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لو قولت إني نجحت هلاقي ألف مبروك ولا 1000 وارجع؟🥳

اهم الاسئلة في ال Hubbard

Procedures of Hubbard tank :-

- Explain procedure of treatment to the patient
( تنفع لأي حاجه اول ما تتزنق قولها 😂 )
- the patient should be dressed cotton clothes
- Ear stoppers are NOT recommend but you can use small's lambs wool pad
- the patient lies on a canvas which are attached to the hoist by cables
- the patient lift in and out the tank through Overhead hoist or hand operated hoist
- apply cold compress on a patient's head
- give to the patient cold drinks after treatment
- remove the patient carefully from the tank
- After treatment, Dry his hair and apply dry towel in head

■ Indication
( مهمة عشان ال cases )
Poor circulation
amputations
Paraplegia
Infected wounds
Poliomyelitis
Polyplegia
passive stretching
Arthritis with stiff and swollen joints

■ Contraindication

Diabetes mellitus
Varicose veins
Advanced arteriosclerosis Advanced peripheral vascular diseases

■ Physiological effects

Vasodilation
Improving LOCAL artieral and lymphatic circulation
Diminution of edema and effusion.
regression of the inflammatory process.
removing dirt, dead tissue and pus
Cleaning and stimulating of wound healing..
Breaking down old adhesions

ملخص ال hydrocollator

----‐---‐---------Equipment----------------

- metal hot pack container
- packs are various in shape and size
- enough towels
- Tongs or gloves

----------------- Procedures----------------

- the level of water in hydrocollator should be at the top of backs in all times
- check the temperature at is 75 : 80 C
- check the room temperature at 23 :27 C
- it takes 2 hours to be heated
- the duration of treatment from 20: 30 minutes
- Explain the procedure of treatment to the patient
(بتنفع لأي حاجه )
- Test for hot and cold sensation
- The unit should be cleaned every month
- Fold a towel into 1:6 layers

---------- Dangers and precautions-----
1 Burn
- lacks on number of towels
- impaired sensation
- impaired circulation
- hypersensitive skin

2 Dehydration
- it applied in more than one area at the same time .

-------------Thermal effects ---------------

■Raise the temperature of skin as
much as 20 C and reach to 57 C

■ raise the temperature of tha muscle to 6 C

■ raise the subcutaneous tissue as much as 15 C

Thermal effects leads to :-

■ decrease joint stiffness
■ decrease muscle spasms
■ muscle relaxation
■ decrease joint stiffness
■ collagen fibers more stretchable

-----------Circulatory effects ---------------

■ vasodilation of the capillaries
■ increase blood flow

----------- Metabolic effects ----------------

■ increase metabolism
■Change in rate of enzymatic activity
■ decrease blood pressure
■ one more the area my cause dehydration and sweating 😓

----------Sedative effect ------------------

■ muscle relaxation
■ safe Analgesic

------------Indication ------------------

■chronic Inflammation
■chronic edema
■ adhesions
■ muscle spasm

-----------Contraindication ------------------

■ cancer or tuberculosis
■gross edema
■ deep x-ray therapy
■ lack of comprehension
■ open wounds
■ Dermatological conditions as acne or eczema

--------------- Advantages ------------------

■ the packs various in size
■ not need much handling
■ save time
■ easy to apply

-------------Disadvantages ----------------

■ not easy to apply around shoulders and hips
■ not use on sensitive patients
■ cause skin rash

Indication، physiological,
contraindication المميزة لكل جهاز

Whirlpool :- 🚨🚨🚨🚨🚨

immobilized who cannot be cleaned in another manner after immobilization or casting.

Patients who are morbidly obese

. Skin ulceration and infection.

Acute musculoskeletal injuries

Contractures Burns

- A relief of pain by stimuli which act through the pain gate mechanism.

Active assisted, resistive and stretching exercises can be done for the upper and lower extremities in various positions.

Hubbard tank 🚨🚨🚨🚨

passive stretching

Poliomyelitis and paraplegia

Arthritis with stiff and swollen joints

Pain relief in amputations

Infected wounds → with added antiseptic agent

muscle re-education or active exercises.

stretching of soft tissues

Softening of scar tissue.

Contrast 🚨🚨🚨

Reflex sympathetic dystrophy.

Post-traumatic swelling and edema

Neuropathic pain.

Excessive sweating

Chronic sprains and contusions.

Rheumatologic disease

can increase local blood flow by up to 100%

vascular flush or circulatory whip

An increase of deeper circulation occurs reflexively

more effective at increasing local circulation in a tissue area than heat or cold alone.

Contrast bath

-----Application = procedure---------

-2 tanks
One for hot water and second for cold water
- first immersion the part in hot water at 40:45 C at 4 :6 minutes
- second immersion in cold water at 15:20 C at 1: 4 minutes
- Repated this cycle for 4 times
- total treatment take 15 : 30 minutes

■--------------- inductions -------------

Rheumatologic disease
Reflex sympathetic dystrophy.
Post-traumatic swelling and edema
Neuropathic pain.
Contusion = burise
Excessive sweating
Chronic sprains

■----------- contraindication --------------

Diabetes
Arterial insufficiency
Advanced peripheral vascular disease.

_Treatment time :
1.Hydrocollator packs (20-30 mins) وممكن من 30-45
وفى الحالة دى بعمل renewing لى الpack.
2.whirl pool tank ( 20-45 mins)
4.contrast baths (15-30 mins)
_4-6 mins hot , then 1-4 mins cold

Whirlpool

----Procedures = applications ---------

- select the type and the style of
tank according to needs of patient
- the tank is filled with water and check the temperature by the thermometer
- the position of patient according to the treated part
- place the part in water
- encourage the patient to move the part and make exercise
- if treating wound or dead tissue , shut off the agitatior and removed the pieces tissue from
- Duration 20:45 min

---------types of whirlpool ------------------

1 low boy tank
هنعلمها ب LLR
L = long sitting position
L = lower trunk and pelvis
R = ROM exercise

2 high boy tank
يستخدم لل hip or leg

•In a high boy tank the patient is seated in a chest high water with flexed hips and knees

3 extremity

used for the upper or lower extremities
وفي ال lower لحد ال Knee بس مش بيوصل لل hip
has a capacity of 10 to 45 gallons of water.

-------------------- indication-------------------
- acute musculoskeletal injuries
-contractuers Burns
- skin ulceration
-skin infection
- muscle spasm
-Degenerative arthritis
- Patients who are morbidly obese
- immobilized

---------------- contraindication-----------

- diabetes
- vascular disease
-Varicose veins
- Arteriosclerosis

------------Advantage -------------------------

NOT occupy a large space
Allow exercise and movment
Cleaning open wounds

------‐--------Disadvantages -----------------

Risk of infection
Time consuming
Tank is expensive

المحاضرة التاسعة 🥲
Cryo means
= low temperature
= snow temperature
= freezing temperatures

Cryotherapy has effects on Superficial circulation ( Direct )

Cryotherapy has effects on Deep circulation Reflexively ( indirect )

Cryotherapy make Stimulation of cold receptors in skin
وده هياثر علي Sympathetic nervous system وهو جزء من automatic nervous system

ويحصل vasocontraction ولون الجلد يصبح paile بسبب نقص لل blood supply

Blockage of nerve impulse = anesthezia تخدير

Sympathetic
هو الي مسؤول عن حدوث ال vasocontraction
Para sympathetic
هو الي مسؤول عن حدوث
ال vasodilation

Shivering. رعشه
Piloerection. شعر جسمك يقف

ال cold مهم لاطفال الي عندهم
Cerebral Palsied ( CP )
لفك التشنجات وال muscles spasm عندهم عشان بعد كده تقدر تعمل ال exercises

الي مسؤول عن المحافظه علي درجه حراره الجسم ثابته هو ال hypothalamus

Gamma fibers efferent
دي motor
والي بيتحكم فيها ال muscle spindle وال golgi tendon organs

🚨🚨🚨🚨🚨سؤال امتحان 🚨🚨🚨🚨
Hunting response
vasodilation and constriction following prolonged cold application
وخلي بالك من prolonged لأن من غيرها مش هيحصل الكلام ده

🚨🚨🚨سلايد ٢٣ مهمة🚨🚨🚨
بتيجي كمقالي في الامتحان ويقولك اشرحها

Cryotherapy has neuromuscular effect ( Sensory and motor )

🚨🚨سلايد ٢٧ مهمة 🚨🚨
بتيجي ف الامتحان
Stinging = paile skin
حصل بسبب ال vasocontraction

Numbness
تنميل مش حاسس بحاجه

🚨🚨سلايد ٢٨ مهمة 🚨🚨

Inflammation
1 pain
2 swelling
3 hotness
4 redness
5 loss function
تعني ان فيه acute Inflammation هتحصل نتيجه خبطه مثلا
عشان تعالج ده لازم تعمل cold application

Decreased viscosity = decrease edema

Decrease nerve conduction velocity
= Blockage of nerve impulse

Pain reduction = anesthezia

Overuse
تعني انك تقعد في ماء بارد بعد مجهود عنيف
مثلا لاعب كورة بعد الماتش بيقعد في ماء بارده

🚨🚨🚨 مهمين في T & F 🚨🚨
Cryotherapy leads to
⬆️ increase pain threshold ( PTH )
⬆️ increase pain tolerance (PTO )
⬇️ decrease pain
⬇️. decrease NCV
( Nerve conduction velocity)
سرعة توصيل العصب
Numb = decrease pain
ولما تقلل الالم يبقى كده سهل تتحرك اكتر

VAS = ( Visual Analog Scale. )
الي هو بتحط مسطره كده علي المنطقه الي بتوجع المريض وبتقيس الالم قبل تطبيق ال Cryotherapy وبعد اما تطبقه وتشوف النتيجة

ROM ( Range of motion)
SLR. ( Straight leg raise )
PNF
( proprioception neuromuscular facilitation)

بس كده دي ملاحظات المحاضرة ❤️🔥

الحاجات دي الي هي ال increase وال decrease في ال Cryotherapy عشان ال T&F

⬇️ reduce sensation of pain
⬇️. Pain reduction
⬇️. reducing muscle spasms
⬇️ HEAT lessening stimulus threshold of muscle spindles
⬇️. HEAT decreasing gamma efferent
⬇️ cold decrease local neural activity
⬇️ Decrease Nerve conduction velocity
⬇️. Decreases afferent discharge from cutaneous receptors
⬇️. reduces metabolic rate
⬇️ decrease in production of metabolites
⬇️. decrease in metabolic heat
⬇️.Reduction in muscle guarding
⬇️ decreased nutrient
⬇️ decreased phagocyte
⬇️ decreased muscle blood flow
⬇️ Decreased cell permeability
⬇️ Decreased edema accumulation
⬇️ reduction in inflammation
⬇️. diminishing the activity of collagenases
⬇️ decreased cellular output
⬇️ slowing of Na - k pump
⬇️ decreased need for oxygen
⬇️ decreased secondary injury
⬇️ reduced swelling
⬇️ limit scope of trauma
⬇️ slows the rate of the chemical reactions
⬇️ hotness
⬇️ redness
⬇️ edema
⬇️ loss of faction
⬇️.reduces the rate of oxygen consumption
⬇️ Slowing the rate of metabolism
⬇️ decrease production of pro-inflammatory
⬇️ decreasing the activation threshold of tissue nociceptors
⬇️ temporary inhibition of muscle spindles of the application area
⬇️ if any discomfort recurred, the ice was reapplied
⬇️ The cold reduces the athlete’s pain

----------------------------------------------------------

⬆️ Cold raises the threshold stimulus of muscle spindles
⬆️. increase in epinephrine secretion
⬆️. effects of ice application diminish with increased tissue depth
⬆️ increased fluid viscosity
⬆️ increased depolarization threshold
⬆️ higher production of anti-inflammatory
⬆️ increase Pain Threshold (PTH)
⬆️ increase pain Tolerence (PTO)
⬆️ enhanced short-term improvements
⬆️ Manual stretch and manual stretch with ice improving the length of hamstrings muscle
⬆️ with exercises, it improves VAS
⬆️ With exercises, it improves ROM

ملاحظات المحاضرة ال 11 😬
Aquatic exercise
Aquatic = water
Exercises = performed movements in water.

Gait training
تمرينات المشى
Endurance training

تدريب القدرة على التحمّل (Endurance Training) هو نوع من التمارين الرياضية التي تهدف إلى تحسين قدرة الجسم على الاستمرار في الأداء لفترات زمنية طويلة دون الشعور بالإرهاق. يشمل هذا النوع من التدريب الأنشطة مثل الجري على المسافات الطويلة، ركوب الدراجات لمسافات طويلة، والسباحة الطويلة الأمد.

Provide three-dimensional access to the patient.
هيعالج المريض من ثلاث اتجاهات
أنه يعلمه يمشي لوراء ولقدام وعلي الجنب.

زيادة أنماط الحركة (Motor patterns) تعني تحسين قدرة الجسم على تنفيذ حركات معينة بشكل أكثر فعالية ودقة.

proprioceptive deficits
Improve sensation of position and movement
انك تبقى حاسس بالمكان الي انت بتحركه

المخطط بيجي في الامتحان سلايد 5

ال hydrostatic pressure عند ال manubrium بتكون 88.9 mm Hg
تعالا نقارن بضغط الدم
ضغط الدم 120 /80
80 دي ال diastolic
ال 120 دي لل systolic
كده بقى ال hydrostatic pressure لما الماء توصل عند ال manubrium بتكون
أكبر قليلا من ال diastolic
وده هيساعد أنه يقلل ال edema

Displaces venous blood proximal
دي الي هو هيساعد ان الدم ينتشر للجزاء القريبة

وهنا فيه سؤال مقالي مهم
How Aquatic exercise improves stroke volume and cardiac output ?

سلايد 8 مهمة 🚶‍♂️
Exercise induced asthma
بيحصل shallow and rapid breathing
من حدوث ال exercises

open chain exercise
دي تمارين بتعملها وفيها بتعمل
Fixation of proximal
And movment of distals
زي وانت بتكتب بتحرك ال distal وفيه ثبات في shoulder و كوعك

Closed chain exercise
fixation of distal
And movment proximal
زي وانت بتقعد بيكون في الأول ال proximal متحرك وال distal ثابت

حركه طلوع السلم في البداية بتكون
Open chain
بعد كده بتبقى
Closed chain

وانت نايم وبتتحرك دي open chain

Decrease Maternal hyperthermia
بيقل درجه حراره الواحدة الحامل

Precautions
دي محاذير يعني بتعمل التمارين وأنت جمب المريض لأن الحالات دي خطر محتاجه متابعة

مريض ال ataxic بيكون ماشي زي مشيت السكران drinking gite
angina
جلطه في ال coronary الشريان التاجي الي بيدي ال blood supply لل heart
thrombosis in coronaries

Tracheotomies
واحد عامل فتحه في ال trachea

Contraindication
مينفعش خالص يتعالج ب aquatic

Cases 🫵🫵

- orthopedic Rehabilitation
- Fibromyalgia
- Spondylosis
- Artificial joint
- arthroplasty
- ACL reconstruction
- meniscectomy
- disc bulges or herniations

سؤال مهم ال
floating equipment in aquatic

- Neck collar
- Rings
- vests
- life jacket
- Belts
- swim Bars
- Kickboard

سؤال مهم
New Equipment in aquatic

- underwater treadmills
- swimming pools
( circular or straight )
- aqua walkers

Treadmill Grapevine / caricoa
دي تمارين بيعملها وهو ماشي علي أطراف اصابعه

صور التمارين الي ف pdf مهمة
وده فيديو بيوضح التمارين دي وده الي متاخد منه الصور الي ف pdf 😂😂

https://youtu.be/ZhC4XDZGlFg?si=UwRjRrOKyLktyr2g

https://youtu.be/7ithICDZKqs?si=j8VAwme0W1FMh1Yw

بس كده دي ملاحظات المحاضرة 🔥❤️

Questions Scentific term
الجزء الأول

also known as water therapy or aquatic therapy, is a broad term encompassing the use of water in any form for therapeutic purposes like maintenance of health or the treatment of disease.

👉 Hydrotherapy

are produced by the application of water at temperatures above or below that of the body

👉 Thermal effects

effects are produced by the impact of water upon the surface of the body in the form of sprays, douches, frictions, whirlpools, etc.


👉 The mechanical effects

water molecules on the surface have greater tendency to hold together

👉 surface tension

the tendency of water molecule to adhere to other substances

👉 Adhesion

(Water in motion): the tendency of water molecules to adhere to each other

👉 hydromechanics

are external form of energy (e.g. heat, cold, light, electricity) applied to the patients to assess in the rehabilitation process.

👉 Physical agents modalities (PAMs)

is a direct transfer of energy between two objects in physical (direct) contact with each other.

👉 conduction.

is a direct transfer of energy from higher temperature to lower temperature without the need for an intervening medium

👉 radiation

is a transfer of heat through direct contact between circulating medium (air/ water) and another material of different temperature

👉 Convection.

non-thermal form of energy (mechanical,electrical and/ or chemical) in to heat.

👉 Conversion

heat is absorbed bythe liquid on the skin surface and cools the skin as it turns into a gaseous state.

👉 evaporation

A condition(s) that could benefit from a specific therapeutic modality.

👉 indication

A condition(s) that could be adversely affected if a particular therapeutic modality is used.

👉 contraindication

Applied with special care or limitations. “Relative contraindications”

👉 precautions

In acute trauma or hemophilia

👉 bleeding

Due to potential peripheral superficial vasodilatation and decrease blood pressure .

👉 Fainting

Poor technique
Patients' inability to dissipate or detect heat
•Treatment over areas of implanted metal or open wounds

👉 burn

من اول هنا بقى اهم حاجة 🚨

It is an efficient automatic unit producing a uniform and constant temperature to heat silica gel packs

👉 hydrocollator

Is a stainless steel tank in which silica gel packs are heated.

👉 hydrocollator Tunk

The packs are filled with silica granules

👉 silica gel packs

is most commonly used to treat the distal body segments of the upper and lower extremities of adults.

👉 Whirlpool

is essentially a local bath for extremities, with the limb submerging in rapidly circulating water.

👉 Whirlpool

is an Immersion Hydrotherapy which involves a part of an body immersion tanks

👉 Whirlpool

can be used to allow the patient to be in a long sitting position and perform ROM exercises.

👉low boy tank

referred to as a hip or leg tank, •can be used for the immersion of both lower extremities.

👉high boy tank

is usually used for the upper or lower extremities and has a capacity of 10 to 45 gallons of water.

👉Extremity tank

used for special massage effects or to give under water douche.

👉jet hose

may be used to convey non ambulatory patients in and out the tank.

👉water stretcher and overhead carrier

A narrow section at the middle of the tank allows the therapist to reach the patient and wider sections at each end

👉hubbard tank

can be used to transport the patient into the hydrotherapy tank in a seated position

👉body sling

With a special shape looking like a figure of 8, it is designed for practical use by allowing the therapist treatment without having to enter the water

👉hubbard tank

is named for the engineer who first designed it.

👉hubbard tank

designed for full immersion of the body, usually filled with warm water, used in therapeutic exercises in a program of physiotherapy.

👉hubbard tank

it is alternate immersions of the part in hot (100-105°F/40-45°C) and cold (59 -68°F/15-20°C) water to produce marked hyperemia of the skin.

👉contrast path