Outpatient Physical Therapy Policies And Procedures Manual
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Description MCN Healthcare's Rehabilitation Services Policy and Procedure Manual contains Physical Therapy, Occupational Therapy and Speech-Language Pathology policies as they relate to CMS regulations and Joint Commission, NIAHO and CIHQ standards for acute care. ABPTS Policies and Procedures 05/16 - 1- I. INTRODUCTION This document contains the policies and procedures of the American Board of Physical Therapy.
Please review the you were asked to complete during your registration with us. If you have any questions or special needs, please do not hesitate to talk with your therapist.
Treatment Modalities & Procedures • • Therapeutic Treatment Modalities used in Physical Therapy Physical therapists employ a number of different therapeutic tools to enable recovery for a very broad array of physical injuries, disorders and long term chronic problems, too numerous to outline completely in this section. We do, however, offer a brief description of many [not all] the tools we use at OrthoBalance Physical Therapy to help manage recovery of soft tissue injuries and disorders, increase your functional range of motion, your muscular strength, improve posture and body mechanics and restore balance, walking capabilities and reduce your risk of initial or recurrent injury from sports, work overuse or falling. Physical therapists are trained in the therapeutic application of various basic physical agents that we call modalities. These agents are thermal [heat and cold], electrical, sound, light and mechanical, each briefly explained below. They are used to reduce pain and joint swelling, reduce muscle spasm, restore functional joint mobility, increase local blood flow to injured tissues and deliver medications subcutaneously in conjunction with other procedures.
MODALITIES often used: Thermal Modalities [heat & cold] Ultrasound (US) Many different musculoskeletal conditions, such as muscles strains and tendonitis, are treated with ultrasound by a physical therapist. Often used to reduce local inflammation, promote tissue healing by increasing blood supply in relatively superficial tissues, no deeper than 5 or 6 centimeters • High frequency sound waves that produce a form of deep tissue heating • For relief of pain and muscle spasm • Promotes circulation • Relaxes tight muscles/soft tissue – prepares tissues for stretching Phonophoresis • Use of ultrasound to drive in topical medications through the skin • Medications are usually a form of cortisone and xylocaine • For treatment of localized inflammations, eg. Heel spurs, tendonitis Moist Heat (Hydrocollator) • Produces a deeper heat than a dry heating pad; still relatively superficial due to local blood cooling effect; penetrates only 1-2 cm. • Increases local circulation, reduces swelling, relaxes muscles/soft tissue, prepares tissue for other treatments Paraffin • A form of heat using paraffin wax and mineral oil • Usually applied to hands or feet where other applications of heat are difficult Short Wave Diathermy • Deep soft tissue heating; 5-10cm tissue depth; • Increases muscular blood supply and tissue perfusion; • Increases healing and extensibility of these tissues; • Also used to prepare for other treatments. Cryotherapy [Cold/Ice] • Use of “ice packs” or “ice massage” in acute injuries and for pain relief (acute or chronic) • Reduces swelling, inflammation, muscles spasm. • Spray and stretch technique is used to facilitate stretching of very sensitive muscles in spasm while applying manual therapeutic techniques.
Electrotherapeutics Used in a variety of conditions to reduce pain and inflammation, promote tissue healing, stimulate or promote nerve and or muscle function, ionic transdermal medication transfer, muscular re education, biofeedback and sensory integrative therapy. Electrotherapeutics are well researched, not painful and are a foundation of some PT interventions.
The most commonly used electrotherapeutic techniques are listed below, in some technical detail. • IFC; Interferential Current; Analgesia, blood flow; joints • Pre-modulated Current; Analgesia; intramuscular edema; muscles • HVGS; High Volt Galvanic Stimulation; Analgesia; intraarticular edema; joints • DC Current; Manual e-stimulation; Facial Nerve Palsy; Denervated Muscle; muscle re-education • TENS: Transcutaneous Electr. Nerve Stim; Pain mediation; chronic pain syndromes • MENS; Microcurrent Electr.
Therapeutic Massage, Myofascial and Connective Tissue Release Techniques • This is quite a broad area and common physical therapy techniques that involve the therapist applying pressure to the affected area to help decrease pain, reduce muscle tension and improve circulation. • A form of specific soft tissue mobilization using the hands for systematic manipulation and release of the muscles and surrounding connective tissue. These techniques may be used to improve local circulation, reduce swelling, relieve muscle spasm and tightness, stretch acquired adhesions and generally help restore lost or impaired mobility. It can also be used during manual lymphatic drainage techniques to reduce chronic swelling.
Canalith Repositioning Procedures [CRP] Some disorders of the inner ear result from the displacement of very small granular material from where they normally reside [within the vestibule] to other areas [semicircular canals], causing vertigo and imbalance. These symptoms can be very disabling, brought on by certain commonly performed movements such as turning in bed, looking up or turning one’s head. Physical therapists who have specific training, can employ specialized techniques [Canalith Repositioning Procedures; CRP] to return these tiny granules to their correct resting place, resolving this type of positional vertigo. The treatment is quick, painless and highly effective, after only 1-4 visits. Postural Training Analysis of the body’s posture to identify areas of imbalance and inordinate stress, possibly contributing to a person’s chronic pain or functional impairment. 2017 Chevrolet Cruze Maintenance Manual.
We use corrective measures to restore proper alignment of the musculoskeletal system to reduce undue stress and strain. Body Mechanics/Ergonomics This is the way we sit, stand, bend, lift, push and generally position our body to perform simple or complex physical tasks, during regular activities of daily living [ADL’s] or within the worksite environment. Physical therapists are trained to understand proper movement techniques and identify incorrect techniques, with the goal of correction to a more efficient and productive movement model. We utilize our education skills, teaching corrective and proper technique, sometimes our manual skills to correct certain body impediments to proper mobility and corrective exercise to strengthen and fortify those body areas necessary for long term effectiveness. Neuromuscular Re-education Retraining of movement, balance, coordination, posture and position sense. This is a highly specialized form of therapeutic exercise and movement re-training that often involves computerized pre exercise testing to guide and evaluate treatment and the use of visual biofeedback techniques in order to enhance the effects of training.
Gait Training Analysis of the different stages of walking to determine any deviations and the training to re-educate the body in the proper movement patterns Balance/Coordination Training Exercises and activities to improve the ability to maintain the body in equilibrium both statically (indifferent positions) and dynamically (in different activities). Therapeutic Exercise Prescription Exercise is a very common and non-invasive method of treatment used in a physical therapy setting.
Exercise can help to improve a patient’s strength, flexibility and range of motion, and can help a patient regain their functional and mobile independence. The uses, categories and variations of therapeutic exercise are too numerous to be presented in any detail here. However, very generally, they can be: • PASSIVE: Manual procedures [different than those previously described above] carried out by the therapist, without active patient participation.
• ACTIVE: Movements performed by the patient, either independently or with some form of manual or mechanical assistance. This is generally used to increase or restore normal joint mobility and to prepare for more vigorous exercise.
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