3. Introduction
• Any surgical intervention on the human body is a traumatic event.
• Restoring the patient’s health after surgery is the job of the surgeon and the
physician.
• But restoring the patient to gainful and enjoyable life is the task of the
postoperative rehabilitation team.
• As soon as the patient has stabilized after surgery, diligent post operative
assessment is needed to identify short-term complications, as they develop,
and long-term problems, even before they manifest
4. Types of Surgery
1. Removal of diseased
gut,
2. ovarian cysts,
3. hernia repairs,
4. Hysterectomy
5. Laprotomy
6. Others
5. Role of
Physiotherapy
Natural healing mechanisms of the body without the use of
drugs, to restore the patient to optimum functional ability.
Identify and maximize movement potential through health
promotion, preventive health care, treatment and
rehabilitation.
Plays a vital part in pain relief, healing of injured
musculoskeletal tissue, improving cardiorespiratory fitness
and functional rehabilitation in most surgical conditions.
To prevent or treat the common postoperative complications
such as postoperative atelectesis, DVT, pressure sores, etc.
6. Physiotherapy Goals- Short Term
1. To control and
minimize
postoperative pain
2. To promote rapid
healing of surgical
wounds
3. To reduce
respiratory
incompetence
4. To Prevent loss
of cardiac
conditioning due to
prolonged bed rest
5. To strengthen
and mobilize
weakened and stiff
muscles
6. To prevent
worsening of pre-
existing disorders,
such as arthritis.
7. Physiotherapy
Management
1. Breathing exercises
2. Electrotherapy modalities for pain
management, muscle reconditioning, fluid
mobilization and tissue healing
3. Soft tissue massage to promote blood
circulation and lymphatic drainage.
4. Corrective positioning of the body and
passive/assisted/active movements of the
extremities
8. Role of Corrective Positioning and Movement
Why we give positioning and movement of extremity??
Ans:- Pain, weakness and stiffness arising from prolonged bed rest after surgical
operations
How ???
Ans:- Prescribe and demonstrate-primary caregiver procedures such as proper
positioning on bed using rolls and pillows, two hourly turning of the patient from one
side to the other and give passive/assistive/active exercises that will prevent
contractures
Rationale??
Ans:- It help the patient regain normal use of the body, maintain muscle integrity,
reduce pain, and restore mobility by loosening of stiff joint.
9. To reduce effect of recumbency
Exercises to perform while
in bed during recovery to
maintain good blood flow
and prevent stiffness.
Movement techniques to
lessen the stretch on the
incision.
Deep breathing and
coughing techniques.
Relaxation training.
10. Chest
Physiotherapy
• Breathing exercises can be used to optimize gas
exchange, promote lung expansion, minimize
postoperative atelectasis, decrease dyspnea, and
promote secretion removal.
• Lung Expansion techniques include deep breathing,
deep breathing with breath stacking, deep breathing with
inspiratory hold, and incentive spirometry.
• To reduce dyspnea (shortness of breath—SOB)-
breathing control, minimizing work of breathing,
improving exercise tolerance and pursed lip-breathing
techniques to cope with severe SOB.
11. Electrotherapy in Pain Management
Electrotherapy devices that help control both
chronic and acute pain fall into one of three
categories:
Interferential,
Transcutaneous
Electrical Nerve
Stimulation (TENS).
12. Interferential Therapy :-
• Interferential therapy uses two independent frequencies
that deeply penetrate muscles and stimulate
parasympathetic nerve fibers for increased blood flow.
• nterfere with the transmission of pain messages at the
spinal cord level, and help block their transmission to
your brain.
• Interferential therapy uses two independent frequencies
that deeply penetrate muscles and stimulate
parasympathetic nerve fibers for increased blood flow.
14. Electrotherapy in Muscle Rehabilitation
• NMS:-
• low-voltages current to stimulate motor nerves to cause involuntary
muscular contractions.
1. Neuromuscular therapy induces muscle contractions which pump fluid
through both the venous and lymphatic systems. This helps to resolve the
swelling or fluid build-up in the area.
2. NMS devices have the ability to the strength of each muscular
contraction. Like exercise, NMS helps to strengthen the injured area and
has been found to effectively treat a variety of musculoskeletal and
vascular conditions.
15. Manual therapy, Tapping and Massage
• Manual therapy and massage also called Hands on Treatment which includes passive
mobilizing of joints, manipulation of joints, mobilization with movement, soft tissue
techniques and manual traction with or without aids.
• massage can reduce stress by unknotting muscles and causing the body to relax.
Massages will even improve blood circulation, lymphatic drainage, range of motion and
increase flexibility
• Strapping techniques are a component of manual therapy which is very useful to rest
painful tissues, if required. Sports taping techniques and manual therapy taping techniques,
e.g. mulligan taping are commonly used following soft tissue release and repair surgeries
16. Physiotherapy Goals- Long Term
1. Patient education: counselling, home regimen, ergonomic advice,
2. Scar and wound management:
3. Improve muscular strength: PRE
4. Improve cardiovascular endurance: Aerobic training
5. Improve Functional Capacity: Recreational activity and group therapy
17. References:
1. Took of Physiotherapy in surgical Conditions by Puspal K mitra
2. Therapeutic Exercise by Carol A kisner
3. Electrotherapy Explained By Jagmohan singh
