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Physiotherapy - Medical Science-The Physical Way

Dr. Dinesh Sharma

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Paediatrics and Physiotherapy

The primary focus for a physiotherapist is to observe children for their individual strengths and abilities and to promote a functional, quality developmental process. The plan includes prevention, evaluation, diagnosis, treatment and rehabilitation.

Impairment, disability and handicap acknowledge their inter-relationship and impact on each other. The physical impairment (e.g. Central nervous system abnormality) directly affects the child physically.

Common Conditions

Club foot, scoliosis, congenital deformities, osteogenesis imperfecta, genetic disorders, Duchanna muscular dystrophy (DMD), Spina bifida occulta, meningocele, meningomyelocele, chromosomal disorders, Down's syndrome, environment related disorders, cerebral palsy etc.

Common Neurological Conditions and Physiotherapy

Neuropyrexia, brain, nerve and spinal cord injuries, headache, migraine post herpetic neuralgia poliomyelitis, residual paresis/palsy, monolegia, hemiplegia, paraplegia, quadriplegia, parkinson, athetosis, chorea ataxia, rigidity, encephalopathy, myopathies, bells palsy, cranial nerve palsy, myasthenia gravis, insomnia.

Common Muscular and Skeletal Conditions and Physiotherapy

This includes overuse injuries and trauma of muscle, ligament, tendon, meniscus and other soft tissues.

Spondylosis, ankylosing spondylosis, myalgia, myositis, rheumatoid arthritis, peri arthritis, poly arthritis, frozen shoulder, cervico brachial syndrome, bursitis, distortions, osteochondropathy, atonia of muscles, amputation, spondylolisthesis, lumbarisation, sacralisation, post immobilisation, movement dysfunction, disability management, kyphosis, lordosis and scoliosis, rickets, genuvalgus, varum, recurvatum, cocodynia, disuse atrophy, muscular dystrophy, epicondylitis, tennis elbow, golfers elbow, trigger finger, carpal tunnel syndrome, contractures, calcaneal spur, flat feet, C.T.E.V., tendinitis, lumbago, causalgia, congenital dysplasia, irritative radiculitits, haemarthrosis, effusion of the knee joint, tendosynovitis, tendo va****tis, prolapse I.V. disc, sacroiliatis, IV ligament strain, sciatica and low back pain, delayed healing in fractures, dental pain, temporomandibular ankylosis.

Surgical conditions commonly referred to the physiotherapist include preoperative care, total joint replacement, amputation, synovectomy etc for prevention and minimising the extent of disability.

Common Cardio-Pulmonary Conditions and Physiotherapy

This includes conditions such as ischaemia, arteriosclerosis, coronary heart disease and lung diseases.
  • Obstructive: If the pathological changes in the lung cause abnormality in airflow through the bronchial tubes.
    Symptoms: Chronic productive cough, excessive mucous production, changes in sound produced when air passes through the bronchial tubes and shortness of breath. The specific disorders that can produce these changes include chronic bronchitis (inflammation of the bronchi), emphysema (trapping air in the alveoli), peripheral airway disease (collapsing of terminal bronchioles). Other disorders are asthma (spasm like contraction of the bronchi resulting in air trapping) and cystic fibrosis (dysfunction of glands causing blockage of the bronchi).
  • Restrictive lung disease: If the pathological changes cause the decrease in the volume of air in the lungs.
    Cause of this disease: The process, which affects lung tissues directly, is idiopathic or unknown. Other causes include chronic inhalation of air pollutants such as coal dust, silicon or asbestos, infections of the lungs such as pneumonia, cancer of the lungs etc. Some of these affect the lung tissue itself while others affect the chest wall or the muscles of respiration.

Common Gynaecological, Obstetric Conditions and Physiotherapy

The disease, trauma and natural physiological process of menstruation and pregnancy demand the introduction of physiotherapy at different levels and at various stages of illness. The common ailments indicated for physiotherapy are pelvic inflammatory disease (PID), menstrual pain, adnexitis, parametritis, salpingitis, hydrosalpinx, prolapsed uterus, and rectum, stress incontinence, tubal blockages causing sterility often need physiotherapy management besides antenatal and postnatal care.

Aims of Physiotherapy in Obstetrics (During Antenatal /Postnatal Care)

  • To assist in establishing a healthy psychological approach to the birth.
  • To teach the patient to relax, so that she may really rest between uterine contractions and thus preserve her energy.
  • To teach the patient, elementary physiology of labour
  • Posture corrections and prevent following back pain
  • During labour-to prevent premature bearing down
  • Restore fitness
With the increasing awareness amongst the patients about physiotherapy and its benefits, more number of patients are opting for physiotherapy nowadays.

Avoid the H-A-R-M Factors

H - Heat increases bleeding
A - Alcohol increases swelling
R - Running or exercising too soon makes an injury worse
M - Massage in the first 24 hours increases swelling and bleeding

Geriatric Physiotherapy For the older persons

The population of the older adults in the country is approximately 7.8%. The difficulties observed in this group in performing the A.D.L's is identified for the possibilities of decreased fitness levels and presence of developing or developed disability and need to be assessed, evaluated and managed on the basis of clinical findings observed.

 

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