Prevention Practice: A Holistic Perspective for Physical Therapy PDF

PREVENTION PRACTICE: Health Dr. YUMNA ILYAS And Wellne A HOLISTIC Assistant Profesor ss PERSPECTIVE FOR JMDC/Sohail University PHYSICAL THERAPY CONTENTS Health Public Health Elements of Health/ The Health Triangle Poor health Wel...

PREVENTION PRACTICE: Health Dr. YUMNA ILYAS And Wellne A HOLISTIC Assistant Profesor ss PERSPECTIVE FOR JMDC/Sohail University PHYSICAL THERAPY CONTENTS Health Public Health Elements of Health/ The Health Triangle Poor health Wellness and its types 7 dimensions of Wellness Models of Wellness Prevention Practice The Physical Therapist’s Role in Promoting Health and Wellness Holistic Medicine & Principles of Holistic Medical Practice “A doctor of the future will give no medicine, but will interest his patient in the care of human frame, in diet, and in the cause and prevention of disease”  HEALTH Derived from Old English term “hal” meaning sound, or whole Health is essentially a purpose of medicine, the promotion and restoration of wholeness. By Webster Dictionary “state of being healthy, happy, and prosperous” According to WHO “A state of complete physical, mental, social and spiritual well-being and not merely the absence of disease.”  Defined as “A quality of life revolving and dynamic interaction and independence among an individual’s physical wellbeing, mental and emotional reactions and the social complexes among which he/she exist” Promotes and protects the health of the people and communities.  Physical Health The Health Triangle Mental/ Emotional Social Health Health Optimal health: Balance of physical, mental, spiritual, and social health Life style changes: 1. Enhance self awareness and knowledge of healthy habits 2. Change behaviors interfere with good health 3. Create environment support good health  POOR HEALTH Include physical ailments --acute & chronic disabilities, Mental health issues--limit independent functioning. Poor health --significant impact on individual, family, community and society--- depending on severity individual lose functional independently and opportunity to fulfill role in community and home. Family members lose support of those who are ill and disabled. POOR HEALTH Musculoskeletal disabilities in US cost more than 1 trillion dollar/year in total costs. National center for chronic disease prevention and health promotion.: unhealthy life style lead to early diseases-  increase risk factors for heart, kidney diseases and diabetes chronic diseases--disabilities  early deaths. Life style risk factors include: smoking, tobacco, eating high fat/trans fat food,/ low fiber diets, sedentary life style, alcohol & drug abuse Emphasis is on effective prevention, active intervention for disability progression. WELLNESS An active, life long process of becoming aware of choices and making decisions toward a more balanced and fulfilling life. Wellness involves choices about one’s life and the priorities that determine one’s lifestyle. Wellness integrates mental, social, occupational, emotional, spiritual, and physical dimensions of one’s life and reflects how one feels about life as well as one’s ability to function effectively.  WELLNESS A state of good health often achieved through healthy lifestyle choices including the following six dimensions of wellness described by the National Wellness Institute (National Wellness 1:Social Wellness: Perception of having support from family or friends in time of need; and perception of being valued by support provider. Interacting and contributing to one’s community or environment establish meaningful relations that enhance quality of life Social support valuable asset for health and wellness as well recovery from injury. 2:Psychological Wellness: General perception that one will experience positive outcomes to events and circumstances in life. The mix qualities of optimism, determination, hope; are vital in preventive practice and positively dealing with life problem. 3:Spiritual Wellness : Belief in unifying force b/w mind and body. Finding and living a life that has meaning and purpose. It includes a person’s ability to establish values and act on system of belief as well as to establish meaningful & constructive lifetime goals 4: Physical Wellness : Positive perception and expectation of health. It includes the ability to meet daily demands at work & to use free time productively. Making appropriate nutritional choices and participating in regular physical activity. 5. Intellectual/Environmental Wellbeing: Perception of being internally energized by an optimal amount of intellectually stimulating activities. Actively using your mind to develop new skills and learn new information. 6.Emotional Wellness: A progression of a secure self identity and positive sense of self regard & self esteem. Ability to cope with daily circumstances & to deal with personal feeling in positive, optimistic & constructive manner.  HOWARD CLINEBELL’S 7 DIMENSIONS OF WELLNESS: Seven dimensions provide a framework for exploring various aspects of health & wellness, including versatile individual & perspective of world. 1. The Spiritual Well being dimension incorporates healthy religious beliefs, practices, values, and institutions that energize and enrich all aspects of our lives. It addresses an individual’s need for purpose, guidance, meaning and values. 2.The Mental Well being dimension represents profound interdependence of the mind and body that manifests itself in our mental and physical health. it incorporates problem solving ,creativity, clarity in thinking ,services and productivity. 3. The Physical Wellbeing dimension reflects the body’s health. Physical well being is evidenced by ability to effectively function with adequate energy to be responsible for self care and to care others. 4.The Relationship Wellbeing dimension represents the most important factors for our healing and general wellness. It incorporates the need for progress and love, forgiving and receiving, for empowering others and for creating interpersonal bonds. 5. The Work wellbeing dimension satisfies the thirst for purpose. It addresses the need for fulfilling the purpose in one’s profession. Self worth, satisfaction and personal fulfillment are all related to individual's ability 6.The Play Wellbeing dimension acknowledges that play provides the individual with laughter, cheer, energy and balance. It is ability to successfully play that provides the needed healing and revitalization to meet the demands of other dimensions. 7.The Wellbeing of Our World dimension reflects an individual’s perspective on living in a healthy environment and protecting natural resources. it incorporates a broad overview of the world. it includes responsibility, justice, an earth caring lifestyle, desire of wellbeing for all and adequate health care. MODELS OF WELLNESS  These models provide multidimensional aspects of wellness and give framework for clients need for management of illness. TRAVIS AND RYANS ILLNESS-WELLNESS CONTINUM Signs: Changes due to any pathology that is detected on diagnostic tests(i.e. lab test) by a pathologist, or by a physician, or therapist. They are physiological and anatomical markers of pathology Example: Hb levels, findings of CBC, PCR etc Symptoms: Sensation or changes in the bodily function experienced by a client or patient Example: Pain Disability : Inability to engage in gainful activity or work, often results from chronic and long term illness and has significant impact on an individual’s well-being Advantage of model: help in early identification of sings &symptoms of pathology -early intervention- prevent disability and premature death. At the far left of the scale we have Premature Death and on the far right we have High Level Wellness. Everything to the left of the neutral point involves varying degrees of disability, symptoms and signs. This red zone is the treatment area where most healthcare (or more accurately, disease care) takes place. To the right of the neutral point is increasing health that comes with health education, awareness and personal growth. This is very much about lifestyle. Being proactive when it comes to healthy eating, performing regular exercise, meditating to keep you relaxed and spiritually connected Physical Therapy care sits on both sides of the neutral point. When a patient sees a therapist for acute sciatica or chronic migraines, they would be in the red zone. However, when a client attends for a wellness check-up to maintain spinal and body balance, they are operating the blue/indigo zone. ARDELL’S MODEL OF WELLNESS Physical fitness Self Nutritional responsibil Wellne awareness ity ss Environme Stress ntal managem sensitivity ent Ardell's Model Donald B. Ardell defines wellness as “a choice to assume responsibility for the quality of your life.” He explores three domains of wellness, with specific practices within each: 1. Meaning and purpose—Having a life-direction or “calling,” caring relationships, joy, and humor. 2.Physical domain—Exercise and fitness, nutrition, adapting to challenges, and healthy lifestyle habits. 3.Mental domain—Developing emotional intelligence, effective decision-making, factual knowledge, mental health, and stress management Prevention Prevention practice encompasses health acre designed to promote health, fitness, and wellness through education and appropriate guidance designed to prevent or delay the progression of pathology It also minimizes the impairments and functional limitation Health care profession are involved in three types of preventive practice 1. Primary prevention 2. Secondary prevention 3. Tertiary prevention PRIMARY PREVENTION Is preventing a target condition in a susceptible or potentially susceptible population through specific measures, such as general health promotion efforts. SECONDARY PREVENTION Is decreasing the duration of illness, severity of disease, and numbering of sequelae (abnormalities following or resulting from disease, injury, or treatment)through early diagnosis and prompt intervention. TERTIARY PREVENTION Involves limiting the degree if disability and promoting rehabilitation and restoration of function in patients with chronic or reversible disease. THE PHYSICAL THERAPIST’S ROLE IN PROMOTING HEALTH AND WELLNESS Physical therapist play a major role in prevention practice Physical therapist were traditionally involved in the management of physical impairments. Their current role is, identifying the risk factors and developing health promotion strategies. Physical therapist are experts in examining and evaluating the motor capabilities, goals, and functional limitations of individual with Musculoskeletal Neurological Cardiopulmonary Integumentary And other body system RISK REDUCTION Risk factors that may predispose an individual to diminished well-being and health problems include physical risk factors: poor nutrition, physical inactivity, a poor physical environment, and substance abuse; psychological, spiritual, and social risk factor: low self-esteem, and lacking values and a direction in one’s life; and environment risk factors: person, things, or conditions that negatively influence other dimensions. By identifying and addressing these risk factors, the health professional can reduce the incidence of injury and illness Populations that are susceptible to illness or injury are in particular need of this awareness, accomplished through appropriate education and guidance CONVENTIONAL MEDICINE A system in which medical doctors and other healthcare professionals (such as nurses, pharmacists, and therapists) treat symptoms and diseases using drugs, radiation, or surgery. Also called allopathic medicine, biomedicine, mainstream medicine, orthodox medicine, and Western medicine. HOLISTIC MEDICINE Holistic medicine is an attitudinal approach to health care rather than a particular set of techniques. It addresses the psychological, familial, societal, ethical and spiritual as well as biological dimensions of health and illness. HOLISTIC HEALTH This holistic perspective looks beyond the physical functioning of the individual and recognizes the importance of multiple factors contributing to good health and optimal wellness, emphasizing the unity of mind, spirit, and body. According to American Holistic Health Association, perspective of holistic health considers “the whole person and the whole situation” PRINCIPLES OF HOLISTIC MEDICAL PRACTICE 1. The goal of holistic medical practice is achieving optimal health for each client. Optimal health involves both a conscious awareness of wellness domain( social, spiritual, mental, emotional, physical, and environmental) and chieving balance in these domains. 2. Practitioner offer “holistic care” i.e, care to entire person(mind, body, and spirit) 3. Holistic medicine is person-centered, treating the individual with pathology rather than focusing on the pathology itself. 4. Practitioners helps clients take control of their health and use their innate abilities to heal. 5. Holistic medicine involves health promotion, preventive care, and education designed to increase awareness of factors contributing to illness while emphasizing options that optimize well-being 6. Holistic medicine incorporates a variety of healing system, including lifestyle changes, conventional medicine(drugs and surgery), and alternative and complementary medicine, to meet each individual’s unique needs. 7. The relationship of the practitioner and client 8. Using love, kindness, acceptance, grace, humor, enthusiasm, and hope, practitioners help clients optimize their lives while managing any illness 9. Practitioners serve as role models of optimal care by incorporating the principles of holistic medicine into the healing relationship shared with their client 10. Life experiences(birth, suffering, and dying) are viewed as profound learning experiences for both the client and the practitioner of holistic medicine. The quality of life is emphasized as key component of healing.  COMPARING HOLISTIC MEDICINE AND CONVENTIONAL MEDICINE Holistic Medicine Conventional Medicine Philosophy Based on allopathic, Based on allopathic osteopathic, medicine naturopathic, energy Primary objective of To promote optimal care health To cure and reduce To prevent and treat pathology disease Diagnosis Medical history, Medical history, physical exam, physical exam, laboratory data, holistic laboratory data Primary method of care health care sheet Empower patient to Eliminate sign and heal themselves symptoms Primary care treatment through health option promotion and lifestyle changes Diet, Ex, environmental Medication & surgery  Holistic Medicine Conventional Medicine Secondary care Botanical(herbal) Diet, Ex, PT and stress treatment options medicine, homeopathy, medicine acupuncture, manual medicine, biomolecular therapies,PT, medications, & surgery Weakness Ineffective in Shortage of holistic preventing and curing physicians and training chronic disease; prog; time-intensive, expensive requiring a commitment to a Strength healing process, not a quick fix Highly therapeutic in treating both acute and Teaches pt. to take life-threatening illness responsibility for their and injuries health_cost effective_treating both acute and chronic illness, therapeutic in