Role of Physiotherapy

Role of Physiotherapy in Cardiopulmonary Conditions

When someone talks about the rehabilitation of cardiopulmonary conditions, the specialists which come forward are the cardiopulmonary physical therapist. Cardiopulmonary physiotherapy is an area of physiotherapy that specializes in the prevention, rehabilitation, and restoration of patients with diseases of lungs and heart.

The patient having cardiopulmonary diseases suffer from breathlessness, increased sputum production, a decrease in gas exchanges, reduced exercise capacity and increased fatigue, chest pain, etc.  The Cardiopulmonary therapist helps the patients to overcome the physical and functional impairment, activity limitations, and participation restrictions due to the impairments of structures and functions of the cardiovascular and pulmonary system. They also play a significant role in the management of various conditions such as Asthma, chronic obstructive pulmonary diseases, coronary artery disease, heart failure, and many more.

The core component of cardiopulmonary physiotherapy interventions is exercise prescriptions. There are various methods and techniques which are used in cardiopulmonary rehabilitation viz. deep breathing exercises, breathing facilitation exercises, percussions and vibrations, coughing, mobility assistance, and individually tailored exercises, etc. Through these techniques a cardiopulmonary physical therapist can help patients to reduce breathlessness, increase functional capacity, reduce the exacerbations of conditions and thereby reduce the number of hospital admissions; it also enhances mental wellbeing and improves the quality of life.

There are various settings where the cardiopulmonary physical therapist are helpful for the patients to improve quality of life such as ICU, indoor and outdoor patient department, home care, clinics and rehabilitation  In intensive care unit (ICU) where some patients are on a ventilator, there are chances of accumulations of secretions in lungs, decrease oxygenation. In this setting, the physical therapist helps to improve ventilation, facilitate removal of secretions, and improve management of shortness of breath for better function. The patient education and interventions related to corrections of breathing patterns are done through various breathing techniques and manual therapy such as chest percussion and vibrations to mobilize secretions.

In outpatients and rehabilitation clinics individualized education related to the patient’s condition, how to respond in case of increased symptoms, and graded exercise training in form of endurance, resistance, and respiratory muscle training is provided to maximize the patient’s functional level.

During this pandemic COVID-19, the cardiopulmonary therapist has a significant role, as the person with COVID -19 presents with respiratory symptoms like pneumonia and breathlessness and fever. The therapist provides breathing retraining and helps to remove secretions and reduces acute respiratory distress like symptoms.

Dr. Sonia Pawaria
Assistant Professor
Faculty of Physiotherapy
SGT University

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Role of Physiotherapy in Women Health Care

Did you understand that there are Physiotherapists who focus on women’s health care? Sadly it’s a nicely kept secret and plenty of women only find out approximately these professional offerings after problems start occurring, after childbirth or after a referral from their doctors.

According to research statistics Indian consensus, almost 48.5% of the total population is females, with 48.1% stays in urban and 48.6% in rural areas. Due to current lifestyle or work-related issues illnesses are increasing in female population leading to a range of complex health issues like Knee arthritis, Back pain, Pregnancy-related complications, Pelvic floor dysfunction, Obesity, PCOD, Injury, Trauma or illness and the most important of all the lifestyle changes associated with the normal physiological process- middle and old age, Menstruation, Menopause, Osteoporosis significantly affects the women’s body at alarming hormonal changes. Most of the women assume that this is a normal process and they should adapt themselves accordingly and continue with their routines as very little can be done. In many instances, that is not the case. Many Government and private organizations have now become active in providing the women health by many awareness programs to rural as well as urban areas.

Physiotherapy defined as a treatment method that focuses on the science of movement and helps people to restore, maintain, and maximize their physical strength, function, motion, and overall well being by addressing various physical issues. Keeping women’s health care in mind Physiotherapy has added another horizon of achievement in its branches by playing a vital role in women’s health care.  It has increased its role in health care concerns with females across their life spans and has shown great results in all age groups showing benefits from the various rehabilitation programs.

Women’s Health Care Physiotherapy aims at the assessment and planned therapeutic treatment specific to various health problems affecting women of all age groups, with complete knowledge of the physiological differences and the impact of hormonal changes on their well being. Considering the various health concerns of women are as widespread as the role of women themselves in all phases of life and can include everyone from young athletes to postmenopausal women. Most women can attest that we are just built differently than men. From differences in hormones to the unique stresses from pregnancy, our bodies go through a lot in a lifetime.  A physiotherapist understands this and many will be surprised that a physio works with many female related disorders these are;

  • Urinary Incontinence
  • Pelvic floor dysfunction
  • Mensuration related disorders
  • Pre and Post pregnancy physiotherapy
  • Hyperthyroidism
  • PCOD
  • Obesity-related ailments like back pain or knee pain
  • Frequent Urination
  • Loss of bladder /bowel control when laughing or sneezing
  • Weakened core strength

A thorough assessment and well-designed exercise program by a physiotherapist is required to prevent these health issues in women across the life span. Numerous exercises and techniques to treat conditions specific to women like muscle training -improving muscle patterns and Strengthening weak pelvic floor muscles, Exercise therapy helping improve endurance, flexibility strength and mobility, Manual therapy focuses on soft tissue and joints mobility and Electrotherapy modalities like electrical stimulation, Therapeutic ultrasound, etc to reduce pain and stiffness.

Women Physiotherapy Health Care empowers women to recognize how their bodies work and take charge of their well being.”

Dr. Priyanka Rishi
Assistant Professor
Faculty of Physiotherapy
SGT University

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COPD – Role of Physiotherapy

Physical Therapy can help in curing the COPD patients

According to GOLD “Chronic Obstructive Pulmonary disease is a common, preventable and treatable disease and is characterized by persistent respiratory symptoms and airflow limitation. Approximately, 4 million deaths occurred in 1999 from tobacco and it is also estimated that the annual number of deaths is likely to increase to 10 million by the 2030s. Smoking gives a feeling of pleasure as the inhaled substances trigger chemical reactions in nerve endings in the brain, which are similar to naturally occurring substances like endorphins and dopamine.

Cigarettes constitute various harmful substances like Nicotine which leads to smoking causing various diseases like COPD (Chronic obstructive pulmonary disease). COPD describes progressive lung diseases including emphysema and chronic bronchitis. Other causes of COPD are occupational exposure, genetics, air pollution, or auto-immune disease. This may lead to wheezing, frequent coughing with or without sputum, increased breathlessness, reduced endurance of respiratory muscles, and tightness in the chest.

To diagnose COPD spirometry is a simple, non-invasive test that is used to diagnose COPD. It is a test to know how well your lungs work. People with COPD have an FEV1/FVC ratio of less than 70%. Chest X-ray, Arterial blood gas reports can also be used for diagnostic purposes. For managing COPD, bronchodilators, anti-inflammatory, antibiotics, supplemental oxygen, etc., are used.

Physiotherapy plays an important role in treating the symptom of COPD specially Dyspnea. Pulmonary rehabilitation programs are designed to improve lung function, reduce symptom severity, and improve quality of life. Therefore, therapeutic interventions are required to improve exercise ability and breathing by augmentation of respiratory muscle function.

The aim of breathing exercise interventions is to improve strength, endurance, and coordination of respiratory muscles. Breathing exercises are designed for the following:

  • To restrain the muscles of respiration
  • To mobilize secretions
  • To increase the effectiveness of coughing
  • To improve ventilation
  • Helps in spine correction
  • To improve chest mobility
  • To prevent impairments and promotes relaxation

Deep breathing exercises can reduce the work of breathing by decreasing the respiratory rate and relaxing accessory muscles. The strength and endurance of respiratory muscles can be improved by various breathing exercises such as Pursed-lip breathing, Diaphragmatic breathing, Glossopharyngeal breathing, and Costal breathing.

One of the most effective techniques viz. Inspiratory muscle training is also commonly used to treat the symptoms of dyspnea, it helps in strengthing of the muscles involved in inhaling and is recommended in combination with aerobic and limb strengthening exercises.  IMT improves inspiratory muscle strength and endurance, functional exercise capacity, dyspnea, and quality of life.

Muscle strength can be enhanced through three-dimensional spiral large scale resistive exercises using proprioceptive neuromuscular facilitation (PNF) indicated by a study which was conducted by Dietz. Chest PNF exercise is an effective and established treatment tool. It provides proprioceptive feedback to the respiratory muscles which create reflex respiratory movement responses and improves rate and depth of respiration.
Indications for Chest PNF are the following:

  • Breathing problems (inspiration or expiration)
  • Chest mobilization
  • Trunk and shoulder mobility
  • Active recuperation after exercise
  • Relief of pain
  • Relaxation
  • Decrease spasticity

Stretch reflex is used to facilitate the initiation of inhalation and Repeated Contractions are used to facilitate an increase in inspiratory volume. For breathing control, isotonic contractions are also useful. The patient should do breathing exercises in all positions which include:

  1. Supine
  2. Prone
  3. Side-lying
  4. Prone on elbows

Dr. Shivangi Sachdeva
MPT (Cardiopulmonary)

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