Physiotherapy

Musculoskeletal physiotherapy is a form of therapy that treats people with muscle, joint, or soft tissue conditions that affect movement, strength, posture, or cause pain.  This includes common disorders associated with trauma, post-operative recovery, poor posture, athletic injuries and obesity. Patients suffering from chronic conditions, such as arthritis, can also benefit from musculoskeletal physiotherapy with the goals of returning to optimal activity, as well as minimising disability associated with disease progression.

What do musculoskeletal physiotherapists do?

Musculoskeletal physiotherapists have expertise in the treatment of orthopedic conditions – those affecting your body’s bones, muscles, joints, ligaments, tendons and related connective tissue. They use musculoskeletal evaluation techniques that help identify the specific problem creating pain and disability, and develop a therapy plan to:

• Release tight muscles that cause pain and prevent joints from moving normally
• Mobilise stiff joints to help restore normal movement
• Educate patients on correcting posture to even-out the load on the muscles and joints
• Educate patients on correct ergonomics
• Improve flexibility, muscle strength, quality of movement and co-ordination
• Provide patients with self-management strategies to prevent the build-up of pain or future injury recurrences
• Prescribe exercises to do at home or in the gym to enhance a patient’s recovery

What treatment techniques do musculoskeletal physiotherapists use?

Depending on the specific condition, musculoskeletal physiotherapists offer a full range of rehabilitation techniques and therapies such as:

• Manual therapy techniques, such as joint mobilisations and manipulations
• Soft tissue release, including massage, myofascial release and stretches
• Acupuncture/dry needling
• Electrotherapy
• Shock wave therapy
• Biofeedback
• Strapping and taping
• Personalised therapeutic exercise programs
• Postural and ergonomic advice
• Work site assessment
• Patient advice and education

Neuromuscular problems caused by neurological conditions can severely impact a person’s quality of life. Common types of impairments associated with neurological conditions include balance, vision and speech. Daily activities such as walking and grasping objects may also be damaged, leading to a loss of functional independence.

What types of neurological conditions can benefit from physiotherapy?

Physiotherapy can benefit a range of neurological conditions either by restoring function and capability, or managing the discomfort and pain associated with the illness. Some types of neurological conditions that may be treated through physiotherapy include alzheimer's disease, cerebral palsy, muscular dystrophy, Parkinson’s disease, multiple sclerosis, stroke, or head and spinal cord injuries.

What do neurological physiotherapists do?

Neurological physiotherapists specialise in the evaluation and treatment of individuals with movement problems due to disease or injury of the nervous system.  They are familiar with various conditions that affect the neurological system, as well as the impact these conditions have on the body. In general, they teach those with neurological conditions how to perform movements that will maintain muscle mass. Neurological physiotherapists work to improve or restore a person’s strength and mobility, so they are able to perform certain activities and live as independently as possible.

Physiotherapy for neurological disorders will be tailored to the particular needs of the patient and the specific condition. For patients who have difficulty with getting up, physiotherapy can help promote circulation through range of motion or stretching exercises, which can improve joint function and prevent pressure ulcers. Physiotherapy may assist patients with taking steps to practice walking by providing stand-by assistance or using a gait belt. Patients who are walking and are mobile will benefit from physiotherapy by performing exercises to strengthen core muscles. This can improve balance and may also help with pain management and prevent muscle weakness or spasticity. Finally, neurological physiotherapists may also use several measures to help control pain or stiffness, such as muscle stimulation machines and heat or cold packs.

Cardiovascular problems are conditions that affect the heart and circulatory system, and include coronary heart disease, angina and hypertension. A physiotherapist can help prevent cardiovascular problems and the onset of heart disease by implementing a treatment program that addresses all the contributing factors of this disease. This may include providing extensive education and advice on smoking cessation and other heart healthy lifestyle changes. Another key intervention is exercise, in particular aerobic conditioning and strength training, used for weight management and to improve cholesterol levels. These are prescribed by physiotherapists as part of a structured, safe and effective program.

Physiotherapists also run cardiac rehabilitation programs for patients who are suffering from severe heart disease, have had a heart attack or are recovering after cardiac surgery. In this situation, the University of Washington Medical Center describes the goals of physical therapy as being to teach the patient, family or caregiver to:

• Move safely to protect incisions
• Do exercises to strengthen muscles and manage swelling
• Monitor the patient’s activity level so that they exercise at the right level and intensity
• Encourage an increase in activity slowly and safely once the patient returns home
• Reduce the risk of developing complications such as pneumonia, swelling, and blood clots
• Increase the amount of oxygen that the heart receives, which will help it heal
• Improve the patient’s strength, balance, and energy
• Improve the patient’s mood to help them sleep better at night

What techniques do physiotherapists use to prevent or treat cardiovascular problems?

Depending on the patient’s condition, physiotherapy treatment may include:

• Breathing and Circulation Exercises: to prevent further vascular complications such as deep vein thrombosis
• Mobility Assistance: advice, prescription and instruction on how to move safely in bed, sit up, stand and walk
• Individually Tailored Exercises: to control the patient’s breathing pattern, build muscle strength and endurance and improve general health and well-being
• Ongoing Fitness Program: Tailored exercises to help the patient maintain mobility and fitness

Respiratory physiotherapy relates to the assessment and treatment of people with disorders of the respiratory system. This includes conditions affecting the lungs, as well as a wide range of other conditions that impact that respiratory system and cause symptoms such as shortness of breath, coughing up blood or mucus, and a decreased ability to exercise. Some common illnesses that may be treated by respiratory physiotherapy include chronic bronchitis, emphysema, cystic fibrosis and other lung diseases. In patients with respiratory conditions, physiotherapy includes, but is not limited to, various chest clearance techniques and breathing exercises.

What do respiratory physiotherapists do?

Physiotherapists who specialise in treating patients with respiratory problems typically begin an appointment by conducting a comprehensive assessment of the patient’s breathing pattern, respiratory function and exercise capacity. According to the European Respiratory Society, a respiratory physiotherapist will then use this information to develop a therapy plan with the aim to:

• Mobilise and aid the removal of secretions in the chest
• Maintain or improve exercise tolerance, coaching patients towards improving healthy behaviour
• Improve functional abilities, such as a patient’s ability to carry out daily tasks
• Reduce breathlessness and the work of breathing
• Improve the efficiency of ventilation
• Reduce thoracic pain
• Support patients in their transition from mechanical ventilation to noninvasive mechanical ventilation
• Improve knowledge and understanding

What treatment and management techniques are used by respiratory physiotherapists?

Physiotherapists use a variety of techniques to help treat respiratory problems, such as:

• Manual techniques to enable chest clearance
• Postural drainage
• Therapeutic exercises
• Rehabilitation, such as post abdominal surgery
• Use of various types of equipment to assist in respiratory care, such as flutter devices, positive expiratory pressures mask and cough assist devices
• Education and advice on self management, including learning pacing and resting positions to enable maximum functional ability

If you are looking for help locally, look at our directory for Physiotheraphy providers in Dubai, Abu Dhabi and wider UAE. If you need more information or look for associations that can help you, please check out the below sites:

• American Physical Therapy Association
• Australian Physiotherapy
• Canadian Physiotherapy Association, ‘The Value of Physiotherapy’
• Chartered Society of Physiotherapy
• Toronto Physiotherapy, ‘Physiotherapy for Mom and Baby’ (Articles)
• University of Washington Medical Center, ‘Physical Therapy After Cardiac Surgery’