The purpose of physical rehabilitation
The purpose of physical rehabilitation
By Dr. Daniel Rocha DN LMT CPT CNS
The purpose of rehabilitation is to restore a patient's physical, sensory, and mental capabilities caused by injury, illness, or disease. Rehabilitation instructs a patient to compensate for deficits that cannot be reversed medically. It is designated for many types of injury, illness, or disease, including amputations, arthritis, cancer, cardiac disease, neurological problems, orthopedic injuries, spinal cord injuries, stroke, and traumatic brain injuries. Rehabilitation addresses the patient's physical, psychological, and environmental needs by restoring the patient's physical functions, and modifying the patient's physical and social environment. The main types of rehabilitation are physical, occupational, and speech therapy.
Physical therapy helps the patient restore the use of muscles, bones, and the nervous system through the use of heat, cold, massage, whirlpool baths, ultrasound, exercise, and other techniques. The goals are to relieve pain, improve strength, mobility, and reteach daily tasks. Physical therapy is prescribed after amputations, arthritis, burns, cancer, cardiac disease, cervical and lumbar dysfunction, neurological problems, orthopedic injuries, pulmonary disease, spinal cord injuries, stroke, traumatic brain injuries, and other injuries/illnesses. Exercise is widely used in and best-known type of physical therapy. Exercises are performed by the patient alone, with the therapist's help, or with the therapist moving the patient's limbs.
Heat treatment, applied with hot-water compresses, infrared lamps, short-wave radiation, high-frequency electrical current, ultrasound, paraffin wax, or warm baths, are all used in physical therapy to stimulate the patient's circulation, relax muscles, and relieve pain. Cold treatment is applied with ice packs or cold-water soaking. Whirlpool soaks ease muscle spasm pain and helps strengthen movements. Massage aids circulation, helps the patient relax, relieves pain from muscle spasms, and reduces swelling. Dry needling and low strength electrical acupressure pens stimulate muscles causing contractions, helping paralyzed or weakened muscles respond again.
Occupational therapy instructs patients to do normal everyday tasks, by restoring old skills and teaching new skills to adjust to disabilities through adaptive equipment, orthotics, and modification of the home environment. Occupational therapy use devices to assist in walking such as artificial limbs, canes, crutches, walkers but not limited to wheelchairs, motorized scooters, boards, lifts, and bars. Home analysis of what the patient can and cannot do is conducted by a therapist while establishing modifications that need to be done to the home, such as rearranging furniture or adding a wheelchair ramp. Health aids in bathing and grooming are also included.
Speech therapy corrects speech disorders and restores speech. Speech therapy is prescribed after a brain injury, cancer, neuromuscular diseases, stroke, and other injuries/illnesses. A speech pathologist will conduct therapy through regular meetings in an individual or group setting and advise home exercises. The patient must practice words, smile, close his mouth, or stick out his tongue to strengthen facial muscles. Picture cards help the patient remember everyday objects, increase their vocabulary, and communicate with others. Workbooks recall the names of objects, practice reading, writing, and listening for patients. Computer programs sharpen speech, reading, recall, and listening skills for speech patients.
Exercise is any activity employing physical exertion. It is done for the sake of health. Activities range from walking to yoga to lifting weights and martial arts. Exercise comes in three basic types, resistance, aerobics, and stretching. Yoga and martial arts are based on muscle-stretching routines; walking and running are primarily aerobic, and weight lifting is mainly resistance. Some exercises with crossover activities build muscle and provide cardiovascular training simultaneously such as swimming.
Exercise keeps people healthy by improving fitness, promotes weight loss, prevents diseases, increases flexibility and range of motion. Studies show it improves mental health by improving self-esteem and self-confidence, and increasing coordination. Exercise will lower cholesterol, and reduce health risks like diabetes, high blood pressure, cardiovascular disease, and some cancers, all while increasing life expectancy.
The main adverse effects of exercise are sore muscles and stiff joints lingering for several days. Other minor problems include headaches, dizziness, fatigue, and nausea. Agitation of old injuries or the development of new ones by improperly using equipment or wearing inadequately cushioned shoes is a concern.
The main precaution with exercise is to avoid strain and overexertion. Exercise does not need to be strenuous to be beneficial. Patients with chronic health problems should take special precautions. Diabetics should monitor their blood sugar before and after exercising. Heart disease patients should never exercise to the point of chest pain. Patients with asthma or breathing difficulties should get their doctor's permission before starting an exercise program. Proper form in any activity is required to avoid strain and injury, especially when using exercise equipment. Patients should know what muscles and joints are used in all exercises. If a patient is unable to do certain exercises, a supplemental exercise or stretch should be added to balance to the exercise program.
Active range of motion exercises improves joint function. The range of motion is the movement of one’s joints in different directions. Daily exercise improves joint mobility through its full range of motion. Movement improves joint flexibility, reduces pain, improves balance and strength. Practicing all exercises with a healthcare provider should be done before trying them alone. Exercise daily, or as directed by a healthcare provider. To remember the series of moves, start with the feet exercises first moving towards the head. Do each group of exercises for both sides of the body. It is normal to feel some discomfort at first, but regular exercise will decrease the discomfort over time. An example is having a patient tilt their head to the side, bringing the ear toward the shoulder. Do not raise the shoulder to the ear. Keep the shoulder still. Return the head to the starting position.
The passive range of motion exercises keeps joints flexible. The exercises help move all the person's joints through their full range of motion, preventing contractures. Contractures are severely tightened joints and muscles. Exercises can be spread out over the course of the day and can be done while the patient lies in bed. Movement of each joint should be to the point where resistance is felt. Discomfort is ok, but hurting in pain is not. Hold the position a few seconds, and then return to a resting position. Do each group of exercises for both sides of the body. An example is now the therapist will tilt the person's head, bringing the ear toward the shoulder. Then tilt the person's head toward the other shoulder.
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