian © 2011 The McGraw-Hill Companies, Inc All rights reserved 118 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 measure • Muscle strength testing – Determines the amount of force the patient can exert with a group of muscles – Compare each side of body © 2011 The McGraw-Hill Companies, Inc All rights reserved 119 Patient Assessment (cont.) • Gait testing – The way a person walks (gait and swing) – Includes • • • • Length of stride Balance Coordination Direction of knees and feet • Posture – Body position and alignment – Checks spinal curves – Symmetry of alignment • Shoulders • Knees • Hips © 2011 The McGraw-Hill Companies, Inc All rights reserved 1110 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 _ Good Job! © 2011 The McGraw-Hill Companies, Inc All rights reserved 1131 Traction (cont.) • Skeletal – Long-term/heavy weights – Pins, wires, or tongs surgically placed – Pulleys and weights provide continuous traction • Mechanical – Device intermittently pulls and relaxes – Promotes relaxation © 2011 The McGraw-Hill Companies, Inc All rights reserved 1132 Apply Your Knowledge ANSWER: True or False: F Static traction uses a harness and weights to induce _ relieve muscle spasms T Manual traction stretches muscles and separates joints by _ gently pulling on them T Skeletal traction uses pulleys and weights to provide _ continuous traction F Mechanical traction maintains constant tension on the _ extremity alternately pulls and relaxes F A N T A S T I C ! © 2011 The McGraw-Hill Companies, Inc All rights reserved 1133 Mobility Aids • Devices to improve patients’ ability to ambulate or move about • Mobility aid chosen depends on – Patient’s disability – Muscle coordination – Strength – Age © 2011 The McGraw-Hill Companies, Inc All rights reserved 1134 Canes • Standard – Patient who needs only small amount of support • Tripod (3 legs) and quad-base (4 legs) – Create wide base of support – More stable than standard canes • Must be adjusted to correct height for patient © 2011 The McGraw-Hill Companies, Inc All rights reserved 1135 Walkers • Used by older patients with – Difficulty walking unassisted – Balance problems • Provides a sense of stability • Types – Table 11-2 Adjust to proper height for patient â 2011 The McGraw-Hill Companies, Inc All rights reserved 1136 Crutches • Transfers weight to the arms • Types – Axillary • Ground to axilla • Short-term use – Lofstrand, or Canadian Ground to forearm Long-term use â 2011 The McGraw-Hill Companies, Inc All rights reserved 1137 Crutches (cont.) • Complications may arise if not measured properly – Pressure on nerves in axilla – Strain on back, imbalance • Measuring for crutches – Should be to fingerwidths between supports and axilla – 30º flexion at elbow © 2011 The McGraw-Hill Companies, Inc All rights reserved 1138 Crutches (cont.) • Crutch gaits – Four-point – slow gait for a patient who can bear weight on both legs – Three-point – used when patient cannot bear weight on one leg – Two-point – used when patient can have some weight on both legs; must have good muscle coordination and balance – Swing gait – used when patient has severe disabilities © 2011 The McGraw-Hill Companies, Inc All rights reserved 1139 Wheelchairs • Type of chair chosen – Depends on patient’s disability – Length of time wheelchair needed • Always ensure patient safety during transfers • Use appropriate lifting techniques © 2011 The McGraw-Hill Companies, Inc All rights reserved 1140 Apply Your Knowledge When would a walker be an appropriate mobility device for use by your patient? ANSWER: Walkers are used by older patients who are too weak to walk unassisted or who have balance problems Hip-HipHurray! © 2011 The McGraw-Hill Companies, Inc All rights reserved 1141 Referral to a Physical Therapist • Referrals to preferred therapists – Provide physician’s order – Provide patient information • Therapists – Independent practitioners – Hospital or clinic – Home health © 2011 The McGraw-Hill Companies, Inc All rights reserved 1142 In Summary 11.1 A medical assistant may be asked to apply cold and heat; teach basic exercises; demonstrate how to use a cane, walker, and crutches; demonstrate how to use a wheelchair; and discuss with the patient specific therapies for use at home 11.2 Various physical tests are performed on patients, including joint mobility testing, muscle strength testing, gait, and posture testing 11.3 Cold and heat therapy promote healing and increase patient comfort © 2011 The McGraw-Hill Companies, Inc All rights reserved 1143 In Summary (cont.) 11.4 Contraindications to cold and heat therapies include circulation problems, pain, and hemorrhage 11.5 There are various types of cold and heat therapies These include dry and wet, cold, and heat applications 11.6 The general steps to applying cold and heat therapies include checking the physician’s order, positioning and draping the patient, applying the pack, and monitoring the patient 11.7 Various types of hydrotherapy used to treat physical problems include whirlpools, contrast baths, and underwater exercises © 2011 The McGraw-Hill Companies, Inc All rights reserved 1144 In Summary (cont.) 11.8 There are several methods of exercise therapy, including active mobility, passive mobility, aided mobility, and active resistance 11.9 The different methods of traction used to treat physical problems include manual, static, skeletal, and mechanical 11.10 There are various mobility aids, including 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 © 2011 The McGraw-Hill Companies, Inc All rights reserved 1145 End of Chapter 11 Dis ability is a matte r o f pe rc e ptio n. If yo u c an do jus t o ne thing we ll, yo u're ne e de d by s o me o ne ~ Martina Navratilo va © 2011 The McGraw-Hill Companies, Inc All rights reserved ... Therapy 11 7 (cont.) • Specialized therapies – Art – Music – Dance – Writing – Crafts – Aquatic – Horticultural – Equestrian © 2 011 The McGraw-Hill Companies, Inc All rights reserved 11 8 Patient... Physiologic responses to cold – Prevents swelling – Controls bleeding – Reduces inflammation – Anesthetic effect for pain – Reduces pus formation – Lowers body temperature © 2 011 The McGraw-Hill Companies,... Cryotherapy • Thermotherapy – Applying cold for therapeutic reasons – Applying heat for therapeutic reasons – Types – Types • Wet or dry • Dry • Chemical or natural • Moist © 2 011 The McGraw-Hill Companies,