Physical Therapy for Common Medical Disorders
Role of PT Aide in PT Physical therapy aide – assists the PT How? Setups/breakdowns Massage Modalities TE assistance Patient education Miscellaneous
Role of PT in Common Medical Disorders PT = musculoskeletal disorders PT also = neurological, cardiovascular, respiratory, & genitourinary disorders, amputations, burns, dermatological conditions, and conditions of the eyes, ears, nose, and throat The PT Aide must have an understanding of these conditions in order to help the PT treat them
Common Musculoskeletal Disorders – Pain Considerations Patient’s report of pain location/type/occurrence is key to choosing treatment Typically: Pain occurring w/ rest that improves w/ mvmt – osteoarthritis or mild sprains & strains Pain occurring w/ weight bearing – static deficiency or overstraining Pain occurring immediately after injury - fracture or major tear of muscle, ligament, or tissue
Pain Considerations – Con’t Typically – Pain occurring after an interval – minor sprain or strain Pain occurring w/ mvmt of joint; ceasing w/joint at rest – acute joint disorder/injury or sprain/strain Pain radiating along a nerve distribution – presence of a lesion/impingement on a nerve by contracted muscles Pain occurring with work activities – injury sustained as part of the patient’s occupation
PT for Musculoskeletal Disorders Arthritis/Rheumatic Conditions Subacutely inflamed joints – Moist or infrared heat, 30 min., 2-3x/day Acute-stage arthritis – Full ROM 2-3x/day; NO HEAT Subacute /chronic stages – Heat (moist, infrared, paraffin, tub baths, or diathermy), massage, and TE\s, 1x/day
PT for Musculoskeletal Disorders Arthritis/Rheumatoid Conditions - Modalities Heat – used in nonacute phases for comfort and increased circulation/flexibility Massage – post acute phases ROM strengthen muscles at a joint and increase joint motion Types – PROM, AAROM, AROM, RROM
PT for Musculoskeletal Disorders Low Back Pain (Lumbago) Lumbosacral/Sacroiliac strain – generalized low back pain Periosteal/Ligamentous tear – hx of snapping/slipping in back Mild/chronic arthritis of spine – pain on awakening; lessens with activity Defective intervertebral disk (pain w/ sciatica down leg) – reccurring attacks of pain and tingling; worsened by sneezing/coughing Fracture/abscessed vertebrae – localized pain Poor posture – daytime pain with nighttime cessation
PT for Musculoskeletal Disorders Rest w/ postural alignment Moist heat (Not continuous) Massage (post acute) Corrective TEs Painful during exercise/1-2 hours post exercise is ok Painful later that day or the next day is not ok; exercise duration/intensity/frequency must be reduced
PT for Musculoskeletal Disorders Bursitis – inflammation of bursa Rest Ice initially Infrared heat post inflammatory phase Massage PROM, transitioning to AROM
PT for Musculoskeletal Disorders Cervical Disorders – whiplash, arthritis, strains/sprains, disk injuries Traction (acute, compression, disk injuries) Moist heat Massage Manual therapies Injections
PT for Musculoskeletal Disorders Degenerative Joint Disease (OA) REST Local – bracing General – bed rest Heat Massage TEs
PT for Neurological Disorders Cerebrovascular accident (CVA; aka stroke) resulting in hemiplegia Needed to prevent/correct deformity, improve motor function, & help develop the ability to carry out ADLs PT includes: Positioning therapies (acute) Heat Stimulating massage Movement reeducation TEs Training in the use of assistive devices
PT for Neurological Disorders Guillain-Barre Syndrome Condition caused by viral encephalitis Characterized by fever, pain, weakness, muscle tenderness, and interruption/lack of motor reflexes PT includes: PROM TEs (initial) Breathing exercises (initial) Positioning exercises (initial) AROM TEs (post acute) Gait training Learning ADLs