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physicaltherapy: 05 Feb : 06:54 pm

Is there anyone who has gone through CWT6 or type 1 evaluation with FCCPT?
If so, kindly let me know from where can the following deficiencies be fulfilled?
1. History
2. Systems Review
3. Findings that warrant referral
4. Supervision of support staff
5. Documentation

nani: 28 Sep : 04:31 am

plz pleasec tell me where to do phd in india

Nikhilphysio: 02 Jun : 03:55 am

I am working as physiotherapist in Shalby hospital ahmedabad for 4 years. I have passed out from Rajiv gandhi university of health and sciences Bangalore. I want to apply for Newzealand physiotherapy board registration so anyone there from India who got registered as physiotherapist in new zealand please help me.

Arun: 10 May : 12:36 am

Hi Priyank, welcome. Feel free to go through these forum threads returned by search [link]

Priyank: 09 May : 10:28 pm

Hi..need advice. What are the options in Australia after MPT?


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Moderators: Arun, Boopathi, Robin, baskar, AJIN, MDK-Physio
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Wed Sep 13 2006, 04:45am
purni
Registered Member #718
Joined: Thu Jul 20 2006, 02:05am
Posts: 39
can u please tell me what is the best treatment for chronic swelling in knee o.a? which method of therapy i.e cryotherapy or thermo shud be used in chronic stage? i am pretty confused due to an overflow of various views... please hhelp me out... and happy belated world physiotherapy day!

Wed Sep 13 2006, 09:10am
Robin
Keep looking around. There's always something you've missed.

Registered Member #4
Joined: Thu Jul 08 2004, 06:56am
Location: Kollam, Keralam, INDIA
Posts: 2120

yeah purni..not the best description of teh condition to state a reply..still, if teh swellin is not due to an acute flare up ( so often in o.a as we all know ), then i woudl better go on with hot modalities..
-as it tends to break up adhesions( common in chronic swellings and particularly o.a cases)
-relaxes the adjoining muscle spasms
- increases circulation and thusby healin process
- and hopefully maintain some range of motion

elastic bandagin along would be another option to check teh swellin i feel! and purni..pls dont mind to share the views u got too..it wil be always nice if we can discuss abut each and every topic , so that we may stumble across somethn new in it!
[ i moved u'r topic to the orthopeadic forum, purni]

Thu Sep 14 2006, 01:20am
Merlin Perumal
Registered Member #821
Joined: Sat Aug 05 2006, 12:38am
Location: Bahrain
Posts: 49

Hai Purni,
It's good to discuss & share these topics among us so that we will be able to aquire more knowledge. I'm just supporting what Robin said.Yes, Thermotherapy seems to me more effective for that stage than Cryotherapy. Cryotherapy is also good but in acute cases.

-Cold compression therapy constricts the blood vessels and slows down the metabolism of the cells. The reduced metabolism lowers the need for the oxygen and nutrients and slows the rate of cell death and the resulting excess build up of blood and fluid.

-Cold therapy also has a numbing effect on the nerve endings decreasing the impulses to the brain perceived as pain.

Moreover, Passive Treatment such as Combination therapy with IFT (amplitude summation) and Pulsed Ultrasound is also effective to reduce swelling.Here the active electrode should be applied at lower Quadriceps area and Ultrasound head should be placed on areas around knee joint. Anyway pls share ur views tht ur getting toooooo.
Regards.....................

Tue Sep 19 2006, 04:54pm
Guru
Registered Member #980
Joined: Tue Sep 19 2006, 04:40pm
Location: Vanthali, Gujarat, India
Posts: 103

Keeping the latest reserch in mind, cold is of no use in any condition post 5 days. Injury or post-op. Also use of any other passive modalites like US and Heat is of no use. You should encourage your patient to maintain max poss. ROM and increase Quad strength as much as poss. For this use of Russian stimulation to increase Quad strength is very well documented. The above stated benifits for Heat and US are true but you will get lot beeter results by actively exercising the patient. YOu must be abel to judge what form of exercise you want your patient to preform. Given he/she has swelling start with NWB and progress to FWB exercise. DO not make your patients depandent on you. Unless they really need intervention like passiave modalites adn the use of these modalites are well documented, you should refrain from using these. I hope this helps

Wed Sep 20 2006, 09:52am
Robin
Keep looking around. There's always something you've missed.

Registered Member #4
Joined: Thu Jul 08 2004, 06:56am
Location: Kollam, Keralam, INDIA
Posts: 2120

adjunct modalitties always has it's use guru,if u use it appropriately. it alwys helps u treat the patient better ! 'aims' shoudl be supported by 'means' and if our aim is to preserve teh ROM , tehn our means should be abel to reduce the factors( primary or secondary , if not both) that would be preventing or reducing the ROM.
If it is a chronic swellin then teh adhesion woudl be the primary factor ..how would one break the adhesion Iin knee better than havin a SWD or a Wax application?and sooner we break the adhesion easier for us to reagin some range of motion !active participation of the patient himself is needed in most of the treatment as u pointed out guru, but that alone wont count .
and woudl u say bitmore abut the russian stimulation too guru!

Fri Sep 22 2006, 02:28am
MDK-Physio
mdk-physio
Registered Member #486
Joined: Thu Mar 23 2006, 02:44am
Location: University of applied science Krems, Austria
Posts: 93

hi guys, hi purni,
the discussion so far is pretty academic, as we don´t really know anything about your patient, other than thet he has a swelling of the knee(intra-articular or extra-articular?). Perhaps you would like to share with us your entire assessment, so we might have a proper discussion over this patient´s condition.
Cheers,
Mart

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Fri Sep 22 2006, 04:15am
Guru
Registered Member #980
Joined: Tue Sep 19 2006, 04:40pm
Location: Vanthali, Gujarat, India
Posts: 103

Dear Robin

All I am saying is that you will get far better results from ROM exercise then any other modalites. Most of the Modalites we use is suppose to increase tissue temp. and break adhisions. But does it? Check the latest research, the avidance at best is poor. Modalities are not compleatly useless but it's use should be very limited in my view. You will get lot better increase in tissue temp with just AROM exercise then any modlites. That is a proven fact. As far as Russian stim goes. this is how I use it. 10 second of max tol. intensity f/b 30 sec of rest. During the stimulation phase of this therapy patient will attempt max contraction of involved mus. group. I hope this help. Again please dont take this as a personal attack on your position. However we as clinician must look at the research rather then following blindly. I want to thank all of you who maintain this site. It is a lively exchange of ideas. Thank you again. GURU

Fri Sep 22 2006, 09:06am
Robin
Keep looking around. There's always something you've missed.

Registered Member #4
Joined: Thu Jul 08 2004, 06:56am
Location: Kollam, Keralam, INDIA
Posts: 2120

ooops mate, dont take that to be offendin..! this is just a discusion..and many things does come up..! what would one do when the ROM is limited..modalities and manipulation works along well to maek some movement possible..after we gain some movement , for sure active muscle movement helps a lot in the recovery..!
 oh and nice to know abut the russian stimulation, seems to be a sort of static exercise, guru ..!

[ Edited Sat Sep 23 2006, 09:18am ]

Sat Sep 23 2006, 08:44am
Robin
Keep looking around. There's always something you've missed.

Registered Member #4
Joined: Thu Jul 08 2004, 06:56am
Location: Kollam, Keralam, INDIA
Posts: 2120

hey purni..what method are u tryin out wioth u'r patient adn what was the result?

Sat Sep 23 2006, 04:33pm
Guru
Registered Member #980
Joined: Tue Sep 19 2006, 04:40pm
Location: Vanthali, Gujarat, India
Posts: 103

Robin
THis is what I do for limited rom. 10 min warm up on bike. f/b EROM stretching by patient with holding EROM position in flexion and extension for 15 sec each 3 times. After this Joint mobs for approprate direction. this is f/b SAQ, LAQ and SLR in flexion, abduction, adduction and extension 15 x3 each with russian stim. after this patient stretches the knee in flexion and extension with 15 sec holds every two hours and does SLR in Flexion with quad set at least 100x day. Sounds like a lot but this is what it take to deliver results. If the patient is s/p TKR or the ROM is limited significantly then they go on my BIODEX system three starting with passive with 15 sec holds in flexion and extension.

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