Physiotherapy in abdominal surgery

Acute physiotherapy management in patient with abdominal surgery

1. Physiotherapy in Abdominal surgery BY: Dr. Rekha Marbate

2. Content Introduction Role of Physiotherapy Complications and Problems Goals Intervention

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 Removal of diseased gut, ovarian cysts,  hernia repairs,  Hysterectomy Laprotomy Others

5. Role of Physiotherapy

6. Physiotherapy Goals- Short Term

7. Physiotherapy Management  Breathing exercises  Electrotherapy modalities for pain management, muscle reconditioning, fluid mobilization and tissue healing   Soft tissue massage to promote blood circulation and lymphatic drainage. 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

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  

12. Transcutaneous electrical nerve stimulation (TENS)  Uses  a two pronged approach to pain relief. First, they target sensory nerves, stimulating them to block pain signals and prevent their transmission to the brain. TENS also promotes production of endorphins, the body’s natural pain reducing substances. 

13. Electrotherapy in Muscle Rehabilitation NMS:-   low-voltages current to stimulate motor nerves to cause involuntary muscular contractions.   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.  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.

14. 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 

15. Physiotherapy Goals- Long Term  Patient education: counselling, home regimen, ergonomic advice,  Scar and wound management: Improve muscular strength: PRE Improve cardiovascular endurance: Aerobic training Improve Functional Capacity: Recreational activity and group therapy

16. References: Took of Physiotherapy in surgical Conditions by Puspal K mitra Therapeutic Exercise by Carol A kisner Electrotherapy Explained By Jagmohan singh

17. THANK YOU