Clinics Physical Medicine

Physical Medicine, Rheumatology and Rehabilitation

Introduction to Rheumatology and Rehabilitation:

Dr./Amal El-Ganzouri

Prof. of Physical Med. And Rehab. Ain shams university

By rehabilitation we mean the restoration of the patient to his best ability, physical and vocational after trauma or disease . This branch usually deals with locomotive problems related to bones, joints ,muscles, tendons and nerves.

The Most Commonly Encountered Problems:

• Arthritic Problems: (Whether degenerative or inflammatory)
  • Degenerative as knee and hip osteoarthritis
  • Cervical and lumbar spondylosis
  • Inflammatory, Rheumatoid arthritis, SLE and gouty arthropathy
• Neurological Deficits:
  • Nerve injuries
  • Hemiplegia, paraplegia
  • Bell's palsy, cerebral palsy and facial palsy
  • Ataxia and parkinsonism ( Management of spasticity and Botox injection )
• Orthopedic Problems:
  • Post fracture care
  • Post operative care

Evaluation of the Patients:

There is no one to one relationship between the physical impairment and the disability so, the function is our goal.

The patient should be evaluated in four phases:

Phase 1 History taking, physical examination, daily activity assessment and laboratory data.

Phase 2 Identification of special problem list.

Phase 3 Description of specific treatment program either (physical or medical) for each.

Phase 4 Reevaluation of the program at the end of treatment.

The Goal of Treatment Protocol is:

• Relief of pain or stiffness
• Restoration of movement and function
• Restoration of strength and daily activity

Different Modalities and Exercises Included in the Treatment Program:

• Therapeutic exercises, stretching and massage
• Hydrotherapy
• Electrotherapy and paraffin wax and infrared
• laser therapy
• Traction: Cervical, Lumbar
• Aids and appliances to facilitate function as Braces, Splints, and Crutches

Short Notes on the Different Medical Modalities:

• Electrical Currents:

Used in nerve injuries, muscle reduction, muscle strengthen and / or to decrease pain.

They activate the excitable tissue whether nerves, innervated muscles and denervated muscles. Types: Galvanic, faradic, interferential, Russian, dynamic and Tens.

• Superficial and Deep Heating Modalities:

Used in arthritic condition; tendonitis, sprain, strains and stiffness

Note: Heating modalities increase blood flow, decrease pain, and Increase tissue elasticity.

• Laser Therapy

Laser Therapy :