For example, an individual who has undergone hip replacement surgery because of limited mobility will have to perform a prescribed set of exercises to rebuild the muscles in the hip region and restore joint flexibility. This is necessary to enable him or her to regain a measure of independence in performing the activities of daily living and eliminate or reduce the number of mobility aids needed.
The job of treating the motor and sensory disabilities in stroke victims falls on the shoulders of the physical therapist. The physical therapist's training is grounded in human physiology and anatomy and usually covers various techniques of providing treatment, including the use of exercise, massage therapy, joint manipulation, heat and cold therapy, water therapy and electrical current. The physical therapist also helps an individual become more proficient in the use of assistive mobility aids and devices such as crutches, a cane, walker, or even prosthetic or artificial arms and legs. For special work with older adults, the American Physical Therapy Association has a certification program for physical therapists to qualify as geriatric therapists.
Stroke survivors, as another example, need custom-designed rehabilitation programs, particularly if hthe stroke left them with limited mobility. The physical therapist has to assess the individual's muscle strength, range of motion capability, sensory deficiencies and related important functions. Once a program has been set up, the therapist can proceed to carry out therapy in a familiar setting where the patient will be comfortable.
The physical therapist tries to overcome sensory deficiencies by stimulating the affected areas through massage strokes, stretching and endurance exercises to develop range of motion and routines to practice motor skills. This will revive muscles that have stiffened and begun to shrink from lack of use. A transcutaneous electrical nerve stimulation (TENS) device is often very helpful in re-establishing nerve network connections between the brain and the limbs affected by the stroke. The stimulation is done with a probe that introduces electric current into the nerves, which helps restore the motor functions.
In the early stages of rehabilitation, the individual's limbs may not be strong enough to bear his or her body weight. Simple movements are usually practiced first, to build up the patient strength. The exercise set may shift from one type of motion to another. As the individual becomes more capable, more complex movements are tried. These are movements that involve better coordination and balance, such as going up the stairs or getting around furniture and other obstacles.
For people still unable to support their weight, exercises involving repetitive movements may be performed through hydrotherapy, which uses water to support body weight and to generate the desired sensory stimulation, or with partial support from a specially designed harness. Grab bars and other support devices may also be used.
It's important to maintain the schedule devised by your physical therapist. Muscle strength and newly rejuvenated motor skills may be lost if exercises are performed with irregular frequency. Expect your therapist to gradually increase the degree of independence and responsibility until you are able to execute these movements without assistance.