Therapeutic Gymnasium.pptx

therapeutic Gymnasium,

1. Therapeutic Gymnasium Dr.Harshal Patel (MPT) (Musculoskeletal and sports science)

2. Introduction Therapeutics means having medicinal or healing properties. The word gymnasium is the latinisation of the Greek noun gymnasion , whose meaning is to “Train in gymnastic exercise” generally “ to train to exercise” Historically, such a place was a place for both exercise, as well as bathing, especially social (communal) bathing. In 1598, the term was adopted from a "place to be naked" to a "place of exercise". The abbreviation to gym was introduced in 1871.

3. Therapeutic Gymnasium is room or building equipped for indoor sports or a large room containing equipment such as bars, weights, and ropes, for physical exercise. Healthcare consumers (patients and clients) typically seek out or are referred for physical therapy services because of physical impairments associated with injury, disease or disorders that interfere with their ability to perform or pursue any number of activities that are necessary or important to them.

4. Health care consumers are directly benefited from the Therapeutic Gymnasium. Physical therapy services may also be sought by those individuals without any impairment who wish to improve their overall level of fitness or reduce the risk of injury or disease.

5. Definition: Therapeutic Gymnasium is room or building equipped for indoor sports or a large room containing equipment such as bars, weights, and ropes, for physical exercise or building or room with equipment for physical exercise.

6. Gym based Therapeutic Exercise is rehabilitation oriented fitness program that are designed to improve strength, stamina, stability, flexibility, functionality, and/or mobility This can be using exercise equipment that is specifically designed to meet needs of patients with acute or chronic health conditions, physical disabilities or other problems or through individualized exercise routines that improve or restore physical function so that activities of daily living are no longer a challenge, reduce risk factors and improve overall health and fitness.

7. Therapeutic gymnasium should have the following facilities: 1. Therapeutic treatment private rooms 2. Remodeling of dressing rooms and bathroom facilities, with a large area for lockers. 3. Large windows that contribute to a bright environment and an ample and cosy atmosphere. 4. New physiotherapy state-of-the-art equipment.

8. The main advantage of this service is the interdisciplinary work, carried out by kinesiologists , physical therapists and doctors together with the medical professional ordering the treatment. All procedures are carried out under the strict medical protocol, inherent to each respiratory, cardiovascular or physical therapy specialty.

9. Equipment There's a cardio section and there is an aerobic section. The gymnasium is spacious, replete with electric treadmills, cycle treadmills, weights, equipment's for strength training like wall bars, triceps table, multi-gym, television and music system etc. It has wooden flooring and latest equipment's like mobilization couches with adjustable height, traction unit, dumbbells, treadmills (electric and cycle), and multi-exerciser machines, in addition to regularly required equipment's like parallel bars, wall bars, quadriceps table etc.

10. Exercise benefits/effects from the gym include: 1. Increased muscle strength 2. Increased flexibility 3. Weight Management 4. Reduced Stress 5. Improved sleep patterns 6. Enhanced self-image 7. Increased energy The ultimate effect of therapeutic gymnasium is to improve overall health and physical fitness

11. Health Benefits of Gym Exercise and Physical Activity: # Reduce the risk of premature death # Reduce the risk of developing and/or dying from heart disease # Reduce high blood pressure or the risk of developing high blood pressure # Reduce high cholesterol or the risk of developing high cholesterol

12. # Reduce the risk of developing colon cancer and breast cancer # Reduce the risk of developing diabetes # Reduce or maintain body weight or body fat # Build and maintain healthy muscles, bones, and joints # Reduce depression and anxiety # Improve psychological well-being # Enhanced work, recreation, and sport performance

13. Equipment used for : Therapeutic training Strength training Balance training

14. Therapeutic training Treadmill A treadmill is a device for or running while staying in the same place The machine provides a moving platform with a wide conveyer belt driven by an a electric motor or a fly wheel

15. Advantage Treadmill give a great cardiovascular workout and help to improve heart health Each time you step on a treadmill you strengthen your heart And as your heart grows stronger you lower your blood pressure Running or walking help to get the blood flowing which reduce the stress on your heart

16. Stationary cycle A stationary bicycle (also known as exercise bicycle, exercise bike ) is a devise with saddle, paddles, and some from of handlebars arranged as on a bicycle, but used as exercise equipment rather than transportation

17. Uses Exercise bike are used to increase generalise fitness and for training cycle event The exercise bike has long being used for physical therapy because of low impact , safe , and effective cardiovascular exercise it provide Stationary bike are also used to exercise for weightless It is used to increase lower limb strength and endurance

18. Elliptical trainer / cross trainer It provide non impact, reciprocal resistance to the lower extremities in upright, weight bearing position Both type of equipment also provide reciprocal resistance to the upper extremities.

19. PLINTH (COUCH) Used for treating patients.

20. Multi-gym :- Parts – seat, back rest, handle, shin pad, thigh pad, fixed & movable pulley, ropes, weights & knobs Uses – Used to give strengthening exercise to various body parts (upper & lower limb, back & chest)

21. Four Station Multi Gym • Lat pulley, Pec deck, Arm pulley, Leg curling /extension Six Station Multi Gym • Lat pulley, Pec deck, Chest / Shoulder press, Arm pulley, Leg curling / extension, Standing calf raise Ten Station Multi Gym • Lat pulley, Rowing pulley, Pec deck, Chest press, Shoulder press, Arm pulley, Leg curling / extension, Leg press, Standing calf raise, Dip, chin-up, abdominal unit

22. SHOULDER WHEEL It is a wheel mounted on the wall. Consists of fulcrum, handle and hand piece. Two types are available – one with giant wheel & other with axial rod Parts – giant wheel or axial rod, fulcrum, handle, resistance knob, vertical bar to change the height Used for shoulder exercises. Even used for elbow exercises.

23. Principle – 2 nd order lever Fulcrum at Centre of wheel, effort applied at handle & resistance applied through the knob Patient stands besides the wheel and moves wheel in clockwise as well as anticlockwise direction. Useful in shoulder circumduction movement. Increase ROM of shoulder abduction, flexion & circumduction

24. ROPE AND PULLEY Consists of pulley attached on the ceiling. The rope is wounded around the pulley. It also has hand piece. Used in performing shoulder exercises.

25. Patient sits on a chair and grips the hand piece. Patient keeps the upper limb forward for performing shoulder flexion and keeps upper limbs by the side for performing shoulder abduction.

26. FINGER LADDER It is the wooden ladder mounted on the wall. Patient places the finger tips on it and climbs up. Used for shoulder exercises.

27. Patient stands in front of the ladder to perform shoulder flexion. Stands besides to perform shoulder abduction.

28. WAND(STICK) Use to perform self-assisted shoulder exercises. Use for shoulder exercises like flexion, extension, horizontal abduction-adduction and combination of movement. Cane (stick) can be used in place of wand.

29. Patient is positioned in supine or standing In supine- flexion, horizontal abduction-adduction. In prone- extension, combination of movement. In standing- all the movements. Maintain shoulder in external rotation while performing abduction (thumb out). Maintain shoulder in internal rotation while performing flexion (thumb in).

30. WRIST ROLLER It is a wooden rod mounted on the wall. Consists of varying diameter for different grips of patient. Used for wrist flexion and extension exercises. To increase gripping power

31. Principle – 2 nd order lever Fulcrum at centre , effort applied through hand & resistance through knob Patient stands in front of the device and grasps the rod and roll it clockwise and anticlockwise.

32. SUPINATOR – PRONATOR EXERCISER It is a device mounted on the wall. Consists of wheel and a hand grip. Uses – To strengthen muscles of supination & pronation To mobilize radio ulnar joints & increase ROM of supination & pronation movements. To give resisted exercises for supination & pronation. Hand gripper also present which can be used to increase gripping power of hand & fingers.

33. Patient stands in front of the device. Shoulder is in adduction and elbow 90 degrees flexion. Holds the hand piece and then rotates in clockwise and anticlockwise direction. So that supination and pronation occurs. Principle – 2 nd order lever Parts-circular board, handle, resistance knob Fulcrum at centre of circular board, effort applied at handle & resistance through knob

34. PEG BOARD It is a wooden board with holes in which pegs are placed. Are of different types based on their colour , weight, shape, texture, etc Used for co-ordination exercises and gripping exercises.

35. Patient grasps the peg from the board and keep it aside than again can place it back. Uses finger flexors. Helps to improve gripping power of patients with weakness in prehension Useful to give game-like activities along with co-ordination training in patients with cerebral palsy & mental retardation

36. SPONGE BALL It is a soft ball. Used for gripping exercises. Wrist should be in neutral or slight extension position while performing exercises.

37. FINGER EXERCISE SPRINGS Consist of set of 5 springs Each spring is of different size and resistance Resistance gradually increases from spring 1 to 5. USES: Finger flexion exercises and opponent muscles of thumb.

38. FINGER EXERCISE RING Consist of metallic ring with 5 springs fitted to the ring, each spring for fingers and thumb. Spring ends have leather loops for inserting fingers. USES : Finger flexion exercises. Avoid wrist flexion while exercising

39. HAND ROLLER EXERCISE BOARD Board has different small rollers of different diameters, which provide different amount of resistance and also has one square block with loop and one roller with side knob. Here Velcro arrangement is used to provide the resistance. USES : For finger muscles strengthening Wrist flexors and extensors strengthening Supinator-pronator strengthening

40. PUSH UP BLOCK They are the two metal rods with hand grips. They placed on both sides of patient in sitting position and can perform strengthening of latissimus dorsi . It is by taking weight on ULs and lifting buttocks Can be used in prone lying. Patient does extension of trunk by taking weight on ULs. It is used to strengthen triceps.

41. SKATES ROLLER Consists of a skates with a ball bearing rubber wheels Straps are there so that it can be secured with the exercising part. Ball bearing arrangement reduces the friction so movement will be easier. USES In UL, elbow flexion-extension, horizontal add-abduction of shoulder. Also rotation of shoulder. In LL, knee flexion-extension.

42. SUPINATION – PRONATION DUMBBELLS Consists of a set of 3 wooden dumbbells of different size and weight Resistance provided by the dumbbells increases as the size of dumbbell increases, so it is useful for the PROGRESSIVE RESISTED EXERCISES. USES : To develop the strength of forearm muscles To develop strength of supinator's and pronators.

43. QUADRICEPS EXERCISE TABLE It is a table with fixed arm and swing arm. A roll is attached to fixed arm and resistances can be attached on the swing arm. If there is back support than it is called quadriceps exercise chair.

44. Patient sits on the table. Places leg behind the roll on fixed arm and than knee extension is done. Resistances can be adjusted accordingly. If the angle is fixed and swing arm are changed it can be used for hamstring muscles for that in sitting position patients places leg in front of the roll and does knee flexion. Trick Movements :- Trunk movements.

45. QUADRICEPS EXERCISE TABLE

46. BALANCE BOARD It is a wooden board with a rod or a disc below it. It makes the board unstable. Used for balancing exercises.

47. Patient stands on the board and moves the board in front, back and side to side. Patient stands on board with both the feets apart and tries to maintain the balance. Balance training initially is carried out in a parallel bar with support , then gradually progress to out of parallel bar without support .

48. WOBBLE BOARD

49. ANKLE EXERCISER Consists of two hinged planes one is horizontal and other one is inclined. There is spring attached between the two planes. Used for plantarflexor strengthening.

50. Patient sits on the chair and the device is placed in front. Patient places the foot on the device with heel at the bottom and toes at the top. Than presses the plane down.

51. ANKLE EXERCISER Parts : aluminum foot plate with straps, secured horizontally over the wooden base, springs are there to provide the resistance. resistance can be adjusted. USES : strengthening of plantarflexors and dorsiflexors Patient position- sitting, position the foot over the foot rest so that knee is directly over the footrest.

52. HEEL EXERCISER Parts : wooden base, piston arrangement to provide the resistance, footrest with the straps.

53. EXERCISE STAIR CASE (CORNER TYPE) It is L – shaped stair case. Has railings on the side. Uses :- training the patient for stair ascending and descending.

54. PARALLEL BAR It is a wooden floor with two horizontal rods on the sides with four vertical rods. Height of the horizontal rods can be adjusted at the level of greater trochanter of patient. Mirror is placed in front of the parallel bars.

55. Uses :- Sit to stand, Standing with support and without support, Gait training with support and without support, Balancing exercises. Patient is asked to see in mirror and make corrections in posture accordingly.

56. TILT TABLE It is a table which can be tilted. Angle of tilt can be changed from below. Patient is asked to lie down on table and is secured by straps around pelvis and thoracic region.

57. Then angle of tilt is changed so patient can be brought in standing position. Uses :- Helps to bring patient in standing position.

58. QUADRICEPS BOARD Made up of two hinged wooden planks, out of these two planks one is hinged and one is straight having zigzag arrangement. With these arrangement (zigzag n hinged plank) any angle can be adjusted and progressed over time as patient gain strength.

59. USES Knee extensors strengthening in terminal range. Sand bag can be tied to patient’s ankle for additional load-more strengthening.

60. WHEELCHAIR It is one of the walking aids. Consists of seat, back support, arm rests, foot rests, hand rims, wheels, brakes. Uses :- Transfer of patient.

61. WALKER (ADJUSTABLE, FOLDABLE) It is used for training gait in patient with support. Made up of plastic or aluminium. Consists of four tubular rods, ferrules and hand grips. Its height can be adjusted.

62. ELBOW (FOREARM) CRUTCH Made up of plastic or aluminiun. Consists of single upright rod, ferrule, hand piece and forearm cuff. Height can be adjusted. Used for gait training.

63. AXILLARY CRUTCH Made up of plastic or aluminium. Consists of axillary bar, hand piece, ferrule and double uprights which are joined distally into single upright. Height could be adjusted. Used for gait training.

64. STICK (CANE) Made up of plastic or aluminium. Consists of single upright, ferrule and has a curved hand piece. Used for gait training.

65. THERABANDS Made up of rubber. One set consists of 6 thera bands of different colours according to resistance offered. Used for strengthening exercises. Yellow Resistance Band (lightest) Red Resistance Band (light) Green Resistance Band (light-medium) Blue Resistance Band (medium) Black Resistance Band (heavy) Silver/Gold-resistance (heaviest)

66. Theratube

67. Flex bar Improve grip strength in the arm, hand and shoulder

68. WEIGHT CUFFS Used for strengthening exercises. Cuff contains sand or small pieces of metal. Tied over the distal part of the segment.

69. DUMBBELL RACK Rack consists of variety of dumbbells of different size and resistance. Used for strengthening exercises.

70. PHYSIO BALL (SWISS BALL) An exercise ball, also known as a yoga ball, is a ball constructed of soft elastic with a diameter of approximately 35 to 85 centimeters and filled with air. The air pressure is changed by removing a valve stem and either filling with air or letting the ball deflate. Use - Core strengthening, sitting balance training, upper limb lower limb exercise

71. SUSPENSION FRAME (GUTHRICK SMITH’S APPARATUS) Frame consists of rope, pulley, sling, cuff and hooks. Used for suspending limb for active assisted exercises.

72. WALL BARS Wooden bars are mounted on the walls. Uses:- Can make patient stand. Hanging

73. STATIC CYCLE Used for improving fitness of patient Also for lower limb exercises.

74. ROWING MACHINE Parts : tubular frame, padded seat, 4 big nylon castors which slides smoothly over the frame, two foot plates with straps and springs. Resistance can be adjusted by the number of springs.

75. Ask the patient to push over the footrests and straighten the knees. USES Strengthening of LL extensors, plantarflexors.

76. CONTINOUS PASSIVE MOTION (CPM)

77. BOLSTER

78. PEDAL CYCLE