wikidoc - User contributions [en]

Proprioceptive neuromuscular facilitation

2012-04-24T13:53:55Z

Abhiksin: /* HOW TO PERFORM UPPER EXTREMITIES PNF PATTERN */

{{SI}}
{{CMG}}; '''Associate Editors-In-Chief:''' [[Abhishek Singh|Abhishek Singh, B.P.T]] [mailto:abhiksin7556@yahoo.co.in]
==Overview==
Proprioceptive neuromuscular facilitation is a motor learning approach used in neuro-motor development training to improve motor function and facilitate maximal muscular contraction.
==Historical perspective==
According to Kabat (1951) "The basis of the PNF philosophy is the idea that all human beings, including those with disabilities have untapped existing potential.
==PNF BASIC PROCEDURES FOR FACILITATION==
====Patterns Of Motion====
[[File:Pnf.jpg|200px|centre|thumbnail|<div align="center">This is <span style="color: green">the </span><br /> [[PNF Pattern]]<br /> '''Of <span style="color: red">Upper Extremities</span>'''</div>]]

Normal Motor activity occurs in synergistic & functional patterns of movement. PNF technique are "spiral & diagonal" in character and combine motion in all 3 planes i.e. flexion/extension, abduction/adduction and rotation.

Extremities patterns are named according to the movement occurring at the proximal joint or by diagonal(antagonist patterns are make up the diagonal).

====UPPER EXTREMITIES====

* D1 Flexion- Flexion,Adduction,External Rotation.

* D1 Extension-Extension,Abduction,Internal rotation.(Antagonist pattern of D1 flexion).

* D2 Flexion- Flexion, Abduction, External Rotation.

* D2 Extension- Extension,Adduction,Internal Rotation.(Antagonist pattern of D2 flexion).

====LOWER EXTREMITIES====

(D1 Flexion of Lower Extremities is similar to Upper Extremities pattern).

* D1 Flexion- Flexion,Adduction,External Rotation.

* D1 Extension- Extension,Abduction,Internal Rotation.(Antagonist pattern of D1 flexion).

* D2 Flexion- Flexion, Abduction,Internal Rotation.

* D2 Extension- Extension,Adduction,External Rotation.(Antagonist pattern of D2 flexion).

===HOW TO PERFORM UPPER EXTREMITIES PNF PATTERN===

'''D1 Flexion'''

* Starting Position
* Patient Position- Extension/abduction/internal or medial rotation of the shoulder with pronation of the forearm,extension with ulnar deviation of the wrist,extension of the fingers,extension and abduction of the thumb.The therapist ensure that patient near to the side of plinth to enable the arm to be taken to extension. The patient's arm should be abducted around 20°-30° from the side of the body.Care must be taken that patient's finger are in fully extension before the movement begins.
* Therapist Stance- Therapist stands at patient's upper arm level in Lunge position facing towards the patient's feet & with his weight on her front right foot & parallel with proposed line of movement.During the arm's movement of patient,therapist transfers his weight from the front foot to the back foot rotating so that he can watch the movement throughout the movement pattern.
* Grip- Therapist grasp the patient's right palm approaching from palm approaching from radial side. He uses the lumbrical grip ensuring that extensor surface of patient's hand does not touch.Fingers of right hand placed on flexor aspect of patient's wrist approaching from ulnar side.
* Commands- Therapist prepares patient for the movement by saying 'now' & then follows this with command like"grip my hand, pull up and across the face.
* Movements- Flexion of fingers, particularly the little & ring fingers,adduction & flexion of thumb, flexion of wrist towards the radial side with supination of the forearm,flexion,adduction & lateral rotation of the shoulder joint,while scapular joint is in rotation,elevation & protraction.Movement is initiated by rotary component.Movement then occurs at distal joints followed in succession by more proximal joints until whole extremities is moving.

'''Flexion/Adduction/External or Lateral Rotation with Elbow Flexion'''
----
Starting Position-
----

* Patient Position- As for D1 flexion.
* Therapist Position- Stance & grip as for D1 flexion.The therapist may move his right hand nearer to the patient's elbow.
* Movement- As in the D1 flexion with addition of elbow flexion.This is the eating pattern.

'''Flexion/Adduction/External or Lateral Rotation with Elbow Extension'''
----
Starting Position
----
* Patient Position- Same as D1 flexion with addition of elbow flexion.
* Therapist Position- Stance & grip similar to D1 flexion.
* Movement- Similar to D1 flexion with addition of elbow extension.Similar to the fundamental component of upper cut in boxing.

'''D1 EXTENSION'''

Extension/Abduction/Internal/Medial Rotation

----
Starting Position
----

* Patient Position- Flexion/Adduction/External or Lateral Rotation,forearm supinated,flexion and radial deviation of wrist,fingers flexed,flexion & adduction of thumb.

* Therapist Position- In Lunge position facing head of the patient at patient's upper arm level. Therapist weight is on front left foot & parallel with the line of movement.During movement therapist weight is transfers from front foot to the back foot,rotating so that watch patient's movement.

* Grip- Right hand & lumbrical grip of therapist grasps dorsum of patient's right hand ensuring stretch is obtained,main emphasis is on exteroceptors on ulnar side of patient's hand with pressure from therapist fingers.After movement has started fingers of therapist's left hand are placed on extensor surface of patient's wrist.

* Commands- 'Now'-'push'.

* Movement-
** Fingers-Extension(particularly ring & little)
** Thumb- Extension & abduction
** Wrist- Extension & ulnar deviation
** Forearm- Pronation
** Shoulder/Gleno-Humeral Joint- Extension,abduction & internal rotation
** Scapula- Rotation,depression & adduction.

'''Extension/Abduction/Internal/Medial Rotation with Elbow Flexion'''

----
Starting Position
----

* Patient Position- Same as D1 extension.
* Therapist Position- Position & grip of right hand as for D1 extension,but left hand fingers are placed at elbow approaching from ulnar side for free elbow flexion movement.

* Movement - Same as D1 extension with addition of elbow flexion.

'''Extension/Abduction/Internal/Medial Rotation with Elbow Extension'''

----
Starting Position
----

* Patient Position- Same as D1 extension with addition of elbow flexion.

* Therapist Position- Position & grip same as D1 extension.

* Movement- Same as D1 extension along with elbow extension.Movement similar in eating when hand is returning from mouth.

==References==

1-Physical Rehabilitation: Susan B O'Sullivan & Thomas J Schmitz (Fifth Edition)

2-Proprioceptive Neuromuscular Facilitation Patterns: P J Waddington

{{Reflist|2}}
[[Category:Health sciences]]
[[Category:Rehabilitation medicine]]
[[Category:Healthcare occupations]]
[[Category:Physical therapy]]
[[Category:Sports medicine]]
[[Category:Therapy]]
[[Category:Exercise]]
[[Category:Manipulative therapy]]
[[Category:Massage]]
[[Category:Hospital departments]]
{{WH}}
{{WS}}

Ankylosing spondylitis physical therapy

2012-03-03T14:56:00Z

Abhiksin:

{{CMG}}; '''Associate Editors-In-Chief:''' [[Abhishek Singh|Abhishek Singh, B.P.T]] [mailto:abhiksin7556@yahoo.co.in]
==Overview==
'''Ankylosing Spondylitis''' (AS, from Greek ankylos, stiff; spondylos, vertebrae), previously known as Bekhterev's disease, Bekhterev syndrome, and Marie-Strümpell disease is a chronic inflammatory disease of the axial skeleton with variable involvement of peripheral joints and nonarticular structures. AS is a form of spondyloarthritis, a chronic, inflammatory arthritis and autoimmune disease. It mainly affects joints in the spine and the sacroiliac joint in the pelvis, and can cause eventual fusion of the spine. It is a member of the group of the spondyloarthropathies with a strong genetic predisposition. Complete fusion results in a complete rigidity of the spine, a condition known as "bamboo spine".

==Physical therapy==
===Aims Of Physiotherapy Management===
To minimise deformity & disability & to improve well-being,by maintaining normal function & improving person's quality of life.The aims can be achieved by:

* Postural awareness/correction & ergonomics advice.

* Pain Reduction.

* Improving & maintaining cardiovascular fitness.

* Regular assessment & monitoring of posture & mobility.

* Designing a suitable home program of specific exercises & regularly monitoring all exercises.

* Giving knowledge about disease & its management.

* Maintaining & improving posture,mobility & function by increasing mobility of costovertebral,spinal & peripheral joints,stretching of tight muscle groups/bulk & strengthening of anti gravity muscles.

== Posture ==

[[Image:AS.jpg|centre|500px|]]

== Ergonomic considerations & Postural Correction ==

Ergonomic advice AS person's how to maintain good posture during work,home or leisure activities.

Longer the patient maintain a flexed posture,it is more likely that spine attains a flexed posture if vertebrae fuse.So,it is advisable that patient's with job that requires stooped posture would move around at regular intervals & pay attention towards his posture.

Posture can be checked in a mirror or by patient standing as straight as possible against a wall with tucking chin in & should maintain this posture after walking away from the wall.

The ideal chair for an AS patient should support the whole spine including the neck,hips & knees should be at right angles & feet should be supported.Forearms should be supported on arm rest.

== Exercise In Ankylosing spondylitis ==

Regular exercise program must start as soon as possible after AS diagnosis & performed for life.Physiotherapist role in providing patient with ongoing education,stimulus & inspiration so that exercise becomes part of his daily routine.

'''Joint Mobility Exercises'''

Exercises program should be designed to improve movements like flexion,extension,rotation & lateral flexion of lumbar,cervical& thoracic spines which is limited due to bony changes
(formation of syndesmophytes),fibrosis & calcification of ligaments & muscle tension.

Full range of motion exercises should be done on a daily basis with a variety of equipments like gym ball to make exercise more interesting & fun.

== Strengthening Exercises ==

Due to postural deformity & inactivity as a result of pain leads to muscle weakness which is a common feature of AS.So,strengthening of anti gravity muscle group i.e. extensor muscle & abdominal muscles are very important to maintain activities of daily living.Examples of extensor muscle groups are cervical,thoracic,lumbar spine extensors & glutei.
Strengthening of all these muscle group can be effectively done in hydrotherapy pool & resistance should be raised as needed by the patient. All the exercises are held for 15-30 seconds & repeated at least five times.

== References ==

1-Tidy's Physiotherapy Edited by Stuart Porter(Thirteenth edition)

Ankylosing spondylitis physical therapy

2012-03-03T14:46:13Z

Abhiksin:

Ankylosing spondylitis physical therapy

2012-03-01T18:58:44Z

Abhiksin:

Ankylosing spondylitis physical therapy

2012-03-01T18:34:43Z

Abhiksin:

{{CMG}}; '''Associate Editors-In-Chief:''' [[Abhishek Singh|Abhishek Singh, B.P.T]] [mailto:abhiksin7556@yahoo.co.in]
==Overview==
'''Ankylosing Spondylitis''' Ankylosing spondylitis (AS, from Greek ankylos, stiff; spondylos, vertebrae), previously known as Bekhterev's disease, Bekhterev syndrome, and Marie-Strümpell disease is a chronic inflammatory disease of the axial skeleton with variable involvement of peripheral joints and nonarticular structures. AS is a form of spondyloarthritis, a chronic, inflammatory arthritis and autoimmune disease.

It mainly affects joints in the spine and the sacroiliac joint in the pelvis, and can cause eventual fusion of the spine.

It is a member of the group of the spondyloarthropathies with a strong genetic predisposition. Complete fusion results in a complete rigidity of the spine, a condition known as "bamboo spine".
==Physical therapy==
'''Aims Of Physiotherapy Management'''
To minimise deformity & disability & to improve well-being,by maintaining normal function & improving person's quality of life.The aims can be achieved by:

i-Postural awareness/correction & ergonomics advice.

ii-Pain Reduction.

iii-Improving & maintaining cardiovascular fitness.

iv-Regular assessment & monitoring of posture & mobility.

v-Designing a suitable home program of specific exercises & regularly monitoring all exercises.

vi-Giving knowledge about disease & its management.

vii-Maintaining & improving posture,mobility & function by increasing mobility of costovertebral,spinal & peripheral joints,stretching of tight muscle groups/bulk & strengthening of anti gravity muscles.

== Posture ==

[[Image:AS.jpg|centre|500px|]]

File:AS.jpg

2012-03-01T18:26:04Z

Abhiksin:

2012-02-25T18:15:17Z

Abhiksin: /* Passive Movements */

Paraplegia physical therapy

2012-02-25T18:14:26Z

Abhiksin: /* Phases Of Rehabilitation */

Paraplegia physical therapy

2012-02-25T18:13:08Z

Abhiksin: /* Overview */

Paraplegia physical therapy

2012-02-25T18:11:55Z

Abhiksin:

{{CMG}}; '''Associate Editors-In-Chief:''' [[Abhishek Singh|Abhishek Singh, B.P.T]] [mailto:abhiksin7556@yahoo.co.in]
==Overview==
'''Paraplegia''' denotes a state of paresis or paralysis of both lower limb due to psychogenic cause or interruption in any part of motor path from the cerebral cortex to & including the muscles.Often internal organs below the waist are involved.

==Physical therapy==
===Phases Of Rehabilitation===
* '''Phase1''': Immediately after spinal cord injury(SCI),there is loss of movement & function due to neurotrauma & immobilization .The main emphasis of rehabilitation is to lessen adverse effects of immobilization.It includes all therapeutic intervention during the critical & acute care stages of rehabilitation.It may lasts from a few days to several weeks,when the patient begin activities out of bed.Goal- prevention of secondary complications.
* '''Phase2''':Early rehabilitation phase.Out of bed activities are tolerated for a longer duration & patient begins to work toward specific long term goals & able to participate in therapeutic programs for minimum of 3 hours per day.
* '''Phase3''':Most active & rewarding period,efforts of weeks & months of work are realized & results can be seen.The patient gains varying level of independence in specific skills.The patient may be taught advance skills in transferring,wheel chair mobility,grooming & various Activities of daily living(ADL).
* '''Phase4''':Aimed at a smooth transition to home,patient discharged from rehabilitation centre at this stage.
* '''Phase5''':Comprises of outpatient & other follow-up services,as well as community reintegration.Individuals may return to work.
===Positioning===
* '''Postural Re-education''':Two pillows are generally sufficient to extend(to maintain hyper extension of spine) and support fractures of dorsolumbar spine.Pillows are adjusted in such a way that bony prominences are always free from pressure.Flexion & rotation of trunk & lower limbs are specifically avoided.
* '''Upper Limbs Positioning'''
* '''Shoulder''' - slightly flexed;to relieve pressure on shoulder.
* '''Elbow''' - extended.
* '''Forearm''' - supinated & supported by pillow.
* '''Upper arm''' - pillow between arm & chest wall.
* '''Lower Limb'''
* '''Hips'''- extended & slightly abducted.
* '''Knees''' - extended but not hyperextended.
* '''Ankles''' - neutral or mild dorsiflexion.
* '''Toes''' - extended

One or two pillows are kept between the legs to maintain abduction & prevent pressure on the bony points,i.e. medial condyles & malleoli.
===Passive Movements===
Passive movements of paralyzed limbs are essential to stimulate circulation ,preserve FROM(full range of motion) in joints & soft tissues & prevent muscle shortening.
Treatment starts usually on first day after injury & during this spinal shock period(approx 6 weeks) treatment should be given twice daily.
While the patient is immobilized in bed or turning frame,full ROM(range of motion) exercises should be completed slowly,smoothly & rhythmically(to avoid injury to insensitive,unprotected joints & paralysed structures) daily except in those areas that are contraindicated or needs selective stretching for example Motion of trunk& some motion of hip are contraindicated.Generally,straight leg raise more than 60° & hip flexion beyond 90° should be avoided.This will put strain on lower thoracic & lumbar spine.
When spinal activities returns limb should be handled very carefully so as not to elicit spasm & reinforce the spastic pattern.Forced PROM(passive range of movement)against spasticity may cause injury or fracture of the limb.
==References==
{{Reflist|2}}

{{WH}}
{{WS}}

2012-02-25T15:30:15Z

Abhiksin:

Paraplegia physical therapy

2012-02-25T15:14:36Z

Abhiksin:

== Paraplegia ==

{{CMG}}; '''Associate Editors-In-Chief:''' [[Abhishek Singh|Abhishek Singh, B.P.T]] [mailto:abhiksin7556@yahoo.co.in]
==Overview==
'''Paraplegia''' denotes a state of paresis or paralysis of both lower limb due to psychogenic cause or interruption in any part of motor path from the cerebral cortex to & including the muscles.Often internal organs below the waist are involved.

==Physical therapy==

'''Phases Of Rehabilitation'''

'''Phase1''': Immediately after spinal cord injury(SCI),there is loss of movement & function due to neurotrauma & immobilization .The main emphasis of rehabilitation is to lessen adverse effects of immobilization.It includes all therapeutic intervention during the critical & acute care stages of rehabilitation.It may lasts from a few days to several weeks,when the patient begin activities out of bed.Goal- prevention of secondary complications.

'''Phase2''':Early rehabilitation phase.Out of bed activities are tolerated for a longer duration & patient begins to work toward specific long term goals & able to participate in therapeutic programs for minimum of 3 hours per day.

'''Phase3''':Most active & rewarding period,efforts of weeks & months of work are realized & results can be seen.The patient gains varying level of independence in specific skills.The patient may be taught advance skills in transferring,wheel chair mobility,grooming & various Activities of daily living(ADL).

'''Phase4''':Aimed at a smooth transition to home,patient discharged from rehabilitation centre at this stage.

'''Phase5''':Comprises of outpatient & other follow-up services,as well as community reintegration.Individuals may return to work.

== Positioning ==

'''Postural Re-education''':Two pillows are generally sufficient to extend(to maintain hyper extension of spine) and support fractures of dorsolumbar spine.Pillows are adjusted in such a way that bony prominences are always free from pressure.Flexion & rotation of trunk & lower limbs are specifically avoided.

'''Upper Limbs Positioning'''

'''Shoulder''' -slightly flexed;to relieve pressure on shoulder.
'''Elbow''' -extended.
'''Forearm''' -supinated & supported by pillow.
'''Upper arm''' -pillow between arm & chest wall.

'''Lower Limb'''

'''Hips''' -extended & slightly abducted.
'''Knees''' - extended but not hyperextended.
'''Ankles''' -neutral or mild dorsiflexion.
'''Toes''' -extended
One or two pillows are kept between the legs to maintain abduction & prevent pressure on the bony points,i.e. medial condyles & malleoli.

Paraplegia physical therapy

2012-02-25T14:34:59Z

Abhiksin: /* Overview */

Paraplegia physical therapy

2012-02-25T14:27:50Z

Abhiksin: Created page with " == Paraplegia == {{CMG}}; '''Associate Editors-In-Chief:''' Abhishek Singh, B.P.T [mailto:abhiksin7556@yahoo.co.in] ==Overview== '''Paraplegia''' denote..."

Physical therapy

2012-02-25T07:40:53Z

Abhiksin: /* Neurological */

{{Infobox_Disease |
Name = Physical therapy |
Image = Polio physical therapy.jpg |
Caption = This [[physical therapist]] is assisting two [[polio]]-stricken children holding on to a rail whilst they exercise their lower limbs. |
}}

{{CMG}}; '''Associate Editors-In-Chief:''' [[Abhishek Singh|Abhishek Singh, B.P.T]] [mailto:abhiksin7556@yahoo.co.in]

==Overview==
'''Physical therapy''' (or '''physiotherapy''' as it is known outside the U.S.) is a [[healthcare]] [[profession]] concerned with prevention, treatment and management of movement disorders arising from conditions and diseases occurring throughout the lifespan. Physical therapy is performed by either a physical therapist (PT) or a physical therapist assistant (PTA) acting under the direction of a PT.<ref name ="descriptionAPTA">{{cite web |url=http://www.apta.org/AM/Template.cfm?Section=Consumers1&Template=/CM/HTMLDisplay.cfm&ContentID=39568 |title=Discovering Physical Therapy. What is physical therapy |publisher=[[American Physical Therapy Association]] |work= |accessdaymonth=27 January |accessyear=2008}}</ref> However, various non-PT health professionals (e.g., [[chiropractors]], [[Doctor of Osteopathic Medicine|Doctors of Osteopathy]]) employ the use of some physical therapeutic modalities in practice.<ref name="chiro">{{cite journal | LAST =Homola| FIRST =S.|title =Can Chiropractors and Evidence-Based Manual Therapists Work Together? An Opinion From a Veteran Chiropractor|journal = The Journal of Manual & Manipulative Therapy|volume = 14|issue = 2|date = 2006|pages = E15|url = http://jmmtonline.com/documents/HomolaV14N2E.pdf|accessdate = }}</ref> A program of physical therapy will typically also involve a patient's caregivers.<ref name="descriptionWCPT">{{cite web |url=http://www.wcpt.org/policies/position/description/whatis.php |title=Description of Physical Therapy - What is Physical Therapy?] |publisher=World Confederation for Physical Therapy (WCPT) |work= |accessdaymonth=27 January |accessyear=2008}}</ref>

Physiotherapy or Physical Therapist or PT is a health care professional who examines, treat, advice & instruct person with movement dysfunction, bodily malfunction, physical disorder, healing and pain from trauma and disease, disability, physical and mental conditions, by using physical agents like exercise, mobilization, manipulation, hydrotherapy, mechanical, and electrotherapy.

PTs utilize a patient's history and physical examination in diagnosis and treatment, and if necessary, PTs will also incorporate the results of laboratory and imaging studies. Electrodiagnostic testing (e.g., electromyograms, nerve conduction velocity testing) may also be of assistance.<ref>http://www.aptasce-wm.org/documents/guidelines/ENMG%20EvaluationGuidelines.pdf</ref> PTs practice in many settings, such as outpatient clinics or offices, inpatient rehabilitation facilities, extended care facilities, patient homes, education or research centers, schools, hospices, industrial workplaces or other occupational environments, fitness centers and sports training facilities.<ref>http://www.apta.org/AM/Template.cfm?Section=Physical_Therapy&TEMPLATE=/CM/HTMLDisplay.cfm&CONTENTID=33205</ref>

For decades, physical therapy practice has been the subject of criticism for its lack of a research base, and "most physical therapists continued to base practice decisions largely on anecdotal evidence."<ref name="EBP2"/> The World Confederation for Physical Therapy, has called on the profession to adopt and adhere to evidence-based practices formally based on the best available scientific sources.<ref name='EBP_WCPT'/>

== History ==
[[Image:GreekReduction.jpg|thumb|right|A [[woodcut]] of the reduction of a [[dislocation|dislocated]] shoulder with a Hippocratic device.]]
Physicians like [[Hippocrates]] and [[Hector]] are believed to have been the first practitioners of a primitive physical therapy, advocating [[massage]] and [[hydrotherapy]] to treat patients in 460 B.C.<ref>Wharton MA. Health Care Systems I; Slippery Rock University. 1991</ref> The earliest documented origins of actual physical therapy as a professional group, however, date back to 1894 when four nurses in England formed the Chartered Society of Physiotherapy.<ref>http://www.csp.org.uk/director/about/thecsp/history.cfm</ref> Other countries soon followed and started formal training programs, such as the School of Physiotherapy at the University of Otago in New Zealand in 1913,<ref>http://physio.otago.ac.nz/about/history.asp</ref> and the United States' 1914 [[Reed College]] in Portland, Oregon, which graduated "reconstruction aides."<ref>http://www.reed.edu/about_reed/history.html</ref>

Research catalyzed the physical therapy movement. The first physical therapy research was published in the United States in March 1921 in The PT Review. In the same year, Mary McMillan organized the Physical Therapy Association (now called the [[American Physical Therapy Association]] (APTA)). In 1924, the Georgia Warm Springs Foundation promoted the field by touting physical therapy as a treatment for [[Polio]].<ref>http://www.rooseveltrehab.org/history.php</ref>

Treatment through the 1940s primarily consisted of exercise, massage, and traction. Manipulative procedures to the spine and extremity joints began to be practiced, especially in the British Commonwealth countries, in the early 1950s.<ref>McKenzie RA. The cervical and thoracic spine: mechanical diagnosis and therapy. Spinal Publications Ltd. New Zealand. 1998 pp: 110</ref><ref>McKenzie R. Patient Heal Thyself. Worldwide Spine & Rehabilitation 2(1) 2002; pp 16-20</ref> Later that decade, physical therapists started to move beyond hospital based practice, to outpatient orthopedic clinics, public schools, college/universities, geriatric settings (skilled nursing facilities), rehabilitation centers, hospitals, and medical centers.

Specialization for physical therapy in the U.S. occurred in 1974, with the Orthopaedic Section of the APTA being formed for those physical therapists specializing in Orthopedics. In the same year, the International Federation of Orthopaedic Manipulative Therapy was formed,<ref>http://www.ifomt.org/ifomt/about/history</ref> which has played an important role in advancing manual therapy worldwide ever since. In the 1980s, the explosion of technology and computers led to more technical advances in rehabilitation. Some of these advances have continued to grow, with computerized [[sensory modality|modalities]] such as [[ultrasound]], electric stimulators, and [[iontophoresis]] with the latest advances in therapeutic cold laser, which finally gained FDA approval in the U.S. in 2002.<ref>http://www.eugenept.com/history.html</ref>
==Physiotherapy modalities==
PT’s uses individual’s history and do [[physical examination]]s in their diagnosis & setting a treatment protocol, and if necessary, will include the results of laboratory and imaging studies.
Physiotherapist uses various modalities like-
* Exercises like active, passive,aerobic,cardio,strengthening,stretching etc.
* Hydrotherapy
* Mobilization
* Manipulation
* Electrical Modalities like Ultrasonic Therapy, Laser, Microwave Diathermy, Interferential therapy, [[TENS]] ([[Transcutaneous Nerve Stimulator]]),Shock Wave Therapy and many more.

'''Active Exercise Motion''' derived from a part by doing voluntary contraction and relaxation of its controlling muscles.
Active Assistive exercise voluntary contraction of muscles controlling a part, assisted by a therapist or by some other means.
Aerobic Exercise a type of physical activity,which increases the heart rate and as a result use of oxygen is increased in order to improve the overall body condition.

'''Ballistic stretching's''' rapid, jerky movements employed in exercises,for stretching of muscles and connective tissue.

'''Buerger-Allen exercises'''- Perform to enhance blood circulation of the legs and feet. In this exercise the lower limb s are raised to 45-90 degree angle with some support for 2 to 3 minutes until skin blanches. After that the feet and legs are lowered or the patients adopt a high sitting posture for 5 to 10 minutes until redness appears, Followed by flat lying on bed for 10 minutes.

'''Cardiovascular Exercise''' are exercises to enhance cardiovascular system capacity. Done at least twice per week, with most programs conducted three to five or more times weekly. The contraction of major muscle groups must be repeated often enough to elevate the heart rate to a target level determined during testing. Used in cardiac rehabilitation, or as a preventive measure.

'''Corrective Exercise''' are exercises planned and performed to attain a specific physical benefit, such as maintenance of the range of motion, strengthening of weakened muscles, increased joint flexibility, or improved cardiovascular and respiratory function.
Endurance Exercise Involvement of several large groups of muscles and is dependent on the delivery of oxygen to the muscles by the cardiovascular system; used in physical fitness programs as well as cardiovascular and pulmonary function testing.

'''Isokinetic exercise''' are dynamic muscle activity performed at a constant angular velocity.
Isometric Exercise (Iso= Same, Metric-Length) Active exercise performed against constant resistance, without change in the length of the muscle.

'''Isotonic Exercise'''(Iso= Same, Tonic= Tone) are active exercise with negligible change in the force of muscular contraction, with shortening of the muscle.

'''Kegel Exercises'''- Exercise for strengthening of pelvic floor and prevention urinary incontinence. Performed by a series of contractions and relaxations of perineal muscles. Done with the help of Kegel’s Exerciser.

'''McKenzie Exercise''' are exercise regimen used in the treatment of low back pain and sciatica, prescribed according to findings during mechanical examination of the lumbar spine and using a combination of lumbar motions, including flexion, rotation, side gliding, and extension. It is sometimes referred to as McKenzie extension exercises, but this is a misnomer because the regimen involves movements other than extension.

'''Muscle-Setting Exercise''' (Static Exercise) are voluntary contraction and relaxation of skeletal muscles static/constant muscle length or moving the associated part of the body.

'''Passive Exercise Movement''' or motion done to a body part or segment by another individual, machine or outside force or by voluntary effort of another segment of patient's own body.

'''Pelvic Floor Exercise'''-Combination of strength and endurance exercises of pelvic floor muscles (circumvaginal or perianal). These are used in stress [[urinary incontinence]]; the patient is taught to isolate and contract muscles 103 times daily.

'''Quadriceps Setting Exercise''' - Isometric exercise to strengthen (Quadriceps) muscles needed for ambulation. The patient is instructed to contract the quadriceps muscle while at the same time elevating and dorsiflexing the heel and pushing the knee toward the mat.

'''Range Of Motion (ROM) Exercises''' are exercises that move joint through its full range of motion, that is, to the highest degree of motion of which joint normally is capable; they may be either active or passive.

Examples of range of motion exercises:

* Flexion: The bending of a joint in the body.(angle between the joint decreases)
* Extension: A movement opposite to that of flexion in which a joint is in a straight position.
* Rotation: Pivoting a body part around its axis, as in shaking the head.
* Adduction: Moving toward the midline of the body or to the central axis of a limb.
* Abduction: A movement of a limb away from the median plane of the body; the fingers are abducted by spreading them apart.
* Circumduction: A combination of movements that cause a body part to move in a circular fashion.(combination of all movements like flexion,extension,abduction and adduction).
* Supination: Extension of the forearm to bring the palm of the hand upward.
* Pronation: Movement of the forearm in the extended position that brings the palm of the hand to a downward position.
* Inversion: Movement of the ankle to turn the sole of the foot medially.
* Eversion: Movement of the sole of the foot laterally.

'''Resistive Exercises'''-performed against an opposing force(as tolerated by a person) to increase muscle strength.Resistance applied may be either isometric,isotonic or isokinetic.

'''Static Stretching Exercise'''-placement of muscles and connective tissues at their maximum length by a constant force in the direction of lengthening.

'''Strengthening Exercises'''- also known as force increasing exercises, prescribed to a person who shows weakness in individual muscles or muscle groups. Performed with relatively high resistance, but with few repetitions(3 to 10) followed by 1-2 minutes of rest.It is performed daily in early stages of rehabilitation.

== [['''Electro Therapy''']] ==

The therapeutic use of electricity to the human body as in the treatment of pain,paralysis or muscles weakness.
Numerous modalities are in use like Ultrasonic therapy(UST),Transcutaneous Electrical Nerve Stimulation(TENS),Interferential Therapy(IFT),Laser,Shock wave Therapy,Diathermy[Long, Short, Micro](Continuous or pulse Mode),Traction(Cervical or Lumbar) and many more.

== Ultrasonic Therapy (UST) ==

Defined as a high frequency acoustic energy,available in longitudinal waveforms in frequency range of .5 to 3.5 MHz. Most commonly used frequencies for treatment purpose in UST are .75 to 3.0 MHz(1 MHz = 1,000,000 cycles/second).

''''''Indications For UST''''''

i-Acute soft tissue injuries.

ii-Inflammation of joint capsules,tendons,bursa & ligaments associated with degenerative & inflammatory disorders like osteoarthritis,rheumatoid arthritis,repetitive stress injuries,gout.

iii-Wound Healing.

iv-Chronic Indurate Oedema.

v-Scar Tissue.

''''''Contraindications For UST''''''

i-Vascular Conditions like Thrombophlebitis or Phlebothrombosis.

ii-In Burger's disease,atherosclerosis,varicose veins or any other conditions where blood supply is poor or insufficient.

iii-Infected Lesion like Cellulites,Abscess or Carbuncles.

iv-Areas near Malignant Tumor.

v-Areas around Pregnant women uterus.

vi-Person with Metal or plastic Implants.

== TENS ==
TENS or "Trans-cutaneous Electrical Nerve Stimulation" is a modern non invasive, drug free pain management electro therapeutic modality(electroanalgesia).
Frequently used for acute or chronic pain in neck,back,joint pain of shoulder or knee etc, work or sports related injuries e.g. carpal tunnel syndrome,postural musculo-skeletal pain due to faulty work culture.

'''Types Of TENS'''

* High Rate TENS-
** Pulse Rate- 50-100 Hertz
** Pulse Width- 50-100 µs(micro second)
** Treatment Time-30-60 minutes/session or 7-9 hours(if required)
** Uses- Acute & post operative pain, increased Muscle tone.
* Low Rate TENS-
** Pulse rate- 1-5 Hertz
** Pulse Width- 150-300 µs
** Treatment Time- 15-30 minutes/session
** Uses- Chronic pain,Shows good results on tissues/skin of diabetic neuropathy,neuralgia where long pulse width is needed
* Brief Intense TENS-
** Pulse Rate- 80-150 Hertz
** Pulse Width- 40-250 µs
** Treatment Time- 10-20 minutes
** Uses- Acute or chronic pain.
* Burst Mode TENS-
** Pulse Rate-50-100 hertz(delivered in bursts mode with 1-4 pulses/second)
** Pulse Width-50-200 µs
** Treatment Time- 25 minutes
** Uses- Chronic muscle spasm, Neuro-musculo-skeletal pain like sciatica syndrome.

'''Indications For The Use Of TENS'''

i-Musculoskeletal Pain like joint pain from osteoarthritis or rheumatoid arthritis,post operative pain,posttraumatic pain.

ii- Neurogenic Pain like pain after spinal cord injury,trigeminal neuralgia,brachial plexus avulsion etc.

iii- Visceral Pain & dysmenorrhea.

iv- Headache,Migraine, Toothache.

'''Contraindications For The Use Of TENS'''

i-Person with metal or Plastic Implant.

ii-Over chest wall of cardiac patients.

iii-Over Larynx,eyes,pharynx or mucosal membrane.

iv-Head or neck region of patient with recent history of epilepsy or stroke.

== Interferential Therapy (IFT) ==
It is a form of electrical treatment in which two medium frequency sinusoidal currents(4000 to 5000 Hz) are used to produce a low frequency current effect.

'''Principle'''

The IFT works on interference effect where 2 medium frequency currents cross in the patient's tissues.One current is kept constant at 4000 Hz, while frequency of another keep varying between 3900-4000 Hz. An interference effect at a "beat frequency"(difference between two medium frequency currents) is produced where the current cross(low frequency current effect produced at the desired point by changing the point of electrodes).[[File:B 3900Hz.jpg]]

'''Indications For The Use Of IFT '''

i- Pain Relief.

ii- Muscle Stimulation.

iii- Increased Blood Flow.

iv- Wound healing & tissue repair.

v- Reduction of oedema.

'''Contraindications For The Use Of IFT'''

i-Person with metal or Plastic Implant.

ii-Over chest wall of cardiac patients.

iii-Patients with skin problem eg skin cut,dermatitis.

iv-Pregnant women's uterus.

v- Malignant Tumor.

== LASER ==

LASER stands for Light Amplification by the Stimulated Emission Of Radiation.

Compressed light of a wavelength from cold red part of the spectrum of electromagnetic radiation,it is monochromatic(single wavelength & color),Coherent(travel in a straight line) & polarized(concentrates its beam in defined location or spot).

'''LASER Regulation'''

Classified by the FDA's center for Devices and Radiological Health based on the Accessible Emission Limit.

Class Level Of LASER:-

I -laser radiation are not considered to be hazardous.

2 IIa levels of laser radiation are not considered to be hazardous if viewed for any period of time < 1*1000seconds,considered to be a chronic viewing hazard for any period of time > 1*1000seconds.

3-II levels of laser radiation are considered to be a chronic viewing hazard.

4- IIIa levels of laser radiation are considered to be, depending upon the irradiance, either an acute intrabeam viewing hazard or chronic viewing hazard, and an acute viewing hazard if viewed directly with optical instruments.

5- IIIb levels of laser radiation are considered to be an acute hazard to the skin and eyes from direct radiation.

6- IV levels of laser radiation are considered to be an acute hazard to the skin and eyes from direct and scattered radiation.

'''Types Of LASER'''

4 types of LASER-

1-Crystal & glass (solid -rod) - Synthetic Ruby.

2-Gas (Chamber) - HeNe, Argon, CO2.

3-Semi conductor(Diode channel) -Gallium Arsenide.

4-Liquid (Dye)- Organic dye as Lasing medium

== Indications For the Use Of LASER ==

i-Soft Tissue Injuries.

ii-Pain.

iii-Osteoarthritis & rheumatoid arthritis.

iv-Fracture.

v-Open Wound.

vi-Diabetic & Pressure ulcer.

'''Contra Indications For the Use Of LASER'''

i-Application over or around eyes.

ii-Malignant or cancerous cells.

iii-Pregnant women uterus.

iv-Over and around Thyroid or endocrine glands.

v- Epiphyseal Plates in children.

vi-Over vagus nerve.

vii- Over cardiac region.

viii- Patients who have been previously treated with photo sensitizers.

== Shock Wave Therapy==

Shock Wave Therapy or Extracorporeal Shock Wave Therapy- involves direct bursts of high pressure sound waves at the affected area.Useful in the treatment of Tennis Elbow,Plantar Fascitis,Calcaneal Spur etc.

'''Characteristics Of Shock Wave Therapy'''

-Peak Pressure - typically 50-8- MPa(MegaPascals){according to ogden et al 2001} and 35-120 MPa {according to speed,2004}.

-Fast Pressure Rise- usually less than 10 ns(nanoseconds).

-Short duration -Usually about 10 µs(microseconds).

-Narrow effective beam- 2-8 mm(millimeter) diameter.

'''Indications For Shock Wave Therapy'''

i-Tennis & golfer elbow.

ii-Plantar Fascitis.

iii- Calcaneal Spur.

iv-Jumper's Knee.

v- Achilles Tendon.

vi-Calcifying Tendinitis of Shoulder.

'''Contraindications For Shock Wave Therapy'''

i- Epiphyseal Region should be avoided.

ii-Malignant or cancerous cells.

== Specialty areas ==

Because the body of knowledge of physical therapy is quite large, some PTs specialize in a specific practice. While there are many specialty areas in physical therapy,<ref>http://www.apta.org/AM/Template.cfm?Section=Chapters&Template=/CM/ContentDisplay.cfm&CONTENTID=36890 text here</ref> the following are the five most common specialty areas in physical therapy:<ref name=Inverarity>[http://physicaltherapy.about.com/od/typesofphysicaltherapy/a/typesofpt.htm Types of Physical Therapy]</ref>

=== Cardiopulmonary ===
Cardiovascular and pulmonary rehabilitation physical therapists treat a wide variety of patients with cardiopulmonary disorders or those who have had cardiac or pulmonary surgery. Primary goals of this specialty include increasing patient endurance and functional independence. Manual therapy is utilized in this field to assist in clearing lung secretions experienced in patients with [[cystic fibrosis]]. Patients with disorders including [[heart attacks]], post [[coronary bypass surgery]], [[chronic obstructive pulmonary disease]], and [[pulmonary fibrosis]] are only a few examples of those who would benefit from cardiovascular and pulmonary specialized physical therapists.<ref name=Inverarity/>

=== Geriatric ===
Geriatric physical therapy covers a wide area of issues concerning people as they go through normal adult aging, but is usually focused on the older adult. There are many conditions that affect many people as they grow older and include but are not limited to the following: [[arthritis]], [[osteoporosis]], [[cancer]], [[Alzheimer's disease]], hip and joint replacement, balance disorders, [[incontinence]], etc.
Geriatric physical therapy helps those affected by such problems in developing a specialized program to help restore mobility, reduce pain, and increase fitness levels.<ref name=Inverarity/>

=== Neurological ===
Neurological physical therapy is a discipline focused on working with individuals who have a [[neurological disorder]] or disease. These include Alzheimer's disease, [[Anterolateral system|ALS]], brain injury, [[cerebral palsy]], [[multiple sclerosis]], [[Parkinson's disease]], spinal cord injury, and stroke. Common problems of patients with neurological disorders include paralysis, vision impairment, poor balance, inability to ambulate, and loss of functional independence. Therapists work with patients to improve these areas of dysfunction.<ref name=Inverarity/>
====[[Guillain-Barré syndrome physical therapy]]====
====[[Paraplegia physical therapy]]====

=== Orthopedic ===
Orthopedic physical therapists diagnose, manage, and treat disorders and injuries of the [[musculoskeletal system]] as well as rehabilitate patients post orthopedic surgery. This specialty of physical therapy is most often found in the out-patient clinical setting. Orthopedic therapists are trained in the treatment of post operative joints, acute sports injuries, arthritis, and amputations.
Joint mobilizations, strength training, hot/cold packs, and electrical stimulation (e.g., [[cryotherapy]], [[iontophoresis]], [[electrotherapy]]<ref>Cameron, M. (2003). ''Physical Agents in Rehabilitation - From Research to Practice'', USA: W.B. Saunders Company. ISBN 0-7216-9378-4</ref>) are [[stimulus modality|modalities]] often used to expedite recovery in the orthopedic setting. Additionally, an emerging treatment in this field is the use of [[sonography]] to guide treatments like muscle retraining.<ref>http://www.rtuspt.com/resources/references.php</ref><ref>http://dx.doi.org/10.1016/S0268-0033(02)00011-6</ref><ref>http://www.ncbi.nlm.nih.gov/pubmed/17970407?ordinalpos=5&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_RVDocSum</ref><ref>http://jospt.org/issues/articleID.690,type.2/article_detail.asp</ref> Those who have suffered injury or disease affecting the muscles, bones, ligaments, or tendons of the body will benefit from assessment by a physical therapist specialized in orthopedics.

=== Pediatric ===
Pediatric physical therapy assists in early detection of health problems and uses a wide variety of modalities to treat disorders in the pediatric population. These therapists are specialized in the diagnosis, treatment, and management of infants, children, and adolescents with a variety of congenital, developmental, neuromuscular, skeletal, or acquired disorders/diseases. Treatments focus on improving gross and fine motor skills, balance and coordination, strength and endurance as well as cognitive and sensory processing/integration. Children with developmental delays, cerebral palsy, [[spina bifida]], and [[torticollis]] are a few of the patients treated by pediatric physical therapists.<ref name=Inverarity/>

*Another PT specialty area is [[Integumentary system|Integumentary]] (treatment of conditions involving the skin and related organs).

== Education ==
=== United States ===
In the U.S., physical therapists must have a graduate degree from an accredited physical therapy program before taking the national licensing examination. Federal law also requires physical therapists to pass the National Physical Therapy Examination<ref>http://fsbpt.org/ForConsumers/PhysicalTherapy/index.asp</ref> after graduating from an accredited physical therapist educational program before they can practice. Also physical therapists must apply for a state license to practice. Each state regulates licenses for physical therapists independently.

According to the [[American Physical Therapy Association]], there were 210 accredited physical therapist programs in 2008–of those 23 offered the [[Master of Physical Therapy]], and 187 offered the [[Doctor of Physical Therapy]] (DPT) degree. Most programs are in transition to a DPT program.<ref>http://www.apta.org/AM/Template.cfm?Section=Student_Resources&CONTENTID=46936&TEMPLATE=/CM/ContentDisplay.cfm</ref>



== Evidence-based practice ==
For decades, physical therapy practice has been the subject of criticism for its lack of a research base.<ref name="EBP2">{{cite journal | LAST =Turner| FIRST =P.|title =Evidence based practice and physiotherapy in the 1990's|journal = Physiotherapy Theory and Practice|volume = 17|issue =|date = |url = |accessdate = }}</ref> In a late 1990s survey of English and Australian physical therapists, fewer than five percent (5%) of survey respondents indicated that they regularly reviewed scientific literature to guide practice decisions.<ref name=EBP3>{{cite journal | LAST =Turner| FIRST =P.|title =Physiotherapists' reasons for selection of treatment techniques: A cross-national survey|journal = Physiotherapy Theory and Practice|volume = 15|issue =|date = |pages = 235-246|url = |accessdate = }} </ref><ref name="EBP4">{{cite journal | LAST =Turner| FIRST =P.|title =Physiotherapists' use of evidence based practice: A cross-national study|journal = Physiotherapy Research International|volume = 2(1)|issue =|date = |pages = 17-29|url = |accessdate = }}</ref> Despite an overall positive attitude towards [[evidence based practice|evidence-based practice]],<ref name='EBP_Jette'> {{cite journal|title=Evidence-Based Practice: Beliefs, Attitudes, Knowledge, and Behaviors of Physical Therapists|journal=Physical Therapy|date=2003-09|first=Diane U.|last=Jette|coauthors=Kimberly Bacon, Cheryl Batty, Melissa Carlson, Amanda Ferland, Richard D Hemingway, Jessica C Hill, Laura Ogilvie and Danielle Volk|volume=83|issue=9|pages=786-805|id=PMID 12940766 |url=http://www.ptjournal.org/cgi/content/abstract/83/9/786|format=|accessdate=2007-12-21 }}</ref> most physical therapists utilized treatment techniques with little scientific support.<ref name=EBP8>{{cite journal | LAST =Newham| FIRST =D.|title =PracticalResearch|journal = Physiotherapy|volume = 80|issue =|date = |pages = 337 - 339|url = |accessdate = }} </ref><ref name=EBP>{{cite journal | last =Schreiber | first =J. | authorlink = | coauthors = | title =A review of the literature on evidence-based practice in physical therapy | journal =The Internet Journal of Allied Health Sciences and Practice | volume =3 | issue =4 | pages = | publisher = | location = | date =October 2005 | url = http://ijahsp.nova.edu/articles/vol3num4/Schreiber-Stern.htm
| doi = | id = | accessdate =12/1/07 }}</ref> Although numerous calls have been made for a shift toward the use of research and scientific evidence to guide practice decisions, at least throughout the 1990s, "most physical therapists continued to base practice decisions largely on anecdotal evidence."<ref name=EBP/>

To overcome these limitations, the World Confederation for Physical Therapy,<ref name='EBP_WCPT'> {{cite web|url=http://www.wcpt.org/policies/principles/ebp.php |title=Declarations of Principle - Evidence Based Practice |accessdate=2007-12-21 |date=2007-06 |publisher=World Confederation for Physical Therapy }}</ref> the [[American Physical Therapy Association]] (APTA),<ref name='EBP_APTA'> {{cite web|url=http://www.apta.org/AM/Template.cfm?Section=Policies_and_Bylaws&CONTENTID=34443&TEMPLATE=/CM/ContentDisplay.cfm |title=Evidence-Based Practice |accessdate=2007-12-21 |publisher=American Physical Therapy Association }}</ref> and a number of authors<ref name='EBP_Schreiber'> {{cite journal|title=A Review of the Literature on Evidence-Based Practice in Physical Therapy|journal=The Internet Journal of Allied Health Sciences and Practice|date=2005-10|first=J.|last=Schreiber|coauthors=P. Stern|volume=3|issue=4|pages=|id= |url=http://ijahsp.nova.edu/articles/vol3num4/Schreiber-Stern.htm|format=|accessdate=2007-12-21 }}</ref> have called on the profession to adopt and adhere to evidence-based practices formally based on the best available scientific sources.<ref>{{cite journal |journal= BMC Health Serv Res |date=2007 |volume=7 |issue=103 |pages= |title=The propensity to adopt evidence-based practice among physical therapists |author=Bridges PH, Bierema LL, Valentine T |doi=10.1186/1472-6963-7-103 |pmid=17615076 |url=http://www.pubmedcentral.nih.gov/articlerender.fcgi?tool=pubmed&pubmedid=17615076}}</ref>

== Journals and publications ==

Physical therapists have access to a wide range of publications and [[journals]].<ref>[http://www.pubmedcentral.nih.gov/articlerender.fcgi?artid=226272 Mapping the literature of physical therapy.] E M Wakiji. ''Bull Med Libr Assoc.'' 1997 July; 85(3): 284–288.</ref> Some are dedicated solely to physical therapy topics, while others (e.g., various [[orthopedic]] and [[surgical]] journals) cover a broader range of health-improvement topics, including physical therapy.
{| width="100%"
|-----
| valign="top" |
* [http://www.ingentaconnect.com/content/tandf/sort Acta Orthopaedica Scandinavica]
* [http://physical-therapy.advanceweb.com/ Advance for Physical Therapists & PT Assistants]
* [http://www.amjphysmedrehab.com/ American Journal of Physical Medicine & Rehabilitation]
* [http://ajs.sagepub.com/ American Journal of Sports Medicine]
* [http://www.archives-pmr.org/ Archives of Physical Medicine and Rehabilitation]
* [http://www.physiotherapy.asn.au/AJP Australian Journal of Physiotherapy]
* [http://www.biomedcentral.com/bmcmusculoskeletdisord BMC Musculoskeletal Disorders]
* [http://www.corronline.com/ Clinical Orthopedics and Related Research]
| valign="top" |
* [http://jmmtonline.com/ Journal of Manual & Manipulative Therapy (JMMT)]
* [http://www.jospt.org/ Journal of Orthopaedic & Sports Physical Therapy (JOSPT)]
* [http://www.tandf.no/rehabmed/ Journal of Rehabilitation Medicine]
* [http://www.neurology.org/ Neurology]
* [http://www.ptjournal.org/ Physical Therapy: Journal of the American Physical Therapy Association]
* [http://www.apta.org/ptmag/ PT–Magazine of Physical Therapy]
* [http://www.spinejournal.com/ Spine]
* [http://www.todayinpt.com/ Today in PT]
|}

== References ==

1-Description of Physical Therapy – The World Confederation for Physical Therapy (WCPT)

2-^ Initiatives in Rehabilitation Research http://ptjournal.apta.org/cgi/content/full/86/1/141

3-^ American Physical Therapy Association. "Discovering Physical Therapy. What is physical therapy". American Physical Therapy Association. Retrieved 2008-05-29.

4-^ "Physical Therapists". US Department of Labor. Retrieved 24 February 2011.

5-^ American Physical Therapy Association Section on Clinical Electrophysiology and Wound Management. "Curriculum Content Guidelines for Electrophysiologic Evaluation" (PDF). Educational Guidelines. American Physical Therapy Association. Retrieved 2008-05-29.

6-^ American Physical Therapy Association (2008-01-17). "APTA Background Sheet 2008". American Physical Therapy Association. Retrieved 2008-05-29.

7-^ Health policy implications for patient education in physical therapy http://findarticles.com/p/articles/mi_qa3956/is_199901/ai_n8843473/

8-^ http://www.electrotherapy.org/downloads/Modalities/Interferential%20Therapy%20Jan%202012.pdf

9-^ Gail M. Jensen, PhD, PT, FAPTA http://chpe.creighton.edu/people/profiles/jensen.htm

10-^ Smith joins Health Policy & Administration faculty http://www.wsutoday.wsu.edu/pages/publications.asp?Action=Detail&PublicationID=21304&TypeID=3

11-^ DPT/MBA Program http://www.goizueta.emory.edu/degree/fulltimemba/DPT-MBA.html

12-^ Orozco Appointed CEO of Rancho http://pt.usc.edu/SubLayout.aspx?id=2682

13-^ WHY DO WE OFFER PHYSICAL THERAPY CONSULTATIVE SERVICES? http://www.imxmed.com/pt_services.html

14-^ Wharton MA. Health Care Systems I; Slippery Rock University. 1991

15-^ Sarah Bakewell, "Illustrations from the Wellcome Institute Library: Medical Gymnastics and the Cyriax Collection," Medical History 41 (1997), 487–495.

16-^ Chartered Society of Physiotherapy (n.d.). "History of the Chartered Society of Physiotherapy". Chartered Society of Physiotherapy. Retrieved 2008-05-29.

17-^ Knox, Bruce (2007-01-29). "History of the School of Physiotherapy". School of Physiotherapy Centre for Physiotherapy Research. University of Otago. Archived from the original on 2007-12-24. Retrieved 2008-05-29.

18-^ Reed College (n.d.). "Mission and History". About Reed. Reed College. Retrieved 2008-05-29.

19-^ http://beckerexhibits.wustl.edu/mowihsp/health/PTdevel.htm

20-^ McKenzie, R A (1998). The cervical and thoracic spine: mechanical diagnosis and therapy. New Zealand: Spinal Publications Ltd.. pp. 16–20. ISBN 978-0959774672.

21-^ Roosevelt Warm Springs Institute (n.d.). "History". About Us. Roosevelt Warm Springs Institute. Retrieved 2008-05-29.

22-^ McKenzie, R (2002). "Patient Heal Thyself". Worldwide Spine & Rehabilitation 2 (1): 16–20.

23-^ http://www.apta.org//AM/Template.cfm?Section=&WebsiteKey=

24-^ Basson, Annalie (2010). "History: Abridged version of IFOMPT History". International Federation of Orthopaedic Manipulative Physical Therapists (IFOMPT). Retrieved 2011-01-09.

25-^ Commission on Acredidation in Physical Therapy Education Criteria http://www.apta.org/AM/Template.cfm?Section=PT_Programs3&TEMPLATE=/CM/ContentDisplay.cfm&CONTENTID=62414

26-^ American Physical Therapy Association (n.d.). "APTA Sections". American Physical Therapy Association. Retrieved 2008-05-29.

27-^ a b c Inverarity, Laura; Grossman, K (2007-11-28). "Types of Physical Therapy". About.com. The New York Times Company. Retrieved 2008-05-29.

28-^ Cameron, Michelle H. (2003). Physical agents in rehabilitation: from research to practice. Philadelphia: W. B. Saunders. ISBN 0-7216-9378-4.

29-^ Bunce SM, Moore AP, Hough AD (May 2002). "M-mode ultrasound: a reliable measure of transversus abdominis thickness?". Clin Biomech (Bristol, Avon) 17 (4): 315–7. doi:10.1016/S0268-0033(02)00011-6. PMID 12034127.

30-^ Wallwork TL, Hides JA, Stanton WR (October 2007). "Intrarater and interrater reliability of assessment of lumbar multifidus muscle thickness using rehabilitative ultrasound imaging". J Orthop Sports Phys Ther 37 (10): 608–12. PMID 17970407.

31-^ Henry SM, Westervelt KC (June 2005). "The use of real-time ultrasound feedback in teaching abdominal hollowing exercises to healthy subjects". J Orthop Sports Phys Ther 35 (6): 338–45. PMID 16001905.

32-^ http://www.womenshealthapta.org/plp/index.cfm

33-Foster & Palastanga "Clayton's Electro Therapy" Theory & practice AITBS Publishers.

34-http://www.accessdata.fda.gov/scripts/cdrh/cfdocs/cfcfr/CFRSearch.cfm?FR=1040.10

35-http://www.physio-chelsea.co.uk/shockwave.html

== See also ==
{| width="100%"
|-----
| valign="top" |
* [[Bobath concept]]
* [[Brunnstrom Approach]]
* [[Exercise]]
* [[Geriatrics]]
| valign="top" |
* [[Joint manipulation]]
* [[Occupational Therapy]]
* [[Phonophoresis]]
* [[Physical medicine and rehabilitation]]
|}

== External links ==
* [http://fsbpt.org/ Federation of State Boards of Physical Therapy]
* [http://www.dptschools.com/ List of DPT Programs]
* [http://wcpt.org/ World Confederation for Physical Therapy]
* [http://www.payscale.com/research/US/Job=Physical_Therapist/Salary U.S. Physical Therapist Salary Data]
* [http://www.rehablicense.com/professional.php?profID=8 Rehab License Network- PT License Information]

'''''National associations'''''
{| width="100%"
|-----
| valign="top" |
* [http://www.apta.org/ American Physical Therapy Association]
* [https://apa.advsol.com.au/ Australian Physiotherapy Association]
* [http://www.physio.at/ Austrian Physiotherapy Association]
* [http://www.bpa-bd.org Bangladesh Physiotherapy Association]
* [http://www.physiotherapy.ca Canadian Physiotherapy Association]
* [http://www.fysio.dk Danish Physiotherapy Association]
* [http://fysioterapia.net/ Finnish Association of Physical Therapists]
* [http://zvk.org German Physiotherapy Association]
* [http://physio.is/ Icelandic Physiotherapy Association]
* [http://www.physiotherapyindia.org/ Indian Association of Physiotherapists]
* [http://www.iscp.ie/ The Irish Society of Chartered Physiotherapists]
* [http://wwwsoc.nii.ac.jp/jpta/ The Japanese Physical Therapy Association]
| valign="top" |
* [http://kpta.co.kr Korean Physical Therapy Association]
* [http://physiotherapy.org.nz/ New Zealand Society of Physiotherapists]
* [http://nigeriaphysio.org/ Nigeria Society of Physiotherapy]
* [http://www.fysio.no/ Norwegian Physiotherapy Association]
* [http://www.physiotherapy.org.sg/ Singapore Physiotherapy Association]
* [http://www.physiosa.org.za/ South African Society of Physiotherapy]
* [http://www.aefi.net/ Spanish Physiotherapy Association]
* [http://www.sjukgymnastforbundet.se/ Swedish Association of registered Physiotherapists]
* [http://www.csp.org.uk/ (UK) Chartered Society of Physiotherapy]
* [http://www.ptaroc.org.tw/ (Taiwan) The Physical Therapy Association of The R.O.C.]
* [http://www.spta.org.sa/ (Saudi Arabia) Saudi Physical Therapy Association]
|}

{{Allied health professions}}

[[Category:Health sciences]]
[[Category:Rehabilitation medicine]]
[[Category:Healthcare occupations]]
[[Category:Physical therapy]]
[[Category:Sports medicine]]
[[Category:Therapy]]
[[Category:Exercise]]
[[Category:Manipulative therapy]]
[[Category:Massage]]
[[Category:Hospital departments]]

[[af:Fisioterapie]]
[[ar:علاج طبيعي]]
[[ast:Fisioterapia]]
[[ca:Fisioteràpia]]
[[cs:Léčebná rehabilitace]]
[[da:Fysioterapi]]
[[de:Physiotherapie]]
[[el:Φυσιοθεραπεία]]
[[es:Fisioterapia]]
[[fa:فیزیوتراپی]]
[[fr:Physiothérapie]]
[[it:Fisioterapia]]
[[he:פיזיותרפיה]]
[[nl:Fysiotherapie]]
[[ja:理学療法]]
[[no:Fysioterapi]]
[[pl:Fizjoterapia]]
[[pt:Fisioterapia]]
[[fi:Fysioterapia]]
[[sv:Sjukgymnastik]]
[[tt:Fizioterapiä]]
[[th:กายภาพบำบัด]]
[[zh:物理治療]]

{{jb1}}
{{WH}}
{{WS}}

Guillain-Barré syndrome physical therapy

2012-02-21T16:46:40Z

Abhiksin: /* Physical therapy */

{{Guillain-Barré syndrome}}

{{CMG}}; '''Associate Editors-In-Chief:''' [[Abhishek Singh|Abhishek Singh, B.P.T]] [mailto:abhiksin7556@yahoo.co.in]
==Overview==
'''Guillain-Barré syndrome''' ('''GBS''') is an acute, autoimmune, [[neuropathy|polyradiculoneuropathy]] affecting the [[peripheral nervous system]], usually triggered by an acute infectious process. It is included in the wider group of [[peripheral neuropathy|peripheral neuropathies]].

----
==Physical therapy==
----

*The main aim of rehabilitation is to restore and maintain person's functional independence.

*Rehabilitation utilises a multidisciplinary team approach including physiotherapist,occupational therapist,nurse,social worker.

*Encouraging active patient & family education & participation using a time based,goal focused,functional approach to minimise disability & maximise function & community participation.

*A common scenario for a patient with severe Guillain-Barre syndrome(GBS)would be inpatient rehabilitation for 3-4 weeks followed by home based rehabilitation for 3-4 months.

'''Respiratory Complications'''

*Physical Therapist(PT) work are to clear respiratory secretions to reduce the work of breathing & this is attained by breathing exercise,chest percussion,shaking,vibration,resistive inspiratory training & postural drainage.

'''Deep Vein Thrombosis'''

* Pulmonary Embolism has been reported in 1/3rd of patients with GBS.

* In rehabilitation setting, patients are encouraged to wear compression stockings.

* Encouraged to perform active movements as much as possible.

*Progressive mobilisation protocols such as improving bed mobility,safe transfer technique like bed to chair & chair to commode with or without adaptive equipment.

*Patients lie in Trendelenburg Position-body is laid in supine position with feet higher than head by 15º-30º.

'''Dysautonomia'''

*Toning muscles especially in the legs does help in increasing blood flow to the heart.Leg exercises involving ankle weights & bands should be done.

*Do isometric or active exercises in your bed or on floor.

*Hydrotherapy can be effective.The water helps blood flow & allow body to be in a balanced state.

*Use of Compression stockings.

*Dysautonomia can cause early lower motor bladder & bowel involvement.So strengthning of muscles around bladder & pelvic floor muscle exercise or Kegel Exercises.

'''Immobilisation'''

*A tilt table for immobilised patients can be effectively used in rehabilitation units.

*PT includes a graduated mobility program which includes:

-maintenance of posture & alignment.

-maintenance of joint range of movement by doing active,passive or active assisted exercises.

-prevention of plantar contracture with the help of ankle foot orthosis.

-Improvingendurance by giving low resistance exercises(few repetition).

-Strengthning different muscle groups & improving flexibilty with progressive ambulation program that starts with bed mobility techniques,use of wheelchair & ends with patients walking independently(if possible) or using adaptive gait aids like crutches,frames etc.

-Pressure sores-Patient/partner/carer education in skin care & continuous posture changes to release body pressure is essential.

-Heterotopic ossification can be prevented by early aggresive joint range of motion exercise & mobilisation.

==References==
{{reflist|2}}

{{WH}}
{{WS}}

[[Category:Autoimmune diseases]]
[[Category:Neurological disorders]]
[[Category:Neurology]]
[[Category:Immunology]]
[[Category:Syndromes]]
[[Category:Overview complete]]
[[Category:Disease]]
[[Category:Emergency medicine]]
[[Category:Infectious disease]]

Abhishek Singh

2012-02-21T04:44:12Z

Abhiksin:

==Abhishek Singh, B.P.T.==

==Education==
Bachelor Of Physiotherapy from '''National Institute For the Orthopedically Handicapped Kolkata India.

Abhishek Singh

2012-02-21T04:43:32Z

Abhiksin: Created page with "'''Abhishek Singh, B.P.T.''' ==Education== Bachelor Of Physiotherapy from '''National Institute For the Orthopedically Handicapped Kolkata India."

'''Abhishek Singh, B.P.T.'''

==Education==
Bachelor Of Physiotherapy from '''National Institute For the Orthopedically Handicapped Kolkata India.

Physical therapy

2012-02-21T04:31:00Z

Abhiksin: /* Neurological */

{{Infobox_Disease |
Name = Physical therapy |
Image = Polio physical therapy.jpg |
Caption = This [[physical therapist]] is assisting two [[polio]]-stricken children holding on to a rail whilst they exercise their lower limbs. |
}}

{{CMG}}; '''Associate Editors-In-Chief:''' [[Abhishek Singh|Abhishek Singh, B.P.T]] [mailto:abhiksin7556@yahoo.co.in]

==Overview==
'''Physical therapy''' (or '''physiotherapy''' as it is known outside the U.S.) is a [[healthcare]] [[profession]] concerned with prevention, treatment and management of movement disorders arising from conditions and diseases occurring throughout the lifespan. Physical therapy is performed by either a physical therapist (PT) or a physical therapist assistant (PTA) acting under the direction of a PT.<ref name ="descriptionAPTA">{{cite web |url=http://www.apta.org/AM/Template.cfm?Section=Consumers1&Template=/CM/HTMLDisplay.cfm&ContentID=39568 |title=Discovering Physical Therapy. What is physical therapy |publisher=[[American Physical Therapy Association]] |work= |accessdaymonth=27 January |accessyear=2008}}</ref> However, various non-PT health professionals (e.g., [[chiropractors]], [[Doctor of Osteopathic Medicine|Doctors of Osteopathy]]) employ the use of some physical therapeutic modalities in practice.<ref name="chiro">{{cite journal | LAST =Homola| FIRST =S.|title =Can Chiropractors and Evidence-Based Manual Therapists Work Together? An Opinion From a Veteran Chiropractor|journal = The Journal of Manual & Manipulative Therapy|volume = 14|issue = 2|date = 2006|pages = E15|url = http://jmmtonline.com/documents/HomolaV14N2E.pdf|accessdate = }}</ref> A program of physical therapy will typically also involve a patient's caregivers.<ref name="descriptionWCPT">{{cite web |url=http://www.wcpt.org/policies/position/description/whatis.php |title=Description of Physical Therapy - What is Physical Therapy?] |publisher=World Confederation for Physical Therapy (WCPT) |work= |accessdaymonth=27 January |accessyear=2008}}</ref>

Physiotherapy or Physical Therapist or PT is a health care professional who examines, treat, advice & instruct person with movement dysfunction, bodily malfunction, physical disorder, healing and pain from trauma and disease, disability, physical and mental conditions, by using physical agents like exercise, mobilization, manipulation, hydrotherapy, mechanical, and electrotherapy.

PTs utilize a patient's history and physical examination in diagnosis and treatment, and if necessary, PTs will also incorporate the results of laboratory and imaging studies. Electrodiagnostic testing (e.g., electromyograms, nerve conduction velocity testing) may also be of assistance.<ref>http://www.aptasce-wm.org/documents/guidelines/ENMG%20EvaluationGuidelines.pdf</ref> PTs practice in many settings, such as outpatient clinics or offices, inpatient rehabilitation facilities, extended care facilities, patient homes, education or research centers, schools, hospices, industrial workplaces or other occupational environments, fitness centers and sports training facilities.<ref>http://www.apta.org/AM/Template.cfm?Section=Physical_Therapy&TEMPLATE=/CM/HTMLDisplay.cfm&CONTENTID=33205</ref>

For decades, physical therapy practice has been the subject of criticism for its lack of a research base, and "most physical therapists continued to base practice decisions largely on anecdotal evidence."<ref name="EBP2"/> The World Confederation for Physical Therapy, has called on the profession to adopt and adhere to evidence-based practices formally based on the best available scientific sources.<ref name='EBP_WCPT'/>

== History ==
[[Image:GreekReduction.jpg|thumb|right|A [[woodcut]] of the reduction of a [[dislocation|dislocated]] shoulder with a Hippocratic device.]]
Physicians like [[Hippocrates]] and [[Hector]] are believed to have been the first practitioners of a primitive physical therapy, advocating [[massage]] and [[hydrotherapy]] to treat patients in 460 B.C.<ref>Wharton MA. Health Care Systems I; Slippery Rock University. 1991</ref> The earliest documented origins of actual physical therapy as a professional group, however, date back to 1894 when four nurses in England formed the Chartered Society of Physiotherapy.<ref>http://www.csp.org.uk/director/about/thecsp/history.cfm</ref> Other countries soon followed and started formal training programs, such as the School of Physiotherapy at the University of Otago in New Zealand in 1913,<ref>http://physio.otago.ac.nz/about/history.asp</ref> and the United States' 1914 [[Reed College]] in Portland, Oregon, which graduated "reconstruction aides."<ref>http://www.reed.edu/about_reed/history.html</ref>

Research catalyzed the physical therapy movement. The first physical therapy research was published in the United States in March 1921 in The PT Review. In the same year, Mary McMillan organized the Physical Therapy Association (now called the [[American Physical Therapy Association]] (APTA)). In 1924, the Georgia Warm Springs Foundation promoted the field by touting physical therapy as a treatment for [[Polio]].<ref>http://www.rooseveltrehab.org/history.php</ref>

Treatment through the 1940s primarily consisted of exercise, massage, and traction. Manipulative procedures to the spine and extremity joints began to be practiced, especially in the British Commonwealth countries, in the early 1950s.<ref>McKenzie RA. The cervical and thoracic spine: mechanical diagnosis and therapy. Spinal Publications Ltd. New Zealand. 1998 pp: 110</ref><ref>McKenzie R. Patient Heal Thyself. Worldwide Spine & Rehabilitation 2(1) 2002; pp 16-20</ref> Later that decade, physical therapists started to move beyond hospital based practice, to outpatient orthopedic clinics, public schools, college/universities, geriatric settings (skilled nursing facilities), rehabilitation centers, hospitals, and medical centers.

Specialization for physical therapy in the U.S. occurred in 1974, with the Orthopaedic Section of the APTA being formed for those physical therapists specializing in Orthopedics. In the same year, the International Federation of Orthopaedic Manipulative Therapy was formed,<ref>http://www.ifomt.org/ifomt/about/history</ref> which has played an important role in advancing manual therapy worldwide ever since. In the 1980s, the explosion of technology and computers led to more technical advances in rehabilitation. Some of these advances have continued to grow, with computerized [[sensory modality|modalities]] such as [[ultrasound]], electric stimulators, and [[iontophoresis]] with the latest advances in therapeutic cold laser, which finally gained FDA approval in the U.S. in 2002.<ref>http://www.eugenept.com/history.html</ref>
==Physiotherapy modalities==
PT’s uses individual’s history and do [[physical examination]]s in their diagnosis & setting a treatment protocol, and if necessary, will include the results of laboratory and imaging studies.
Physiotherapist uses various modalities like-
* Exercises like active, passive,aerobic,cardio,strengthening,stretching etc.
* Hydrotherapy
* Mobilization
* Manipulation
* Electrical Modalities like Ultrasonic Therapy, Laser, Microwave Diathermy, Interferential therapy, [[TENS]] ([[Transcutaneous Nerve Stimulator]]),Shock Wave Therapy and many more.

'''Active Exercise Motion''' derived from a part by doing voluntary contraction and relaxation of its controlling muscles.
Active Assistive exercise voluntary contraction of muscles controlling a part, assisted by a therapist or by some other means.
Aerobic Exercise a type of physical activity,which increases the heart rate and as a result use of oxygen is increased in order to improve the overall body condition.

'''Ballistic stretching's''' rapid, jerky movements employed in exercises,for stretching of muscles and connective tissue.

'''Buerger-Allen exercises'''- Perform to enhance blood circulation of the legs and feet. In this exercise the lower limb s are raised to 45-90 degree angle with some support for 2 to 3 minutes until skin blanches. After that the feet and legs are lowered or the patients adopt a high sitting posture for 5 to 10 minutes until redness appears, Followed by flat lying on bed for 10 minutes.

'''Cardiovascular Exercise''' are exercises to enhance cardiovascular system capacity. Done at least twice per week, with most programs conducted three to five or more times weekly. The contraction of major muscle groups must be repeated often enough to elevate the heart rate to a target level determined during testing. Used in cardiac rehabilitation, or as a preventive measure.

'''Corrective Exercise''' are exercises planned and performed to attain a specific physical benefit, such as maintenance of the range of motion, strengthening of weakened muscles, increased joint flexibility, or improved cardiovascular and respiratory function.
Endurance Exercise Involvement of several large groups of muscles and is dependent on the delivery of oxygen to the muscles by the cardiovascular system; used in physical fitness programs as well as cardiovascular and pulmonary function testing.

'''Isokinetic exercise''' are dynamic muscle activity performed at a constant angular velocity.
Isometric Exercise (Iso= Same, Metric-Length) Active exercise performed against constant resistance, without change in the length of the muscle.

'''Isotonic Exercise'''(Iso= Same, Tonic= Tone) are active exercise with negligible change in the force of muscular contraction, with shortening of the muscle.

'''Kegel Exercises'''- Exercise for strengthening of pelvic floor and prevention urinary incontinence. Performed by a series of contractions and relaxations of perineal muscles. Done with the help of Kegel’s Exerciser.

'''McKenzie Exercise''' are exercise regimen used in the treatment of low back pain and sciatica, prescribed according to findings during mechanical examination of the lumbar spine and using a combination of lumbar motions, including flexion, rotation, side gliding, and extension. It is sometimes referred to as McKenzie extension exercises, but this is a misnomer because the regimen involves movements other than extension.

'''Muscle-Setting Exercise''' (Static Exercise) are voluntary contraction and relaxation of skeletal muscles static/constant muscle length or moving the associated part of the body.

'''Passive Exercise Movement''' or motion done to a body part or segment by another individual, machine or outside force or by voluntary effort of another segment of patient's own body.

'''Pelvic Floor Exercise'''-Combination of strength and endurance exercises of pelvic floor muscles (circumvaginal or perianal). These are used in stress [[urinary incontinence]]; the patient is taught to isolate and contract muscles 103 times daily.

'''Quadriceps Setting Exercise''' - Isometric exercise to strengthen (Quadriceps) muscles needed for ambulation. The patient is instructed to contract the quadriceps muscle while at the same time elevating and dorsiflexing the heel and pushing the knee toward the mat.

'''Range Of Motion (ROM) Exercises''' are exercises that move joint through its full range of motion, that is, to the highest degree of motion of which joint normally is capable; they may be either active or passive.

Examples of range of motion exercises:

* Flexion: The bending of a joint in the body.(angle between the joint decreases)
* Extension: A movement opposite to that of flexion in which a joint is in a straight position.
* Rotation: Pivoting a body part around its axis, as in shaking the head.
* Adduction: Moving toward the midline of the body or to the central axis of a limb.
* Abduction: A movement of a limb away from the median plane of the body; the fingers are abducted by spreading them apart.
* Circumduction: A combination of movements that cause a body part to move in a circular fashion.(combination of all movements like flexion,extension,abduction and adduction).
* Supination: Extension of the forearm to bring the palm of the hand upward.
* Pronation: Movement of the forearm in the extended position that brings the palm of the hand to a downward position.
* Inversion: Movement of the ankle to turn the sole of the foot medially.
* Eversion: Movement of the sole of the foot laterally.

'''Resistive Exercises'''-performed against an opposing force(as tolerated by a person) to increase muscle strength.Resistance applied may be either isometric,isotonic or isokinetic.

'''Static Stretching Exercise'''-placement of muscles and connective tissues at their maximum length by a constant force in the direction of lengthening.

'''Strengthening Exercises'''- also known as force increasing exercises, prescribed to a person who shows weakness in individual muscles or muscle groups. Performed with relatively high resistance, but with few repetitions(3 to 10) followed by 1-2 minutes of rest.It is performed daily in early stages of rehabilitation.

== [['''Electro Therapy''']] ==

The therapeutic use of electricity to the human body as in the treatment of pain,paralysis or muscles weakness.
Numerous modalities are in use like Ultrasonic therapy(UST),Transcutaneous Electrical Nerve Stimulation(TENS),Interferential Therapy(IFT),Laser,Shock wave Therapy,Diathermy[Long, Short, Micro](Continuous or pulse Mode),Traction(Cervical or Lumbar) and many more.

== Ultrasonic Therapy (UST) ==

Defined as a high frequency acoustic energy,available in longitudinal waveforms in frequency range of .5 to 3.5 MHz. Most commonly used frequencies for treatment purpose in UST are .75 to 3.0 MHz(1 MHz = 1,000,000 cycles/second).

''''''Indications For UST''''''

i-Acute soft tissue injuries.

ii-Inflammation of joint capsules,tendons,bursa & ligaments associated with degenerative & inflammatory disorders like osteoarthritis,rheumatoid arthritis,repetitive stress injuries,gout.

iii-Wound Healing.

iv-Chronic Indurate Oedema.

v-Scar Tissue.

''''''Contraindications For UST''''''

i-Vascular Conditions like Thrombophlebitis or Phlebothrombosis.

ii-In Burger's disease,atherosclerosis,varicose veins or any other conditions where blood supply is poor or insufficient.

iii-Infected Lesion like Cellulites,Abscess or Carbuncles.

iv-Areas near Malignant Tumor.

v-Areas around Pregnant women uterus.

vi-Person with Metal or plastic Implants.

== TENS ==
TENS or "Trans-cutaneous Electrical Nerve Stimulation" is a modern non invasive, drug free pain management electro therapeutic modality(electroanalgesia).
Frequently used for acute or chronic pain in neck,back,joint pain of shoulder or knee etc, work or sports related injuries e.g. carpal tunnel syndrome,postural musculo-skeletal pain due to faulty work culture.

'''Types Of TENS'''

* High Rate TENS-
** Pulse Rate- 50-100 Hertz
** Pulse Width- 50-100 µs(micro second)
** Treatment Time-30-60 minutes/session or 7-9 hours(if required)
** Uses- Acute & post operative pain, increased Muscle tone.
* Low Rate TENS-
** Pulse rate- 1-5 Hertz
** Pulse Width- 150-300 µs
** Treatment Time- 15-30 minutes/session
** Uses- Chronic pain,Shows good results on tissues/skin of diabetic neuropathy,neuralgia where long pulse width is needed
* Brief Intense TENS-
** Pulse Rate- 80-150 Hertz
** Pulse Width- 40-250 µs
** Treatment Time- 10-20 minutes
** Uses- Acute or chronic pain.
* Burst Mode TENS-
** Pulse Rate-50-100 hertz(delivered in bursts mode with 1-4 pulses/second)
** Pulse Width-50-200 µs
** Treatment Time- 25 minutes
** Uses- Chronic muscle spasm, Neuro-musculo-skeletal pain like sciatica syndrome.

'''Indications For The Use Of TENS'''

i-Musculoskeletal Pain like joint pain from osteoarthritis or rheumatoid arthritis,post operative pain,posttraumatic pain.

ii- Neurogenic Pain like pain after spinal cord injury,trigeminal neuralgia,brachial plexus avulsion etc.

iii- Visceral Pain & dysmenorrhea.

iv- Headache,Migraine, Toothache.

'''Contraindications For The Use Of TENS'''

i-Person with metal or Plastic Implant.

ii-Over chest wall of cardiac patients.

iii-Over Larynx,eyes,pharynx or mucosal membrane.

iv-Head or neck region of patient with recent history of epilepsy or stroke.

== Interferential Therapy (IFT) ==
It is a form of electrical treatment in which two medium frequency sinusoidal currents(4000 to 5000 Hz) are used to produce a low frequency current effect.

'''Principle'''

The IFT works on interference effect where 2 medium frequency currents cross in the patient's tissues.One current is kept constant at 4000 Hz, while frequency of another keep varying between 3900-4000 Hz. An interference effect at a "beat frequency"(difference between two medium frequency currents) is produced where the current cross(low frequency current effect produced at the desired point by changing the point of electrodes).[[File:B 3900Hz.jpg]]

'''Indications For The Use Of IFT '''

i- Pain Relief.

ii- Muscle Stimulation.

iii- Increased Blood Flow.

iv- Wound healing & tissue repair.

v- Reduction of oedema.

'''Contraindications For The Use Of IFT'''

i-Person with metal or Plastic Implant.

ii-Over chest wall of cardiac patients.

iii-Patients with skin problem eg skin cut,dermatitis.

iv-Pregnant women's uterus.

v- Malignant Tumor.

== LASER ==

LASER stands for Light Amplification by the Stimulated Emission Of Radiation.

Compressed light of a wavelength from cold red part of the spectrum of electromagnetic radiation,it is monochromatic(single wavelength & color),Coherent(travel in a straight line) & polarized(concentrates its beam in defined location or spot).

'''LASER Regulation'''

Classified by the FDA's center for Devices and Radiological Health based on the Accessible Emission Limit.

Class Level Of LASER:-

I -laser radiation are not considered to be hazardous.

2 IIa levels of laser radiation are not considered to be hazardous if viewed for any period of time < 1*1000seconds,considered to be a chronic viewing hazard for any period of time > 1*1000seconds.

3-II levels of laser radiation are considered to be a chronic viewing hazard.

4- IIIa levels of laser radiation are considered to be, depending upon the irradiance, either an acute intrabeam viewing hazard or chronic viewing hazard, and an acute viewing hazard if viewed directly with optical instruments.

5- IIIb levels of laser radiation are considered to be an acute hazard to the skin and eyes from direct radiation.

6- IV levels of laser radiation are considered to be an acute hazard to the skin and eyes from direct and scattered radiation.

'''Types Of LASER'''

4 types of LASER-

1-Crystal & glass (solid -rod) - Synthetic Ruby.

2-Gas (Chamber) - HeNe, Argon, CO2.

3-Semi conductor(Diode channel) -Gallium Arsenide.

4-Liquid (Dye)- Organic dye as Lasing medium

== Indications For the Use Of LASER ==

i-Soft Tissue Injuries.

ii-Pain.

iii-Osteoarthritis & rheumatoid arthritis.

iv-Fracture.

v-Open Wound.

vi-Diabetic & Pressure ulcer.

'''Contra Indications For the Use Of LASER'''

i-Application over or around eyes.

ii-Malignant or cancerous cells.

iii-Pregnant women uterus.

iv-Over and around Thyroid or endocrine glands.

v- Epiphyseal Plates in children.

vi-Over vagus nerve.

vii- Over cardiac region.

viii- Patients who have been previously treated with photo sensitizers.

== Shock Wave Therapy==

Shock Wave Therapy or Extracorporeal Shock Wave Therapy- involves direct bursts of high pressure sound waves at the affected area.Useful in the treatment of Tennis Elbow,Plantar Fascitis,Calcaneal Spur etc.

'''Characteristics Of Shock Wave Therapy'''

-Peak Pressure - typically 50-8- MPa(MegaPascals){according to ogden et al 2001} and 35-120 MPa {according to speed,2004}.

-Fast Pressure Rise- usually less than 10 ns(nanoseconds).

-Short duration -Usually about 10 µs(microseconds).

-Narrow effective beam- 2-8 mm(millimeter) diameter.

'''Indications For Shock Wave Therapy'''

i-Tennis & golfer elbow.

ii-Plantar Fascitis.

iii- Calcaneal Spur.

iv-Jumper's Knee.

v- Achilles Tendon.

vi-Calcifying Tendinitis of Shoulder.

'''Contraindications For Shock Wave Therapy'''

i- Epiphyseal Region should be avoided.

ii-Malignant or cancerous cells.

== Specialty areas ==

Because the body of knowledge of physical therapy is quite large, some PTs specialize in a specific practice. While there are many specialty areas in physical therapy,<ref>http://www.apta.org/AM/Template.cfm?Section=Chapters&Template=/CM/ContentDisplay.cfm&CONTENTID=36890 text here</ref> the following are the five most common specialty areas in physical therapy:<ref name=Inverarity>[http://physicaltherapy.about.com/od/typesofphysicaltherapy/a/typesofpt.htm Types of Physical Therapy]</ref>

=== Cardiopulmonary ===
Cardiovascular and pulmonary rehabilitation physical therapists treat a wide variety of patients with cardiopulmonary disorders or those who have had cardiac or pulmonary surgery. Primary goals of this specialty include increasing patient endurance and functional independence. Manual therapy is utilized in this field to assist in clearing lung secretions experienced in patients with [[cystic fibrosis]]. Patients with disorders including [[heart attacks]], post [[coronary bypass surgery]], [[chronic obstructive pulmonary disease]], and [[pulmonary fibrosis]] are only a few examples of those who would benefit from cardiovascular and pulmonary specialized physical therapists.<ref name=Inverarity/>

=== Geriatric ===
Geriatric physical therapy covers a wide area of issues concerning people as they go through normal adult aging, but is usually focused on the older adult. There are many conditions that affect many people as they grow older and include but are not limited to the following: [[arthritis]], [[osteoporosis]], [[cancer]], [[Alzheimer's disease]], hip and joint replacement, balance disorders, [[incontinence]], etc.
Geriatric physical therapy helps those affected by such problems in developing a specialized program to help restore mobility, reduce pain, and increase fitness levels.<ref name=Inverarity/>

=== Neurological ===
Neurological physical therapy is a discipline focused on working with individuals who have a [[neurological disorder]] or disease. These include Alzheimer's disease, [[Anterolateral system|ALS]], brain injury, [[cerebral palsy]], [[multiple sclerosis]], [[Parkinson's disease]], spinal cord injury, and stroke. Common problems of patients with neurological disorders include paralysis, vision impairment, poor balance, inability to ambulate, and loss of functional independence. Therapists work with patients to improve these areas of dysfunction.<ref name=Inverarity/>
====[[Guillain-Barré syndrome physical therapy]]====

=== Orthopedic ===
Orthopedic physical therapists diagnose, manage, and treat disorders and injuries of the [[musculoskeletal system]] as well as rehabilitate patients post orthopedic surgery. This specialty of physical therapy is most often found in the out-patient clinical setting. Orthopedic therapists are trained in the treatment of post operative joints, acute sports injuries, arthritis, and amputations.
Joint mobilizations, strength training, hot/cold packs, and electrical stimulation (e.g., [[cryotherapy]], [[iontophoresis]], [[electrotherapy]]<ref>Cameron, M. (2003). ''Physical Agents in Rehabilitation - From Research to Practice'', USA: W.B. Saunders Company. ISBN 0-7216-9378-4</ref>) are [[stimulus modality|modalities]] often used to expedite recovery in the orthopedic setting. Additionally, an emerging treatment in this field is the use of [[sonography]] to guide treatments like muscle retraining.<ref>http://www.rtuspt.com/resources/references.php</ref><ref>http://dx.doi.org/10.1016/S0268-0033(02)00011-6</ref><ref>http://www.ncbi.nlm.nih.gov/pubmed/17970407?ordinalpos=5&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_RVDocSum</ref><ref>http://jospt.org/issues/articleID.690,type.2/article_detail.asp</ref> Those who have suffered injury or disease affecting the muscles, bones, ligaments, or tendons of the body will benefit from assessment by a physical therapist specialized in orthopedics.

=== Pediatric ===
Pediatric physical therapy assists in early detection of health problems and uses a wide variety of modalities to treat disorders in the pediatric population. These therapists are specialized in the diagnosis, treatment, and management of infants, children, and adolescents with a variety of congenital, developmental, neuromuscular, skeletal, or acquired disorders/diseases. Treatments focus on improving gross and fine motor skills, balance and coordination, strength and endurance as well as cognitive and sensory processing/integration. Children with developmental delays, cerebral palsy, [[spina bifida]], and [[torticollis]] are a few of the patients treated by pediatric physical therapists.<ref name=Inverarity/>

*Another PT specialty area is [[Integumentary system|Integumentary]] (treatment of conditions involving the skin and related organs).

== Education ==
=== United States ===
In the U.S., physical therapists must have a graduate degree from an accredited physical therapy program before taking the national licensing examination. Federal law also requires physical therapists to pass the National Physical Therapy Examination<ref>http://fsbpt.org/ForConsumers/PhysicalTherapy/index.asp</ref> after graduating from an accredited physical therapist educational program before they can practice. Also physical therapists must apply for a state license to practice. Each state regulates licenses for physical therapists independently.

According to the [[American Physical Therapy Association]], there were 210 accredited physical therapist programs in 2008–of those 23 offered the [[Master of Physical Therapy]], and 187 offered the [[Doctor of Physical Therapy]] (DPT) degree. Most programs are in transition to a DPT program.<ref>http://www.apta.org/AM/Template.cfm?Section=Student_Resources&CONTENTID=46936&TEMPLATE=/CM/ContentDisplay.cfm</ref>



== Evidence-based practice ==
For decades, physical therapy practice has been the subject of criticism for its lack of a research base.<ref name="EBP2">{{cite journal | LAST =Turner| FIRST =P.|title =Evidence based practice and physiotherapy in the 1990's|journal = Physiotherapy Theory and Practice|volume = 17|issue =|date = |url = |accessdate = }}</ref> In a late 1990s survey of English and Australian physical therapists, fewer than five percent (5%) of survey respondents indicated that they regularly reviewed scientific literature to guide practice decisions.<ref name=EBP3>{{cite journal | LAST =Turner| FIRST =P.|title =Physiotherapists' reasons for selection of treatment techniques: A cross-national survey|journal = Physiotherapy Theory and Practice|volume = 15|issue =|date = |pages = 235-246|url = |accessdate = }} </ref><ref name="EBP4">{{cite journal | LAST =Turner| FIRST =P.|title =Physiotherapists' use of evidence based practice: A cross-national study|journal = Physiotherapy Research International|volume = 2(1)|issue =|date = |pages = 17-29|url = |accessdate = }}</ref> Despite an overall positive attitude towards [[evidence based practice|evidence-based practice]],<ref name='EBP_Jette'> {{cite journal|title=Evidence-Based Practice: Beliefs, Attitudes, Knowledge, and Behaviors of Physical Therapists|journal=Physical Therapy|date=2003-09|first=Diane U.|last=Jette|coauthors=Kimberly Bacon, Cheryl Batty, Melissa Carlson, Amanda Ferland, Richard D Hemingway, Jessica C Hill, Laura Ogilvie and Danielle Volk|volume=83|issue=9|pages=786-805|id=PMID 12940766 |url=http://www.ptjournal.org/cgi/content/abstract/83/9/786|format=|accessdate=2007-12-21 }}</ref> most physical therapists utilized treatment techniques with little scientific support.<ref name=EBP8>{{cite journal | LAST =Newham| FIRST =D.|title =PracticalResearch|journal = Physiotherapy|volume = 80|issue =|date = |pages = 337 - 339|url = |accessdate = }} </ref><ref name=EBP>{{cite journal | last =Schreiber | first =J. | authorlink = | coauthors = | title =A review of the literature on evidence-based practice in physical therapy | journal =The Internet Journal of Allied Health Sciences and Practice | volume =3 | issue =4 | pages = | publisher = | location = | date =October 2005 | url = http://ijahsp.nova.edu/articles/vol3num4/Schreiber-Stern.htm
| doi = | id = | accessdate =12/1/07 }}</ref> Although numerous calls have been made for a shift toward the use of research and scientific evidence to guide practice decisions, at least throughout the 1990s, "most physical therapists continued to base practice decisions largely on anecdotal evidence."<ref name=EBP/>

To overcome these limitations, the World Confederation for Physical Therapy,<ref name='EBP_WCPT'> {{cite web|url=http://www.wcpt.org/policies/principles/ebp.php |title=Declarations of Principle - Evidence Based Practice |accessdate=2007-12-21 |date=2007-06 |publisher=World Confederation for Physical Therapy }}</ref> the [[American Physical Therapy Association]] (APTA),<ref name='EBP_APTA'> {{cite web|url=http://www.apta.org/AM/Template.cfm?Section=Policies_and_Bylaws&CONTENTID=34443&TEMPLATE=/CM/ContentDisplay.cfm |title=Evidence-Based Practice |accessdate=2007-12-21 |publisher=American Physical Therapy Association }}</ref> and a number of authors<ref name='EBP_Schreiber'> {{cite journal|title=A Review of the Literature on Evidence-Based Practice in Physical Therapy|journal=The Internet Journal of Allied Health Sciences and Practice|date=2005-10|first=J.|last=Schreiber|coauthors=P. Stern|volume=3|issue=4|pages=|id= |url=http://ijahsp.nova.edu/articles/vol3num4/Schreiber-Stern.htm|format=|accessdate=2007-12-21 }}</ref> have called on the profession to adopt and adhere to evidence-based practices formally based on the best available scientific sources.<ref>{{cite journal |journal= BMC Health Serv Res |date=2007 |volume=7 |issue=103 |pages= |title=The propensity to adopt evidence-based practice among physical therapists |author=Bridges PH, Bierema LL, Valentine T |doi=10.1186/1472-6963-7-103 |pmid=17615076 |url=http://www.pubmedcentral.nih.gov/articlerender.fcgi?tool=pubmed&pubmedid=17615076}}</ref>

== Journals and publications ==

Physical therapists have access to a wide range of publications and [[journals]].<ref>[http://www.pubmedcentral.nih.gov/articlerender.fcgi?artid=226272 Mapping the literature of physical therapy.] E M Wakiji. ''Bull Med Libr Assoc.'' 1997 July; 85(3): 284–288.</ref> Some are dedicated solely to physical therapy topics, while others (e.g., various [[orthopedic]] and [[surgical]] journals) cover a broader range of health-improvement topics, including physical therapy.
{| width="100%"
|-----
| valign="top" |
* [http://www.ingentaconnect.com/content/tandf/sort Acta Orthopaedica Scandinavica]
* [http://physical-therapy.advanceweb.com/ Advance for Physical Therapists & PT Assistants]
* [http://www.amjphysmedrehab.com/ American Journal of Physical Medicine & Rehabilitation]
* [http://ajs.sagepub.com/ American Journal of Sports Medicine]
* [http://www.archives-pmr.org/ Archives of Physical Medicine and Rehabilitation]
* [http://www.physiotherapy.asn.au/AJP Australian Journal of Physiotherapy]
* [http://www.biomedcentral.com/bmcmusculoskeletdisord BMC Musculoskeletal Disorders]
* [http://www.corronline.com/ Clinical Orthopedics and Related Research]
| valign="top" |
* [http://jmmtonline.com/ Journal of Manual & Manipulative Therapy (JMMT)]
* [http://www.jospt.org/ Journal of Orthopaedic & Sports Physical Therapy (JOSPT)]
* [http://www.tandf.no/rehabmed/ Journal of Rehabilitation Medicine]
* [http://www.neurology.org/ Neurology]
* [http://www.ptjournal.org/ Physical Therapy: Journal of the American Physical Therapy Association]
* [http://www.apta.org/ptmag/ PT–Magazine of Physical Therapy]
* [http://www.spinejournal.com/ Spine]
* [http://www.todayinpt.com/ Today in PT]
|}

== References ==

1-Description of Physical Therapy – The World Confederation for Physical Therapy (WCPT)

2-^ Initiatives in Rehabilitation Research http://ptjournal.apta.org/cgi/content/full/86/1/141

3-^ American Physical Therapy Association. "Discovering Physical Therapy. What is physical therapy". American Physical Therapy Association. Retrieved 2008-05-29.

4-^ "Physical Therapists". US Department of Labor. Retrieved 24 February 2011.

5-^ American Physical Therapy Association Section on Clinical Electrophysiology and Wound Management. "Curriculum Content Guidelines for Electrophysiologic Evaluation" (PDF). Educational Guidelines. American Physical Therapy Association. Retrieved 2008-05-29.

6-^ American Physical Therapy Association (2008-01-17). "APTA Background Sheet 2008". American Physical Therapy Association. Retrieved 2008-05-29.

7-^ Health policy implications for patient education in physical therapy http://findarticles.com/p/articles/mi_qa3956/is_199901/ai_n8843473/

8-^ http://www.electrotherapy.org/downloads/Modalities/Interferential%20Therapy%20Jan%202012.pdf

9-^ Gail M. Jensen, PhD, PT, FAPTA http://chpe.creighton.edu/people/profiles/jensen.htm

10-^ Smith joins Health Policy & Administration faculty http://www.wsutoday.wsu.edu/pages/publications.asp?Action=Detail&PublicationID=21304&TypeID=3

11-^ DPT/MBA Program http://www.goizueta.emory.edu/degree/fulltimemba/DPT-MBA.html

12-^ Orozco Appointed CEO of Rancho http://pt.usc.edu/SubLayout.aspx?id=2682

13-^ WHY DO WE OFFER PHYSICAL THERAPY CONSULTATIVE SERVICES? http://www.imxmed.com/pt_services.html

14-^ Wharton MA. Health Care Systems I; Slippery Rock University. 1991

15-^ Sarah Bakewell, "Illustrations from the Wellcome Institute Library: Medical Gymnastics and the Cyriax Collection," Medical History 41 (1997), 487–495.

16-^ Chartered Society of Physiotherapy (n.d.). "History of the Chartered Society of Physiotherapy". Chartered Society of Physiotherapy. Retrieved 2008-05-29.

17-^ Knox, Bruce (2007-01-29). "History of the School of Physiotherapy". School of Physiotherapy Centre for Physiotherapy Research. University of Otago. Archived from the original on 2007-12-24. Retrieved 2008-05-29.

18-^ Reed College (n.d.). "Mission and History". About Reed. Reed College. Retrieved 2008-05-29.

19-^ http://beckerexhibits.wustl.edu/mowihsp/health/PTdevel.htm

20-^ McKenzie, R A (1998). The cervical and thoracic spine: mechanical diagnosis and therapy. New Zealand: Spinal Publications Ltd.. pp. 16–20. ISBN 978-0959774672.

21-^ Roosevelt Warm Springs Institute (n.d.). "History". About Us. Roosevelt Warm Springs Institute. Retrieved 2008-05-29.

22-^ McKenzie, R (2002). "Patient Heal Thyself". Worldwide Spine & Rehabilitation 2 (1): 16–20.

23-^ http://www.apta.org//AM/Template.cfm?Section=&WebsiteKey=

24-^ Basson, Annalie (2010). "History: Abridged version of IFOMPT History". International Federation of Orthopaedic Manipulative Physical Therapists (IFOMPT). Retrieved 2011-01-09.

25-^ Commission on Acredidation in Physical Therapy Education Criteria http://www.apta.org/AM/Template.cfm?Section=PT_Programs3&TEMPLATE=/CM/ContentDisplay.cfm&CONTENTID=62414

26-^ American Physical Therapy Association (n.d.). "APTA Sections". American Physical Therapy Association. Retrieved 2008-05-29.

27-^ a b c Inverarity, Laura; Grossman, K (2007-11-28). "Types of Physical Therapy". About.com. The New York Times Company. Retrieved 2008-05-29.

28-^ Cameron, Michelle H. (2003). Physical agents in rehabilitation: from research to practice. Philadelphia: W. B. Saunders. ISBN 0-7216-9378-4.

29-^ Bunce SM, Moore AP, Hough AD (May 2002). "M-mode ultrasound: a reliable measure of transversus abdominis thickness?". Clin Biomech (Bristol, Avon) 17 (4): 315–7. doi:10.1016/S0268-0033(02)00011-6. PMID 12034127.

30-^ Wallwork TL, Hides JA, Stanton WR (October 2007). "Intrarater and interrater reliability of assessment of lumbar multifidus muscle thickness using rehabilitative ultrasound imaging". J Orthop Sports Phys Ther 37 (10): 608–12. PMID 17970407.

31-^ Henry SM, Westervelt KC (June 2005). "The use of real-time ultrasound feedback in teaching abdominal hollowing exercises to healthy subjects". J Orthop Sports Phys Ther 35 (6): 338–45. PMID 16001905.

32-^ http://www.womenshealthapta.org/plp/index.cfm

33-Foster & Palastanga "Clayton's Electro Therapy" Theory & practice AITBS Publishers.

34-http://www.accessdata.fda.gov/scripts/cdrh/cfdocs/cfcfr/CFRSearch.cfm?FR=1040.10

35-http://www.physio-chelsea.co.uk/shockwave.html

== See also ==
{| width="100%"
|-----
| valign="top" |
* [[Bobath concept]]
* [[Brunnstrom Approach]]
* [[Exercise]]
* [[Geriatrics]]
| valign="top" |
* [[Joint manipulation]]
* [[Occupational Therapy]]
* [[Phonophoresis]]
* [[Physical medicine and rehabilitation]]
|}

== External links ==
* [http://fsbpt.org/ Federation of State Boards of Physical Therapy]
* [http://www.dptschools.com/ List of DPT Programs]
* [http://wcpt.org/ World Confederation for Physical Therapy]
* [http://www.payscale.com/research/US/Job=Physical_Therapist/Salary U.S. Physical Therapist Salary Data]
* [http://www.rehablicense.com/professional.php?profID=8 Rehab License Network- PT License Information]

'''''National associations'''''
{| width="100%"
|-----
| valign="top" |
* [http://www.apta.org/ American Physical Therapy Association]
* [https://apa.advsol.com.au/ Australian Physiotherapy Association]
* [http://www.physio.at/ Austrian Physiotherapy Association]
* [http://www.bpa-bd.org Bangladesh Physiotherapy Association]
* [http://www.physiotherapy.ca Canadian Physiotherapy Association]
* [http://www.fysio.dk Danish Physiotherapy Association]
* [http://fysioterapia.net/ Finnish Association of Physical Therapists]
* [http://zvk.org German Physiotherapy Association]
* [http://physio.is/ Icelandic Physiotherapy Association]
* [http://www.physiotherapyindia.org/ Indian Association of Physiotherapists]
* [http://www.iscp.ie/ The Irish Society of Chartered Physiotherapists]
* [http://wwwsoc.nii.ac.jp/jpta/ The Japanese Physical Therapy Association]
| valign="top" |
* [http://kpta.co.kr Korean Physical Therapy Association]
* [http://physiotherapy.org.nz/ New Zealand Society of Physiotherapists]
* [http://nigeriaphysio.org/ Nigeria Society of Physiotherapy]
* [http://www.fysio.no/ Norwegian Physiotherapy Association]
* [http://www.physiotherapy.org.sg/ Singapore Physiotherapy Association]
* [http://www.physiosa.org.za/ South African Society of Physiotherapy]
* [http://www.aefi.net/ Spanish Physiotherapy Association]
* [http://www.sjukgymnastforbundet.se/ Swedish Association of registered Physiotherapists]
* [http://www.csp.org.uk/ (UK) Chartered Society of Physiotherapy]
* [http://www.ptaroc.org.tw/ (Taiwan) The Physical Therapy Association of The R.O.C.]
* [http://www.spta.org.sa/ (Saudi Arabia) Saudi Physical Therapy Association]
|}

{{Allied health professions}}

[[Category:Health sciences]]
[[Category:Rehabilitation medicine]]
[[Category:Healthcare occupations]]
[[Category:Physical therapy]]
[[Category:Sports medicine]]
[[Category:Therapy]]
[[Category:Exercise]]
[[Category:Manipulative therapy]]
[[Category:Massage]]
[[Category:Hospital departments]]

[[af:Fisioterapie]]
[[ar:علاج طبيعي]]
[[ast:Fisioterapia]]
[[ca:Fisioteràpia]]
[[cs:Léčebná rehabilitace]]
[[da:Fysioterapi]]
[[de:Physiotherapie]]
[[el:Φυσιοθεραπεία]]
[[es:Fisioterapia]]
[[fa:فیزیوتراپی]]
[[fr:Physiothérapie]]
[[it:Fisioterapia]]
[[he:פיזיותרפיה]]
[[nl:Fysiotherapie]]
[[ja:理学療法]]
[[no:Fysioterapi]]
[[pl:Fizjoterapia]]
[[pt:Fisioterapia]]
[[fi:Fysioterapia]]
[[sv:Sjukgymnastik]]
[[tt:Fizioterapiä]]
[[th:กายภาพบำบัด]]
[[zh:物理治療]]

{{jb1}}
{{WH}}
{{WS}}

Guillain-Barré syndrome physical therapy

2012-02-21T04:29:07Z

Abhiksin:

Guillain-Barré syndrome physical therapy

2012-02-21T04:27:40Z

Abhiksin: Created page with "{{Guillain-Barré syndrome}} {{CMG}}; '''Associate Editors-In-Chief:''' Priyamvada Singh, MBBS [mailto:psingh@perfuse.org] ==Overview== '''Guillain-Barr..."

{{Guillain-Barré syndrome}}

{{CMG}}; '''Associate Editors-In-Chief:''' [[Priyamvada Singh|Priyamvada Singh, MBBS]] [mailto:psingh@perfuse.org]

==Overview==
'''Guillain-Barré syndrome''' ('''GBS''') is an acute, autoimmune, [[neuropathy|polyradiculoneuropathy]] affecting the [[peripheral nervous system]], usually triggered by an acute infectious process. It is included in the wider group of [[peripheral neuropathy|peripheral neuropathies]].
==Physical therapy==

==References==
{{reflist|2}}

{{WH}}
{{WS}}

[[Category:Autoimmune diseases]]
[[Category:Neurological disorders]]
[[Category:Neurology]]
[[Category:Immunology]]
[[Category:Syndromes]]
[[Category:Overview complete]]
[[Category:Disease]]
[[Category:Emergency medicine]]
[[Category:Infectious disease]]

Proprioceptive neuromuscular facilitation

2012-02-17T19:16:09Z

Abhiksin: /* HOW TO PERFORM UPPER EXTREMITIES PNF PATTERN */

{{SI}}
{{CMG}}; '''Associate Editors-In-Chief:''' [[Abhishek Singh|Abhishek Singh, B.P.T]] [mailto:abhiksin7556@yahoo.co.in]
==Overview==
Proprioceptive neuromuscular facilitation is a motor learning approach used in neuro-motor development training to improve motor function and facilitate maximal muscular contraction.
==Historical perspective==
According to Kabat (1951) "The basis of the PNF philosophy is the idea that all human beings, including those with disabilities have untapped existing potential.
==PNF BASIC PROCEDURES FOR FACILITATION==
====Patterns Of Motion====
[[File:Pnf.jpg|200px|centre|thumbnail|<div align="center">This is <span style="color: green">the </span><br /> [[PNF Pattern]]<br /> '''Of <span style="color: red">Upper Extremities</span>'''</div>]]

Normal Motor activity occurs in synergistic & functional patterns of movement. PNF technique are "spiral & diagonal" in character and combine motion in all 3 planes i.e. flexion/extension, abduction/adduction and rotation.

Extremities patterns are named according to the movement occurring at the proximal joint or by diagonal(antagonist patterns are make up the diagonal).

====UPPER EXTREMITIES====

* D1 Flexion- Flexion,Adduction,External Rotation.

* D1 Extension-Extension,Abduction,Internal rotation.(Antagonist pattern of D1 flexion).

* D2 Flexion- Flexion, Abduction, External Rotation.

* D2 Extension- Extension,Adduction,Internal Rotation.(Antagonist pattern of D2 flexion).

====LOWER EXTREMITIES====

(D1 Flexion of Lower Extremities is similar to Upper Extremities pattern).

* D1 Flexion- Flexion,Adduction,External Rotation.

* D1 Extension- Extension,Abduction,Internal Rotation.(Antagonist pattern of D1 flexion).

* D2 Flexion- Flexion, Abduction,Internal Rotation.

* D2 Extension- Extension,Adduction,External Rotation.(Antagonist pattern of D2 flexion).

===HOW TO PERFORM UPPER EXTREMITIES PNF PATTERN===

'''D1 Flexion'''

* Starting Position
* Patient Position- Extension/abduction/internal or medial rotation of the shoulder with pronation of the forearm,extension with ulnar deviation of the wrist,extension of the fingers,extension and abduction of the thumb.The therapist ensure that patient near to the side of plinth to enable the arm to be taken to extension. The patient's arm should be abducted around 20°-30° from the side of the body.Care must be taken that patient's finger are in fully extension before the movement begins.
* Therapist Stance- Therapist stands at patient's upper arm level in Lunge position facing towards the patient's feet & with his weight on her front right foot & parallel with proposed line of movement.During the arm's movement of patient,therapist transfers his weight from the front foot to the back foot rotating so that he can watch the movement throughout the movement pattern.
* Grip- Therapist grasp the patient's right palm approaching from palm approaching from radial side. He uses the lumbrical grip ensuring that extensor surface of patient's hand does not touch.Fingers of right hand placed on flexor aspect of patient's wrist approaching from ulnar side.
* Commands- Therapist prepares patient for the movement by saying 'now' & then follows this with command like"grip my hand, pull up and across the face.
* Movements- Flexion of fingers, particularly the little & ring fingers,adduction & flexion of thumb, flexion of wrist towards the radial side with supination of the forearm,flexion,adduction & lateral rotation of the shoulder joint,while scapular joint is in rotation,elevation & protraction.Movement is initiated by rotary component.Movement then occurs at distal joints followed in succession by more proximal joints until whole extremities is moving.

'''Flexion/Adduction/External or Lateral Rotation with Elbow Flexion'''
----
Starting Position-
----

* Patient Position- As for D1 flexion.
* Therapist Position- Stance & grip as for D1 flexion.The therapist may move his right hand nearer to the patient's elbow.
* Movement- As in the D1 flexion with addition of elbow flexion.This is the eating pattern.

'''Flexion/Adduction/External or Lateral Rotation with Elbow Extension'''
----
Starting Position
----
* Patient Position- Same as D1 flexion with addition of elbow flexion.
* Therapist Position- Stance & grip similar to D1 flexion.
* Movement- Similar to D1 flexion with addition of elbow extension.Similar to the fundamental component of upper cut in boxing.

'''D1 EXTENSION'''

Extension/Abduction/Internal/Medial Rotation

----
Starting Position
----

* Patient Position- Flexion/Adduction/External or Lateral Rotation,forearm supinated,flexion and radial deviation of wrist,fingers flexed,flexion & adduction of thumb.

* Therapist Position- In Lunge position facing head of the patient at patient's upper arm level. Therapist weight is on front left foot & parallel with the line of movement.During movement therapist weight is transfers from front foot to the back foot,rotating so that watch patient's movement.

* Grip- Right hand & lumbrical grip of therapist grasps dorsum of patient's right hand ensuring stretch is obtained,main emphasis is on exteroceptors on ulnar side of patient's hand with pressure from therapist fingers.After movement has started fingers of therapist's left hand are placed on extensor surface of patient's wrist.

* Commands- 'Now'-'push'.

* Movement-

Fingers-Extension(particularly ring & little)

Thumb- Extension & abduction

Wrist- Extension & ulnar deviation

Forearm- Pronation

Shoulder/Gleno-Humeral Joint- Extension,abduction & internal rotation

Scapula- Rotation,depression & adduction.

'''Extension/Abduction/Internal/Medial Rotation with Elbow Flexion'''

----
Starting Position
----

* Patient Position- Same as D1 extension.
* Therapist Position- Position & grip of right hand as for D1 extension,but left hand fingers are placed at elbow approaching from ulnar side for free elbow flexion movement.

* Movement - Same as D1 extension with addition of elbow flexion.

'''Extension/Abduction/Internal/Medial Rotation with Elbow Extension'''

----
Starting Position
----

* Patient Position- Same as D1 extension with addition of elbow flexion.

* Therapist Position- Position & grip same as D1 extension.

* Movement- Same as D1 extension along with elbow extension.Movement similar in eating when hand is returning from mouth.

==References==

1-Physical Rehabilitation: Susan B O'Sullivan & Thomas J Schmitz (Fifth Edition)

2-Proprioceptive Neuromuscular Facilitation Patterns: P J Waddington

{{Reflist|2}}
[[Category:Health sciences]]
[[Category:Rehabilitation medicine]]
[[Category:Healthcare occupations]]
[[Category:Physical therapy]]
[[Category:Sports medicine]]
[[Category:Therapy]]
[[Category:Exercise]]
[[Category:Manipulative therapy]]
[[Category:Massage]]
[[Category:Hospital departments]]
{{WH}}
{{WS}}

Proprioceptive neuromuscular facilitation

2012-02-16T08:37:15Z

Abhiksin: /* Patterns Of Motion */

{{SI}}
{{CMG}}; '''Associate Editors-In-Chief:''' [[Abhishek Singh|Abhishek Singh, B.P.T]] [mailto:abhiksin7556@yahoo.co.in]
==Overview==
Proprioceptive neuromuscular facilitation is a motor learning approach used in neuro-motor development training to improve motor function and facilitate maximal muscular contraction.
==Historical perspective==
According to Kabat (1951) "The basis of the PNF philosophy is the idea that all human beings, including those with disabilities have untapped existing potential.
==PNF BASIC PROCEDURES FOR FACILITATION==
====Patterns Of Motion====
[[File:Pnf.jpg|200px|centre|thumbnail|<div align="center">This is <span style="color: green">the </span><br /> [[PNF Pattern]]<br /> '''Of <span style="color: red">Upper Extremities</span>'''</div>]]

Normal Motor activity occurs in synergistic & functional patterns of movement. PNF technique are "spiral & diagonal" in character and combine motion in all 3 planes i.e. flexion/extension, abduction/adduction and rotation.

Extremities patterns are named according to the movement occurring at the proximal joint or by diagonal(antagonist patterns are make up the diagonal).

====UPPER EXTREMITIES====

* D1 Flexion- Flexion,Adduction,External Rotation.

* D1 Extension-Extension,Abduction,Internal rotation.(Antagonist pattern of D1 flexion).

* D2 Flexion- Flexion, Abduction, External Rotation.

* D2 Extension- Extension,Adduction,Internal Rotation.(Antagonist pattern of D2 flexion).

====LOWER EXTREMITIES====

(D1 Flexion of Lower Extremities is similar to Upper Extremities pattern).

* D1 Flexion- Flexion,Adduction,External Rotation.

* D1 Extension- Extension,Abduction,Internal Rotation.(Antagonist pattern of D1 flexion).

* D2 Flexion- Flexion, Abduction,Internal Rotation.

* D2 Extension- Extension,Adduction,External Rotation.(Antagonist pattern of D2 flexion).

===HOW TO PERFORM UPPER EXTREMITIES PNF PATTERN===

'''D1 Flexion'''

* Starting Position
* Patient Position- Extension/abduction/internal or medial rotation of the shoulder with pronation of the forearm,extension with ulnar deviation of the wrist,extension of the fingers,extension and abduction of the thumb.The therapist ensure that patient near to the side of plinth to enable the arm to be taken to extension. The patient's arm should be abducted around 20°-30° from the side of the body.Care must be taken that patient's finger are in fully extension before the movement begins.
* Therapist Stance- Therapist stands at patient's upper arm level in Lunge position facing towards the patient's feet & with his weight on her front right foot & parallel with proposed line of movement.During the arm's movement of patient,therapist transfers his weight from the front foot to the back foot rotating so that he can watch the movement throughout the movement pattern.
* Grip- Therapist grasp the patient's right palm approaching from palm approaching from radial side. He uses the lumbrical grip ensuring that extensor surface of patient's hand does not touch.Fingers of right hand placed on flexor aspect of patient's wrist approaching from ulnar side.
* Commands- Therapist prepares patient for the movement by saying 'now' & then follows this with command like"grip my hand, pull up and across the face.
* Movements- Flexion of fingers, particularly the little & ring fingers,adduction & flexion of thumb, flexion of wrist towards the radial side with supination of the forearm,flexion,adduction & lateral rotation of the shoulder joint,while scapular joint is in rotation,elevation & protraction.Movement is initiated by rotary component.Movement then occurs at distal joints followed in succession by more proximal joints until whole extremities is moving.

'''Flexion/Adduction/External or Lateral Rotation with Elbow Flexion'''
----
Starting Position-
----

* Patient Position- As for D1 flexion.
* Therapist Position- Stance & grip as for D1 flexion.The therapist may move his right hand nearer to the patient's elbow.
* Movement- As in the D1 flexion with addition of elbow flexion.This is the eating pattern.

'''Flexion/Adduction/External or Lateral Rotation with Elbow Extension'''
----
Starting Position
----
* Patient Position- Same as D1 flexion with addition of elbow flexion.
* Therapist Position- Stance & grip similar to D1 flexion.
* Movement- Similar to D1 flexion with addition of elbow extension.Similar to the fundamental component of upper cut in boxing.

==References==

1-Physical Rehabilitation: Susan B O'Sullivan & Thomas J Schmitz (Fifth Edition)

2-Proprioceptive Neuromuscular Facilitation Patterns: P J Waddington

{{Reflist|2}}
[[Category:Health sciences]]
[[Category:Rehabilitation medicine]]
[[Category:Healthcare occupations]]
[[Category:Physical therapy]]
[[Category:Sports medicine]]
[[Category:Therapy]]
[[Category:Exercise]]
[[Category:Manipulative therapy]]
[[Category:Massage]]
[[Category:Hospital departments]]
{{WH}}
{{WS}}

Proprioceptive neuromuscular facilitation

2012-02-16T08:35:43Z

Abhiksin: /* PNF BASIC PROCEDURES FOR FACILITATION */

{{SI}}
{{CMG}}; '''Associate Editors-In-Chief:''' [[Abhishek Singh|Abhishek Singh, B.P.T]] [mailto:abhiksin7556@yahoo.co.in]
==Overview==
Proprioceptive neuromuscular facilitation is a motor learning approach used in neuro-motor development training to improve motor function and facilitate maximal muscular contraction.
==Historical perspective==
According to Kabat (1951) "The basis of the PNF philosophy is the idea that all human beings, including those with disabilities have untapped existing potential.
==PNF BASIC PROCEDURES FOR FACILITATION==
====Patterns Of Motion====
[[File:Pnf.jpg|right|right|thumbnail|<div align="center">This is <span style="color: green">the </span><br /> [[PNF Pattern]]<br /> '''Of <span style="color: red">Upper Extremities</span>'''</div>]]

Normal Motor activity occurs in synergistic & functional patterns of movement. PNF technique are "spiral & diagonal" in character and combine motion in all 3 planes i.e. flexion/extension, abduction/adduction and rotation.

Extremities patterns are named according to the movement occurring at the proximal joint or by diagonal(antagonist patterns are make up the diagonal).

====UPPER EXTREMITIES====

* D1 Flexion- Flexion,Adduction,External Rotation.

* D1 Extension-Extension,Abduction,Internal rotation.(Antagonist pattern of D1 flexion).

* D2 Flexion- Flexion, Abduction, External Rotation.

* D2 Extension- Extension,Adduction,Internal Rotation.(Antagonist pattern of D2 flexion).

====LOWER EXTREMITIES====

(D1 Flexion of Lower Extremities is similar to Upper Extremities pattern).

* D1 Flexion- Flexion,Adduction,External Rotation.

* D1 Extension- Extension,Abduction,Internal Rotation.(Antagonist pattern of D1 flexion).

* D2 Flexion- Flexion, Abduction,Internal Rotation.

* D2 Extension- Extension,Adduction,External Rotation.(Antagonist pattern of D2 flexion).

===HOW TO PERFORM UPPER EXTREMITIES PNF PATTERN===

'''D1 Flexion'''

* Starting Position
* Patient Position- Extension/abduction/internal or medial rotation of the shoulder with pronation of the forearm,extension with ulnar deviation of the wrist,extension of the fingers,extension and abduction of the thumb.The therapist ensure that patient near to the side of plinth to enable the arm to be taken to extension. The patient's arm should be abducted around 20°-30° from the side of the body.Care must be taken that patient's finger are in fully extension before the movement begins.
* Therapist Stance- Therapist stands at patient's upper arm level in Lunge position facing towards the patient's feet & with his weight on her front right foot & parallel with proposed line of movement.During the arm's movement of patient,therapist transfers his weight from the front foot to the back foot rotating so that he can watch the movement throughout the movement pattern.
* Grip- Therapist grasp the patient's right palm approaching from palm approaching from radial side. He uses the lumbrical grip ensuring that extensor surface of patient's hand does not touch.Fingers of right hand placed on flexor aspect of patient's wrist approaching from ulnar side.
* Commands- Therapist prepares patient for the movement by saying 'now' & then follows this with command like"grip my hand, pull up and across the face.
* Movements- Flexion of fingers, particularly the little & ring fingers,adduction & flexion of thumb, flexion of wrist towards the radial side with supination of the forearm,flexion,adduction & lateral rotation of the shoulder joint,while scapular joint is in rotation,elevation & protraction.Movement is initiated by rotary component.Movement then occurs at distal joints followed in succession by more proximal joints until whole extremities is moving.

'''Flexion/Adduction/External or Lateral Rotation with Elbow Flexion'''
----
Starting Position-
----

* Patient Position- As for D1 flexion.
* Therapist Position- Stance & grip as for D1 flexion.The therapist may move his right hand nearer to the patient's elbow.
* Movement- As in the D1 flexion with addition of elbow flexion.This is the eating pattern.

'''Flexion/Adduction/External or Lateral Rotation with Elbow Extension'''
----
Starting Position
----
* Patient Position- Same as D1 flexion with addition of elbow flexion.
* Therapist Position- Stance & grip similar to D1 flexion.
* Movement- Similar to D1 flexion with addition of elbow extension.Similar to the fundamental component of upper cut in boxing.

==References==

1-Physical Rehabilitation: Susan B O'Sullivan & Thomas J Schmitz (Fifth Edition)

2-Proprioceptive Neuromuscular Facilitation Patterns: P J Waddington

{{Reflist|2}}
[[Category:Health sciences]]
[[Category:Rehabilitation medicine]]
[[Category:Healthcare occupations]]
[[Category:Physical therapy]]
[[Category:Sports medicine]]
[[Category:Therapy]]
[[Category:Exercise]]
[[Category:Manipulative therapy]]
[[Category:Massage]]
[[Category:Hospital departments]]
{{WH}}
{{WS}}

Proprioceptive neuromuscular facilitation

2012-02-16T08:14:44Z

Abhiksin: /* PNF BASIC PROCEDURES FOR FACILITATION */

{{SI}}
{{CMG}}; '''Associate Editors-In-Chief:''' [[Abhishek Singh|Abhishek Singh, B.P.T]] [mailto:abhiksin7556@yahoo.co.in]
==Overview==
Proprioceptive neuromuscular facilitation is a motor learning approach used in neuro-motor development training to improve motor function and facilitate maximal muscular contraction.
==Historical perspective==
According to Kabat (1951) "The basis of the PNF philosophy is the idea that all human beings, including those with disabilities have untapped existing potential.
==PNF BASIC PROCEDURES FOR FACILITATION==
====Patterns Of Motion====
[[File:Pnf.jpg|200px|right|right|thumbnail|<div align="center">This is <span style="color: green">the </span><br /> [[PNF Pattern]]<br /> '''Of <span style="color: red">Upper Extremities</span>'''</div>]]

Normal Motor activity occurs in synergistic & functional patterns of movement. PNF technique are "spiral & diagonal" in character and combine motion in all 3 planes i.e. flexion/extension, abduction/adduction and rotation.

Extremities patterns are named according to the movement occurring at the proximal joint or by diagonal(antagonist patterns are make up the diagonal).

====UPPER EXTREMITIES====

* D1 Flexion- Flexion,Adduction,External Rotation.

* D1 Extension-Extension,Abduction,Internal rotation.(Antagonist pattern of D1 flexion).

* D2 Flexion- Flexion, Abduction, External Rotation.

* D2 Extension- Extension,Adduction,Internal Rotation.(Antagonist pattern of D2 flexion).

====LOWER EXTREMITIES====

(D1 Flexion of Lower Extremities is similar to Upper Extremities pattern).

* D1 Flexion- Flexion,Adduction,External Rotation.

* D1 Extension- Extension,Abduction,Internal Rotation.(Antagonist pattern of D1 flexion).

* D2 Flexion- Flexion, Abduction,Internal Rotation.

* D2 Extension- Extension,Adduction,External Rotation.(Antagonist pattern of D2 flexion).

===HOW TO PERFORM UPPER EXTREMITIES PNF PATTERN===

'''D1 Flexion'''

* Starting Position
* Patient Position- Extension/abduction/internal or medial rotation of the shoulder with pronation of the forearm,extension with ulnar deviation of the wrist,extension of the fingers,extension and abduction of the thumb.The therapist ensure that patient near to the side of plinth to enable the arm to be taken to extension. The patient's arm should be abducted around 20°-30° from the side of the body.Care must be taken that patient's finger are in fully extension before the movement begins.
* Therapist Stance- Therapist stands at patient's upper arm level in Lunge position facing towards the patient's feet & with his weight on her front right foot & parallel with proposed line of movement.During the arm's movement of patient,therapist transfers his weight from the front foot to the back foot rotating so that he can watch the movement throughout the movement pattern.
* Grip- Therapist grasp the patient's right palm approaching from palm approaching from radial side. He uses the lumbrical grip ensuring that extensor surface of patient's hand does not touch.Fingers of right hand placed on flexor aspect of patient's wrist approaching from ulnar side.
* Commands- Therapist prepares patient for the movement by saying 'now' & then follows this with command like"grip my hand, pull up and across the face.
* Movements- Flexion of fingers, particularly the little & ring fingers,adduction & flexion of thumb, flexion of wrist towards the radial side with supination of the forearm,flexion,adduction & lateral rotation of the shoulder joint,while scapular joint is in rotation,elevation & protraction.Movement is initiated by rotary component.Movement then occurs at distal joints followed in succession by more proximal joints until whole extremities is moving.

'''Flexion/Adduction/External or Lateral Rotation with Elbow Flexion'''
----
Starting Position-
----

* Patient Position- As for D1 flexion.
* Therapist Position- Stance & grip as for D1 flexion.The therapist may move his right hand nearer to the patient's elbow.
* Movement- As in the D1 flexion with addition of elbow flexion.This is the eating pattern.

'''Flexion/Adduction/External or Lateral Rotation with Elbow Extension'''
----
Starting Position
----
* Patient Position- Same as D1 flexion with addition of elbow flexion.
* Therapist Position- Stance & grip similar to D1 flexion.
* Movement- Similar to D1 flexion with addition of elbow extension.Similar to the fundamental component of upper cut in boxing.

==References==

1-Physical Rehabilitation: Susan B O'Sullivan & Thomas J Schmitz (Fifth Edition)

2-Proprioceptive Neuromuscular Facilitation Patterns: P J Waddington

{{Reflist|2}}
[[Category:Health sciences]]
[[Category:Rehabilitation medicine]]
[[Category:Healthcare occupations]]
[[Category:Physical therapy]]
[[Category:Sports medicine]]
[[Category:Therapy]]
[[Category:Exercise]]
[[Category:Manipulative therapy]]
[[Category:Massage]]
[[Category:Hospital departments]]
{{WH}}
{{WS}}

Proprioceptive neuromuscular facilitation

2012-02-16T08:12:39Z

2012-02-16T03:55:30Z

Abhiksin: