Observation Of Sessions : Type And Amount Of Motion

Interventions will often include the use of assistive and adaptive devices such as crutches, wheelchairs, orthotics, and prosthetics. An important component of physical therapist patient management involves teaching the patient appropriate ways to move or perform particular tasks to prevent further injury and to promote health and wellness”.

I have been fortunate enough to observe my coach perform various techniques to restore mobility and motion.  One such technique that I was able to survey was the rehabilitation of an anterior shoulder dislocation. During the acute phase of therapy, isometric exercises were used to strengthen the rotator cuff muscles. The next phase was to achieve full range of motion without pain and continue to strengthen the muscles. This was done through abduction and external rotation, wall climbs/slides, and pulley’s.

The main purpose of the approach is done with the goal of releasing tension within the body that are a result of accidents, poor posture, emotional issues, and stress. The approach uses “gentle, rhythmic rocking motions” in order to cause the body to relax deeply, which will allow the patient to ultimately live a freer life and move with increased ease (dr.weil.com). The three proponents of the approach include Tablework, Menstatics, and Hook-up (ariticle). A Trager session usually lasts between 60 to 90 minutes, in which the client physically engages in Table Work and Menstatics (Dr.w). Through Tablework, the person being treated, lies on a massage table as the practitioner performs gentle rocking, traction, compression, and other lengthening movements to the client’s body in order to engage the body’s various tissues. The sensations that the clients feel are important to the process, because their bodies are being rocked and supported as if they were babies (article). The second Menstatics phase of The Trager Approach, combines the words “mental” and “gymnastics” (article). Menstatics are self-directed exercises that are given to the client by practicioners after a bodywork session, in which the client is given various exercises to do at home to continue to improve their condition and build strength within

Exercises completed during sessions could include stretching on a padded mat to increase swiftness and ability to lift up and out of bed or sitting position, or the pulling apart of elastic bands to increase upper body duration. Other tools such as weights are used in different positions to increase strength and ability with everyday movements such as standing or lifting. However, in an outpatient clinic, patients are homebound and would potentially be capable of participating in a higher form of activity. “It often includes a variety of exercise equipment and machines to improve strength and balance” (The Difference Between Physical, Speech and Occupational Therapy). Machines that are seen in a normal gyms such as a treadmill or stationary bike would be tools used for increased resistance and range of motion on a patient. Lastly, within a home setting, Physical Therapy will be based from the reason their medical status would keep them homebound. The job of the PT would be to improve quality of life and accessibility at home. An example of what the home patient would do could include: walking up and down stairs, strength exercises from the side of the bed or counter, and getting into and out of a vehicle. Overall, however, Physical Therapy’s purpose is to reduce pain, increase movement and agility, and strengthen a weakened area from injury or surgery.

When an individual sits they are able to save twenty-five percent of their energy (Lou & Tischenkel, 2009). The participants will examine together and with the therapist assistance, activities can be done sitting with each other and the occupational therapist. The occupational therapist can help them also determine other tasks that are not typically done sitting. An example is folding laundry, doing dishes and bathing (Lou & Tischenkel, 2009). Having the individual break up tasks into smaller tasks can make them manageable (Canadian Association of Occupational Therapy,

Physical Therapy is a vital method of medical care when determining the treatment and recovery of injured individuals because the profession aids in the pain management and convalescence of patients. When a person becomes injured, it is crucial that they receive a treatment plan that will help them to recuperate and recover their past capabilities, such as receiving an exorcise plan through Physical Therapy. Physical Therapists provide a variety of care to a multitude of patients in order to increase the specific individual’s flexibility and mobility, opposed to certain doctors that only specialize in treating an injuries

This information suggests that teaching movement skills can be optimized when the patient is highly motivated, attending fully to the task, and able to relate or integrate the new information to information they already know about the task. When retraining gait, it would be important to find a goal that is important to the patients, such as being able to walk to the mailbox for the newspaper, work with them in an environment where they can attend fully to the task instructions and their own performance outcome, and relate instructions for improved gait characteristics to previous knowledge so that they can remember them after the therapy session is

During my time observing, I experienced both the therapists and the technicians preforming many different types of activities. Some of these activities included ultrasounds, e-stim, and manual therapy techniques. Manual therapy is an effective practice utilized by the therapists at this clinic. Many of the manual therapy applications I observed were applied to help patients by decreasing their pain and increasing their range of motion. I was also given the opportunity to directly observe my supervisor develop various exercise/therapy programs for his patients. Every plan was developed based upon each patient’s individual needs. My supervisor would typically make slight adjustments to his patient’s exercise/therapy plan based upon their

Treating new patients, begins with an initial evaluation that will go over medical history, current problems, pain intensity, how it is impacting daily activities, and set goals with physical therapy. The therapist will use palpation to touch the area of pain and check for tenderness, swelling, tissue temperature, and inflammation. The therapist will then check the range of motion to evaluate mobility and any restrictions present. Followed by muscle testing of the muscles contracting and if any pain is noted. The final assessment is checking for posture. Thereafter, the physical therapist will create a treatment plan, the duration and visits needed, home program, and co-create short term/long term goals.

Keep in mind: You would progress with assessing your patient’ stability, history taking and examination; all simultaneously; while with advancing any needed interventions that would stabilize your patient and alleviate their pain or distress.

The biomechanical model is used with problems related to musculoskeletal capacities that underlie functional motion in occupational performance (Kiehlhefner 66). The Biomechanical model also assesses deficit in ROM, strength and/or endurance regardless of the cause. Biomechanical looks into a client's physical capacity such as their; movement, muscle strength and endurance which can be assessed within the information gathering section within the OT process (McMillan, 2006). The Occupational Therapist thru clinical observations will identify limitations to client’s range of motion (ROM), muscle strength, and endurance. Further assessment may be needed if observation identifies any limitations. In case of muscle strength, Manual Muscle testing

I have personally witnessed many times that an occupational therapist used these techniques to assess their client. Not only does this measurement let the therapist know how much the client is improving over time, but it can also build confidence in the client by knowing that the work they are putting into therapy is paying off. Recording a client’s range of motion is a good way to keep track of what stage of the recovery process the client may be in. Many times a client will go to an occupational therapist, because they cannot complete their full range of motion without experiencing pain or fatigue.

A typical ASTYM treatment includes 8-10 treatments, two times per week, with a 2 day break in between each session (e.g. Mon-Th, Tu- F, M-F). As for intensity, the pressure of using the tool varies based on the condition being treated as well as the patient’s tolerance. Training is required to use the tools properly and address the soft tissue dysfunction. After the certified PT uses the ASTYM tool on the soft tissue dysfunction, exercises are given to the patient to do in order to use that new range of motion, and for functional purposes. Interventions vary depending on the body impairment, but could include: strengthening the weak muscles, increasing range of motion (by using the new motion gained from treatment), performing daily activities with proper mechanics, etc. Each intervention of ASTYM for treating one body impairment lasts about 10 minutes each session (or whenever the dysfunction appears to be less restricted). Maximal results usually achieved in 6-9 treatments. After 12 treatments, a patient probably won’t see much more results. 1

In the past year, I have gained more I have gained more knowledge in the physical therapy field through observation and hands on experience. Being a part of Spectrum Physical Therapy, I saw new mobility techniques, such as the Mulligan mobilities, new stretches, different uses for each machine and Kinesio taping. In addition, Spectrum Physical Therapy allows me to encounter with a wide variety of patients with different needs for physical therapy. In addition, I am able to ask the physical therapist and physical therapy assistants any questions with unfamiliar protocols in the patients regime.

The data are collected from observation of over 100 patients’ visits, 50 of which were observed and audio taped. The research questions that are asked by Davidson are: