Physical Therapy Skills
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Transcript Physical Therapy Skills
Allied Health
Assisting
PHYSICAL THERAPY SKILLS
Career Highlights
Physical Therapy Assistant (PTA)
Provide treatment to improve mobility and prevent or limit permanent
disability
Important members of the health care team
Work under supervision of a Physical Therapist
Most PTA’s have an associates degree
Licensure is required
Career Highlights
Physical Therapy Assistant (PTA)
Job duties include
Performing exercises
Ultrasound therapy
Electrical stimulation treatment
Hot, cold, and moist therapy applications
Educating patients
Career Highlights
Physical Therapy Assistant (PTA)
Must learn and master the following skills
Presenting a professional appearance and attitude
Obtaining continuing knowledge
Communicating effectively
Being sensitive and respecting cultural diversity
Learning medical terminology
Comprehending anatomy, physiology, pathophysiology
Administering CPR and first aid
Promoting good nutrition
Computer literacy
Cleaning and maintaining equipment
Ordering and maintaining supplies
Performing administrative duties
Performing Range-of-Motion (ROM)
Exercises
Range-of-Motion (ROM)
Exercises done to maintain the health of the musculoskeletal system
Each joint and muscle in moved through its full range of motion
Frequently ordered by the physician for patients with limited ability to
move
Administered by at physical therapist, nurse, nursing assistant, physical
therapy assistant, or other authorized person
ROM exercises are done to prevent problems caused by a lack of
movement and inactivity such as:
Performing Range-of-Motion (ROM)
Exercises
Contracture:
A tightening and shortening of a muscle, resulting in permanent flexing of a
joint. Foot drop is a common contracture, but contractures can also affect
the knees, hips, elbows, and hands.
Performing Range-of-Motion (ROM)
Exercises
Contracture:
Performing Range-of-Motion (ROM)
Exercises
Muscle and joint function:
Circulatory impairment:
The circulation of blood is affected, and blood clots and pressure ulcers
(bed sores) can develop
Mineral loss:
Muscles atrophy and become weak. Joints stiffen and become difficult to
move
Caused by inactivity. Calcium is lost from the bones. Bones become brittle
and fractures occur. Increases blood calcium levels, renal calculi develop
Other problems:
Poor appetite, constipation, urinary infections, respiratory problems,
hypostatic pneumonia
Performing Range-of-Motion (ROM)
Exercises
There are four main types of ROM exercises:
Active ROM exercises:
Performed by patients who are able to move each joint without assistance
Strengthens muscles
Maintains joint function
Helps prevent deformities
Performing Range-of-Motion (ROM)
Exercises
There are four main types of ROM exercises:
Active Assistive ROM exercise
Patients actively move the joints but they receive assistance to complete the
entire ROM
At times equipment can be used to help
Passive ROM exercises
Another person moves each joint for a patient who is not able to exercise
Prevents deformities
Does NOT strengthen muscles
Performing Range-of-Motion (ROM)
Exercises
There are four main types of ROM exercises:
Resistive ROM exercises
Administered by a therapist
Performed against resistance provided by the therapist
Develops strength and endurance
The healthcare worker should note if there are any limitations to the
exercises before performing ROM exercises
In many states and facilities only Physical Therapists or Registered
Nurses may perform ROM to the head and neck
Performing Range-of-Motion (ROM)
Exercises
The main terms for movement:
Abduction: moving a part away from the midline of the body
Adduction: moving a part toward the midline of the body
Flexion: bending a body part
Extension: straightening a body part
Hyperextension: excessive straightening of a body part
Rotation: moving a body part around its own axis
Circumduction: moving in a circle at a joint
Pronation: turning a body part down
Supination: turning a body part up
Performing Range-of-Motion (ROM)
Exercises
The main terms for movement:
Opposition: touching each of the fingers with the tip of the thumb
Inversion: Turning a body part inward
Eversion: turning a body part outward
Dorsiflexion: bending backward
Plantar flexion: bending foot forward
Radial deviation: moving toward the thumb side of the hand
Ulnar deviation: moving toward the little finger side of the hand
Performing Range-of-Motion (ROM)
Exercises
Principles that must be observed while performing ROM exercises
Movements should be slow, smooth, and gentle to prevent injury
Support should be provided to the parts above and below the joint
being exercised
A joint should never be forced beyond its ROM or exercised to the point
of pain, resistance, or extreme fatigue
If a patient complains of pain, STOP the exercise and report this to your
supervisor
Watch the patient closely. If you notice a patient is in pain, has SOB, or
is diaphoretic, or is pale, STOP and notify supervisor
Performing Range-of-Motion (ROM)
Exercises
Principles that must be observed while performing ROM exercises
Each movement should be performed three to five times or as ordered
The patient should be encouraged to assist as much as possible
Prevent unnecessary exposure of the patient
The door or curtain should be closed to provide privacy
Use correct body mechanics at all times to prevent injury
Ambulating Patients Who Use Gait
Belts, Crutches, Canes, or Walkers
Ambulating Patients Who Use Gait
Belts, Crutches, Canes, or Walkers
Ambulating Patients Who Use Gait
Belts, Crutches, Canes, or Walkers
Ambulating Patients Who Use Gait
Belts, Crutches, Canes, or Walkers
Ambulating Patients Who Use Gait
Belts, Crutches, Canes, or Walkers
A transfer (gait) belt is a band of fabric or leather that is positioned
around a patient’s waist
Used to provide additional support for the patient
Provides patient with a sense of security
Helps HCW to provide stability
Ambulating Patients Who Use Gait
Belts, Crutches, Canes, or Walkers
Important facts to remember:
The belt must be the proper size. Must be secure but not too tight
Some belts contain loops that are grasped when ambulating the
patient. If loops are not present, an underhand grasp should be used
The belt should be grasped at the back during ambulation
The HCW should walk slightly behind the patient
When assisting a person to stand, grasp the belt on both sides
The belt should only be applied over clothing. Never on a patient’s skin
The use of a gait belt is contraindicated in patients who have an
ostomy, gastrostomy tube, abdominal pacemaker, severe cardiac
or respiratory disease, fractured ribs, recent chest or abdominal
surgery, or pregnancy
Ambulating Patients Who Use Gait
Belts, Crutches, Canes, or Walkers
Crutches are artificial supports that assist a patient who needs help
walking.
Usually prescribed by a physician
A therapist or other authorized individual fits them to the patient,
and teaches proper use
Exercises to strengthen muscles of shoulders, arms, and hands are
also frequently prescribed
Ambulating Patients Who Use Gait
Belts, Crutches, Canes, or Walkers
Three main types of crutches
Axillary Crutches
Made of wood or aluminum
Used for a short period of time
Bear weight on the hands and not to axillary support
Not recommended for weak or elderly patients
Require good upper body strength and balance
Ambulating Patients Who Use Gait
Belts, Crutches, Canes, or Walkers
Three main types of crutches
Ambulating Patients Who Use Gait
Belts, Crutches, Canes, or Walkers
Three main types of crutches
Ambulating Patients Who Use Gait
Belts, Crutches, Canes, or Walkers
Three main types of crutches
Forearm or Lofstrand Crutches
Attach to forearms
Used for patient with weakness, or paralysis, in both legs
Recommended for patients who need crutches for a long time or
permanently
Requires arms in good condition with good strength
Ambulating Patients Who Use Gait
Belts, Crutches, Canes, or Walkers
Three main types of crutches
Forearm or Lofstrand Crutches
Ambulating Patients Who Use Gait
Belts, Crutches, Canes, or Walkers
Three main types of crutches
Platform crutches
Used for patients who cannot grip handles of other crutches or bear weight
on their wrists or hands
Do not require as much upper body strength
Does require good sense of balance or coordination
Patient bears weight on the forearm
Ambulating Patients Who Use Gait
Belts, Crutches, Canes, or Walkers
Three main types of crutches
Platform crutches
Ambulating Patients Who Use Gait
Belts, Crutches, Canes, or Walkers
Three main types of crutches
Platform crutches
Ambulating Patients Who Use Gait
Belts, Crutches, Canes, or Walkers
The following should be observed when fitting crutches to a patient
Patient should wear walking shoes that fit well and provide good
support
Crutches should be positioned 4-6 inches in front of and 2-4 inches to
the side of the patient’s foot
Ambulating Patients Who Use Gait
Belts, Crutches, Canes, or Walkers
The following should be observed when fitting crutches to a patient
Length of the axillary crutches should be adjusted so that there are 2
inches or 2 to 3 finger widths between the armpit and the axillary bar of
the crutch
The hand pieces of axillary or forearm crutches should be adjusted so
that each elbow is flexed at a 25-30 degree angle
Ambulating Patients Who Use Gait
Belts, Crutches, Canes, or Walkers
Common crutch-walking gaits
Four-point gait:
Used when both legs can bear weight
Slow gait
Ambulating Patients Who Use Gait
Belts, Crutches, Canes, or Walkers
Common crutch-walking gaits
Two-point gait
Often taught after four-point gait is mastered
Faster gait
Usually used when both legs can bear some weight
Closest to the natural rhythm of walking
Ambulating Patients Who Use Gait
Belts, Crutches, Canes, or Walkers
Common crutch-walking gaits
Three-point gait
Used only when one leg can bear weight
It also can be taught initially
Swing-to or Step-to gait
More rapid gait
Taught after other gaits are mastered
Requires upper body and shoulder strength
Swing-through or Step-through gait
Most rapid gait
Requires most strength, balance, and skill
Ambulating Patients Who Use Gait
Belts, Crutches, Canes, or Walkers
Cane
An assistive device that provides balance and support
Several different types of canes
Standard
Single tipped
Curved handles
T-handles
J-handles
Ambulating Patients Who Use Gait
Belts, Crutches, Canes, or Walkers
Cane
An assistive device that provides balance and support
Several different types of canes
Tripod
Three tips
Quad Cane
Four tips
Provided widest base of support
Ambulating Patients Who Use Gait
Belts, Crutches, Canes, or Walkers
Cane
An assistive device that provides balance and support
Several different types of canes
Walkcane or Hemiwalker
Has four legs and a handlebar
Good for patients with hemiplegia
Bottom of cane tips should be capped with non slip tips
Ambulating Patients Who Use Gait
Belts, Crutches, Canes, or Walkers
Cane
Ambulating Patients Who Use Gait
Belts, Crutches, Canes, or Walkers
Cane
A cane is used on the unaffected (good) side
Gives a wider base of support
Prevents patient from leaning toward the cane
Leg and opposite arm move together
Canes must be correctly fitted
Bottom tip should be positioned approximately 6-8 inches from the side of
the unaffected foot
Handle should be level with the top of the femur
Elbow should be flexed 25-30 degrees
Ambulating Patients Who Use Gait
Belts, Crutches, Canes, or Walkers
Cane
Several gaits for can walking can be taught
Two point gait
Patient moves can and affected leg together
Three point gait
Patient moves cane
Then affected leg
Then unaffected leg
Therapist determines the correct gait for patient
https://www.youtube.com/watch?v=8nvPeXIglI8
Ambulating Patients Who Use Gait
Belts, Crutches, Canes, or Walkers
Walker
Ambulating Patients Who Use Gait
Belts, Crutches, Canes, or Walkers
Walker
A four legged device that provides support.
Several styles
Standard
Folding
Rolling
Platform
Walkers are used for weak patients who have a poor sense of balance
even though no injury may be present
To use a walker patients must be strong enough to hold themselves
upright while leaning on the walker
Ambulating Patients Who Use Gait
Belts, Crutches, Canes, or Walkers
Ambulating Patients Who Use Gait
Belts, Crutches, Canes, or Walkers
Walker
Basic principles for walker use
The walker should be fitted to the patient
The handle should be level with the top of the femurs
Each elbow should be flexed at 25-30 degrees
The patient must be taught to lift the walker and place it in front of the body
Only placed where the back legs are even with the toes of the patient
The patient walks into the walker
Administering Heat/Cold
Applications
Cryotherapy
Use of cold for treatment
Relieve pain
Reduce swelling
Reduce body temperature
Control bleeding
Administering Heat/Cold
Applications
Cryotherapy
Moist Cold
Applications are cold and moist against the skin
Cold compresses
Cold packs
Cold soaks
More penetrating than dry cold applications
Administering Heat/Cold
Applications
Cryotherapy
Dry Cold
Cold and dry against the skin
Ice bags
Ice collars
Hypothermia blankets
Administering Heat/Cold
Applications
Cryotherapy
Ice bags or collars
Special containers filled with ice
Most facilities used disposable bags
Hypothermia blanket (thermal blanket)
Contains coils filled with cool fluid
Used to reduce high body temperatures
Rectal probe is used to monitor body temperature continuously
When temperature reaches certain level blanket decreases circulation of
fluid
Administering Heat/Cold
Applications
Thermotherapy
The use of heat for treatment
Relief of pain
Increase drainage from infected area
Stimulate healing
Increase circulation to certain area
Combat infection
Relieve muscle spasms
Increase muscle motility
Administering Heat/Cold
Applications
Thermotherapy
Moist Heat
Warm and wet against the skin
More penetrating
Administering Heat/Cold
Applications
Thermotherapy
Sitz Bath
Provides warm, moist heat to the perineal area and rectal area
Used postpartum and after rectal surgery
Hydrocollator packs
Gel filled packs warmed in a water bath
150-170 degrees F
Gel maintains warmth for approximately 30-40 minutes
Pack can contour to fit smoothly over any area
Pack must be covered prior to use
Administering Heat/Cold
Applications
Thermotherapy
Dry heat
Warm and dry against the skin
Warm water bags
Heating pads
Thermal blankets
Aquamatic pads
Aquathermia pads
Heat lamps
Administering Heat/Cold
Applications
Thermotherapy
Warm water bags
Special containers filled with warm water
Most facilities used disposable bags
Thermal blankets
Contains coils that can be filled with air or fluid to warm a patient
Rectal probe used to monitor patient’s temperature
Aquathermia pads
Smaller version of thermal blanket that uses fluid
Administering Heat/Cold
Applications
Administering Heat/Cold
Applications
Administering Heat/Cold
Applications
Administering Heat/Cold
Applications