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Physical Therapy

FTC-Week 4- Surgical Procedure
by

Engers Fernandez

on 23 June 2015

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Transcript of Physical Therapy

Physical Therapy
Week 4
Compress
Procedures 51-1 to 51-10
To carry out orders for treatments such as heat or cold compresses and exercise
Instruct the patient on how to appropriately use heat or cold applications at home
Demonstrate the use of assistive devices such as canes and crutches
Role of the Medical Assistant on the Therapeutic Team
Range of motion is the degree of movement a joint can experience without pain
Range of motion is measured with a
goniometer
Exercises can help to maintain muscle tone and flexibility
Exercises include AROM, PROM, and AAROM
Range of Motion Exercises
Active range of motion (AROM):
The patient is able to move all limbs through the entire range of motion unassisted
Passive range of motion (PROM):
The patient must have someone else move his or her limbs through the range of motion exercises because he or she is unable to do it
Active assist range of motion (AAROM):
The patient participates to a limited extent in range of motion exercises, but will require assistance
ROM Exercises
Quickens the healing process
Causes dilation of blood vessels and allows for increased circulation to injured tissues
Assists in relieving pain and muscle spasms
Softens hard crusts of exudate
Hastens suppuration
Benefits of Applying Heat
Warm to hot compresses
Sitz baths
Tub baths
Warm soaks
Heat hydrotherapy
Whirlpool bath
Paraffin treatment
Methods of Applying Moist Heat
Infrared radiation
Electric heating pads
Hot water bottles
Chemical hot packs
Aquathermia or aquamatic pads
Methods of Applying Dry Heat
Cold compresses
Soaks
Ice packs
Hypothermia blankets
Methods of Cold Applications
Equipment used to assist recovery from physical disorders or disabilities
Includes wheelchairs, walkers, canes, crutches, and special furniture, such as shower chairs and geriatric chairs
Mobility aids or mobility assistive devices are designed to enable the patient to ambulate
Other devices, including braces, casts, traction, prostheses, splints, and slings, are used to manipulate the patient’s damaged bones and tissues
Overview of Adaptive Equipment and Devices
Canadian or elbow crutch:
Variation of the Lofstrand crutch that extends further up the arm
Three Most Common Types of Crutches
Lofstrand (forearm crutch):
Single aluminum tube with an arm cuff that fits snugly around the patient’s forearm and uses a handgrip for weight bearing
Allows patient to release the handgrip to use the hand while still having the crutch held in place by the arm cuff for support
Three Most Common Types of Crutches
Axillary crutch:
Tall crutch with shoulder rest and handgrip that reaches from the ground to under the axilla
Commonly used for a patient who has suffered a fractured leg
Three Most Common Types of Crutches
Have the patient wear walking shoes and stand straight
Place the crutch tips 4 to 6 inches to the side and 4 to 6 inches in front of each foot
Adjust the crutch, using the bolts and nuts at the sides of the crutch, so that the axillary crutch bars are three finger widths below the axilla
Steps for Measuring Axillary Crutches
Measurement has to be determined carefully to prevent pressure damage to the axilla
If crutches are too long, the patient may develop a condition known as crutch palsy, resulting in muscle weakness in the arm, wrist, and hand
Crutches that are too short can result in the patient having to bend forward while walking
Back pain, nerve damage, and injury to the axilla and palms of the hands can occur if the crutches are improperly fitted
Axillary Crutch Measurement
Slow and steady gait
Used when a patient can bear weight on both legs
Considered the safest of all gaits since the patient always has three points of support in contact with the ground at all times
Used by patients who may have muscular weakness and some lack of coordination
Four-Point Gait
Used when one leg is stronger than the other or when there is no weight bearing on one leg
Patient must have good muscle coordination and arm strength
To use this gait, the patient must be able to support his or her full weight on one leg
Three-Point Gait
Faster moving than the four-point gait
Used by the patient who can bear some weight on both feet and maintain good balance
Occurs when a crutch and the opposite foot are moved forward at the same time
Two-Point Gait
Used by patients with severe leg disabilities, such as deformities or paralysis
They may use either of the two swing gaits:
Swing-to gait:
Patient moves the crutches forward, lifts his or her body, and then swings the legs up to the same point
Swing-through gait:
Patient moves the crutches forward, as in the swing-to gait, and then swings the legs past the crutches
Swing Gaits
Swing-to Gait
Used by patients who have muscle or bone weakness on one side or need assistance with balance
Two common types of canes are the standard cane and the four-point (quad) cane
Several types of wooden and aluminum canes are available
All canes should have a rubber tip on the end to prevent slipping
A PT determines the most suitable cane
Canes
Instruct the patient to move the injured leg and cane forward simultaneously.
Instructing a Patient in Using
a Cane
Always think of moving a patient as the process of transferring him or her from one place to another
In many cases, the patient is familiar with the techniques necessary for the transfer and will be able to assist the medical assistant
When Transferring a Patient from a Wheelchair
One type of orthotic used to support weakened body parts, to correct deformities, and prevent joint movement
May be made out of metal, plastic, or leather and are customized to the patient’s needs and anatomy
To wear this type of assistive leg device, the brace is placed in the patient’s shoe, the patient’s foot is inserted, and a hook-and-loop strap is used to hold the brace in place
Braces
Any orthotic positioned over a bony point must be padded to avoid skin breakdown
Prolonged use of a brace may weaken muscles
Braces
Measure this by inserting your own fingers between the patient’s axilla and the crutch bar
Next adjust the handgrips so the patient can flex his or her elbows at a 30-degree angle when the crutch is in place and the patient’s hands are on the hand bars
51- 1 Application of a Hot Compress
51-2 Application of a Hot Soak
51-3 Application of a Heating Pad
51-4 Application of a Cold Compress
51-5 Application of an Ice Bag
51-6 Application of a Cold Chemical Pack
51-7 Instructing Patient to use Crutches
51-8 Instructing a Patient to use a Cane
51-9 Teaching a patient to correctly use a walker
51-10 Wheelchair transfer to a Chair or examination table
Applying A Bandage Over A Sterile Dressing
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