MUSCULOSKELETAL

REHABILITATION

Dr. Cok Dalem Kurniawan, Sp.KFR

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Definision :
Branch of Medical science handling
Disable effect of trauma or disease at systems
of Neuro MusculoSkeletal ,cardio Respiration
and also affects psycho-sosio-vocational..

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GOAL:

*Handicap prevent

* Handicap minimize.

* Optimal of function

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SUBDIVISION RM
 Musculoskletal
 Sport Injury
 Neuromuscular
 Cardivascular
 Respiratory
 Pediatric
 Geriatric
 Cancer & Paliatif
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Trauma Pain Inflammation Infection Emotional tension Cold Immobilization
(Direct or
indirect)

Reflex Muscle
Contraction

Muscle
Spasm

Restricted
Pain
Movement

Circulatory
Stasis
(Tissue Ischemia)
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Physical Therapy (Modalities)

a. Heat Therapy
b. Cold Therapy
c. Massage
d. Traction
e. Electrical Stimulation
f. Hydrotherapy
g. Exercise Therapy

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Physical Therapy…….
a. Heat Therapy
- Analgesic effects
- Inflamation effects
- Muscle Relaxan effects
- Vasodilation blood flow
- Collagen Extensibility
- Sedative

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Physical therapy…………
b. Cold therapy
- Analgesic
- spasticity
- Acute trauma manage
- Inflamation process
- Muscle reeducate

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Physical therapy……………
c. Massage
 Muscle relaxation
 Sedative effects
 Blood flow
 Breaking of adhesion
 Edema
 Pain
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Physical therapy………………
d. Traction
- CRS
- Neck muscle spasm
- LBP
- HNP

e. Electrical stimulation
- TENS
- ES ( Faradik - Galvanik )
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Physical therapy………
f. Hydrotherapy
Characteristic :
- Bouyancy
- Resistency
- Hydrostastic

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Physiological Effects Hydrotherapy
1. Cleansing effect
2. Musculoscletal effect
3. Cardiovascular effect
4. Respiratory effect
5. Renal effect
6. Psychological effect
Exercise therapy

-ROM Exercise
-Strengthening exercise (Isotonic,
Isometric,Isokinetic )
-Stretching exercise
-Endurance exercise
-Coordination exercise

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MUSCULOSkLETAL INJURY

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Musculoskletal Injury
 Bone Injury
 Ligament Injury
 Muscle &Tendon Injury
 Soft Tissue Injury

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The Purpose of Rehab MS Injury
 Pain / Muscle spasm Control
 Reduce Edema
 Prevent Deformity
 Improve Range of Motion
 Improve Muscle Strength
 Prevent Complication
 Return to Activity
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Long Immobilization
Complication
Atropy
 Contracture
 Muscle Strength
 Osteoporosis
 Ulcus Decubitus
 Pnemonia
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Complication……..
Orthostatic Hipotension
DVT
Hipercalsiuria
Urinary stone
Constipation
Depression
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Prevention
 Muscle’s Weakness & Atropy
-Strengthening Exercise
(Isotonic, Isometric,Isokinetic)
-ROM Exercise
-Early Mobilization
 Contracture
- Early Mobilization
- ROM exercise
- Proper Positioning
- Static Splinting

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 Prevention………
 Osteoporosis
- Early Weight Bearing
- Isotonic & Isometric Exercise
- Dynamic Axial Compression Exercise

 Pneumonia
- Early Mobilization
- Breath & Cough Exercise
- Vibration& Percution
- Postural Drainage
- Turning position every 2 hours

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 Prevention………
 Ulcus Decubitus
- Proper Positioning
- Turning Position every 2 hours
- Good Nutrition
- Keep the skin clean and dry
- Decrease the pressure in the High risk area

 Orthostatic Hypotension
- Step by step Mobilization
- Bandage on the legs
- If need, use Corset
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Prevention……….
 DVT
- ROM Exercise
- Ankle pumping
- Avoid cross of leg
- If need, use stocking

 Urinary stone
- Early Mobilization
- Adequate fluid intake
- Bladder training

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 Prevention……..
 Constipation
- Early Mobilization
- Adequate fluid intake
- Use high fibre diet

 Depresion
- Give the physical activity if possible
- Support from family and environment
- Support from Doctor and medical officer

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 Walking AID
Walkers
Canes
Forearm crutch
Axillary crutch
Platform crutch
Point Gait
Two Three Four

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Descend and Up Stairs

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TERIMA KASIH

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