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Clinical Observation

Therapists apply several therapeutic exercises in treating several medical conditions. For example, for patients with cardiac diseases, they conduct cardiac rehabilitation test to try to recover the heart's normal rate. COPD is a medical condition that breaks down and narrows the lungs. Excessive smoking of cigarettes mainly causes it. General body weakness caused by low intestinal absorption, stroke caused by the rapture of blood vessels to the brain, rotator cuff injury and arthritis all have therapeutic procedures of treatment.

For the patient with cardiac disease, the therapist conducted cardiac rehabilitation a sum of interventions for chronic or post acute cardiac disease. Cardiac dysfunctions such as myocardial infarction caused by the failure of oxygen supply to the heart, failure of the heart to contract and lack of an impulse to initiate contraction. The therapist conducted deep diaphragmatic breathing exercises, ankle pumps and leg dangling with feet support. He then made the patient sit flat on a stool and conducted ankle pumps and knee extensions with limited room ambulation. The therapist instructed the patient to walk for minutes and documented the distance walked. He then assessed the intensity of fitness directly proportional to the rate of heartbeat using Borg's rates. AROM of the trunk and all extremities while standing accompanied by an increased frequency in ambulation at comfortable pace followed. Stair climbing tests at alternating patterns followed later on. He designed an exercise program for the patient upon discharge and advised the patient to try to change positions hourly when resting.

The four therapeutic exercises conducted for patients with COPD include stretching exercises designed to lengthen muscles, aerobic exercises to improve respiratory muscles, strengthening exercises to tighten muscles until they begin to tire and breathing exercises. Pursed lip breathing entailing relaxing the neck and shoulder muscles and breathing in for two seconds through the nose with a closed mouth then finally breathing out for four seconds through pursed lips. The therapist conducted diaphragmatic breathing test on the patient by making them lie on their back with knees bent. He put one hand on the patient's belly and another on the stomach and told them to inhale deeply through the nose at the count of three. The patient then tightened their stomach and exhaled at the count of six. The therapist applies short acting beta agonist to relieve shortness of breath. Short acting anti cholinergic are sometimes used to improve lung functioning are recommended. The therapist gave the patient a short acting combination inhaler containing albuterol depending on how the symptoms are severe. For patients who must use the medication frequently, the therapist applied long acting treatments. These include long-term beta agonists. The patient was given other long-term treatment is long acting anticholinergics that may be taken twice a day.

A diagnosis of malnutrition manifested through edema, a weight for height index way below 70%, a MUAC less than one hundred and sixty millimeters and BMI below sixteen indicate general weakness. Conducting a physical exam, temperature tests conducted, blood pressure examined and the rate of the heartbeat recorded. These symptoms clearly indicated the patient was suffering from general body weakness condition. For general body weakness patients, the therapists administered albendazole for the empiric treatment of intestinal worms. In cases of bacterial infections, the therapists gave the patients amoxicillin to add on a therapy for oral rehydration and a three phase nutritional supplementation according to the WHO guidelines. The therapist released the patient and advised them to come for later follow-up.

For stroke patients, the therapist first established whether the stroke was caused by a blood clot or bleeding in the brain i.e. hemorrhagic. Therapeutic exercises involved range motion training to restore mobility of affected areas. The exercise entailed stretching exercises conducted by interlacing fingers in front of the body with arms straight and bringing hands above the head. Coordination training involving sitting in front of a mirror and alternating between smiling and frowning to rectify coordination impairment and cardiovascular exercise to recover blood supply to the brain followed. The treatment involved the restoration of blood flow in the case of ischemia and trying to control bleeding for a hemorrhagic caused stroke. The therapist started administering aspirin as another form of ant platelet medicine. For a hemorrhagic stroke patient, the therapist made efforts to control bleeding in the brain by reducing blood pressure in the brain. Monitoring of signs such as restlessness, confusion and a general difficulty in following commands indicated high blood pressure in the brain. If the bleeding is due to a ruptured blood vessel in the brain i.e. an aneurysm, the therapist conducted a surgery by clamping both sides of the ruptured vessel or inserting a small coil into the blood vessel to stop the bleeding. Stitching of the two sides of the vessel followed later on.

In the case of a rotator cuff injury, the therapist has first to try and eases the pain. Administering acetaminophen to the patient eased the pain. A physical therapy to determine the patient's range of motion helped the therapist determine the shoulder function and strength. The therapist then injected steroids into the patient's shoulder. In cases of an acute tear, the therapist applied ice on the shoulder to ease the swelling. He administered anti-inflammatory medicines such as ibuprofen administered later on to reduce the swelling and pain. The therapist gave the patient a sling and an armrest to rest the arm muscles but not for a long time as it may stiffen the shoulder rotator cuff muscles. Conducting a range of motion exercise frequently helps attain muscle stability.

Therapeutic exercises involved the range of motion exercises to mobilize joints. Mild pain relievers such as aspirin reduced pain. Acetaminophen administered in adequate doses reduced the pain. Pain relieving creams such as capsaicin and salycin applied on the skin around the affected area also helped in reducing pain. The therapist gave his patient cortisone orally and also injected some directly to the inflamed joint to further reduce the pain and restore the joint function. In cases of persisting pain, the therapist injected hyaluronic acid into the joint to restore the thickness of the synovial fluid in the joint. This increases the joint mobility by greatly reducing the friction occurring between the joint. The therapist then advised the patients to check on their weight to reduce the chances of arthritis.

Therapeutic exercises designed to rectify medical conditions, for example, cardiac disease, rotator cuff injury, arthritis, stroke, general body weakness, COPD are just but to mention a few. Most therapeutic exercises aim at improving body stability and restoring them to normal.