OF PERSON Members: Alexandrino, Jony CI: 16580669 Chevez, A. Karina CI: 16153790 Gonzalez A, Karime CI: 82293485 Gonzalez S, Dagmar CI: 17315400 Guanchez, Sergio CI: 1841 2832 Martin, Jennifer CI: 17248738 Perez, Mariafernanda CI: 16030106 Subject: Pr osthesis Prof. Mayra Marchan San Diego, July 28, 2006. INTRODUCTION It is important to know how disabled people can reach their almost total independence, which is why we must take into account as the transfer is of vital significance for the disabled, and how it can achieve his daily life acti vities without any problem . However, the quality of life of people with a disab ility, impairment or disability, is not as healthy as they come other problems s uch as pressure ulcers if the patient were to remain long in one position, like muscle contractures as well as the weight would be affected if you do different demonstrations and exercises to prevent the increase or decrease of the same, or might even reached the urinary tract would be altered to complicate their respi ratory system if it did not change position On the other hand is causing intesti nal problems such as urinary incontinence and voiding problems evacuation. Nor c an we ignore the fundamental thing that is for a disabled person, the use of att achments, as these removals is much easier and faster, without forgetting it is clear that, if made or invented by the therapist (physiotherapist) will be more accessible and less expensive to buy, and easier to send it by someone who is fa miliar with these devices. BASIC DEFINITIONS: Transportation: the means of transport used by every human be ing to reach a specific place, either by walking, or using attachments in this c ase mulatto, canes, wheelchairs, walkers, and others . ADL: o also Activities of Daily Living; activities normally performed by a person in everyday life such a s eating, dressing, washing or brushing teeth. The ability to perform daily acti vities may be affected by chronic diseases, neurological or accidents, of course the limitation that may arise from these diseases may be temporary or permanent . Deficiency: can be defined as a disorder whether functional or structural whic h may arise due to physiological changes or abnormalities, anatomical and psycho logical that may cause the individual with a disability in the conduct or perfor mance of normal activity. Disability: is what we know as the absence, loss, redu ction or better yet the limitation resulting from physical or mental capacity th at human beings cause an impairment in important activities in their daily lives and bring social, community and family labor among others. Disability: the rela tionship between impairment and disability, which results in the impairment of n ormal performance of an individual. Functional capacity: the capacity of a perso n to perform everyday activities independently and to perform the functions expe cted of it. Amputation: surgical procedure is used to remove a segment of the body and which leads to a new process with the creation of a new body which is the stump. Hemi plegia: Hemiplegia is paralysis of one side of the body, which appears as a resu lt of injury to the pathways of nerve impulses in the brain or spinal cord. This happens, usually as a result of arterial blockage that deprives the brain of bl ood. When the affected muscles are rigid, is called spastic hemiplegia, if they become flaccid and weak, that of flaccid hemiplegia. Monoplegia: neurological di sorder that is characterized by paralysis of a single member. Diplegia: bilatera l paralysis on both sides of any portion of the body or similar parts on opposit e sides of the body. One type of facial diplegia diplegia is Paraplegia: When a person has lost feeling and is not able to move the lower body. The lesion is in the area dorsal, lumbar or sacral. Quadriplegia or tetraplegia: Although diffus

e brain injury may be responsible for quadriplegia is not the brain the most com mon site of this abnormality. A distinction should be quadriplegia brainstem lev el of the cervical spinal cord injury produced.€Key symptoms of brainstem compr omise are paresis of cranial nerve symptoms and signs associated with cerebellar compromise, such as ataxia. Paralysis of all four limbs. Often corresponds to a lesion to the spinal cord or brain stem. ACTIVITIES OF DAILY LIVING, by definition, the activities of daily living relate d to personal care, and include food, the use of sanitary facilities, bathing an d dressing. For the normal adult sedentary occupation, bathing and dressing can be more varied exercise of their daily lives. Because of its personal nature, ac tivities of daily life are of paramount importance to the morale and motivation of the patient. IMPACT OF PHYSICAL DISABILITIES Persons with disabilities may ex perience changes in patterns of urination, in the integrity of the skin or stool , depending on the type of physical disability. Mobility in bed rails involves t he use of aids for physical transfer are lifting devices, stool, shower chair an d table slide. The wheelchair may be the primary means of removal or addition of walking used to preserve the patient's energy. You may be required for ambulati on of assistive devices as a cane, crutches, walkers, braces or prostheses. CONC ERNED PATIENT TRANSFER In the developmental sequence of adapted, there are certa in activities of the wheelchair. To adopt and maintain a seated position, to joi n the standing position from sitting, descending into the squat position and sit ting, and lifting the foot and stamp, prepare the patient to use the wheelchair. The most important transfers are going to be out of bed to wheelchair and vice versa, and from there to a chair or chair to toilet, bathtub, car etc. However, the correct use of the wheelchair as a means of locomotion, can contribute to pa tient recovery. Moreover, the activities through exercise mats allows the functional development of a more complex way, giving the patient greater freedom and skill in handling their needs. The use of a wheelchair through the relocation requires or warrant s the coordination of body segments both in balance and in motion, giving the pa tient the security it needs, as it is for him to improve their ability to mainta in and recover the sitting position, and move their limbs propulsion and generat ing greater efficiency from the chair. Since one of the objectives of this group of patients regarding the use of the wheelchair is raised, get in and out, whic h is achieved by just knowing the proper handling of the brakes, pedals and whee ls itself. This is learned through proprioceptive neuromuscular facilitation tec hniques in order to promote the patient's ability in each of their needs, taking into account the needs and potential of the patient. Walker with these devices is a way similar to parallels with the advantage that it can carry the device wh ile traveling. Its use produces a lot of security, not only for the stability th ey provide, but by the psychological peace of mind. There are a variety of walke rs, are wheels without them articulated. The choice is based on the special char acteristics of the user. Crutch for some people is a bit complicated to use crut ches, so they must be taught the correct way to use them. 1. Crutches should be placed 2 to 3 finger widths from the underarm to avoid com pressing the nerves in the arm and cause paralysis in the upper limbs. 2. DO NOT hang up on crutches, or all your weight on your armpits. 3. The elbows should b e semi - bent to get up and push the legs forward properly. 4. If walking with c rutches, it becomes very difficult, you must first put a crutch on with the oppo site foot and then another crutch with the other foot. 5. For children who have difficulty walking, they can begin moving forward with short hops (this is slowe r but safe), put both crutches and then give short hops and feet are behind the crutches. After they get used to the bumps and make them longer (it is faster, b ut slightly more dangerous), move the crutches and make longer leaps forward bot h legs being ahead of the crutches. Objectives of crutches: Getting good stabili ty and balance, since they have direct support on the trunk.€Making up pendular The most common are the axillary crutch and adjustable axillary crutch. NOTE: T

he concave-shaped axillary support that allows the socket in the anterior and la teral chest, about 5 cm below and slightly forward of the armpit. NOTE: Although it is called axillary CRUTCH, should not go under the armpits, this could compr omise Nervis A vascular bundle that lies at that level, leading to major complic ations, such as tingling in the arm and loss of strength. NEVER SHOULD BE SUSPEN DED BY armpits. STICK 1. Should be placed in the hand opposite the injury in February. Progress must be affected leg while the stick 3. The patient should have anti-slip footwe ar INDICATIONS crutches and canes are shown in: 1. Patients amputees. 2. Patient s to whom they are being re-educating the fly. 3. In hemiplegic patients. 4. In children who have difficulty walking. 5. In lesions traumatologic injuries. For personal bath, the patient must move from the wheelchair into the bathtub. If th e patient can not stand, you can install a seat that is secured with bars on the sides of the tub. Once seated, you can lather up with a glove sponge and wash w ith water from the shower head. For the transfer from the wheelchair to the seat of the bathtub or the toilet will continue the basic scheme of transportation b etween two chairs. If it stays standing, may be sufficient placing a vertical ba r on the wall that allows the subject. Tips for the bathroom: 1. The door should not close with insurance 2. The wheelchair should be left near where the patien t, so as to enable it to move. 3. Family members should be advised if the patien t is using the bathroom 4. The hygiene items should be available at a moderate height easily accessible home adaptations: 1. In the cockpit, the subject bar should be placed vertically or horizontally, or a special seat, if the patient can not stand. 2. The floor of the bath must always have a slip-resistant. 3. Water temperature in the showe r or bath must be set before entering it. 4. If the house has two floors, one in which you want to move, she must have everything you need, unless you can go up and down in a simple or can stay on the floors below. 5. Side rails should be p laced in all sections with a drop or in the hallways and rooms, if necessary. 6. The doors must be wide enough and easy to open. Wheelchairs must be appropriate to the individual requirements of patients. Should enable the brake of the whee ls with a lever for easy access and management by the unaffected limb. It is des irable that the armrest and footrest can be raised or removed easily. As in the transfer of the wheelchair to the bed, the bed should be at the correct height f or easy transfer to a wheelchair and must have a firm mattress. In some cases it may be useful placement of a bar at the bedside, to facilitate the power seat. At home it may be necessary to make minor changes and adjust the level changes w ith ramps. If there stairs inside the face, can be useful to link a chair to the handrails, the controls are on the armrest and electrically operated. Skip the patient from the bed to a wheelchair. The first thing to do is fix the wheels. If still there is danger of the chair to move will need two people, one of which will hold the chair for support to prevent movement, 2. If the bed is t oo high should contain a step that is firm and has a sufficient area for the pat ient to move without falling over 3. The patient will sit on the edge of the bed and will, with the help of the Auxiliary, the robe and slippers (so as not to b e coming out with ease), 4. If the patient can not do only the movements necessa ry to sit on the edge of the bed will help as indicated as the patient lay on th e edge of the bed 5. The chair is placed with the back foot of the bed and paral lel to it, 6. The Keeper Assistant or the patient is placed against the foot tha t is closest to the chair in front of another; 7. The patient puts his hands on the shoulders of assistant or janitor as he grabs him by the waist, 8. The patie nt puts his feet on the ground and the Assistant Keeper subject or with his knee later in the knee for the patient not to bend involuntarily, 9. The Keeper Assi stant or rotates with the patient and, once placed in front of the chair,€Bend your knees so that the patient can go down and sit in the chair. When the wheel chair is not proceed in the same way, but the danger of the chair to move lower. Moving a single person to make a move up without assistance of another person,

the patient should be placed at the top of chair or bed with your feet flat on t he floor and the sound side always ahead. It will stand up and be tilted forward , arms resting on the chair. The body is rotated, it will be back to the chair o r bed and drops smoothly. SAFETY PRECAUTIONS 1. Be avoided, at least in the 1eras stages of recovery, in c arrying out routine daily activities. Efforts should be concentrated interest in each activity and do several things at once. 2. Wear shoes with nonskid soles o r rough. 3. Avoid waxing the floor and application of cleaning products that do the sliding surface. When using crutches, canes should be attached on the surfac e of friction or slip device support. 4. Preferably not place rugs on the floor, to avoid problems in May. Try to keep cables in the ground or other objects, to avoid tripping 6. If the patient lives alone, someone should call the telephone every day or visit him. 7. If possible install phone extensions in multiple roo ms and leave emergency numbers in sight. Physiotherapy for neurological disorder s Hemiplegia Tto monoplegia Paresthesia diplegia Objectives: General: A. Restore body schema B. C. Reset flare reactions Normalize sensitivity D. Restore standi ng and walking patterns specific: A. B. Normalize muscle tone C. restore lost fu nctions Improve reflexes D. AVD wean E. Improve voluntary movements, coordinatio n and F position Inhibit clonus, spasms, associated reactions Treatment Techniqu es: A. Margaret Method B. Rood Brunnstrom method C. Bobath Method D. Passive exercises to the affected limb E. Hydrotherapy exercises (swimming po ol) to retrain up Paraparesis Paraplegia Quadriplegia Quadriplegia Objectives: G eneral: A. Promoting independence Specific: A. B. Train transfer Increase FM and segments uncommitted C. Increase joint range of involved segments D. Postural t raining and personal hygiene E. Reset standing, straightening F. Restore gait pa tterns Treatment Techniques: A. Hydrotherapy exercises (swimming pool) to retrai n up. B. Passive exercises for muscles of the affected family members. C. Bobath Method CONCLUSION It is important to note that aid is the only physiotherapy that he sh ould provide for patients requiring transfer of teaching, but also is of paramou nt importance, socio-cultural support, the therapist's approach should be the pr imary and main . That is why, one must bear in mind that not all patients will a ccept the use of attachments that have been shown in this work, and not always t he therapist will take the decisions of the therapy to be implemented in any cas e that may have at that time. Nor should we forget that the exercises outlined h ere are essential to prevent pressure ulcers, intestinal disorders, cardiovascul ar complications, among others, that could hinder the recovery of disabled patie nts. Of course, the help you can provide daily or family relatives of the disabl ed, I could not go unnoticed, as it will be the person in charge concerned and t hat the disabled can move around the house or free space visit, not forgetting, to achieve the independence of that does not overlook. REFERENCES (Page onceptos.htm (Information page on the orthotic management) visi t informative site about managing orthosis: www.healthwrights.org / books / ENCD / ENCD% 20chap% 2043.pdf Voss - Ionta. Proprioceptive neuromuscular facilitatio n (Patterns and Techniques). 3rd edition. Editorial Panamericana. Madrid. Spain. Voss - Ionta. proprioceptive neuromuscular facilitation in practice (Illustrate d Guide). 2nd Edition. Editorial Panamericana. Madrid. Spain. informative basics ): http://www.ibermutuamur.es/ibertalleres/guias/guia_madrid/accesible/informacion/ c