Transcutaneous electrical nerve stimulation (TENS) is a non-invasive peripheral stimulation technique used to relieve pain. During TENS pulsed electrical currents are delivered across the intact surface of the skin to activate underlying nerves. Patients can self-administer TENS and titrate dosage as required because there is no potential for overdose and there are few side effects or drug interactions.

Maximal analgesia occurs when TENS generates a strong but non-painful electrical paraesthesia beneath the electrodes. Effects are generally rapid in onset and offset so patients are encouraged to administer TENS as needed and throughout the day.

Interferential Therapy or (IFT) is a type of electrotherapy treatments that use electric currents to stimulate tissue which provides pain relief, reduction of swelling and many other health benefits. It is rather a generic means of stimulation – the machine can be set up to act more like a TENS type device or can be set up to behave more like a muscle stimulator – by adjusting the stimulating (beat) frequency. It is often regarded (by patients) to be more acceptable as it generates less discomfort than some other forms of electrical stimulation.

Selection of a wide frequency sweeps has been considered less efficient than a smaller selective range in that by treating with a frequency range of say 1-100Hz, the effective treatment frequencies can be covered, but only for a relatively small percentage of the total treatment time. Additionally, some parts of the range might be counterproductive for the primary aims of the treatment.

The are 4 main clinical applications for which IFT appears to be used:

   Pain relief

   Muscle stimulation

   Increase local blood flow

   Reduction of oedema

Faradic Current

Faradic is an interrupted direct current that has a frequency of 50:100Hz with a pulse duration from 0.1-1 ms. This frequency and duration cause contraction and relaxation in innervated (nerves intact) muscles. It does not work on muscles that are denervated muscle; to cause the same effect a short pulse duration would be required. When applying faradic stimulation, the stimulation of the sensory nerve can result in the patient experiencing a pricking sensation due to the short duration of the pulse. The stimulated nerve causes a reaction in the motor fibres which makes the muscle contract.

Galvanic Current

Galvanic current is interrupted direct current has frequency 30 Hz with pulse duration 1 ms and more. This type of current used for muscle not have the nerve because of injury of the nerve. When applying galvanic, the denervated muscle responds to this stimulus because of the long pulse duration. The denervated muscle does not respond to faradic because pulse duration is short.

Traction is a tool that is useful only for conditions where decompression is required. Examples are nerve impingements and disc prolapses. As poor posture, movement patterns and muscle strength are the primary causes for disc prolapses and impingements, traction alone may reduce the pain but is not a long term solution to the rehabilitation of disc prolapses and nerve impingements.

The pressure within the structures, such as the disc, reduces as the spinal structures are gently pulled away from each other. As such, the space from which nerves exit the spinal cord increases. Therefore, traction is suitable for conditions with compressive stress within the spinal structures like disc proplapses and nerve impingements.Correcting posture, movement patterns and building core strength are the long-term solutions to back pain.

Sound waves are longitudinal waves consisting of areas of compression and rarefaction. Particles of a material, when exposed to a sound wave will oscillate about a fixed point rather than move with the wave itself. As the energy within the sound wave is passed to the material, it will cause oscillation of the particles of that material. Clearly any increase in the molecular vibration in the tissue can result in heat generation, and ultrasound can be used to produce thermal changes in the tissues, though current usage in therapy does not focus on this phenomenon.

In addition to thermal changes, the vibration of the tissues appears to have effects which are generally considered to be non thermal in nature, though, as with other modalities (e.g. Pulsed Shortwave) there must be a thermal component however small. As the US wave passes through a material (the tissues), the energy levels within the wave will diminish as energy is transferred to the material. The energy absorption and attenuation characteristics of US waves have been documented for different tissues.

The application of therapeutic ultrasound can influence the remodelling of the scar tissue in that it appears to be capable of enhancing the appropriate orientation of the newly formed collagen fibres and also to the collagen profile changes, thus increasing tensile strength and enhancing scar mobility

Therapeutic exercise is one of the core skills upon which the profession of physiotherapy is based on. By considering definitions of therapeutic exercise, physical activity and exercise, it is possible to see that, although therapeutic exercise contains the components of both physical activity and exercise, it also provides a systematic exercise programme for remediation of impairments and improvement of function.

Exercise is a physical activity that is planned and is performed with the goal of attaining or maintaining physical fitness. Physical fitness is a set of traits that allows an individual to perform physical activity

Therapeutic exercise include:

   Aerobic and endurance conditioning and reconditioning

   Agility training

   Body mechanics training

   Breathing exercises

   Coordination exercises

   Developmental activities training

   Movement pattern training

   Neuromotor development activities training

   Neuromuscular education or reeducation

   Perceptual training

   Range of motion exercises and soft tissue stretching

   Relaxation exercises

   Strength, power, and endurance exercises

Sound waves are longitudinal waves consisting of areas of compression and rarefaction. Particles of a material, when exposed to a sound wave will oscillate about a fixed point rather than move with the wave itself. As the energy within the sound wave is passed to the material, it will cause oscillation of the particles of that material. Clearly any increase in the molecular vibration in the tissue can result in heat generation, and ultrasound can be used to produce thermal changes in the tissues, though current usage in therapy does not focus on this phenomenon.

In addition to thermal changes, the vibration of the tissues appears to have effects which are generally considered to be non thermal in nature, though, as with other modalities (e.g. Pulsed Shortwave) there must be a thermal component however small. As the US wave passes through a material (the tissues), the energy levels within the wave will diminish as energy is transferred to the material. The energy absorption and attenuation characteristics of US waves have been documented for different tissues.

The application of therapeutic ultrasound can influence the remodelling of the scar tissue in that it appears to be capable of enhancing the appropriate orientation of the newly formed collagen fibres and also to the collagen profile changes, thus increasing tensile strength and enhancing scar mobility

Continuous passive motion (CPM) devices are used during the first phase of rehabilitation following a soft tissue surgical procedure or trauma. The goals of rehabilitation is control post-operative pain, reduce inflammation, provide passive motion in a specific plane of movement and protect the healing repair of tissue.

CPM is used following various types of reconstructive joint surgery such as knee replacement and ACL reconstruction. Its mechanisms of action for aiding joint recovery are dependent upon what surgery is performed. One mechanism is the movement of synovial fluid to allow for better diffusion of nutrients into damaged cartilage, and diffusion of other materials out; such as blood and metabolic waste products. Another mechanism is the prevention of fibrous scar tissue formation in the joint, which tends to decrease the range of motion for a joint.

It is a device used for exercise, consisting of a continuous moving belt on which to walk or run. One of the most popular types of home exercise equipment is the treadmill, which provides a straightforward, efficient aerobic workout. As strength and endurance are developed, the treadmill can be used for jogging and/or for interval training.

  Exercise without pain

    Promote cardiovascular and muscle health

  Work on your gait

  Reduce impact on your joints

  Confidence

Swiss balls are large, heavy-duty inflatable balls with a diameter of 45 to 75 cm (18 to 30 inches). Swiss balls are one of today's top fitness tools - and for good reason! Using a Swiss ball will improve the strength of the abs and the lower back. Since the Swiss ball is unstable you have to constantly adjust your balance, which in turn will improve your balance, proprioception and flexibility. As an extra challenge you can use the exercise ball as a bench using free-weights to target those hard to reach stabilizer muscles. Swiss Ball Pro is more recommended for heavy strength training and body building

  Proper Alignment

  Great Abs

  Muscle Strength and Endurance

  Core Stability

  Stretching

  Losing Weight

Swiss balls offer you a fun, safe and highly effective way to exercise. They will last for a very long time and are inexpensive compared to other exercise equipment.

The mat program involves the patient in activities incorporating both movement and stability. They range from single movements, such as unilateral scapula motions, to complex combinations requiring both stabilization and motion, such as crawling or knee walking. The activities are done in different positions, for function and to vary the effects of reflexes or gravity. The therapist also chooses positions that can help control abnormal or undesired movements.
Mat treatment unites all the parts of the PNF philosophy. In this situation it is easy to begin with activities that are strong and pain free and work toward improving those functions that need improvement. Because the mat activities involve many parts of the body, irradiation from the strong parts is easier to achieve. Last (but not least) the work can be fun.

When working with an infant, it may be necessary to progress treatment using activities that suit the developmental level of the individual. With the adult patient more mature or advanced activities can be used before the more basic activities. Functional goals direct the choice of mat activities. An activity, such as getting from supine to sitting, is broken down and the parts practiced. As there are many different ways in which a person can accomplish any activity, treatments should include a variety of movements. For example, to increase trunk and leg strength, the patient may begin treatment with resisted exercises in sitting and side-sitting. The treatment then progresses to positions involving more extremity weight-bearing. As the patient’s abilities increase, exercises that combine balance and motion in bridging, quadruped, and kneeling positions are used.

With all functional activities, the patient learns:

  Mobility - moving into a position or starting a movement

  Stability - stabilizing (balance) in that position and controlling gravity

  Mobility on stability - possibility to control a movement in any position in a stable position

  Skill - all movements are possible, all body parts can be moved and controlled in all directions

Swiss balls offer you a fun, safe and highly effective way to exercise. They will last for a very long time and are inexpensive compared to other exercise equipment.

The role of the respiratory physiotherapist is to assist in clearing the airways of the patients, and maintaining and improving the integrity of the respiratory system. Treatment interventions include:

  Positioning

  Education

  Manual and ventilator hyperinflation

  Weaning from mechanical ventilation

  Non-invasive ventilation

  Percussion, vibration, suctioning

  Respiratory muscle strengthening

   Breathing exercises and mobilisation