Chapter 23 Physical Therapy Skills Copyright 2017 Cengage

Chapter 23 Physical Therapy Skills Copyright © 2017 Cengage Learning. All Rights Reserved. May not be scanned, copied or duplicated, or posted to a publicly accessible website, in whole or in part.

23: 1 Performing Range-of-Motion (ROM) Exercises • Done to maintain health of musculoskeletal system • Ordered by physicians for patients with limited ability to move • Administered by physical therapist, nurse, health care assistant Copyright © 2017 Cengage Learning. All Rights Reserved. May not be scanned, copied or duplicated, or posted to a publicly accessible website, in whole or in part.

23: 1 Performing Range-of-Motion (ROM) Exercises • Problems caused by lack of movement or inactivity – Contracture – Muscle and joint function – Circulatory impairment – Mineral loss – Other problems Copyright © 2017 Cengage Learning. All Rights Reserved. May not be scanned, copied or duplicated, or posted to a publicly accessible website, in whole or in part.

23: 1 Performing Range-of-Motion (ROM) Exercises • Types of ROM – Active assistive ROM – Passive ROM – Resistive ROM Copyright © 2017 Cengage Learning. All Rights Reserved. May not be scanned, copied or duplicated, or posted to a publicly accessible website, in whole or in part.

23: 1 Performing Range-of-Motion (ROM) Exercises • Be aware of legal requirements for administering/assisting with exercises • Proper terms for movement of each joint – Refer to Figure 23 -3 in text • Principles to observe while performing ROM • Refer to Procedure 23: 1 in text Copyright © 2017 Cengage Learning. All Rights Reserved. May not be scanned, copied or duplicated, or posted to a publicly accessible website, in whole or in part.

23: 2 Ambulating Patients Who Use Transfer (Gait) Belts, Crutches, Canes, or Walkers • Patients may require aids, or assistive devices, for ambulation • Type used depends on injury and a patient’s condition • Certain points must be observed when a patient uses crutches, canes, or walker Copyright © 2017 Cengage Learning. All Rights Reserved. May not be scanned, copied or duplicated, or posted to a publicly accessible website, in whole or in part.

Transfer (Gait) Belts • • • Make sure belt is proper size Loops for use when ambulating Grasp back of belt during ambulation Transfer belt used over patient’s clothing Note contraindications Copyright © 2017 Cengage Learning. All Rights Reserved. May not be scanned, copied or duplicated, or posted to a publicly accessible website, in whole or in part.

Crutches • Artificial supports to assist patients in walking • Types – Axillary crutches – Forearm or Lofstrand crutches – Platform crutches • Notes for fitting crutches to patient Copyright © 2017 Cengage Learning. All Rights Reserved. May not be scanned, copied or duplicated, or posted to a publicly accessible website, in whole or in part.

Crutches • Use of crutch-walking gaits – Four-point gait – Two-point gait – Three-point gait – Swing-to gait – Swing-through gait Copyright © 2017 Cengage Learning. All Rights Reserved. May not be scanned, copied or duplicated, or posted to a publicly accessible website, in whole or in part.

Cane • Assistive device providing balance and support – Standard cane – Tripod cane – Quad cane – Walkcane (Hemiwalker) Copyright © 2017 Cengage Learning. All Rights Reserved. May not be scanned, copied or duplicated, or posted to a publicly accessible website, in whole or in part.

Cane • Used on unaffected side for stability • Must be correctly fitted to patient • Several gaits may be taught to patient Copyright © 2017 Cengage Learning. All Rights Reserved. May not be scanned, copied or duplicated, or posted to a publicly accessible website, in whole or in part.

Walker • Four-legged device providing support – Available as standard, folding, rolling, platform • Basic principles – Walker must be fitted to each patient – Patient must be taught to lift walker – Fit legs of walker with rubber tips Copyright © 2017 Cengage Learning. All Rights Reserved. May not be scanned, copied or duplicated, or posted to a publicly accessible website, in whole or in part.

Ambulation Precautions • Be alert at all times when ambulating patients • Walk on a patient’s weak side and slightly behind • Techniques for helping a falling patient – Write incident report per agency policy • Refer to Procedures 23: 2 A– 23: 2 D Copyright © 2017 Cengage Learning. All Rights Reserved. May not be scanned, copied or duplicated, or posted to a publicly accessible website, in whole or in part.

23: 3 Administering Heat/Cold Applications • Cryotherapy is use of cold for treatment – Pain relief – Reduce swelling – Reduce body temperature – Control bleeding Copyright © 2017 Cengage Learning. All Rights Reserved. May not be scanned, copied or duplicated, or posted to a publicly accessible website, in whole or in part.

23: 3 Administering Heat/Cold Applications • Moist cold – Cold compresses, packs, soaks • Dry cold – Ice bags or collars, hypothermia blankets Copyright © 2017 Cengage Learning. All Rights Reserved. May not be scanned, copied or duplicated, or posted to a publicly accessible website, in whole or in part.

23: 3 Administering Heat/Cold Applications • Thermotherapy is use of heat for treatment – Pain relief – Increase drainage and stimulate healing – Fight infection and increase circulation – Muscle spasm relief – Increase muscle mobility Copyright © 2017 Cengage Learning. All Rights Reserved. May not be scanned, copied or duplicated, or posted to a publicly accessible website, in whole or in part.

23: 3 Administering Heat/Cold Applications • Moist heat – Sitz baths, hydrocollator packs, paraffin wax treatments • Dry heat – Warm-water bags, heating pads, thermal blankets, aquamatic pads, heat lamps Copyright © 2017 Cengage Learning. All Rights Reserved. May not be scanned, copied or duplicated, or posted to a publicly accessible website, in whole or in part.

23: 3 Administering Heat/Cold Applications • Heat applications cause vasodilation • Cold applications cause vasoconstriction • Physician’s order required for heat/cold application – Order should state type of application, duration of treatment, temperature, area of application Copyright © 2017 Cengage Learning. All Rights Reserved. May not be scanned, copied or duplicated, or posted to a publicly accessible website, in whole or in part.

23: 3 Administering Heat/Cold Applications • Be aware of legal requirements for administration of heat/cold • Check a patient often when application is in place • Observe standard precautions • Refer to Procedures 23: 3 A– 23: 3 E in text Copyright © 2017 Cengage Learning. All Rights Reserved. May not be scanned, copied or duplicated, or posted to a publicly accessible website, in whole or in part.