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Physical therapists engage in an examination process that includes taking the individual’s history, conducting a standardized systems review, and performing selected tests and measures to identify potential and existing movement-related disorders. The data gathered during history taking, including answers to review of systems questions, enables the physical therapist to generate diagnostic hypotheses and select specific tests and measures to identify and characterize signs, symptoms, and risk of movement dysfunctions. To establish the individual’s specific diagnosis, prognosis, and plan of care through the evaluation process, physical therapists synthesize the collected examination data and determine whether the potential or existing disorders to be managed are within the scope of physical therapist practice.
Therapeutic exercise is a key component of any rehabilitation program and should be included as part of the concurrent care of any patient whether that patient has two or four legs. Physical therapists have been utilizing therapeutic exercises with great success since the conception of the profession in the beginning of the twentieth century and it has been demonstrated to be fundamental in improving function, performance and disability. Therapeutic exercise can consist of a variety of exercises inclusive of balance, strengthening, range of motion, endurance, and plyometric activities. The goals of therapeutic exercises include the restoration of movement, improvement of function and strength, improvement in gait and balance, and the prevention and the promotion of health, wellness, and fitness. Specific exercises are aimed at restoring strength, power and work, or endurance, or a combination. Therapeutic exercises are also utilized to increase range of motion, decrease pain, improve balance and proprioception, and restore function.
Within the physical therapy profession, manual therapy is defined as a clinical approach utilizing skilled, specific hands-on techniques, including but not limited to manipulation/mobilization, used by the physical therapist to diagnose and treat soft tissues and joint structures for the purpose of modulating pain; increasing range of motion (ROM); reducing or eliminating soft tissue inflammation; inducing relaxation; improving contractile and non-contractile tissue repair, extensibility, and/or stability; facilitating movement; and improving function.
Electrical muscle stimulation, also known as neuro-muscular electrical stimulation or electro-myo-stimulation, is the elicitation of muscle contraction using electric impulses. EMS has received an increasing amount of attention in the last few years for many reasons: it can be utilized as a strength training tool for healthy subjects and athletes; it could be used as a rehabilitation and preventive tool for partially or totally immobilized patients; it could be utilized as a testing tool for evaluating the neural and/or muscular function in vivo; it could be used as a post-exercise recovery tool for athletes. The impulses are generated by a device and are delivered through electrodes on the skin near to the muscles being stimulated. The electrodes are generally pads that adhere to the skin. The impulses mimic the action potential that comes from the central nervous system, causing the muscles to contract. The use of EMS has been cited by sports scientists as a complementary technique for sports training, and published research is available on the results obtained. In the United States, EMS devices are regulated by the U.S. Food and Drug Administration.
Teaching individuals with neurological or musculo-skeletal disorders to ambulate with or without an assistive device. Gait training is considered medically necessary for training individuals whose walking abilities have been impaired by neurological, muscular or skeletal abnormalities or trauma. Gait training is not considered medically necessary when the individual’s walking ability is not expected to improve. Provider supervision of repetitive walk-strengthening exercise for feeble or unstable patients is not considered medically necessary. Gait training is not considered medically necessary for relatively normal individuals with minor or transient abnormalities of gait who do not require an assistive device; these minor or transient gait abnormalities may be remedied by simple instructions to the individual.
WORK HARDENING PROGRAM
Work Hardening is an interdisciplinary, individualized, job specific program of activity with the. goal of return to work. Work Hardening programs use real or simulated work tasks and. progressively graded conditioning exercises that are based on the individual’s measured tolerances.
Ergonomics is a branch of science that aims to learn about human abilities and limitations and then apply that knowledge to improve people’s interaction with products, systems and environments. Ergonomics comes into everything which involves people. Work systems, sports and leisure. Health and safety should all embody ergonomics principles if well designed.
Geriatric physical therapists help elderly patients achieve or maintain high levels of physical health as they age by focusing on ailments like arthritis, osteoporosis, Alzheimer’s disease, and joint soreness. They evaluate each patient and design a custom activity and exercise plan that will allow the patient to remain as physically fit and active as possible. Once the activity plan has been implemented, the geriatric physical therapist monitors the patient’s progress and changes the plan as needed. Geriatric physical therapists usually work in nursing homes or outpatient facilities and can work with patients individually or in group settings.
Hand Therapy is the rehabilitation of the upper extremity, which include the hand, wrist, elbow and shoulder girdle. It is a merging of Occupational therapy and Physical therapy theory and practice that combines comprehensive knowledge of the structure of the upper limb with function and activity. Using specialized skills in assessment, planning, and treatment, hand therapist provide therapeutic interventions to prevent dysfunction, restore funciton and/or reverse the progression of pathology of the upper limb in order to enhance an individual’s abiilty to execute tasks and to participate fully in life situations.