Physical therapy uses natural (physis, Greek: nature) treatments with a broad 
spectrum of orthopaedics for support. It supports the bodily functions and contributes to the healing process of acute as well as chronic pains. Matching the clinical picture, precise measures are taken after ambulant or in-patient operations on the joints, as immediate aid after injuries of the locomotor system operations on the spine, as well as with degenerative and rheumatic diseases.
Aims of rehabilitation:
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Regaining the normal functions
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Reduction and/or elimination of pain
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Improvement of mobility
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Improvement of the quality of life
The therapy offers are for example:
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Electrotherapy
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Mechanotherapy
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Thermotherapy
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Hydrotherapy
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Balneotherapy
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Heliotherapy
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Phototherapy
"Physical therapy" (Greek physis=nature) uses natural measures to influence the bodily functions positively. Especially older people profit from safer therapies. Physical therapy is divided into active and passive treatments. The active treatments, with which the patient has to make an important own contribution, include physiotherapy, kinesiotherapy and respiration therapy. The passive treatments include balneotherapy, massages, electrotherapy, thermal packages, ultra-sonic therapy and many more.
The therapy aims are manifold. With the aid of physical therapy following other therapy aims can be achieved or supported:
- Pain relief
- Retaining and improving the functions of the locomotor system (mobility, exercise tolerance, muscular strength)
- Improvement of circulation and the nutrient supply of the different tissues Improvement of responsiveness and general bodily fitness
Important facts when working with older people
As physical measures influence the bodily functions directly it is important to bear in mind the special changes in the functions of the organic system. These changes include the reduced maximum stress tolerance of the heart and circulation, the reduced elasticity of skin, connective tissue and suspensory tissue and the vascular system, reduced sensitivity of the skin, reduced muscle mass and muscle strength. Because of these changes the skin is e.g. less elastic and also less sensitive as in younger years. That makes working with training devices (aids), e.g. small balls with which the manual strength is trained, more difficult. If not careful bleedings may occur during work. Because of the changes due to age a lack of accelerated blood flow occurs. Therefore the training should be conducted slowly and gradually.
In advanced age illnesses and chronic diseases are more common, e.g. high blood pressure, diabetes, weak heart. This can limit the use of some therapy measures, e.g. physiotherapy.
The individual condition of health has to be taken into account.
Physiotherapists must bear in mind the particularities when working with older patients. Physical therapy represents stress and strain for the body. Before starting the therapy the therapist has to know about eventual illnesses of the patient and judge the individual maximum strain the patient can bear. Moreover all therapy measures should have a preset aim (e.g. an increased stability when walking). The physical therapy should be integrated in a detailed therapy plan with a preset aim that can also contain e.g. a drug based therapy or an operation.
To stay independent for as long as possible is an important aim.
In all older people some important functions should be trained that are inexpendable for the preservation of independence. Those are e.g. muscle strength, ability to walk, balance, manual dexterity and stamina. Especially for life at home particular abilities can be trained, e.g. walking up stairs, dealing with obstacles or lifting objects.
Physical therapy has a considerable importance within the medical therapeutic range of treatments. Physical therapy treatments include physiotherapy, ergotherapy, medical training therapy, manual therapy, massage therapy, electrotherapy, ultra-sonic therapy, lymph drainage, therapeutic application of water and baths, inhalation therapy, climatotherapy, phototherapy as well as thermotherapy and frigotherapy.
A special knowledge is required to choose and combine the optimal method of treatment from this wide-ranging area of therapeutic possibilities.
Our doctor for physical and rehabilitative medicine will devise your individual therapy plan that takes into account your current ailments, test results and diagnoses and functional limitations. She will formulate your therapy aims with you and will regularly control your progress in the treatment so the therapeutic measures can the adapted on time if necessary.
Electrotherapy
In the electrotherapy many differt electrical currents are used. Direct currents (e.g. galvanisation, iontophoresis), low-frequency stimulative currents (e.g. diadynamic currents, ultra impulse currents, high voltage currents, needle impulse currents), medium frequency currents (e.g. interference current method), high frequency therapy (e.g. short-wave, microwave).
Further methods of electrotherapy are the TENS-method (Transcutane electrical nerve stimulation) as an important element in the pain therapy and the EMS (Electrostimulation of the muscular system/electrical muscle stimulation) to strengthen the muscles.
The electrical currents differ in form of impulse, duration of impulse and frequency which also determines their different activity spectrum. With different emphasis they have pain relieving, circulation stimulating, decongesting and/or cell metabolism stimulating effects. Furthermore they can be used for muscle relaxation, muscle re-education and for the improvement of neural activity.
Beside the conventional electrotherapy methods we also regularly introduce new approached for treatment from various sources, that are often based on the lastest discoveries, e.g. PMT (pulsating magnetic field therapy) and the micro current therapy.
Ultra-sonic therapy
Ultra-sonic waves cause a change in pressure in the tissue (mechanical vibratory effect) and are partially transformed into friction energy (thermal effect). They are pain-relieving, circulation stimulating, muscle relaxing and separate adhesions. Moreover they have a stimulating effect on tissue regeneration and fracture healing.
The depth of penetration and thermal effect of the ultra-sonic waves are dependent on frequency and can be individually determined. With the (ultra-sonic) phonophoresis a suitable medicament, such as e.g. Voltaren Emulgel, Mobilat-Gel, Contratubex is used as a contact medium to transport the medicament via ultra-sonic waves into the tissue/under the skin. With this method the depth penetration of the medicament is dependent on the time factor and the frequency rather than on the intensity.
The ultra-sonic therapy can easily be combined with direct current - or some impulse current methods, which can further increase the effectiveness. When indirectly treated with ultrasound the treated part of the body is placed in water. The water acting as a connective medium. Indications:
Clinical characteristics of the disease which require an intensive, local thermal therapy
- Degenerative joint diseases (=arthroses)
- Degenerative spinal diseases
- tennis elbow, golfer's elbow (epicondylopathies)
- shoulder pains
- nerve irritation and neuritis
- rheumatoid arthritis, Bechterew's disease
- sprains, strained muscles, contusions, haematomae, swelling
- tendon irritation (e.g. Achilles tendon)
- muscular tensions, painful myoscleroses
- delayed bone fracture healing
- painful and adhesive scars
TENS (Transcutane electrical nerve stimulation)
The TENS is the electrical stimulation of skin areas via surface electrodes in order to block the pain sensation. Furthermore TENS stimulates the production of endorphines. These are autologous substances that help relieve pain.
The different effects and the resulting pain-relieving effects are determined by the individual stimuation parameter (frequency and current force) as well as the different stimulation patterns (continuous, Burst, amplitude or frequency modulated stimulation).
The TENS is a possibility of treatment with practically no side-effects for acute and chronic pains of different causes. As the therapy success varies from patient to patient the electrical stimulation parameter and the optimal electrode positions have to be tested individuallly for every patient, before assessing the treatment as ineffective.
The best results are to be expected with acute and subacute pains. With chronic pains the effectiveness is often good at the beginning, however it frequently diminishes after a few weeks. In favourable cases the analgesics can be reduced or the patient can stop taking them altogether.
