Physiotherapy After Surgical Operation PDF

Physiotherapy After Surgical Operation Aims of Physical Therapy 1- To decrease pain & improve psychological well being. 2- To decrease edema and improve muscles pump activities. 3- To improve chest movement and respiration. 4- To improve muscles power, affected by surgery. 5- To imp...

Physiotherapy After Surgical Operation Aims of Physical Therapy 1- To decrease pain & improve psychological well being. 2- To decrease edema and improve muscles pump activities. 3- To improve chest movement and respiration. 4- To improve muscles power, affected by surgery. 5- To improve ROM at affected & unaffected limb. 6- Improve functional activities to normal as much as possible.  Complication of interest for physical therapy: 1- Respiratory complication 2- Muscle weakness 3- Limitation of function. 4- Pain. 5- Delayed wound healing, ?. 1- Respiratory complication Physiotherapy treatment: 1- Pre operative care of the chest by breathing exercises, coughing and postural drainage. 2- Early postoperative ambulation. 3- Cough training. 2- Muscles weakness and imbalance: Incision of the muscles during surgery decreases its power by 40 - 60 %. Physiotherapy treatment: -1 Increase the strength of the muscles pre operative. 2- Training to muscles post operative. 3- Limitation of the functions: a. Disturbance of gait after major operation Physiotherapy treatment: Gait training. b. Stiff joints. Physiotherapy treatment: 1. Active exercise 2. Modalities. 3. Stretching exercise 4- Pain Physiotherapy treatment: 1. Positioning. 2. Post operative handling. (Crutch) 3. Modalities, (heat and cold application, Electro therapy (TENS). 4. Hydrotherapy. 5- Delayed wound healing: Physiotherapy treatment: 1. -Active exercises. 2. Modalities e.g. laser.  Common operations 1- Cholecystectomy  Affected muscles: - Upper abdominal muscles (external and internal intercostals muscles).  Pattern used: - Upper trunk flexion with rotation to the right of trunk.  Antagonistic pattern: - Upper trunk extension with rotation to the left. 2- Appendectomy  Muscles affected: - lower abdominal muscles and hip muscles.  Pattern used: a. Lower trunk pattern flexion with rotation to right (lower trunk).  Antagonistic pattern: - Lower trunk extension with rotation to the left. b) For Hip muscles: The pattern used: - Flexion, adduction, external rotation of hip.  Antagonistic pattern: Extension, abduction, and internal rotation. 3- Thyroidectomy Muscles affected are neck flexors Pattern used: Flexion with rotation to the right. Antagnistic pattern: Extension with rotation to the left. *Post operative complications after mastectomy : 1- Post operative pain. 2- Pulmonary complication. 3- Limitation of shoulder R.O.M. 4- Lymphedema. 5- Muscle weakness. 6- Postural deformity. (Trunkal) 7- Limitation of the function. (ADL)  The affected muscles:  - Pectorals major (horizontal adduction  The pattern used:  - Flexion - Adduction – external rotation of shoulder.  Antagonistic pattern:  - Extension, abduction, and internal rotation.   Component of motion:  - Flexion, adduction of fingers. Flexion and radial deviation of wrist. Supination of forearm. Flexion, adduction and external rotation of shoulder. 4- Amputation amputation frequently occur after extensive medical and surgical effort has been expended to save the involved extremity. Preoperative management 1-Evaluation 2-ROM , strength of involved and uninvolved extremities 3- Relaxation ex 4-Correct positioning of the residual limb. 5-Ambulation with gait aids and ADL. Post operative: The goals are: healing of incision, preparation of the residual limb for prosthetic fitting, maintenance of range of motion, independent mobility, independency in self car and adaptation to activities of daily living, education regarding prosthetic fitting. 5 Cesarean section (CS) It is defined as the delivery of the fetus through incision in the anterior abdominal and uterine wall. A cesarean delivery is recommended to prevent maternal and/or fetal morbidity when a contraindication to allowing labor is present or when a completion of a vaginal delivery is anticipated to be unsafe or lengthy. Role of physical therapy in SC Preoperative management: This can be arranged for selective CS.  Goals: Improve pulmonary function to prevent post operative pulmonary complications. Improve circulation: to prevent DVT… Prepare the mother physically and emotionally for the post operative period. Methods: Demonstrate the patient how to mobilize early with minimum amount of strain and pain. Teach the patient how to cough in the postoperative period with the site of the wound supported. Deep breathing exercise Circulatory exercises. II. Post operative management: Goals: Improve pulmonary function and circulation Decrease incisional pain associated with cough, movements or breast feeding. Improve wound healing, and prevent adhesion formation Prevent pelvic floor dysfunction Correct posture Methods: 1. First day: Deep breathing exercises Circulatory exercises Leg exercises Static abdominal contraction 2. Second day: add the following Early ambulation Arm exercises, in the half lying position The third day: add the following Pelvic floor exercises 4. The fourth day: add Pelvic rocking 5. The fifth day: add the following Hip shrugging Postural correction The sixth day: add the following Pelvic rotation 7. The seventh day: add Lateral flexion Trunk rotation Trunk flexion Then precede as in normal labor till the end of puerperium Recovering from Surgery C-Section Complications of CS 1. Respiratory problems: due to the effect of immobilization in post operative period, anesthesia, and post operative pain. Management breathing exercises, cough training. 2.Excessive abdominal pain: increased post operative abdominal pain may be due to wound infection, haematoma formation. Management: Ice packs for 10-15 minutes on the treated area, every 8 hours for 72 hours. TENS: started immediately after recovery from anesthesia. Electrodes can be placed surrounding the incision, or above and below it. Laser: started after 24 hours following the operation day. Laser may accelerate wound healing and help to kill micro organism at the site of the wound. Ultrasonic therapy: using intensity of 1-2 W/cm2, for 10-15 minutes daily over the suture site of the wound until complete healing occurs.