PHYSICAL THERAPY
The physical therapist can offer:
Over 50%
of terminally ill patients can benefit from physical therapy.
It is almost always welcomed by the patient. The aim is to
improve independence lost because of pain, immobility or loss
of confidence. Achieving realistic short-term goals boosts
morale. Many patients are surprised and pleased to have
physical therapy and often say, “Nobody told me how much I
should do.” (see
Rehabilitation)
Exercise programs encourage patients to take an active
part in their own care. They should be taught an exercise
regime, and encouraged to practice.
Walking re-education is often required for patients who
have lost confidence. If a patient can straight leg raise in
bed, it is usually realistic to try walking with a frame. For
patients who have trouble lifting (due to back pain, for
example) a wheeled frame can be used.
Passive exercises reduce stiffness and are usually
welcomed by patients who are unable to move their limbs.
Family members can be taught a program of exercises which
helps them contribute to patient care. (Family members should
also be taught how to lift, turn and position the patient.)
(see Pressure Sores)
Chest
physiotherapy using gentle techniques of percussion,
vibration, coughing exercises or forced expiration can
increase the volume of sputum expectorated from the main
bronchi, and can improve lung function. These techniques can
be very helpful but must be used carefully. Postural drainage
is not indicated, and even the gentler approaches can cause
bronchospasm or short term hypoxia in very ill patients.
(see Dyspnea)
Breathing exercises are useful in almost all cases of
dyspnea, because episodes of panic and hyperventilation are
common. (see
Dyspnea)
Relaxation therapy is especially useful for patients with
dyspnea, but most patients have episodes of anxiety and
benefit from relaxation.
(see Relaxation)
Massage is helpful to ease stiff muscles and to reduce a
feeling of isolation. It can be taught to family carers.
(see Touch)
Lymphedema can often be reduced by a determined program of
compression therapy.
(see Lymphedema)
The author and publisher have taken
precautions to ensure that the information in this book is
error-free. However, readers must be guided by their own
personal and professional standards of good practice in
evaluating and applying recommendations made herein. The
contents of this book represent the views and experience of
the author, and not necessarily those of the publisher.
