Rehabilitation By : Dr.Hassan Hussien El- sharkawy

Physical rehabilitation Aim – methods Aim Physical therapy helps the patient restore the use of muscles, bones, and the nervous system It seeks to relieve pain,pain improve strength and mobility, train the patient to perform important everyday tasks. Physical therapy may be prescribed to rehabilitate a patient after amputations, arthritis, burns, cancer, cardiac disease, cervical and lumbar dysfunction, neurological problems, orthopedic injuries, pulmonary disease, spinal cord injuries, stroke, traumatic brain injuries, and other injuries/illnesses.burns

Methods heat, cold, massage, whirlpool baths, ultrasound, exercise, and other techniquesexercise

Exercise is the most widely used and best known type of physical therapy. Depending on the patient's condition, exercises may be performed by the patient alone or with the therapist's help, or with the therapist moving the patient's limbs. Exercise equipment for physical therapy could include an exercise table or mat, a stationary bicycle, walking aids, a wheelchair, practice stairs, parallel bars, and pulleys and weights. Exercise

Heat treatment applied with hot-water compresses, infrared lamps, short-wave radiation, high frequency electrical current, ultrasound, paraffin wax, or warm baths, is used to stimulate the patient's circulation, relax muscles, and relieve pain Heat treatment

Cold treatment is applied with ice packs or cold-water soaking. Soaking in a whirlpool can ease muscle spasm pain and help strengthen movements. Cold treatment

Massage aids circulation, helps the patient relax, relieves pain and muscle spasms, and reduces swelling. Massage

Very low strength electrical currents applied through the skin stimulate muscles and make them contract, helping paralyzed or weakened muscles respond again Electrical muscle stimulation

Tilt Table

Occupational therapy and ADL is skilled treatment that helps people become successful in their everyday occupations. Often independence is the goal and can be achieved through : Skilled treatment in rehabilitating lost motor or cognitive function Adaptive equipment Home modifications Client and caregiver guidance

Occupational Therapists Work… In these areas: - Physical Rehabilitation - Mental Health Services - Learning Disability - Pediatrics - Environmental Adaptation - Care Management - Equipment for Daily Living - Research In these places: - Community centers - Education establishments - Hospitals - Home Health - Industrial and Commercial organizations - Residential and Nursing homes - Social Services - Schools - Charities and Voluntary agencies

Occupational Therapy Process -To begin treatment… -we need a physician referral! - In an initial evaluation, we look at a patient’s occupational performance and individual goals - We assess a person’s performance skills related to specific tasks, including one’s Motor skills, Process skills, and Communication/interaction skills.

Services Offered ADL and IADL Training ADL stands for “Activities of Daily Living” -These can include bathing, dressing, grooming, and other activities that are basic to our daily lives - We assist individuals in improving function through participation in ADL. - We may suggest adaptive equipment, provide verbal cues for sequencing, work on problem solving, and assess an individual’s ability to perform ADL safely

IADL Instrumental Activities of Daily Living These are more complex activities that we routinely do to take care of ourselves and others and contribute to society These may include money management, community mobility, child rearing, and meal preparation

Cognition -One of the most important factors in an individual’s return home is his or her ability to be safe within the home environment -We address cognition as it relates to participation in occupation -Is an individual able to problem solve through meal preparation? =If not, what sort of external cues might he or she need to be successful?

Neuromuscular Re-Education Physical agent modalities, such as Functional Electrical Stimulation, may be used in addition to functional reaching exercises to regain muscle strength and use after a stroke. Gross and fine motor coordination may be compromised after a neurological insult. OTs assist in regaining coordination for functional activities.

Upper-Extremity Splinting To increase an individual’s ability to participate in occupations, sometimes splinting intervention is indicated to stabilize the wrist and hand and assist in the healing process We splint for such conditions as: Carpal Tunnel Radial Nerve Palsy Tendinitis

Home Safety Evaluation Recommendations for Durable Medical Equipment (DME) Some examples include: Wheelchair, walker, bedside commode, shower chair, and cane Tips for preventing accidents and falls Color-code knobs on stove or washer/dryer for people with low vision Remove throw rugs to prevent falls Recommendations for home modifications to improve safety, security, and independence Ramp construction Bathroom or kitchen modifications for accessibility

Work and Community Integration -Ergonomic evaluations and recommendations for work and home modifications - Driving evaluations - Work capacity evaluation and work hardening

P ATIENT, F AMILY, & C AREGIVER E DUCATION Where is education provided? In a variety of settings such as: Hospice, hospital, rehabilitation, inpatient and outpatient, skilled nursing facility, schools, and home health What is included with patient, family, & caregiver education? Self-treatment or caregiver techniques ADL re-training Eating, dressing, or personal hygiene Precautions after surgeries (i.e., hip replacement) Use of adaptive equipment for functional activity Reacher, sock aid, sliding board for transfers Prosthetic training Pain management

A SSISTIVE T ECHNOLOGY Assistive technology is provided for physical, sensory, or cognitive disabilities. Some examples include: Wheelchairs: seating systems and communication boards Low Vision: magnifiers, enhanced lighting, and color coding Adaptive household equipment is also available for functional needs: Bathing, dressing, grooming, driving, cooking, and other occupations