PHYSIOTHERAPY
Physiotherapy is a branch of treatment that uses physical means to relieve pain, regain range of movement, restore muscle strength and return patients to normal activities of daily living. It is a healthcare profession, which sees human movement as central to the health and well being of individuals.
WHAT DO PHYSIOTHERAPISTS DO?
Physiotherapists identify and maximize potential through health promotion, preventive healthcare, treatment and rehabilitation. Physiotherapists help and treat people of all ages with physical problems caused by illness, accident and ageing. The core skills used by physiotherapists include manual therapy, exercise therapy and electrotherapy modalities. Physiotherapists also have an appreciation of psychological, cultural and social factors, which in turn influence the patient community.
Physiotherapists assess and treat patients referred from all areas of the Hospital. A physiotherapist is allocated to each inpatient ward and sees all patients requiring physiotherapy input for their related problems.
PHYSIOTHERAPY AT ROYAL HOSPITAL
The physiotherapy department is located on Ground Floor near Pharmacy. Phone: 00968-24599440 or via Hospital Ext No: 9440.
The Physiotherapy service at the Royal Hospital is well equipped with the latest technology available in the field of Physiotherapy. It focuses on inpatients, though out-patient care is also provided. There 26 staff which include 22 Physiotherapists, 1 Speech Therapist and 3 Medical Orderies.
The senior staff include:
Aarifa Al Sheibani, Head of Department:
Laurie Ottenbreit, Deputy Head of Department
Fiona Clark, Physiotherapy Supervisor
Barbara Reid, Physiotherapy Supervisor
Najah Al Abdulsalaam, Speech and Language Pathologist.
The Physiotherapy section is divided into four units:
Unit 1:
- Musculo-Skeletal Out Patient Department (OPD)
- Adult ICU
- Oncology and VIP ward.
Unit 2:
- Post Cardiac Surgical unit {PCSU}, Thoracic and Cardio Vascular Surgery,
- Surgical Wards (male and female) and Special Nursing ward
- Gynaecology & Obstetrics.
Unit 3:
- Neurological OPD (adult and paediatric)
- Medical wards.
- Paediatric Wards.
Unit 4:
- Speech and Language pathology.
The physiotherapy department operates from 7.30am - 2.30pm Saturday to Wednesday. In addition we provide on-dall services after duty hours throughout the week. This includes weekends and public holidays. This service is available for Emergency Respiratory Conditions Only.
PHYSIOTHERAPY IN OPD
Outpatients are seen in the physiotherapy department via an appointments based system. Patients must be referred to Physiotherapy by their treating team. Referrals are also received from different clinics including the Emergency room and staff clinic. The outpatient department deals with many patients with different types of musculoskeletal problems, arthritis, sports and other injuries and lymphoedema cases. Safety is of uttermost priority. Initially the main complained of is treated followed by the other problems the patient may have. Different varieties of treatments are provided: soft tissue release (massage, lymphatic drainage etc), Manual techniques, Joint mobilisation, Electrotherapy, Different type of exercises, Education and Advice for the patient. Treatment modality are chosen according to the findings from the full assessment (subjective and objective).
Patients are normally given a home program. They are expected to do all the exercises and whatever advice was given to gain optimal result.
PHYSIOTHERAPY IN THE ICU
The main aim of physiotherapy in Intensive Care Unit is:
To assist in the removal of excessive bronchial secretions.- To ensure adequate ventilation of all areas of the lungs and to help prevent atelectasis.
- To maintain full joint range of movement and muscle length by passive and splint application in case if the patient is unable to perform active exercises.
- To maintain mobility and blood circulation by free active exercises.
- To help rehabilitate the patient to a full and independent life as possible.
The physiotherapy services are available after the normal working hours for emergency chest cases.
Our aim is to provide possible psychological and emotional support to patients who are in distress.
PHYSIOTHERAPY IN ONCOLOGY
The main aim of physiotherapy in the Oncology ward is to evaluate the patient as a whole and set realistic goals for the patient to function at a minimum level of dependency and to optimise their quality of life regardless of their life expectancy.
Most of patients in the oncology ward present with pain as a result of their illness. Pain of musculo-skeletal origin can be treated by pain relief like TENS, simple heat and cold pack fermentation as well as relaxation techniques.
The objectives of physiotherapy for cancer patients include:
- Chest physiotherapy: To remove the excessive lung secretions. To teach relaxed postures and proper breathing techniques to cope with breathlessness.
- Psychological and emotional support.
- Bedridden patients are treated with active, active-assisted or passive movements depending on their level of function. The aim is to prevent muscle atrophy, joint adhesions and soft tissue contractures.
- Lymphoedematic patients are treated with intermittent compression pump, active exercises. Patients are provided leaflets for Home exercise programmes.
PHYSIOTHERAPY IN WOMEN HEALTH
Antenatal Care:
- Assess physical health and identify any musculo-skeletal or neuro-muscular problems that could be aggravated by pregnancy. Teach leg, abdominal and pelvic floor muscle exercises.
- Advice on back care and lifting.
- Teach positions that may be used for labour.
- Teach methods for controlling neuro-muscular tension.
Postnatal Care:
- Re-educate and strengthen pelvic floor muscles.
- Instruct in the care of the perineum and relieve pain in the perineum.
- Strengthen the abdominal muscles.
- Give post operative care following a caesarean section.
- Advice on posture and prevention of back strain with activities related to the baby.
Pre-operative Care and Advice:
- Assist in the prevention of circulatory and respiratory complications.
- Strengthen pelvic and abdominal muscles prior to surgery.
- Teach postural correction.
- Advice for back care and progression of activities to full function.
PHYSIOTHERAPY IN CARDIOTHORACIC AND CARDIOLOGY WARDS
Physiotherapy is also provided to patient in the Adult and Paediatric Post Cardiac Surgery Unit and Thoracic and Cardio-Vascular Surgery ward.
Role of Physiotherapist
- Pre-operative education and counselling of patients.
- Post operatively;
Main aims:
- To clear the secretions from the lungs.
- To ensure that all areas of lungs are well ventilated.
- Circulatory exercises to prevent DVT.
- Limb exercises to maintain general mobility and blood circulation.
- Advice on postural correction. Early mobilisation and gradual progression to maintain cardio-pulmonary function.
- Up on discharge a home programme is given.
The main aim of Physiotherapy services in Post Coronary Care Unit include:
- Respiratory care.
- Maintain mobility in bed.
- Early Ambulation.
PHYSIOTHERAPY IN PAEDIATRICS
A good portion of the Physiotherapy service is devoted to inpatients and outpatient treated by the Department of Child Health. Physiotherapy is provided for different kind of neurological, respiratory, rheumatological and congenital orthopaedic conditions. Inpatient care includes patients in the following wards:
Paediatric Intensive Care Unit .- Paediatric Surgical and Oncology wards
- Paediatric Medical wards and Paediatric Hi-dependency.
- Maternity wards.
Physiotherapy Treatment includes:
- To provide care for acute and chronic respiratory patients.
- Post operative respiratory care.
- To treat the patients with neurological, rheumatological and orthopaedic conditions.
- To educate the patient family about the importance of physiotherapy care at home.
PHYSIOTHERAPY IN GENERAL SURGERY
The physiotherapist has an important role to play in assessing which patients being prepared for surgery are at risk of developing complications that may help to prevent.
As a member of the surgical team the physiotherapist may be alerted about any problems or potential problems by the medical or nursing staff. The medical history of any patient must be checked for any respiratory or circulatory problems that could place the patient at risk.
The physiotherapist will explain to the patient why treatment is necessary and teach the patient the exercises that he will be required to performed post-operatively. The patient will be taught how to cough effectively and how to support the wound site. Instruction will be given on the exercises that patients are expected to perform.
The patient should practice the exercises so as to become familiar with performing them correctly. If the preoperative treatment is taught carefully it will be much easier for the patient to respond to instructions post-operatively. It is very important that, whenever possible, the same physiotherapist should treat the patient both pre- and post-operatively.
Physiotherapy is very important in the rehabilitation of patients post amputation. The physiotherapist is responsible for improving the patient’s physical ability to help him / her to achieve independence following amputation. The physiotherapist will see the patient regularly from DAY 1 post amputation till time of discharge and follow up in OPD. If possible she/he will see the patient before the surgery. The physiotherapist and the patient will decide together on realistic goals of mobility and work towards these either on the ward or in the gym.
Women faced with breast cancer may develop musculoskeletal impairments following mastectomy and breast reconstruction. Suggested exercises guidelines are provided by the physiotherapy in surgical wards. A leaflet is given to the patient to follow up the exercises and to be aware of the lymphoedema and how to prevent it.
MEDICAL PHYSIOTHERAPY
Physiotherapists assess and treat patients with a wide range of diagnoses on the medical wards; most common are respiratory, neurological and rheumatology diseases. Outpatient services are largely focused on pulmonary, stroke and vestibular rehabilitation.
The emphasis of treatment is on assisting patients to achieve their highest level of functional mobility, independence and wellness. Therapists also focus on education of patients to improve self-management skills. Family members are trained to assist the patient throughout their recovery, with educational leaflets provided to promote follow-through on recommendations.
The Physiotherapy staff work in coordination with Doctors, Nurses, Speech & Respiratory Therapy and Social Services to provide a comprehensive approach to patient management. Physiotherapists are also active in promoting education through the provision of outpatient respiratory training sessions.
SPEECH THERAPY
Speech-language pathology is the study of disorders that affect a person's speech, language, cognition, voice, swallowing (dysphagia) and the rehabilitative or corrective treatment of physical and/or cognitive deficits/disorders resulting in difficulty with communication and/or swallowing. Treatment includes specific exercises designed to improve speech skills, language skills, and oral motor skills. It improves communication skills with professional speech and language therapy.
The speech-language pathology unit assess, diagnoses, treats and actively educates individuals suffering from communication and swallowing related disorders. The Speech-Language Pathologist (SLP) identifies and assists to diagnose diseases as well as upper aerodigestive disorders. However, the primary focus of the SLP in the Royal hospital is the treatment of dysphagic, aphasic and patients with upperaerodigestive disorders inpatients and outpatients. Other disorders treated by the SLP include fluency disorders, hearing, resonance, speech, and language and voice disorders.
The treatment is focused on creating an optimal individualized treatment plan for patients. The SLP plays a crucial role in helping to improve the patient's quality of life and greatly contributes boosting their confidence and greatly contributing to patient's life by improving communication skills, improving self-esteem and boosting confidence. Prevention of swallowing problems is of paramount importance. The speech language pathologist also focuses on preventing future swallowing problems that might cause major complications like aspiration, pneumonia.
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