Monday, December 25, 2023

What therapy is best for obesity?

Introduction:
 
Physical therapy can help you from obesity and helps to lose your body weight and getting a good desired body shape. Physical therapist are qualified medical worker which can help you to lose body weight up to the desired amount. Under supervision of a  physical therapist you can do the exercise is as per the requirement. 
In this  article you would come to know about how to reduce body weight with the help of Physical Therapy


What health problems does an Obese person have ? 

1. Shortness of breath during stair climbing or walking and get easily fatigued.
2. Recurrent problem of vertigo and unconsciousness
3. Difficulty in performing daily household activities and dependent on others, thus affecting the quality of life. 
4. Disturbed overall metabolism such as
* Easily prone to diabetes
* Fatty liver 
* Hypertension or high blood pressure
* Sleep disturbances
* Muscular and joint pain

5. Body shaming or feeling awkward in party and functions, also with unable to wear the desired clothes and accessories which results in development of Stress and Depression. 

All the above problems have one solution and that is Physical Therapy.


How Physical Therapy help obesity of overweight person? 

Physical therapist are expert in physical exercises so they made a tailored exercise program for the fitness of obesity person from fat to fit. The fitness program should be in such a manner that it does not produce any extra burden on the person who is reducing weight.




 Starting from the body type to the amount of body weight, age of person, his/her height all this points are considered to be the line of treatment for weight reduction.
 




* It begins with manual stretching exercises of the tight muscles and joint also to reduce the stiffness and increase the flexibility of the joints. Passive stretching is performed by physical therapist and trained the person to do some active stretching exercises also.

* Some lightweight exercises with the help of small dumbbell or theraband to increase the blood circulation and also warms up  the body for proper training. Loose comfortable clothes and proper sport shoes are required for the obese person to perform all the physical activities.

* Some non-weight bearing exercises where also performed without the help of any equipment or weight, just by using body weight to get the required muscle pump and release of good hormones for weight reduction.

* Following a healthy diet and a proper sound sleep are also a important part of weight management training. Regularly doing the weight management program under the supervision of a physical therapist will show some result to the person and also increases him to continue and enjoy the process of his/her desired goal.

* Just be consistent and focused on your goal is a major requirement of physical therapist from the person who really wants to change his/her physique seriously. 


During the weight journey program if you had any kind of body pain, muscular pain,  joint pain physical therapist will help you as they have the knowledge and skills to overcome body pain with the help of electrotherapy modalities. 

Strength training were also included in the later half of your weight reduction journey to get the muscle in shape and burn that extra amount of fat stored in your body. Walking is one of the best exercise your physical therapist will suggest you as it helps in developing your endurance, gaining muscles strength, increase lung volume capacity, cardiac muscles stronger to pump the blood which in turn improves circulation of the body and enhances cardiovascular fitness.

Just to catch up the amount of calories you have burnt you can wear a smart watch  which helps to monitor the amount of calories per day. On monthly basis you can check your body weight on the weighing machine and see the changes in the mirror in the form of visual feedback. Also you can click photos of your month by month which is record of your personal data and see the changes thoroughly. Your smart watch, your monthly photos, monthly weight check all these things will help to motivate you and continue the journey until you reach the goal. 

During Physical Therapy exercises our body release happy hormones like endorphins which reduces the amount of stress level in body and help us to overcome any sort of depression or psychological problems. The quality of sleep will also be facilitated through exercises and our brain recharges up for the next day. 

The quality of life which was earlier a bit lingering and sluggish will become productive, energetic, and transformed into a quality of life through Physical therapy. The Physical Activity Guidelines for American's recommend that older adults should do 150 minutes of moderate intensity physical therapy activity a week. 

Conclusion:
 
For a obese or overweight person he can change his/her quality of life through physical therapy and see the results accordingly. I hope this article provides you information and helpful, if you like the above article please let me know in the comment section.


Friday, December 15, 2023

What is physical therapy of respiratory disease?

Introduction:

 Physical Therapy plays a major role in recovery of patients with respiratory problems such as emphysema, pulmonary fibrosis or lung cancer, asthma, chronic obstructive pulmonary disease ( COPD ), pulmonary hypertension, respiratory tract infections.

In this article you would come to know about the physical therapy techniques in musculoskeletal dysfunction in respiratory disease. 



The person with respiratory disease has a typical posture with tightness of the pectoral chest muscle and weakness of the serratus anterior and the middle and lower fibres of the trapezius. This poor posture results in increased thoracic kyphosis and protracted position of the scapula, also position of the shoulder joint is anteriorly with the humerus in glenoid fossa.

Subjective Assessment: 

Initial assessment of patient with respiratory disease by a Physical therapist include questioning regarding headache, neck, shoulder or thoracic pain and any upper limb pain or paresthesia. The intensity of pain can be measured by an absolute visual analogue scale ( AVAS )




Physical assessment: 

A Physical therapist does the assessment in a systematic manner from evaluation of patient posture to assessment of joint mobility, muscle recruitment pattern, muscle length and strength and endurance.

The assessment is ideally performed in sitting, supine and prone position, examination of dyspnoeic ( not breathing or able to breathe except with difficulty) patients may need to be conducted in semi-supine, sitting or high side lying.

Therapist observes the resting posture of patient with cervical, thoracic and lumbar spine, the scapula and also arms. Thoracic kyphosis with stiffness in the upper thoracic spine and cervical lordosis should be noted.

Also Physical therapist does the assessment manually by palpating mobility of the upper and middle ribs in anteriorly and posteriorly during a deep inspiration, while the lower ribs are assessed by palpating laterally. Joint movements are also checked specially scapulo-humeral rhythm and strength and endurance of specific muscles need to be examined by physical therapist. Neural tissue provocation tests and test for reflexes, power and sensation should be performed.

Physical Therapy Management of Respiratory Disease: 

The patients main problems need to be prioritized before treatment can be started, Many techniques are used by physical therapist in order to overcome different respiratory problems such as joint restriction may be treated with passive mobilization techniques, active assisted exercises or active exercises. Posture may be improved by educating awareness of positioning using visual, auditory and sensory feedback.

Postural correction may change the patients breathing pattern and intensity of dyspnoea (shortness of breathe) therefore these factors need to be monitored carefully during treatment by physical therapist. 



Mobilization Techniques by physical therapist:

Physical therapy management of joint restriction and pain may include passive mobilizations of cervical and thoracic apo-physeal joints, also the therapist focus usually be on improving the range of thoracic extension and on increasing the mobility of the ribs. Physical therapist perform thoracic extension of  patient in a precise manner by instructing the patient to flex his arm combined with deep inspiration and expiration to improve rib mobility and spine extension. 

As seen in many patients following thoracotomy, patients may tend to immobilize the arm on the side of the incision and need to be encourage to move within pain limits as early as possible to reduce the risk of frozen shoulder and scapular movement. 

The long term ventilated patient may also develop musculo-skeletal problems so routine passive mobilization of the shoulder through its full range of flexion, external rotation, and abduction should be mandatory by the physical therapist. 

Muscle Lengthening techniques by physical therapist: 

Physical therapist should have a close sharp observation of the chest, shoulder and back muscles, which becomes tight in respiratory  patients. Some of the tight muscles which need attention are deltoid, Pectoralis, sternocleidomastoid, upper and middle fibres of trapezius levator scapular, Pectoralis minor, Teres major, Latissimus Dorsi  and subscapularis.
Techniques performed by physical therapist for the tight muscles are hold and relax technique and myofascial release. Where possible patient should be taught to perform their own stretches and mobilizations as part of long term maintenance. 

Use of Gym Ball by physical therapist: 

A gym ball may be useful for encouraging a more upright sitting posture in younger patients. Prone position over the ball may be used to stimulate the anti gravity muscles. Side lying over the ball will assist with rib mobility and stretching of the Inter coastal muscles if mobility and shortness of breath allow.  
Muscle retraining and recruitment are a part of treatment of patients with respiratory problem by the Physical Therapist.


What is Breathing Control in Respiratory Problems: 

Breathing control is normal tidal breathing using the lower chest with relaxation of the upper chest and shoulders. This use to be known as 'diaphragmatic breathing' where minimal effort is expended and breathing exercises where either inspiration is emphasized, as in thoracic expansion exercises and inspiratory muscle training or expiration as emphasized, as in the huff of the forced expiration technique. This breathing technique is used by physical therapist in respiratory condition. 

How Breathing Control Technique is performed by Physical Therapist:

To be taught breathing control the person should be in a comfortable well supported position and is encouraged to relax his upper chest, shoulders and arms while using the lower chest. Physical therapist uses his one hand to position lightly on the upper abdomen. As the patient breathes in, the hand should be felt to rise up and out; as the patient breathes out, the hand sings down and in.

Inspiration through the nose allows the air to be warmed, humidified and filtered before it reaches the upper Airways.

Any breathless person with asthma, emphysema, pulmonary fibrosis or lung cancer, will benefit from using breathing control in position which encourage relaxation of the upper chest and shoulders and allow movement of the lower chest and abdomen. One of the most useful positions is high side lying. Other useful positions are
* Relaxed sitting
* Forward lean standing
* Relaxed standing
* Forward lean standing

Surgical patients should continue their breathing exercises in between the treatment sessions with the physical therapist.



Active cycle of breathing technique ( ACBT) in physical therapy: 

This technique is used by physical therapist to mobilize and clear access bronchial secretions and to improve lung function. ACBT is a cycle of breathing control, thoracic expansion exercises and forced expiration technique ( FET ). 
Thoracic expansion exercises are deep breathing exercises emphasizing inspiration and increasing lung volume capacity.
The forced expiration technique is a combination of force expiration (huffs) and breathing control also known as in simple terms huffing.


Techniques performed by physical therapist for chest airway clearance: 

1. Chest clapping - This is performed by the Therapist using a curved hand with a rhythmical flexion and extension action of the wrist. This technique is often done with two hands but, depending on the area of the chest, let may be more appropriate to use one hand. For the infant, chest clipping is performed using two or three fingers of one hand. In patients with neuromuscular weakness or paralysis and the intellectually impaired, chest clipping is a useful technique to stimulate coughing probably by the mobilization of secretions.


2. Chest shaking, vibrations and compression-
 In this technique the therapist hands are placed on the chest wall and during expiration, vibratory action in the direction of the normal movement of the ribs is transmitted through the chest using body weight. This helps to mobilize secretions and this technique is combined with thoracic expansion exercises.

Other techniques which are useful in respiratory patients are
➤ Incentive Spirometry
➤ Glossopharyngeal breathing
➤ Intermittent positive pressure breathing
➤ Airway suction


Conclusion: 
Physical therapy should be the line of treatment in many respiratory problems, I hope you like the information regarding respiratory diseases. Please let me know in the comment section about your experience


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