Physical Therapy Evaluation and Rehabilitation

Physical Therapy Evaluation and Rehabilitation

Range of Motion (ROM) Assessment

• Definition: A systematic approach to measure the extent of movement in a joint or series of joints
• Purposes:
  • Identify joint mobility and flexibility
  • Detect restrictors to movement (e.g., muscle tightness, joint stiffness)
  • Monitor progress and adjust treatment plans
• Types of ROM:
  • Active ROM (AROM): Patient moves joint through range of motion
  • Passive ROM (PROM): Therapist moves joint through range of motion
  • Resistive ROM: Patient moves joint against resistance (e.g., weights, bands)

Manual Therapy

• Definition: Skilled passive movement of joints and soft tissues to improve joint mobility, reduce pain, and promote relaxation
• Techniques:
  • Joint mobilization: Gentle, controlled movements to increase joint mobility
  • Soft tissue mobilization: Techniques to improve flexibility and reduce scar tissue
  • Massage: Manipulation of soft tissues to promote relaxation and reduce pain
• Goals:
  • Improve joint mobility and flexibility
  • Reduce pain and inflammation
  • Enhance muscle strength and function

Goniometria

• Definition: A measurement technique to assess joint range of motion using a goniometer (protractor)
• Purposes:
  • Quantify joint range of motion
  • Monitor progress and adjust treatment plans
• Types of goniometers:
  • Universal goniometer: Measures flexion, extension, abduction, adduction, rotation, and circumduction
  • Inclinometer: Measures joint angle in one plane (e.g., sagittal, frontal)

Escalas de Dolor (Pain Scales)

• Definition: Standardized tools to assess and quantify pain intensity
• Examples:
  • Visual Analog Scale (VAS): 0-10 cm scale with "no pain" to "worst possible pain"
  • Numerical Rating Scale (NRS): 0-10 scale with "no pain" to "worst possible pain"
  • Faces Pain Scale: Facial expressions to rate pain intensity

Lumbalgias Comunes (Common Low Back Pain)

• Definition: Acute or chronic pain in the lower back region
• Causes:
  • Musculoskeletal strain
  • Herniated discs
  • Degenerative disc disease
  • Poor posture
• Physical therapy interventions:
  • Stretching and strengthening exercises
  • Posture correction and education
  • Manual therapy and modalities (e.g., heat, cold, electrical stimulation)

Lesiones Medulares (Spinal Cord Injuries)

• Definition: Trauma to the spinal cord resulting in partial or complete loss of motor and sensory function
• Classification:
  • Complete: No motor or sensory function below the level of injury
  • Incomplete: Some motor or sensory function remains below the level of injury
• Physical therapy interventions:
  • Strengthening and range of motion exercises
  • Posture and positioning education
  • Functional training and activities of daily living (ADLs) retraining

Traumatismos Craneales (Traumatic Brain Injuries)

• Definition: Trauma to the brain resulting in cognitive, physical, and emotional changes
• Classification:
  • Mild: Concussion or mild traumatic brain injury
  • Moderate: More severe cognitive and physical impairments
  • Severe: Significant cognitive and physical impairments
• Physical therapy interventions:
  • Cognitive retraining and memory exercises
  • Balance and vestibular rehabilitation
  • Functional training and ADLs retraining

Accidentes Cerebro Vasculares (Cerebrovascular Accidents)

• Definition: Sudden interruption of blood flow to the brain, resulting in neurological deficits
• Causes:
  • Ischemic stroke (80-90%): Blockage of blood vessel
  • Hemorrhagic stroke (10-20%): Rupture of blood vessel
• Physical therapy interventions:
  • Neuromuscular re-education and strengthening
  • Range of motion and mobility exercises
  • Functional training and ADLs retraining