What types of interventions do physical therapists provide?Introduction Policy decisions about the use of physical therapy personnel and resources to manage patients/clients with impairments, functional limitations, and disabilities should be based on knowledge of the elements of the patient/client management that is provided by physical therapists. Fading to intervene appropriately to prevent illness -- and failing to habilitate or rehabilitate re·ha·bil·i·tate v. 1. To restore to good health or useful life, as through therapy and education. 2. To restore to good condition, operation, or capacity. patients/clients with impairments, functional limitations, and disabilities -- lead to greater costs at both the personal level and the societal level. The Guide provides administrators and policymakers with the information they need to make decisions about the cost-effectiveness of physical therapist intervention. Intervention is the purposeful and skilled interaction of the physical therapist with the patient/client -- and, when appropriate, with other individuals involved in care -- using various methods and techniques to produce changes in the condition that are consistent with the evaluation, diagnosis, and prognosis. Decisions are contingent on Adj. 1. contingent on - determined by conditions or circumstances that follow; "arms sales contingent on the approval of congress" contingent upon, dependant on, dependant upon, dependent on, dependent upon, depending on, contingent the timely monitoring of response to intervention In education, Response To Intervention (commonly abbreviated RTI or RtI) is a method of academic intervention that is designed to provide early, effective assistance to children who are having difficulty learning as part of the process of diagnosing learning disabilities. and the progress made toward anticipated goals and desired outcomes. Patient/client management provided by physical therapists includes ongoing examination, evaluation, and modification of the plan of care when necessary. The physical therapist selects interventions based on the complexity of the clinical problems. The plan of care includes discharge planning that begins early and that is based on anticipated goals and desired outcomes as determined by periodic reexamination re·ex·am·ine also re-ex·am·ine tr.v. re·ex·am·ined, re·ex·am·in·ing, re·ex·am·ines 1. To examine again or anew; review. 2. Law To question (a witness) again after cross-examination. . As soon as clinically appropriate, the patient/client is informed of the prognosis and begins, with the assistance of the physical therapist, long-range planning for managing any residual impairment, functional limitation, or disability. Through appropriate education and instruction, the patient/client is encouraged to develop health habits that will maintain or improve function, prevent recurrence of problems, and promote wellness. Physical therapist intervention encourages functional independence, emphasizes patient/client-related instruction, and promotes proactive, wellness-oriented lifestyles. Physical therapists actively facilitate the participation of the patient/client, family, significant others, and caregivers in the plan of care. Physical therapist intervention has three components: (1) coordination, communication, and documentation, (2) patient/client-related instruction, and (3) direct interventions (Fig. 1). Coordination, communication, and documentation and patient/client-related instruction are a part of all patient/client management. Direct interventions vary because they are selected, applied, or modified according to according to prep. 1. As stated or indicated by; on the authority of: according to historians. 2. In keeping with: according to instructions. 3. data and anticipated goals for a particular patient/client in a specific diagnostic group. An examination, evaluation, or intervention -- unless performed by a physical therapist -- is not physical therapy, nor should it be represented or reimbursed as such. Coordination, Communication, and Documentation Coordination, communication, and documentation are processes that ensure (1) appropriate, coordinated, comprehensive, and cost-effective services between admission and discharge and (2) cost-effective and efficient integration or reintegration reintegration /re·in·te·gra·tion/ (-in-te-gra´shun) 1. biological integration after a state of disruption. 2. restoration of harmonious mental function after disintegration of the personality in mental illness. into home, community, or work (job/school/play) environments. These processes involve collaborating and coordinating with agencies; coordinating and monitoring the delivery of available resources; coordinating data on transition; coordinating the patient/client management provided by the physical therapist; ensuring and facilitating access to health care services and resources and to appropriate community resources; facilitating the development of the discharge plan; facilitating timely delivery of available services; identifying current resources; providing information regarding the availability of advocacy services; obtaining informed consent; protecting patient/client rights through procedural safeguards and services,; providing information, consultation, and technical assistance; and providing oversight for outcomes data collection and analysis. Clinical indications Coordination, communication, and documentation are essential to all patient/client management. They are used to identify or quantify: * Comorbidities that may affect the plan of care, prognosis, or outcome * Discharge destinations * Impairment, functional limitation, or disability that will be the focus of the plan of care * Interventions used, including frequency and duration * Other interventions (eg, medications) that may affect outcomes * Progress toward anticipated goals, using appropriate tests and measures * Rehabilitation rehabilitation: see physical therapy. potential Documentation is required at the onset of and throughout each episode of care. Clinical documentation indicates, in order of sequence: * Modes of interventions selected and the parameters of application * Direct effects of each intervention in terms of impairment status (eg, change in level of pain, sensation, reflexes, strength, endurance, range and quality of joint movement) * Changes in functional limitation and disability, especially as they relate to meaningful, practical, and sustained change in the life of the patient/client. If pain reduction is a goal, for example, the outcome should be documented in terms of how the level of pain reduction relates to a change in functional performance. * Changes since previous intervention and any alteration in technique or intervention Documentation should follow APTA's Guidelines for Physical Therapy Documentation (Appendix 7). Anticipated Goals All benefits of coordination, communication, and documentation are measured in terms of remediation or prevention of impairment, functional limitation, or disability. Specific goals may include: * Accountability for services is increased. * Available resources are maximally utilized. * Care is coordinated with patient/client, family, significant others, caregivers, and other professionals. * Decision making is enhanced regarding the health of patient/client and use of health care resources by patient/client, family, significant others, and caregivers. * Other health care interventions (eg, medications) that may affect goals and outcomes are identified. * Patient/client, family, significant other, and caregiver understanding of expectations and goals and outcomes is increased. * Placement needs are determined. Specific Interventions Coordination, communication, and documentation services may include: * Case management * Communication (direct or indirect) * Coordination of care with the patient/client, family, significant others, caregivers, other professionals, and other interested persons (eg, rehabilitation counselor, Workers' Compensation workers' compensation, payment by employers for some part of the cost of injuries, or in some cases of occupational diseases, received by employees in the course of their work. claims manager, employer) * Discharge planning * Documentation of all elements of patient/client management * Education plans * Patient care conferences * Record reviews * Referrals to other professionals or resources Patient/Client-Related Instruction Patient/client-related instruction is the process of imparting information and developing skills to promote independence and to allow care to continue after discharge. Instruction should focus not only on the patient but on the family, significant others, and caregivers regarding the current condition, plan of care, and transition to roles at home, at work, or in the community, with the goal of ensuring (1) short-term and long-term adherence to the interventions and (2) primary and secondary prevention of future disability. The development of an instruction program should be consistent with the goals of the plan of care and may include information about the cause of the impairment, functional limitation, or disability; the prognosis; and the purposes and benefits and risks of the intervention. All instruction should take into consideration the influences of patient/client age, culture, gender roles, race, sex, sexual orientation sexual orientation n. The direction of one's sexual interest toward members of the same, opposite, or both sexes, especially a direction seen to be dictated by physiologic rather than sociologic forces. , and socioeconomic status socioeconomic status, n the position of an individual on a socio-economic scale that measures such factors as education, income, type of occupation, place of residence, and in some populations, ethnicity and religion. . Clinical indications A patient/client-related instruction program should be developed for all patients for whom physical therapy is indicated. A thorough examination must be performed to determine whether the cognitive status, physical status, and resource status of the patient/client would allow independent performance of a home program or whether family, significant other, or caregiver assistance is required. When family, significant others, or caregivers -- including home health aides -- are required to assist the patient/client with intervention procedures, they must be given instruction. Anticipated Goals All benefits of patient/client-related instruction programs are measured in terms of remediation or prevention of impairment, functional limitation, or disability. Specific goals may include: * Ability to perform physical tasks is increased. * Awareness and use of community resources are improved. * Behaviors that foster healthy habits healthy habit Good habit, see there , wellness, and prevention are acquired. * Decision making is enhanced regarding health of patient/client and use of health care resources by patient/client, family, significant others, and caregivers. * Disability associated with acute or chronic illnesses is reduced. * Functional independence in activities of daily living (ADL) and instrumental activities of daily living instrumental activities of daily living A series of life functions necessary for maintaining a person's immediate environment–eg, obtaining food, cooking, laundering, housecleaning, managing one's medications, phone use; IADL measures a (IADL IADL Instrumental activities of daily living, see there ) is increased. * Intensity of care is decreased. * Level of supervision required for task performance is decreased. * Patient/client, family, significant other, and caregiver knowledge and awareness of the diagnosis, prognosis, interventions, and goals and outcomes are increased. * Patient/client knowledge of personal and environmental factors associated with the condition is increased. * Performance levels in employment, recreational, or leisure activities are improved. * Physical function and health status are improved. * Progress is enhanced through the participation of patient/client, family, significant others, and caregivers. * Risk of recurrence of condition is reduced. * Risk of secondary impairments is reduced. * Safety of patient/client, family, significant others, and caregivers is improved. * Self-management of symptoms is increased. * Utilization and cost of health care services are decreased. Interventions Activities to be included in the development of a patient/client-related instruction program may include: * Computer-assisted instruction computer-assisted instruction Use of instructional material presented by a computer. Since the advent of microcomputers in the 1970s, computer use in schools has become widespread, from primary schools through the university level and in some preschool programs. * Demonstration by patient/client or caregivers in the appropriate environment * Periodic reexamination and reassessment of the home program * Use of audiovisual aids for both teaching and home reference * Use of demonstration and modeling for teaching * Verbal instruction * Written or pictorial instruction Direct Interventions The physical therapist selects, applies, or modifies one or more direct interventions (Fig. 1) based on anticipated goals that are discussed with the patient/client and that relate to specific impairments, functional limitations, and disabilities. Three of the direct interventions -- therapeutic exercise, functional training in self-care and home management, and functional training in community and work (job/school/play) integration or reintegration -- form the core elements of most physical therapy plans of care. Plans of care frequently may include the use of other interventions to augment therapeutic exercise and functional training. The use of any intervention, unless performed by, a physical therapist or under the direction and supervision of a physical therapist, is not physical therapy, nor should it be represented or reimbursed as such. The physical therapist's selection of any direct intervention should be supported by the following: * Examination findings (including those of the history, systems review, and tests and measures), evaluation, and a diagnosis that supports physical therapist intervention * Prognosis that is associated with improved or maintained health status through the remediation of impairment, functional limitation, or disability * A plan of care designed to improve function through the use of interventions of appropriate intensity, frequency and duration to achieve specific anticipated goals efficiently with available resources Physical therapists select interventions based on the data gathered during the examination process and based on anticipated goals and desired outcomes. Factors that influence the complexity of both the evaluation process and the intervention may include the following: chronicity or severity of current condition; level of current impairment and probability of prolonged impairment, functional limitation, or disability; living environment; multisite or multisystem involvement; overall physical function and health status; potential discharge destinations; preexisting pre·ex·ist or pre-ex·ist v. pre·ex·ist·ed, pre·ex·ist·ing, pre·ex·ists v.tr. To exist before (something); precede: Dinosaurs preexisted humans. v.intr. systemic conditions or diseases; social supports; and stability of the condition. Through routine monitoring and reexamination, the physical therapist determines the need for any alteration in an intervention or in the plan of care. The interventions used, including their frequency and duration, are consistent with patient/client needs and physiologic and cognitive status, anticipated goals, and resource constraints. The independent performance of the procedure or technique by the patient/client (or significant other, family, or caregiver) is encouraged following instruction in safe and effective application. Discontinuation dis·con·tin·u·a·tion n. A cessation; a discontinuance. Noun 1. discontinuation - the act of discontinuing or breaking off; an interruption (temporary or permanent) discontinuance of an intervention may be indicated because of lack of progress, lack of tolerance, lack of motivation, attainment of optimal improvement or achievement of other desired outcomes, or determination of a more effective alternative. In the following pages, each type of direct intervention is described. Included are general criteria for appropriate use of the intervention; possible methods, procedures, or techniques; and anticipated goals. Direct INterventions Therapeutic Exercise including Aerobic Conditioning Aerobic conditioning is a process whereby one trains the heart to pump blood more efficiently, allowing more oxygen to get to muscles and organs. Aerobic conditioning is used to train people to perform better while doing something for a long period of time, running a mile ) Therapeutic exercise includes a broad group of activities intended to improve strength, range of motion (ROM) (including muscle length), endurance, breathing, balance, coordination, posture, motor function (motor control and motor learning), motor development, or confidence when any of a variety of problems constrains the ability to perform a functional activity. The physical therapist targets problems with performance of a movement or task and specifically directs therapeutic exercise to alleviate impairment, functional limitation, or disability. Therapeutic exercise includes activities to improve physical function and health status (or reduce or prevent disability) resulting from impairments by identifying specific performance goals that will allow patients/clients to achieve a higher functional level in the home, school, workplace, or community. Also included: activities that allow well clients to improve or maintain their health or performance status (for work, recreational, or sports purposes) and prevent or minimize future potential health problems. Therapeutic exercise also is a part of fitness and wellness programs designed to promote overall well-being or, in general, to prevent complications related to inactivity or overuse overuse Health care The common use of a particular intervention even when the benefits of the intervention don't justify the potential harm or cost–eg, prescribing antibiotics for a probable viral URI. Cf Misuse, Underuse. . The intervention may be used during pregnancy and the postpartum period The postpartum period is the period consisting of the months or weeks immediately after childbirth or delivery. Importance to health The postpartum period is when the woman adjusts, both physically and psychologically, to the process of childbearing. to improve function and reduce stress. it also may be used (with proper guidance) in patients with hematologic hematological, hematologic pertaining to or emanating from blood cells. hematological tests total and differential white cell counts, hematocrit estimation, erythrocyte count. and oncologic disorders to combat fatigue com·bat fatigue n. Posttraumatic stress disorder resulting from wartime combat or similar experiences. No longer in scientific use. Also called battle fatigue, shell shock. and systemic breakdowns. Therapeutic exercise may prevent further complications and decrease utilization of health care resources before, during, and after surgery or hospitalization hospitalization /hos·pi·tal·iza·tion/ (hos?pi-t'l-i-za´shun) 1. the placing of a patient in a hospital for treatment. 2. the term of confinement in a hospital. . Therapeutic exercise is performed actively, passively, or against resistance. When the patient/client cannot participate actively due to weakness or other problems, passive exercise may be necessary. Resistance may be provided manually, by gravity, or through use of a weighted apparatus or of mechanical or electromechanical devices. Aquatic physical therapy uses the physical and hydrodynamic hy·dro·dy·nam·ic also hy·dro·dy·nam·i·cal adj. 1. Of or relating to hydrodynamics. 2. Of, relating to, or operated by the force of liquid in motion. properties of water to facilitate performance. Clinical indications Before applying therapeutic exercise, a thorough examination is performed to identify those patients/clients for whom therapeutic exercise would be contraindicated or for whom therapeutic exercise must be applied with caution. Candidates for therapeutic exercise include patients/clients who: * Are at risk of postsurgical complications * Are at risk of developing or have developed impairment, functional limitation, or disability as a result of defects in the following body systems: - cardiovascular - endocrine/metabolic - genitourinary genitourinary /gen·i·to·uri·nary/ (jen?i-to-u´ri-nar-e) pertaining to the genital and urinary organs. gen·i·to·u·ri·nar·y adj. Abbr. - integumentary integumentary /in·teg·u·men·ta·ry/ (in-teg?u-men´te-re) 1. pertaining to or composed of skin. 2. serving as a covering. integumentary 1. pertaining to or composed of skin. 2. - lymphatic lymphatic /lym·phat·ic/ (lim-fat´ik) 1. pertaining to lymph or to a lymphatic vessel. 2. a lymphatic vessel. lym·phat·ic adj. - musculoskeletal musculoskeletal /mus·cu·lo·skel·e·tal/ (-skel´e-t'l) pertaining to or comprising the skeleton and muscles. mus·cu·lo·skel·e·tal adj. Relating to or involving the muscles and the skeleton. - neuromuscular neuromuscular /neu·ro·mus·cu·lar/ (-mus´ku-ler) pertaining to nerves and muscles, or to the relationship between them. neu·ro·mus·cu·lar adj. 1. - pulmonary * Engage in recreational, organized amateur, or professional athletics * Are prepartum or postpartum postpartum /post·par·tum/ (post-pahr´tum) occurring after childbirth, with reference to the mother. post·par·tum adj. Of or occurring in the period shortly after childbirth. * Are restricted from performing necessary self-care, home management, community and work (job/school /play) integration or reintegration, and leisure tasks, movements, or activities Anticipated Goals All benefits of therapeutic exercise are measured in terms of remediation or prevention of impairment, functional limitation, or disability. Specific goals related to therapeutic exercise may include: * Ability to performing physical tasks related to self-care, home management, community and work (job/ school/ play) integration or reintegration, or leisure activities is increased. * Aerobic capacity is increased. * Airway clearance is improved. * Atelectasis atelectasis or lung collapse Lack of expansion of pulmonary alveoli (see pulmonary alveolus). With a large-enough collapsed area, the victim stops breathing. is decreased. * Balance is improved. * Endurance is increased. * Energy expenditure is decreased. * Gait, locomotion locomotion Any of various animal movements that result in progression from one place to another. Locomotion is classified as either appendicular (accomplished by special appendages) or axial (achieved by changing the body shape). , and balance are improved. * Intensity of care is decreased. * Joint integrity and mobility are improved. * Joint and soft tissue swelling, inflammation, or restriction is reduced. * Level of supervision required for task performance is decreased. * Motor function (motor control and motor learning) is improved. * Muscle performance is increased. * Need for assistive, adaptive, orthotic orthotic /or·thot·ic/ (or-thot´ik) serving to protect or to restore or improve function; pertaining to the use or application of an orthosis. or·thot·ic adj. Of or relating to orthotics. , protective, or supportive equipment and devices is decreased. * Nutrient delivery to tissue is increased. * Osteogenic osteogenic /os·te·o·gen·ic/ (-jen´ik) derived from or composed of any tissue concerned in bone growth or repair. os·te·o·gen·ic or os·te·o·ge·net·ic adj. effects of exercise are maximized. * Pain is decreased. * Performance of and independence in activities of daily living (ADL) and instrumental activities of daily living (IKDL) are increased. * Physical function and health status are improved. * Physiologic response to increased oxygen demand is improved. * Postural control is improved. * Preoperative pre·op·er·a·tive adj. Preceding a surgical operation. preoperative preceding an operation. preoperative care the preparation of a patient before operation. and postoperative complications postoperative complications, n.pl unexpected problems that arise following surgery. The most frequent are bleeding, infection, and protracted pain. are reduced. * Quality and quantity of movement between and across body segments are improved. * Risk factors are reduced. * Risk of recurrence of condition is reduced. * Risk of secondary impairment is reduced. * Safety is improved. * Self-management of symptoms is improved. * Sense of well-being is improved. * Sensory awareness Sensory awareness Bringing attention to the sensations of tension and/or release in the muscles. Mentioned in: Alexander Technique is increased. * Strength, power, and endurance are increased. * Stress is decreased. * Symptoms associated with increased oxygen demand are decreased. * Tissue perfusion perfusion /per·fu·sion/ (-zhun) 1. the act of pouring over or through, especially the passage of a fluid through the vessels of a specific organ. 2. a liquid poured over or through an organ or tissue. and oxygenation oxygenation /ox·y·gen·a·tion/ (ok?si-je-na´shun) 1. the act or process of adding oxygen. 2. the result of having oxygen added. are enhanced. * Tolerance to positions and activities is increased. * Utilization and cost of health care services are decreased. * Weight-bearing status is improved. * Work of breathing is decreased. Specific Direct interventions Therapeutic exercise may include: * Aerobic endurance activities using ergometers, treadmills, steppers, pulleys, weights, hydraulics hydraulics, branch of engineering concerned mainly with moving liquids. The term is applied commonly to the study of the mechanical properties of water, other liquids, and even gases when the effects of compressibility are small. , elastic resistance bands, robotics, and mechanical or electromechanical devices * Aquatic exercises * Balance and coordination training * Body mechanics body mechanics n. The application of kinesiology to the use of proper body movement in daily activities, to the prevention and correction of problems associated with posture, and to the enhancement of coordination and endurance. and ergonomics ergonomics, the engineering science concerned with the physical and psychological relationship between machines and the people who use them. The ergonomicist takes an empirical approach to the study of human-machine interactions. training * Breathing exercises and ventilatory ventilatory /ven·ti·la·to·ry/ (-lah-tor?e) pertaining to ventilation. ventilatory pertaining to or emanating from pulmonary ventilation. muscle training * Breathing strategies (eg, paced breathing, pursed-lip breathing) * Conditioning and reconditioning (including ambulation am·bu·late intr.v. am·bu·lat·ed, am·bu·lat·ing, am·bu·lates To walk from place to place; move about. [Latin ambul activities with manual resuscitator resuscitator (rĭsŭs`ĭtā'tər), device used to revive a person whose normal breathing has been disrupted. Several types are in wide use. bag or portable ventilator ventilator /ven·ti·la·tor/ (ven´ti-la-tor) 1. an apparatus for qualifying the air breathed through it. 2. a device for giving artificial respiration or aiding in pulmonary ventilation. * Developmental activities training * Gait, locomotion, and balance training * Motor function (motor control and motor learning) training or retraining re·train tr. & intr.v. re·trained, re·train·ing, re·trains To train or undergo training again. re·train * Neuromuscular education or reeducation Reeducation may refer to:
* Neuromuscular relaxation, inhibition, and facilitation Facilitation The process of providing a market for a security. Normally, this refers to bids and offers made for large blocks of securities, such as those traded by institutions. * Perceptual training * Posture awareness training * Sensory training or retraining * Strengthening: - active - active assistive - resistive resistive /re·sis·tive/ (re-zis´tiv) pertaining to or characterized by resistance. , using manual resistance, pulleys, weights, hydraulics, elastic resistance bands, robotics, and mechanical or electromechanical The use of electricity to run moving parts. Disk drives, printers and motors are examples. Electromechanical systems must be designed for the eventual deterioration of moving components that wear over time. The first TVs were electromechanical systems (see video/TV history). devices * Stretching * Structured play or leisure activities Functional Training in Self-care and Home Management (Including Activities of Daily Living and instrumental Activities of Daily Living) Functional training in self-care and home management includes a broad group of performance activities designed to (1) enhance neuromusculoskeletal, cardiovascular, and pulmonary capacities and (2) integrate or return the patient/client to self-care or home management as quickly and efficiently as possible. Functional training is used to improve the physical function and health status of patients/clients with physical disability, impaired sensorimotor sensorimotor /sen·so·ri·mo·tor/ (sen?sor-e-mo´ter) both sensory and motor. sen·so·ri·mo·tor adj. Of, relating to, or combining the functions of the sensory and motor activities. function, pain, injury, or disease. Functional training also is used for well clients. It frequently is based on activities associated with growth and development. The physical therapist targets problems with performing a movement or task and specifically directs the functional training to alleviate impairment, functional limitation, and disability. The physical therapist may select from a number of options, including training in the following: activities of daily living (ADL); instrumental activities of daily living (IADL); body mechanics; therapeutic exercise; and use of therapeutic assistive, adaptive, orthotic, protective, supportive, or prosthetic pros·thet·ic adj. 1. Serving as or relating to a prosthesis. 2. Of or relating to prosthetics. prosthetic serving as a substitute; pertaining to prostheses or to prosthetics. devices or equipment. Organized functional training programs such as back schools also may be selected. Clinical indications Before applying functional training, a thorough examination is performed to identify those patients/clients for whom functional training in self-care and home management would be contraindicated or for whom functional training in self-care and home management must be applied with caution. Candidates for functional training in self-care and home management include patients/clients who: * Are at risk of developing or have developed impairment, functional limitation, or disability as a result of defects in the following body systems: - cardiovascular - endocrine/metabolic - genitourinary - integumentary - lymphatic - musculoskeletal - neuromuscular - pulmonary * Are at risk of developing or have developed impairment, functional limitation, or disability as a result of surgical complications * Are restricted from performing necessary self-care, home management, community, or work job/school/play) integration or reintegration, or leisure tasks, movements, or activities Anticipated Goals All benefits of functional training in self-care and home management ate measured in terms of remediation or prevention of impairment, functional limitation, and disability. Specific goals related to functional training in self-care and home management may include: * Ability to perform physical tasks related to self-care and home management (including ADL and IADL) is increased. * Ability to recognize a recurrence is increased, and intervention is sought in a timely manner. * Intensity of care is decreased. * Performance of and independence in * ADL and IADL are increased. * Level of supervision required for task performance is decreased. * Risk of recurrence of condition is reduced. * Safety is improved during performance of self-care and home management tasks and activities. * Sense of well-being is improved. * Tolerance to positions and activities is increased. * Utilization and cost of health care services are decreased. Specific Direct interventions Functional training activities may include: * ADL training (eg, bed mobility and transfer training, gait training The introduction to this article provides insufficient context for those unfamiliar with the subject matter. Please help [ improve the introduction] to meet Wikipedia's layout standards. You can discuss the issue on the talk page. , locomotion, developmental activity, dressing, grooming, bathing, eating, toileting) * Assistive and adaptive device or equipment training * IADL training (eg, maintaining a home, shopping, cooking, home chores, heavy household chores, money management, driving a car or using public transportation, structured play for infants and children) * Injury prevention or reduction training * Organized functional training programs (eg, simulated environments and tasks) * Orthotic, protective, or supportive device or equipment training * Prosthetic device or equipment training * Self-care or home management task adaptation Functional Training in Community and Work (Job/school/play) integration or Reintegration (Including instrumental Activities of Daily Living, Work Hardening work hardening n. The increase in strength that accompanies plastic deformation of a metal. , and Work Conditioning work conditioning Work hardening Occupational medicine A rehabilitation program that prepares a client for return to work through conditioning to improve biomechanical, neuromuscular, cardiovascular and metabolic functions of a worker, with real or simulated work ) Functional training in community and work job/school/play) integration or reintegration includes a broad group of activities designed to integrate or to return the patient/client to community, work job/school/play), or leisure activities as quickly and efficiently as possible. It involves improving physiologic capacities to facilitate the fulfillment of community- and work-related roles. Functional training is used to improve the physical function and health status of patients/clients with physical disability, impaired sensorimotor function, pain, injury, or disease; it also is used for well individuals. It frequently is based on activities associated with growth and development. The physical therapist targets the problems in performance of movements, community activities, work tasks, or leisure activities and specifically directs the functional training to enable return to the community, work, or leisure environment. A variety of approaches may be taken, depending on patient/client needs; for example, the physical therapist may provide training in instrumental activities of daily living (IADL) to a patient/client who needs to live more independently, and body mechanics and posture awareness training to a patient/client who is deficient in those areas. Work hardening and work conditioning are specialized functional training programs designed to reduce the impairment, functional limitation, or disability associated with work-related injuries. Clinical indications Before applying functional training in community and work (job/school/play) integration or reintegration, a thorough examination is performed to identify those patients/clients for whom functional training would be contraindicated or for whom functional training must be applied with caution. Candidates for functional training in community and work (job/school/play) integration or reintegration include patients/clients who: * Are at risk of developing or have developed impairment, functional limitation, or disability as a result of defects in the following body systems: - cardiovascular - endocrine/metabolic - genitourinary - integumentary - lymphatic - musculoskeletal - neuromuscular - pulmonary * Are at risk of developing or have developed impairment, functional limitation, or disability as a result of surgical complications * Are engaged in recreational, organized amateur, or professional athletics * Are restricted from performing necessary self-care, home management, community or work (job/school/play) integration or reintegration, or leisure tasks, movements, or activities * Have a known work-related injury, impairment, functional limitation, or disability Anticipated Goals All benefits of functional training in community and work (job/school/play) reintegration and leisure activities are measured in terms of remediation or prevention of impairment, functional limitation, and disability. Specific goals related to functional training in community and work (job/ school/play) integration or reintegration and leisure activities may include: * Ability to perform physical tasks related to community and work (job/school/play) integration or reintegration and leisure tasks, movements, or activities is increased. * Costs of work-related injury or disability are reduced. * Intensity of care is decreased. * Level of supervision required for task performance is decreased. * Performance of and independence in ADL and IADL are increased. * Risk of recurrence of condition is reduced. * Safety is improved during performance of community, work (job/ school/play), and leisure tasks and activities. * Tolerance to positions and activities is increased. * Sense of well-being is improved. * Utilization and cost of health care services are decreased. Specific Direct interventions Functional training activities in community and work integration or reintegration may include: * Assistive and adaptive device or equipment training * Environmental, community, work job/school/play), or leisure task adaptation * Ergonomic ergonomic - Concerning ergonomics or exhibitting good ergonimics. stressor reduction training * Injury prevention or reduction training * IADL training (eg, shopping, cooking, home chores, heavy household chores, money management, structured play for infants and children, negotiating school environments) job coaching job simulation * Leisure and play activity training * Organized functional training programs (eg, back schools, simulated environments and tasks) * Orthotic, protective, or supportive device or equipment training * Prosthetic device or equipment training Manual Therapy Techniques (Including Mobilization and Manipulation) Manual therapy techniques consist of a broad group of passive interventions in which physical therapists use their hands to administer skilled movements designed to modulate To insert a data signal into a carrier wave or direct current. See modulation. pain; increase joint range of motion (ROM); reduce or eliminate soft tissue swelling, inflammation, or restriction; induce relaxation; improve contractile contractile /con·trac·tile/ (kon-trak´til) able to contract in response to a suitable stimulus. con·trac·tile adj. Capable of contracting or causing contraction, as a tissue. and noncontractile tissue extensibility; and improve pulmonary function. These interventions involve a variety of techniques, such as the application of graded forces. Physical therapists use manual therapy techniques to improve physical function and health status (or reduce or prevent disability) resulting from impairments by identifying specific performance goals that allow patients/clients to achieve a higher functional level in self-care, home management, community and work (job/school/play) integration or reintegration, or leisure tasks and activities. Clinical Indications Before applying manual therapy techniques, a thorough examination is performed to identify those patients/clients for whom manual therapy would be contraindicated or for whom manual therapy must be applied with caution. Candidates for manual therapy include patients/ clients with: * Limited ROM * Muscle spasm muscle spasm n. Persistent increased tension and shortness in a muscle or group of muscles that cannot be released voluntarily. muscle spasm, n * Pain * Scar tissue scar tissue n. Dense, fibrous connective tissue that forms over a healed wound or cut. or contracted tissue * Soft tissue swelling, inflammation, or restriction Anticipated Goals All benefits of manual therapy techniques are measured in terms of a remediation or prevention of impairment, functional limitation, and disability. Specific goals related to manual therapy techniques may include: * Ability to perform movement tasks is increased. * Edema edema (ĭdē`mə), abnormal accumulation of fluid in the body tissues or in the body cavities causing swelling or distention of the affected parts. , lymphedema, or effusion effusion /ef·fu·sion/ (e-fu´zhun) 1. escape of a fluid into a part; exudation or transudation. 2. effused material; an exudate or transudate. is decreased. * Integumentary integrity is improved. * joint integrity and mobility are improved. * Motor function (motor control and motor learning) is improved. * Muscle spasm is reduced. * Pain is decreased. * Quality and quantity of movement between and across body segments are improved. * Risk of secondary impairment is reduced. * Soft tissue swelling, inflammation, or restriction is reduced. * Tolerance to positions and activities is increased. * Utilization and cost of health care services are decreased. * Ventilation, respiration respiration, process by which an organism exchanges gases with its environment. The term now refers to the overall process by which oxygen is abstracted from air and is transported to the cells for the oxidation of organic molecules while carbon dioxide (CO (gas exchange), and circulation are increased. Specific Direct Interventions Manual therapy techniques may include: * Connective connective - An operator used in logic to combine two logical formulas. See first order logic. tissue massage * Joint mobilization joint mobilization Osteopathy The passive movement of joints over their entire ROM, to expand the ROM and eliminate restrictions. See Osteopathy. and manipulation * Manual lymphatic drainage Manual lymphatic drainage (MLD) is a type of gentle massage which is believed by proponents to encourage the natural circulation of the lymph through the body. The lymph system depends on peristalsis and the movement of skeletal muscles to squeeze fluid through lymph ducts and * Manual traction * Passive ROM * Soft tissue mobilization and manipulation * Therapeutic massage Prescription, Application, and, as Appropriate, Fabrication fabrication (fab´rikā´sh  n),n the construction or making of a restoration. of Devices and Equipment (Assistive, Adaptive, Orthotic, Protective, Supportive, and Prosthetic) Prescription, application, and, as appropriate, fabrication of assistive, adaptive, orthotic, protective, supportive, and prosthetic devices and equipment include the use of a broad group of therapeutic appliances, implements, devices, and equipment to enhance performance of tasks or movements, support weak or ineffective joints or muscles, protect body parts from injury, and adapt the environment to facilitate activities of daily living (IADL) and instrumental activities of daily living (IADL). These devices and equipment often are used in conjunction with therapeutic exercise, functional training, work conditioning and work hardening, and other interventions and should be selected in the context of patient/client needs and social and cultural environments. The physical therapist targets the problems in performance of movements or tasks and selects (or fabricates) the most appropriate device or equipment, then fits it and trains the patient/client in its use and application. The goal is for the patient/client to function at a higher level and to decrease functional limitation. Clinical indications Before prescribing, applying, or, as appropriate, fabricating any device or equipment, a thorough examination is performed to identify those patients/clients for whom these devices and equipment would be contraindicated or for whom these therapeutic devices and equipment must be applied with caution. Candidates for these therapeutic devices and equipment include patients/clients who: * Are at risk of developing impairment, functional limitation, or disability as a result of defects in the following body systems: - cardiovascular - endocrine/metabolic - genitourinary - integumentary - lymphatic - musculoskeletal - neuromuscular - pulmonary * Are engaged in recreational, organized amateur, or professional athletics * Are restricted from performing necessary self-care, home management, community and work (job/school/play) integration or reintegration, and leisure tasks, movements, and activities Anticipated Goals All benefits of these therapeutic devices and equipment are measured in terms of remediation or prevention of impairment, functional limitation, and disability. Specific goals related to the prescription, application, and, as appropriate, fabrication of assistive, adaptive, orthotic, protective, supportive, and prosthetic devices and equipment may include: * Ability to perform physical tasks is increased. * Deformities are prevented. * Gait, locomotion, and balance are improved. * Independence in bed mobility, transfers, and gait is maximized. * Edema or effusion is reduced. * Intensity of care is decreased. * Joint integrity and mobility are improved. * Joint stability is increased. * Level of supervision required for task performance is decreased. * Loading on a body part is decreased. * Motor function (motor control and motor learning) is increased. * Optimal joint alignment is achieved. * Functional status is maintained while awaiting recovery. * Pain is decreased. * Performance of and independence in ADL and IADL are increased. * Physical function and health status are improved. * Pressure areas (eg, pressure over bony prominence) are prevented. * Prosthetic fit is achieved. * Protection of body parts is increased. * Risk of secondary impairments is reduced. * Safety is improved. * Sense of well-being is improved. * Soft tissue swelling, inflammation, or restriction is reduced. * Stresses precipitating injury are decreased. * Tolerance to positions and activities is increased. * Utilization and cost of health care services are decreased. * Weight-bearing status is improved. Specific Direct Interventions The selection of these therapeutic devices and equipment may include the prescription, application, and, as appropriate, fabrication of: * Adaptive devices (eg, raised toilet seats, seating systems, hospital beds, environmental controls) * Assistive devices assistive device Public health Any device designed or adapted to help people with physical or emotional disorders to perform actions, tasks, and activities. See Americans with Disabilities Act, Architectural barriers, Assistive technology. (eg, crutches, canes, walkers, wheel-chairs, power devices, long-handled reachers, static and dynamic splints dynamic splint n. A splint that aids in initiating and performing movements by controlling the plane and range of motion of the injured part. Also called active splint, functional splint. ) * Orthotic devices (eg, splints splints inflammation of the interosseous ligament between the small and large metacarpal bones of horses and an accompanying periostitis and exostosis production on the small metacarpal bone. The metatarsal bones are similarly but less frequently involved. , braces, shoe inserts, casts) * Prosthetic devices (eg, artificial limbs) * Protective devices (eg, braces, protective taping, cushions, helmets) * Supportive devices (eg, supportive taping, compression garments, corsets, slings, neck collars, serial casts, elastic wraps, oxygen) Airway Clearance Techniques Airway clearance techniques include a broad group of activities used to manage or prevent consequences of acute and chronic lung diseases lung disease Pulmonary disease Pulmonology Any condition causing or indicating impaired lung function Types of LD Obstructive lung disease–↓ in air flow caused by a narrowing or blockage of airways–eg, asthma, emphysema, chronic bronchitis; and impairment, including those associated with surgery. Airway clearance techniques may be used with therapeutic exercise, manual therapy techniques, or mechanical modalities Modalities The factors and circumstances that cause a patient's symptoms to improve or worsen, including weather, time of day, effects of food, and similar factors. to improve pulmonary function. The physical therapist performs airway clearance techniques to improve physical function and health status (or reduce or prevent disability) resulting from impairments, functional limitations, and disabilities by identifying specific performance goals that allow the patient/client to achieve a higher functional level in home management, community and work (job/school/play) integration or reintegration, and leisure movements, tasks, and activities. Clinical Indications Before applying airway clearance techniques, a thorough examination is performed to identify those patients/clients for whom these techniques would be contraindicated or for whom these techniques must be applied with caution. Candidates for airway clearance techniques include patients/clients who: * Are at risk for postsurgical complications * Are restricted from performing necessary self-care, home management; community and work (job/school/ play) integration and reintegration and leisure tasks, movements, and activities * Have altered breathing patterns * Have impaired airway clearance * Have impaired gas exchange * Have impaired ventilatory pump * Are at risk of developing impairment, functional limitation, or disability as a result of defects in the following body systems: - cardiovascular - endocrine/metabolic - musculoskeletal - neuromuscular - pulmonary Anticipated Goals All benefits of airway clearance techniques are measured in terms of a remediation or prevention of impairment, functional limitation, and disability. Specific goals related to airway clearance techniques may include: * Airway clearance is improved. * Cough is improved. * Exercise tolerance is improved. * Independence in self-care for airway clearance techniques is increased. * Need for an assistive device (mechanical ventilation mechanical ventilation n. A mode of assisted or controlled ventilation using mechanical devices that cycle automatically to generate airway pressure. ) is decreased. * Physical function and health status are improved. * Risk of secondary complications is reduced. * Risk of recurrence of condition is reduced. * Utilization and cost of health care services are decreased. * Ventilation, respiration (gas exchange), and circulation are improved. * Work of breathing is decreased. Specific Direct Interventions Airway clearance techniques may include: * Active cycle of breathing or forced expiratory ex·pi·ra·to·ry adj. Of, relating to, or involving the expiration of air from the lungs. expiratory relating to or employed in the expiration of air from the lungs. techniques * Assistive cough techniques * Assistive devices for airway clearance (eg, flutter valve The introduction to this article provides insufficient context for those unfamiliar with the subject matter. Please help [ improve the introduction] to meet Wikipedia's layout standards. You can discuss the issue on the talk page. ) * Autogenic au·tog·e·nous also au·to·gen·ic adj. 1. Produced from within; self-generating. 2. Medicine Originating with the individual to which applied: an autogenous graft; an autogenous vaccine. drainage * Breathing strategies (eg, paced breathing, pursed-lip breathing) * Chest percussion, vibration, and shaking * Pulmonary postural drainage postural drainage n. A therapeutic technique for drainage, used in bronchiectasis and lung abscess, in which the patient is placed head downward so that the trachea is down and below the affected area. and positioning * Suctioning suctioning removal of material through the use of negative pressure, as in suctioning an operative wound during and after surgery to remove exudates. * Techniques to maximize ventilation (eg, maximum inspiratory in·spi·ra·to·ry adj. Of, relating to, or used for the drawing in of air. inspiratory pertaining to or used in the inspiration of air into the lungs. hold, staircase breathing, manual hyper-inflation) Wound Management Wound management includes procedures used to achieve a clean wound bed, promote a moist wound environment, facilitate autolytic au·tol·y·sis n. The destruction of tissues or cells of an organism by the action of substances, such as enzymes, that are produced within the organism. Also called self-digestion. debridement Debridement Definition Debridement is the process of removing nonliving tissue from pressure ulcers, burns, and other wounds. Purpose Debridement speeds the healing of pressure ulcers, burns, and other wounds. , absorb excessive exudate exudate /ex·u·date/ (eks´u-dat) a fluid with a high content of protein and cellular debris which has escaped from blood vessels and has been deposited in tissues or on tissue surfaces, usually as a result of inflammation. from a wound complex, and enhance perfusion and oxygen and nutrient delivery to tissues in addition to management of the resulting scar. As a component of wound management, debridement is a therapeutic procedure involving removal of nonviable nonviable /non·vi·a·ble/ (-vi´ah-b'l) not capable of living. non·vi·a·ble adj. Not capable of living or developing independently. Used especially of an embryo or fetus. tissue from a wound bed, most often by the use of instruments, autolysis autolysis /au·tol·y·sis/ (aw-tol´i-sis) 1. spontaneous disintegration of cells or tissues by autologous enzymes, as occurs after death and in some pathologic conditions. 2. , therapeutic modalities therapeutic modality, n an intervention used to heal someone. See model, biomedical and homeopathy. , or enzymes. The desired effects The damage or casualties to the enemy or materiel that a commander desires to achieve from a nuclear weapon detonation. Damage effects on materiel are classified as light, moderate, or severe. Casualty effects on personnel may be immediate, prompt, or delayed. of wound management may be achieved in a variety of ways. The physical therapist may use physical agents, electrotherapeutic and mechanical modalities, dressings, topical agents, debridement, and oxygen therapy as part of a plan of care to alter the function of tissues and organ systems required for repair. Wound management interventions are used directly by the physical therapist, based on patient/client needs and the direct physiological effects that are required. Clinical Indications Before applying wound management techniques, a thorough examination is performed to identify those patients/ clients for whom these interventions would be contraindicated or for whom the interventions must be applied with caution. Candidates for wound management include patients/clients with: * Exuding wounds or reepithelialization or connective tissue repair or both * Full- or partial-thickness skin involvement * Nonviable tissue * Signs of inflammation Anticipated Goals All benefits of wound management are measured in terms of remediation or prevention of impairments, functional limitations, and disability. Specific goals related to wound management may include: * Complications are reduced. * Debridement of nonviable tissue is achieved. * Physical function and health status are improved. * Risk factors for infection are reduced. * Risk of secondary impairments is reduced. * Tissue perfusion and oxygenation are enhanced. * Utilization and cost of health care services are decreased. * Wound and soft tissue healing is enhanced. * Wound size is reduced. Specific Direct Interventions Methods of wound management may include: * Assistive and adaptive devices * Debridement -- nonselective - enzymatic debridement - wet dressings - wet-to-dry dressings - wet-to-moist dressings * Debridement -- selective - enzymatic debridement - sharp debridement - debridement with other agents (eg, autolysis) * Dressings (eg, wound coverings, hydrogels, vacuum-assisted closure) * Electrotherapeutic Modalities, (see Electrotherapeutic Modalities, page 3-13) * Orthotic, protective, and supportive devices * Oxygen therapy (eg, topical, supplemental) * Physical agents and mechanical modalities (see Physical Agents and Mechanical Modalities, page 3-14) * Topical agents (eg, ointments ointments, n.pl semisolid, non–water-based treatments that are not water-soluble and that create protective films to prevent dehydration of the skin. , moisturizers moisturizers hydroscopic agents, applied to the skin and hair, as creams, rinses or shampoos, to increase hydration of the stratum corneum. Examples are propylene glycol, glycerine and lactate. , creams, cleansers, sealants) Electrotherapeutic Modalities Electrotherapeutic modalities, which include a broad group of agents involving electricity, are used by physical therapists to augment other active or functionally oriented procedures in the plan of care. Specifically, these modalities are used to help patients/clients modulate or decrease pain; reduce or eliminate soft tissue swelling, inflammation, or restriction; maintain strength after injury or surgery; decrease unwanted muscular activity; assist muscle contraction Noun 1. muscle contraction - (physiology) a shortening or tensing of a part or organ (especially of a muscle or muscle fiber) contraction, muscular contraction shortening - act of decreasing in length; "the dress needs shortening" in gait or other functional training; or increase the rate of healing of open wounds and soft tissue. Clinical Indications Before applying electrotherapeutic modalities, a thorough examination is performed to identify those patients/ clients for whom these interventions would be contraindicated or for whom these interventions must be applied with caution. Candidates for application of electrotherapeutic modalities include patients/ clients with: * Impaired integumentary integrity * Impaired motor function (motor control and motor learning) * Impaired muscle performance * Muscle spasm * Pain * Soft tissue swelling, inflammation, or restriction Anticipated Goals All benefits of electrotherapeutic procedures are measured in terms of remediation or prevention of impairment, functional limitation, and disability. Specific goals related to electrotherapeutic modalities may include: * Ability to perform physical tasks is increased. * Complications are reduced. * Edema, lymphedema, or effusion is decreased. * joint integrity and mobility are improved. * Muscle performance is increased. * Neuromuscular function is increased. * Pain is decreased. * Risk of secondary impairments is reduced. * Soft tissue swelling, inflammation, or restriction is reduced. * Tissue perfusion and oxygenation are improved. * Utilization and cost of health care services are decreased. * Wound and soft tissue healing is enhanced. Specific Direct Interventions Electrotherapeutic modalities may include: * Biofeedback biofeedback, method for learning to increase one's ability to control biological responses, such as blood pressure, muscle tension, and heart rate. Sophisticated instruments are often used to measure physiological responses and make them apparent to the patient, who * Electrical muscle stimulation * Functional electrical stimulation Functional electrical stimulation (commonly abbreviated as FES) is a technique that uses electrical currents to activate nerves innervating extremities affected by paralysis resulting from spinal cord injury (SCI), head injury, stroke or other neurological disorders, (FES) * Iontophoresis iontophoresis /ion·to·pho·re·sis/ (i-on?to-fah-re´sis) the introduction of ions of soluble salts into the body by means of electric current.iontophoret´ic i·on·to·pho·re·sis n. * Neuromuscular electrical stimulation (NMES NMES Neuromuscular Electrical Stimulation NMES National Medical Expenditure Survey ) * Transcutaneous electrical nerve stimulation transcutaneous electrical nerve stimulation n. TENS. Transcutaneous electrical nerve stimulation (TENS) A method for relieving the muscle pain of TMJ by stimulating nerve endings that do not transmit pain. (TENS) Physical Agents and Mechanical Modalities Physical agents and mechanical modalities are used by physical therapists in conjunction with or in preparation for other interventions, such as therapeutic exercise and functional training. Physical agents -- which involve thermal, acoustic, or radiant energy radiant energy n. Energy transferred by radiation, especially by an electromagnetic wave. radiant energy Noun -- are used by physical therapists in increasing connective tissue extensibility; modulating pain; reducing or eliminating soft tissue swelling, inflammation, or restriction caused by musculoskeletal injury or circulatory circulatory /cir·cu·la·to·ry/ (ser´ku-lah-tor?e) 1. pertaining to circulation, particularly that of the blood. 2. containing blood. cir·cu·la·to·ry n. 1. dysfunction; increasing the healing rate of open wounds and soft tissue; remodeling remodeling /re·mod·el·ing/ (re-mod´el-ing) reorganization or renovation of an old structure. bone remodeling scar tissue; or treating skin conditions. Mechanical modalities include a broad group of procedures used by physical therapists in modulating pain; stabilizing an area that requires temporary support; increasing range of motion (ROM); or applying distraction, approximation, or compression. Clinical Indications Before using either physical agents or mechanical modalities, a thorough examination is performed to identify those patients/clients for whom these interventions would be contraindicated or for whom the interventions must be applied with caution. Candidates for physical agents or mechanical modalities include patients/clients with: * Edema, lymphedema, or effusion * Impaired integumentary integrity * Impaired joint integrity and mobility * Need for assisted weight bearing or upright activity support * Impaired sensory integrity * Pain * Pulmonary secretion retention * Soft tissue swelling, inflammation, or restriction Anticipated Goals All benefits of physical agents and mechanical modalities are measured in terms of remediation or prevention of impairment, functional limitation, and disability. Specific goals related to the use of physical agents and mechanical modalities may include: * Ability to perform movement tasks is increased. * Complications of soft tissue and circulatory disorders are decreased. * Debridement of nonviable tissue is achieved. * Independence in airway clearance is achieved. * Edema, lymphedema, or effusion is reduced. * Joint integrity and mobility are improved. * Motor function (motor control and motor learning) is improved. * Neural compression is decreased. * Pain is decreased. * Risk of secondary impairment is decreased. * Soft tissue swelling, inflammation, or restriction is reduced. * Stresses precipitating injury are decreased. * Tissue perfusion and oxygenation are improved. * Utilization and cost of health care services are decreased. * Tolerance to positions and activities is increased. Specific Direct Interventions Physical agents may include: * Athermal modalities (eg, pulsed ultrasound, pulsed electromagnetic fields pulsed electromagnetic fields (PEMF), n.pl a type of electromagnetic therapy in which small electrical currents are intermittently applied to the body. ) * Cryotherapy Cryotherapy Definition Cryotherapy is a technique that uses an extremely cold liquid or instrument to freeze and destroy abnormal skin cells that require removal. (eg, cold packs, ice massage, vapocoolant spray) * Deep thermal modalities (eg, pulsed short-wave diathermy diathermy (dī`əthûr'mē), therapeutic measure used in medicine to generate heat in the body tissues. Electrodes and other instruments are used to transmit electric current to surface structures, thereby increasing the local blood , ultrasound, phonophoresis) * Hydrotherapy hydrotherapy, use of water in the treatment of illness or injury. Although the medicinal and hygienic value of water was recognized by the early Greeks, hydrotherapy attained its widest use in the 18th and 19th cent. (eg, aquatic therapy aquatic therapy Water therapy Rehab medicine The exercising of muscle groups under water, which increases range-of-motion and light resistance for rehabilitation. See Rehabilitation medicine. , whirlpool tanks, contrast baths, pulsatile pulsatile /pul·sa·tile/ (pul´sah-til) characterized by a rhythmic pulsation. pul·sa·tile adj. Undergoing pulsation. pulsatile characterized by a rhythmic pulsation. lavage lavage /la·vage/ (lah-vahzh´) 1. the irrigation or washing out of an organ, as of the stomach or bowel. 2. to wash out, or irrigate. lav·age n. ) * Phototherapy Phototherapy Definition Phototherapy, or light therapy, is the administration of doses of bright light in order to normalize the body's internal clock and/or relieve depression. (eg, ultraviolet) * Superficial thermal modalities (eg, heat, paraffin baths, hot packs, fluidotherapy) Mechanical modalities may include: * Compression therapies (eg, vasopneumatic compression devices, compression bandaging, compression garments, taping, and total contact casting) * Continuous passive motion continuous passive motion n. Abbr. CPM A technique in which a joint, usually the knee, is moved constantly in a mechanical splint to prevent stiffness and to increase the range of motion. (CPM (1) (Critical Path Method) A project management planning and control technique implemented on computers. The critical path is the series of activities and tasks in the project that have no built-in slack time. ) * Mechanical percussors * Tilt table or standing table * Traction (sustained, intermittent, or positional) |
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