Suppose the patient is obese and non co- operative to any exercise schedules and the patient has quadriplegia. What would be your treatment plan?

Well, the first thing to do is to counsel and educate the patient on the benefits of doing exercise.

Early standing using the tilt bed is very important since patient doesn't co-operate, this help to improve cardiovascular system and also the pumping action of muscles.

Progress by using eletrotherapy to stimulate the paralytic muscles.

Elevation and positioing should also be done, to encourage venous return and drainge.

Passive mobilizations and soft tissue massage should be carried out to prevent joints stiffness and muscles wasting.

Educate the caregivers on how to carried out some of these treatment as a home programs on the patient.

Thanks

 

 

Firstly, try to maintain a positive relation ship with the patient by providing psychological support and basic health care according to the need of the patient.

Secondly, give health education regarding the condition and some non-pharmacological measures that can boost up the mind as well as body as follows- Initiate gradual mobilization of each extremities by PASSIVE EXERCISES, using various COMFORTABLE ASISSTIVE DEVICES

Finally,  should give skin care,back care massaging to reduce in getting chances for PRESSURE ULCERS.

 

yeah thats fine it all depends upon the spinal level injury and the present condition of the patient either he or she is on conservative or post surgical rehabilitation management but as per to ur question we should do the counselling of patient and till that time prevent the patient from life threatening problems and try to manage good airways condition and regular log rolls, with compression bandages to the lower limbs to reduce the risk of unilateral vascular drainage. thanks

FIRST OF ALL WE HAVE TO PROVIDE THE PATIENT WITH AN AUTOMATED  AIR BED OR GELL BED,AND IF THERE IS NO PROVISION OF AUTOMATED AIR BED THEN WE HAVE TO TURN THE PATIENT AT REGULAR INTERVALS TO THEIR LATERAL SIDES TO AVOID BED SORES.

THEN CHECK FOR THE LEVEL OF QUADRIPLEGIC CONDITION AND THE MUSCLE STRENGTH OF ALL THE LIMBS BY MANUAL MUSCLE TESTING AND CHECK FOR THE REFLEXES AS WELL.

THEN WE HAVE TO PROVIDE ELECTROTHERAPY BY STIMULATION USING FARADIC TYPE OF CURRENT FOR STIMULATION AS IT HELPS TO ACTIVATE THE MUSCLE TONE WHERE MOTOR POINTS OF MUSCLE ARE STIMULATED AND TELL THE PATIENT ABOUT ITS INTENSITY AND USE AND PROGNOSIS REGULARLY.

THEN WE HAVE TO PERFORM ALL THE PASSIVE MOVEMENTS ON ALL THE FOUR LIMBS,THEN PROVIDE A REGULAR THERAPEUTIC MASSAGE TO IMPROVE THE CIRCULATION WHICH IS A NUTRITON TO THE MUSCLE BY BLOOD IN THE PROCESS OF CIRCULATION.

THEN NOTE FOR REGULAR PROGNOSIS BY CHECKING THE MUSCLE STRENGTHS AND ABILITY OF THE PATIENTS BY ASKING THE  PATIENT TO PERFORM ACTIVE MOVEMENTS HOW MUCH THE PATIENT CAN.

THIS PROCESS IS CONTINUED AND DONE TILL THE PERSON ABILITY IS IMPROVED,AND ALSO HIGH PROTEIN DIET IS PROVIDED WITH LOW CARBOHYDRATE CONTENT.

IMPROVEMENT OF PATIENT ABILITY IS OBSERVED.

Counseling with Patient and caregivers,  Positioning, maintain position, Passive movement, assisted active and active exercise according to patients capability, Stretching, Strengthening and bridging exercise. Gradually Balancing and co-ordination, ambulation/transferring, sitting, standing, walking re-education. 

This is the most difficult part of our field when patient don't want to perform or we have to find a way to make him or her understand.

I will find the reason why the patient is non cooperative. Might the patient need to know what is the benefits of this exercise because physical therapy helps the patient slowly, the patient cannot see the result in 1 day. I will counsel her and show motivational videos that what i am trying to do with you.

A quadriplegic patient who has lost his 4 limbs, our main goal is to make him realize that what thing he or she can do, then i will make my plan to prevent him from complications and do his rehab as he could able to survive

Duty of physiotherapist is #patient Education. This patient needs to be educated about importance of Exercises. Discuss with hr and design exercises which will suit her daily activity.

passive mouvement and positionning

First the a diagnosis must be found for the Quadriplegia!. Then you can start your treatment planning, it should comprises diet, physiotherapy and psychological evaluation

according to cause of the injury and current physical and mental state patient handling plan will be putif quadriplegia due to traumatic brain injury patient my loss his judgement while if it is due to SCI s/he may be lacking motivation due to psychological shock and impact of injury so s/he would need psychological support first to encourage movement and decrease participation restrictions & activity limitationsfor SCI patient potential and needs differ accordin to level of lesion which will affect goals and methods to be usedall over the plan environment has to be modified to be enthusiastic to reach the max potential of the patient as an individual csae

Only a HOME BASED PROGRAM ON PASSIVE  MOVEMENTS ,

POSITIONING & DIETING will help the patient-Ashok.Eappen