1. Physical Therapy for Common Medical Disorders

2. Role of PT Aide in PT Physical therapy aide – assists the PT How?
Setups/breakdowns
Massage
Modalities
TE assistance
Patient education
Miscellaneous

3. 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

4. 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

5. 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

6. 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

7. 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

8. 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

9. 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

10. PT for Musculoskeletal Disorders
Bursitis – inflammation of bursa
Rest
Ice initially
Infrared heat post inflammatory phase
Massage
PROM, transitioning to AROM

11. PT for Musculoskeletal Disorders
Cervical Disorders – whiplash, arthritis, strains/sprains, disk injuries
Traction (acute, compression, disk injuries)
Moist heat
Massage
Manual therapies
Injections

12. PT for Musculoskeletal Disorders
Degenerative Joint Disease (OA)
REST
Local – bracing
General – bed rest
Heat
Massage
TEs

13. 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

14. 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