Your Physical Therapy: March 2014

P.T Modalities

Goniometer for Elbow joint Part 2

Monday, March 17, 2014 Unknown 2 Comments

P.T Modalities

Goniometer for Shoulder Joint Part 1

Saturday, March 15, 2014 Unknown 1 Comments

Shoulder Joint

A- Flexion

1- Patient in supine position

2- place the center point of goniometer in the center of shoulder joint just above humerus head

3- ask the patient to flex his\her shoulder joint as much as possible

4- fix one of goniometer arms and moved the other Parallel to humerus

5- then read the degrees

Normal range for Shoulder flexion

167° ± 4.7° (American Academy of Orthopaedic Surgeons)
150° (American Medical Association)
166° (mean), 4.7° (standard deviation), (Boone and Azen)

B- Extenion

1- Patient in supine position

2- place the center point of goniometer in the center of shoulder joint just above humerus head

3- ask the patient to extend his\her shoulder joint as much as possible

4- fix one of goniometer arms and moved the other Parallel to humerus

5- then read the degrees

Normal range for Shoulder extension

62° ± 9.5° (American Academy of Orthopaedic Surgeons)
50° (American Medical Association)
62.3° (mean), 9.5° (standard deviation), (Boone and Azen)

C- Abduction \ ِAdduction

1- Patient in supine position

2- place the center point of goniometer in front of the center of shoulder joint just above humerus head

3- let the both arms of goniometer run Parallel to the sternum

4- ask the patient to extend his\her shoulder joint as much as possible

5- with fix one of goniometer arms and moved the other Parallel to humerus

6- then read the degrees

Normal range for Shoulder Abduction

184° ± 7.0° (American Academy of Orthopaedic Surgeons)
180° (American Medical Association)
184° (mean), 7.0° (standard deviation), (Boone and Azen)

D- Internal rotation

1- Patient in supine position with elbow flixed 90 shoulder abducted 90

2- place the center point of goniometer over olecranon process of ulna

3- let the both arms of goniometer Vertical to the bed

4- ask patient for internal rotation as much as possible

5- with fix one of goniometer arms and moved the other Parallel to ulna

6- then read the degrees

goniometer for shoulder internal rotation

Normal range for Shoulder Internal rotation

69° ± 4.6° (American Academy of Orthopaedic Surgeons)
90° (American Medical Association)
68.8° (mean), 4.6° (standard deviation), (Boone and Azen)

E- External rotation

1- Patient in supine position with elbow flixed 90 shoulder abducted 90

2- place the center point of goniometer over olecranon process of ulna

3- let the both arms of goniometer Vertical to the bed

4- ask patient for internal rotation as much as possible

5- with fix one of goniometer arms and moved the other Parallel to ulna

6- then read the degrees

goniometer for shoulder external rotation

Normal range for Shoulder external rotation

104° ± 8.5° (American Academy of Orthopaedic Surgeons)
90° (American Medical Association)
103° (mean), 8.5° (standard deviation), (Boone and Azen)

P.T Modalities

Therapeutic ultrasound

Sunday, March 09, 2014 Unknown 1 Comments

Therapeutic ultrasound is type of sound with frequency of greater than 20.000 cycles per second Hz, Human frequency hearing of sounds is from 16 to 20.000 Hz so we can't hear that sound. Therapeutic ultrasound has physical effects that can be typed as Thermal and Non-thermal. The treatment session for Therapeutic ultrasound is from 5-10 minutes only

What you feel if Therapeutic ultrasound used in you?

Normally patient will feel nothing, sometimes patient may feel slightly hot in the place that physical therapist apply Therapeutic ultrasound . physical therapist will always keep move the head of therapeutic ultrasound and if not, you will feel pain on the area, if you feel that pain directly tell your physical therapist.

Types of Therapeutic ultrasound

A- Thermal Ultrasound

used for heat deeply in the skin and smaller areas, it can be reach up to 5 cm depth and provide heat effect for joints capsule, ligaments and tendons

Thermal Effects:

1- Increases metabolic rate

2- Improve the extensibility of collagen structures

3- Help in decreases joint stiffness

4- Pain relief

5- Improve blood circulation for the area

6- Decrease muscle spasm

B- Non-thermal Ultrasound

Cavitation, microstreaming and acoustic streaming are the cause if Non-thermal effects of Ultrasound

Non-thermal Effects:

1- Increase calcium of intracellular

2- Increase permeability of skin and cell membrane

General caution for use therapeutic ultrasound

1- Malignant tumor

use therapeutic ultrasound over a limb or body part with a malignant tumor you should consult the referring physician for patient with history of malignant tumor

2- Pregnancy

use therapeutic ultrasound over the abdomen, low back, or pelvis for females who is or may be pregnant

3- Pacemakers

use therapeutic ultrasound must avoided over the pacemaker area, but can be used over other areas of body

4- Thrombus

use therapeutic ultrasound must avoided over or near area where thrombus is or may present

5- Eyes

use therapeutic ultrasound must avoided to uesd over eyes it can damage patient eyes

P.T Modalities

Range Of Motion (ROM) Types

Friday, March 07, 2014 Unknown 1 Comments

Cardiovascular

Physical therapy for Hemiplegia patients ( Never give up ! )

Wednesday, March 05, 2014 Unknown 13 Comments

We descrip at the last post the First step after Hemiplegia but now we going to show you the physical therapy treatment for Hemiplegia patients but you should need tow important things, first: the patient must always be in contact with his\her Physical therapist, second : patient must work hard with physical therapist and "Never give up"

A- Tissues stretching exercise
You may feel little pain during tissues stretching. but never mind its normal sign phsical therapist will not give patients more than his\her endurance, after several sessions and gradually you and physical therapist will feel the treatment effects on your body just "Never give up"

B- Balance exercise

Physical therapy will ask you to touch something that he\she hold it from different places Physical therapy will start with you in sitting position then in standing position. first it will be little difficult but after training it will become easier "Never give up"

C- Coordination exercise

its some exercises you have to do like touch the knee with your effected heel, touch your nose with your finger and touch the finger of the therapist with his finger those exercise will help to improve coordination "Never give up"

D- The Assistive Device :

With Physical therapy you will know how to use the assistive device in correct way for example you may need : Walker, Walking Stick, Axillary crutch, Elbow crutch, Splints etc... "Never give up"

E- Gait training:

Circumduction gait is the way that a hemiplegic patient walks. this is an incorrect way for walk.Gait training must start depend on this steps: firstly try to stand with your physical therapist or with using assistive device, after your physical therapist feels that you ready for independently stand he/she will ask you to start the second step try to stand independently ! after that try to walk with with your physical therapist or with using assistive device and then day after day you will feel the difference and "Never give up"

F- Sensation exercise

1- Superficial sensation:

Physical therapist will use two pencils and ask you to close your eyes,

Phyiscal therapist will apply smooth press with both pencils on your skin and ask you .. Did you feel something ? how many pencils tought your skin ? and physical therapist will change pencils place each time and you try to answer his\her questions

2- Deep sensation:

Physical therapist will ask you to close your eyes and give you small two or more things that have different shapes and ask you what you holds on your hands ?

3- Position sensation:

Physical therapist will ask you to close your eyes again and make small flexion or extension on your toe on the affected side the ask you what your toes position ?

"Never give up"

Note : all treatment plans will help you to gradually improve and you will see that by your own eyes this is not a work of several days but this may take weeks or months with hard working to feel the difference So pleases "Never give up"

Cardiovascular

First Step After Hemiplegia

Monday, March 03, 2014 Unknown 0 Comments

definition

It is a partial or Full loss of the ability to move muscles of half of the body resulting from a previous cerebrovascular accident (CVA), Stroke or head injury

Brain stroke mean ?

Its sudden accident that leads to obstruction or bleeding of one or more of brain vessels which stop the way of nutrition and oxygen reaching to a specific part of the brain. this leads to disturbance in the function of the part lead to Hemiplegia, if this part is responsible for motor activity this disturbance may be temporary (transient ischemic attack) or complete ( hemiplegia )

Some of problems that may face the patient with hemiplegia (depend on effected the part )

1- Weakness or paralysis of muscles in one side of the body

2- Stiffness in the muscles

3- Mental function problems, awareness, understanding and information analysis

4- Balance and coordination problems which affects the patients abilities to perform

standing, walking and other activities of daily living

5- Problems or loss of sensation

6- difficult in speech, swallowing and vision

7- Intelligence and Focus problems

8- Difficulties in reading or writing

9- Psychological status is affected, cause depression or aggressive reactions with the surrounding society

10- Inability to control urine and feces

11- Sexual dysfunction

Patient may suffer from one or more of these complications. This problem can be managed if you follow what physical therapist orders

Complications of hemiplegia :

1- Dislocation of shoulder joint of the affected side

2- DVT ( Deep venous thrombosis) of lower limbs veins

3- edema of the affected leg

4- Bed sores may form in bony prominence's area

5- Stiffness in the muscles of the effected side

6- Osteoporosis

7- Circumduction gait

8- Cervical and back pain due to the prolonged reduction of the general activities an unilateral weakness of the back and neck muscles

To avoid the complications you should improve your abilities

how to improve your abilities

Hemiplegia stop you form doing your active daily living, but if you follow physical therapy orders that's may change many things and help you to get back to your normal life and regain your power and indepence as much as possible, Self-reliance again or at lest prevent you from having harmful complications or any regression in your health status by providing

A- Physical therapy treatment

Physical therapist services start inside hospital after the doctor allowing that, and after patient leave the hospital physical therapy services can be given in a rehabilitation center or at home by physical therapist home visit program or by rehabilitation team

B- Good family support

i- Dealing with the patient

1- Providing psychological and emotional support to the patient

2- Make the patient feels Popularity and social value

3- Always make the effected side of the patient close to out of the bed

4- Its better if the family and friends sits beside the effected side of the patient

5- TV must be beside the effected side of the patient

6- Make the patient leave the room to outside several time a day

ii- Keep the patient in correct position

Physical therapist can help family to know what the correct position for the patient is depending on his\her case, its better to eat in siting position ,when the patient wants to sleep he should use pillows to support his affected limbs , always make sure that you obay all what physical therapist recommends you to do so plan of treatment will prove its success

iii- Transfer the patient correctly

change patients position in a correct way prevent bed sores, shoulder dislocation and pain in patient muscle. physical therapist can teach the family how to do it without any problem

We Going to Show You The Physical therapy plan of treatment with Hemiplegia patients

P.T Modalities

Postural Drainage Positions

Sunday, March 02, 2014 Unknown 0 Comments

Here some positions that you can applied by used clapping and vibration, NOTE that patient should be out of clothes to perform the massage technique with pest result

1- Self-Postural Drainage

You should site upright and your hand crossed your body to reach the opposite side of front chest then applied clap or vibrate on the front of the chest above the muscle area between collarbone and the top of the shoulder blade then repeat on the opposite side

2- The upper front lobes

The patient should sit upright and the physical therapist clapping and vibrating on the both side of the upper front chest above the muscle area between collarbone and the top of the shoulder

3- The upper back lobes

The patient should sit up and his/her trunk forward on a pillow the trunk angle to the legs as 30 degree, stand or sit behind the patient and apply clapping and vibrating on the both side of the upper back

Note avoid clapping on the vertebral

4- The upper front lobes ( lying supine )

The patient should lying on his\her back (supine) and the arms in neutral position, stand behind the patient head and apply clapping and vibrating on the patient chest on the both side in between the collarbone and the nipple

5- Left side front lobes

The patient should lying on the right side and the left side is higher with rises his\her left arm up to the head, then you should apply clapping and vibrating on the front of the lower left ribs just under the nipple

Note don't clapping or vibrating on the patient stomach

6- Right side front lobes

The patient should lying on the left side and the right side is higher with rises his\her left arm up to the head, then you should apply clapping and vibrating on the front of the lower left ribs just under the nipple

Note don't clapping or vibrating on the patient ribcage

7- Lower back lower lobes

The patient should lying pron clapping or vibrating on the patient both sides on the lower of the chest and avoid clapping or vibrating on the patient bone or lower the ribcage

8- Left lower back lobes

The patient lying on his\her left side and twist the body to you that allow you to reach his\her back, apply clapping and vibrating on the left side of lower back just on the bottom of lower cage

9- Right lower back lobes

The patient lying on his\her right side and twist the body to you that allow you to reach his\her back, apply clapping and vibrating on the right side of lower back just on the bottom of lower cage

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Your Physical Therapy

Popular Posts

Goniometer for Elbow joint Part 2

Goniometer for Shoulder Joint Part 1

Therapeutic ultrasound

Range Of Motion (ROM) Types

Physical therapy for Hemiplegia patients ( Never give up ! )

First Step After Hemiplegia

Postural Drainage Positions

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