Orthopedic Rehabilitation Course - Istanbul Gelisim University

Name of Department Physiotherapy and Rehabilitation Course Code and Name FTY303E ORTHOPEDIC REHABILITATION Course Week 1 Course Day and Time Friday 14:00 : : Course Credit/ACTS 3 Credit 4 ACTS Informati...

Name of Department Physiotherapy and Rehabilitation Course Code and Name FTY303E ORTHOPEDIC REHABILITATION Course Week 1 Course Day and Time Friday 14:00 : : Course Credit/ACTS 3 Credit 4 ACTS Informations : Examination Type and Gradings : Instructor’s Instructors’sName & Surname Name & Lec. Saadet Turhan Tekin Surname E-mail & Phone: E-mail & Phone Instructor’s : Room :: Room of the Instructor Advisor’s Office HoursInformation :: GBS GBSLinkLink :: ALMS ALMSLink Link :: AVESIS AVESISLinkLink https://avesis.gelisim.edu.tr/sturhan | 14 WEEKS’S COURSE CONTENTS |  | WEEKLY LEARNING OUTCOMES | To understand the need for classification systems To understand the evolution of classification systems To look at the importance of soft tissue injury associated with fractures  | DAILY FLOW | 09.00-09.50/ 1st Hour 10.00-10.50/ 2nd Hour 11.00-11.50/ 3rd Hour 12.00-12.50/ 4th Hour Introduction to Orthopedic Rehabilitation and Basic Concepts, General Assessment Principles in Orthopedic Rehabilitation What is “Rehabilitation” Rehabilitation is a problem-solving and educational process aimed at reducing the disability experienced by someone (with physical impairment) as a result of a disease, but always within the limitations imposed by available resources and by the underlying disease. Two Main Philosophies of Rehabilitation - Rehabilitation is a way of thinking, not a way of doing. - The special unique feature of a rehabilitation service is that it thinks about the patient and his problems; not simply that it does something to our patient. The service should focus on trying to help each patient achieve his own goals, thinking how each obstacle can be overcome Difference Between Medical Intervention and Rehabilitative Intervention - Medical intervention: interventions aimed at reversing or stopping the underlying disease process - Rehabilitative intervention: any intervention that reverses, prevents worsening of, or alleviates an impairment and attempts to reduce disability or distress will all be considered part of rehabilitation In order to ensure a person-centred approach, rehabilitation intervention selection should be developed from the patient assessment and goal-setting processes with an evidence-based approach always considered in the design of any rehabilitation plan. The rehabilitation process is a dynamic one that requires health professionals to actively engage with patients and their families in the planning and implementation of interventions.  Rehabilitation professionals need to be open to exploring new avenues for intervention and seek creative solutions to problems with activity limitation and participation restrictions, which may involve interventions to address impairments of body structure and function, but equally may involve interventions to address environmental barriers to function or even to address personal factors that may interfere with patients achieving their life goals. Rehabilitation is about providing opportunities and solving problems. Rehabilitation professionals need to be creative and flexible in their work and develop robust plans for treatment or intervention, based on the needs and preferences of the individual, but be capable of adjusting these plans should initial strategies prove ineffective or as different goals for rehabilitation arise.  Disability is a condition in which an individual's ability to perform certain activities or participate in social life is limited due to the loss or restriction of physical, mental, sensory, or emotional functions. According to the World Health Organization (WHO), disability consists of three key components: - Impairment: A problem in body structure or function, such as the loss or abnormality of a body part or system (e.g., loss of muscle strength or vision). - Activity Limitation: A restriction in the ability of an individual to perform a particular activity (such as walking, writing, or speaking). - Participation Restriction: A limitation in the individual's ability to engage in social life, work, or societal roles. Features of Effective Rehabilitation - Coordinated multidisciplinary teamwork - Involvement of the patient and the family - Members with different expertise with an interest in disability management - Recognises the importance of contextural factors, i.e. personal factors, physical factors, and social factors  An inter-disciplinary approach to rehabilitation is essential  There is no one intervention that characterises all rehabilitation  Involve and educate the patient and family ICF = International Classification of Functioning, Disability, and Health The ICF is a system developed by the World Health Organization (WHO) to assess individuals' health status and functionality. The ICF considers not only a person's abilities and health in terms of illness or disability but also takes into account functionality and environmental factors. CORE SETS Each ICF component, except for personal factors, is assigned a letter code: “b” for body functions, “s” for body structures, “d” for activities and participation, and “e” for environmental factors. Each ICF component consists of different chapters or domains (e.g. in body functions the chapters include sensory functions, functions of the cardiovascular, and respiratory system, etc.), and each chapter is made up of several alphanumerically coded ICF categories which are the specific units of a domain. Each ICF category is given a distinct alphanumeric code that identifies the component (b, s, d, or e), chapter (number), and level (specific domains) in the hierarchical structure. The purposes of the ICF: *Providing a Common Language: To offer a common terminology that facilitates communication between different disciplines regarding health and functionality. *Assessing Health Status and Functionality: To comprehensively evaluate individuals' health status, abilities, and functional capacity. *Understanding the Impact of Illnesses and Disabilities: To identify and better understand the impact of illnesses and disabilities on individuals' daily lives. *Guiding Health and Rehabilitation Services: To guide the planning of rehabilitation and health services and the development of appropriate interventions for individuals. *Supporting Research and Policy Development: To provide data for research and policy development in the areas of health, functionality, and social participation. Disadvantages: *Comprehensive and Complex: The ICF is a highly detailed and comprehensive classification system. This can make its use challenging, especially in clinical settings with limited time and resources. *Inadequate Coverage of Environmental Factors: While the ICF aims to include environmental and personal factors in the evaluation process, it has been criticized for not addressing these factors in sufficient detail in some cases. Particularly, it may be difficult to provide adequate detail on social and cultural contexts. *Suitability for Clinical Use: It has been noted that the ICF may not always be effectively applied in practical clinical settings. The system aims to assess individuals' functionality in a comprehensive manner, but in clinics with high patient flow, there may not be enough time for detailed evaluation. *Data Collection and Reporting Challenges: The comprehensive nature of the ICF can make the analysis and reporting of collected data more complex. What is Orthopedic Rehabilitation? Orthopedic rehabilitation is a highly effective and doctor-supervised program designed to help individuals recover from musculoskeletal injuries, diseases, or surgeries. The musculoskeletal system, which includes the muscles, bones, joints, ligaments, and tendons, plays a crucial role in our ability to perform everyday activities. - When these components are compromised, orthopedic rehabilitation comes to the rescue, restoring motion, function, flexibility, and strength to the affected body part. Important Steps to Ensure Proper Execution of Planned Interventions - Setting up of a multi-disciplinary orthopaedic rehabilitative team - Goal setting: short- and long-term goals - Proper assessment and identification of patient’s problems (not just orthopaedic) and with due attention to contextural factors (personal, physical and social) - Assess the need for behavioural modification - Periodic review of progress  GOAL SETTING ASSESSMENT Goal: a future state that is desired and/or Two key questions: expected. It can include matters involving - What is the most efficient assessment the patient, his environment, his family or algorithm for the clinical problem? another party. - Which specific assessment is able to give Goal setting: the process of agreeing on the most information with the least cost in goals, this agreement is usually between the time and effort patient and all interested parties.  Benefits of Orthopedic Rehabilitation Pain Reduction: Physical therapy can effectively reduce pain levels, allowing individuals to move more comfortably and engage in daily activities with greater ease. Improved Mobility and Functionality: Orthopedic rehabilitation helps restore range of motion, muscle strength, and joint flexibility, enabling individuals to regain their ability to perform everyday tasks and activities. Enhanced Quality of Life: By reducing pain, improving mobility, and restoring functionality, orthopedic rehabilitation significantly enhances an individual’s overall quality of life. It empowers them to participate in activities they enjoy and engage in a more fulfilling lifestyle.  Summary of General Orthopedic Examination Principles 1. Respect your patient and ensure that he or she is comfortable. 2. Give clear instructions on what you want the patient to do. 3. Fully expose the region to be examined yet maintain dignity. 4. Observe not only the region being examined but your patient as a whole. 5. Always compare both limbs. 6. When palpating a region remember to look also at the patient’s face. 7. Assess both active and passive range of movement. 8. Special tests are done to help define other findings. 9. Examine the joint above and the joint below as well as performing a neurovascular assessment. 10. Do not cause pain.  | REFERENCES | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9453191/ https://musculoskeletalkey.com/conceptual-framework-functioning-and-disability/ https://journals.sagepub.com/doi/10.1177/20571585211015792 Book: Orthopedic Rehabilitation, Assessment, and Enablement  | ABOUT THE NEXT WEEK | Assessment Methods Used in Orthopedic Rehabilitation, Orthopedic Assessment in Upper and Lower Extremity Joints  ………….. – ………………………… Since course presentations are private, using the texts and images contained herein on social media or else without permission from the course instructor is against the regulations Law No. 6698. One day my mortal body will turn to dust, but the Turkish Republic will stand forever.