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Physiotherapy
 
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What is Physiotherapy ?

                                     Physiotherapy, or Physical Therapy, is a HealthCare profession concerned with the assessment, maintenance, and restoration of the physical function and performance of the body. It is a well establish branch of medical sciences being practice at global level. Its treatment can be given to patient both in isolation or in conjunction with other types of medical management. Used in conjunction with certain medical or surgical techniques, physiotherapy can complement these techniques to help provide a speedy and complication-free return to normal activity.

                                    Physiotherapy can be useful in the diagnosis and management of a wide range of injuries, disease processes, and other conditions, including
                                        

     · Sports injuries 
    
· Arthritis 
    
· Back and neck pain 
    
· Postural problems 
    
· Asthma management
    
· Chronic airways disease
    
· Occupational injuries 
    
· Neurological conditions
    
· Spinal cord injuries 
    
. Stroke rehabilitation 
    
· Rehabilitation following cardiac surgery 
    
· Impaired mobility 
    
· Amputee rehabilitation  
    
· Women’s health 
    
· Incontinence 
    
· Geriatric problems 
    
· Developmental and paediatric problems 
 

Physiotherapy can help individuals by :

A.  Identifying the problem area and treating this directly :

                  Physiotherapists treat a wide variety of injuries and problems using many different techniques. In many cases, the causes of pain and dysfunction are obvious, but sometimes things are not so black and white, especially when symptoms are inconsistent or difficult to describe. Physiotherapists can perform a wide range of tests to help locate the source of the problem and implement the appropriate treatment strategy.

B. Identifying the causes and predisposing factors :
                  
Physiotherapists are not only interested in the problem, but factors which contribute to the problem. Identifying factors such as poor posture, improper techniques, muscle imbalances, poor work practices, or other bad habits allow interventions to be made to correct these factors. This will reduce the risk of the same thing happening again in the future.

C. Providing Rehabilitation following occupational or sporting injuries :
           
Physiotherapists can help you get back to work or sport more quickly by providing rehabilitation programs and advice on how to prevent a recurrence of the injury.

D. Providing rehabilitation and exercise before and after surgery :
           
If you are having or have had major surgery, physiotherapists are often involved in pre-operative and/or post-operative programs to help get you moving again, making sure your length of stay in hospital is not unexpectedly extended.

E. Providing advice on exercise programs :
          
 If you have the urge to get fit and stay healthy, one of the best ways to do this is by through regular exercise. However if you have not done any serious exercise for a while, it may be advisable to seek assistance to devise an appropriate program for your needs, and ensure you are not at risk of injury.

F. Providing or advising on special equipment :
          
With different conditions or disease processes, special equipment may be required. Physiotherapists can advise on many different types of equipment, including splints, walking aids, wheelchairs, occupational equipment etc.  

What do Physiotherapists do?

            A common misconception is that physiotherapists only deal with injuries to backs, necks, joints, muscles and other ‘sports’ type injuries. While many physios certainly do treat these types of conditions, there are other areas in which physiotherapists are trained and can help you. For simple explanation, physiotherapy can be divided into three broad areas.

· Musculo-skeletal physiotherapy 
· Cardio-thoracic physiotherapy 
· Neurological physiotherapy

Musculo-skeletal Physiotherapy (Orthopaedics) : As the name suggests, this area deals with muscles, bones and joints, and is perhaps the most widely known. Musculo-skeletal physiotherapists can deal with many acute or chronic conditions such as:

·Arthritis
·Joint sprains/stiffness/instability 
. Back and neck pain or stiffness 
·Muscle strains/contusions 
·Muscle imbalances/weakness 
·Muscle spasm 
·Tendonitis/bursitis 
·Rehabilitation following occupational injury, surgery, sporting injuries. 
           

                        The musculoskeletal physiotherapist uses a variety of different treatment methods to help speed up the healing process and reduce the likelihood of the same thing happening again. Some of the techniques include:

· Manual techniques (massage, joint mobilisation, manipulation, stretches) 
· Electrotherapy (ultrasound, interferential, TENS, shortwave, microwave, laser) 
· Heat and cold 
· Therapeutic exercise 
· Correction of posture, lifting techniques, sporting techniques which contribute to the problem 
· Taping, bandaging, splinting 
· Hydrotherapy 

                        The musculoskeletal physiotherapist is not only concerned with treating the injury, but with finding the cause and correcting any biomechanical factors which may contribute to the injury.

Cardio-thoracic Physiotherapy : Cardio-thoracic physiotherapists deal primarily with the function of the cardio-respiratory system. The Cardio-thoracic physiotherapist, often working in the acute hospital, deals with a variety of situations, some of them being:

· Chronic Obstructive Airways Disease (Emphysema, Asthma, Chronic Bronchitis) 
· Following general surgery 
· General medical conditions 
· Following cardiac surgery 
· Following most types of thoracic surgery 
· Intensive Care Unit patients

                        The Cardio-thoracic physiotherapist aims to optimise the function of the Cardio-thoracic system and patient comfort, resulting in increased exercise tolerance, a reduced chance of developing complications such as chest infections, reduced shortness of breath, and a reduced length of stay in hospital. Some of the treatment techniques at the physiotherapists disposal are:

· Breathing techniques either to reduce shortness of breath or increase lung expansion 
· Patient positioning 
· Sputum clearance with percussion, vibrations, coughing, deep
breathing, suction 
· Mobilising, sitting out of bed, or walking 
· Oxygen therapy 
· Mechanical ventilators 
· Medications 
·Exercise programs

Neurological Physiotherapy : Neurological Physiotherapy, as the name suggests, is concerned with disorders of the nervous system. The neurological physiotherapist is involved in the assessment and treatment of patients suffering conditions such as:

· Acquired brain injuries/head injuries 
· Strokes 
· Brain surgery 
· Parkinson’s disease 
· Multiple sclerosis 
· Guillian-Barre syndrome 
· Balance disorders 
· Spinal cord injuries 
· Other neurological conditions

                        The neurological physiotherapist is involved in determining how these conditions affect the patients movement and function, and implementing strategies to regain maximum function, depending on the type of disorder.

Where do Physiotherapists work ?

Physios work in many different places and situations, including:

  • Hospitals

  • Medical centers

  • Nursing homes

  • Private practices

  • Rehabilitation centers

  • Sports clubs

  • Sports clinics

  • Gymnasiums

  • Fitness centers


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DR. SAEED AHMAD, PRESIDENT
Indian Association of Chartered Physiotherapists

   Neuro Science & Physiotherapy Centre,
Towards IIM, Hardoi By Pass, Sitapur Road,
Lucknow, U.P., India
Phone: 9839070304, 3241140
E-mail: iacp_india@rediffmail.com


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