whirlpool ppt

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Whirlpool:

Whirlpool Brennan Batten Laura Jordan Physical Agent Modalities

Whirlpool Article :

Whirlpool Article Devrimsel, G., Turkyilmaz, A. K., Yildirim, M., & Beyazal, M. S. (2015). The effects of whirlpool bath and neuromuscular electrical stimulation on complex regional pain syndrome. Journal of Physical Therapy Science , 27 (1), 27-30.

Aim of Study:

Aim of S tudy This study is designed to examine the effects of using whirlpool bath, underwater ultrasound therapy and neuromuscular electrical stimulation (NMES) as modalities for the treatment of CRPS . It was hypothesized that subjects with CRPS would significantly improve their symptoms with use of these modalities .

Methodology : Sample Size:

Methodology : S ample S ize Sample size: 60 subjects Inclusion Diagnosed with chronic regional pain syndrome (CRPS) type 1 in the upper extremity Exclusion Differential diagnosis such as those suffering from: Peripheral neuropathy Nerve lesion Previous hand fracture Open hand wound Systemic disease (diabetes, infection, tumor) (Devrimsel et al., 2015; page 27, right column).

Intervention :

Intervention Group 1: Group 1 received fifteen sessions over three weeks of underwater ultrasound therapy, whirlpool bath, and exercise therapy. ROM exercises and stretching were performed throughout intervention ( Devrimsel et al., 2015; page 27, right column). Group 2: Group 2 received fifteen sessions over three weeks underwater ultrasound therapy, neuromuscular electrical stimulation (NMES), and exercise therapy. ROM exercises and stretching were performed throughout intervention ( Devrimsel et al., 2015; page 28, left column)

Outcomes of Interest:

Outcomes of Interest Subjective : Visual Analog Scale Objective: Edema measurements were taken comparing the involved to the uninvolved side ROM of wrist flexion and extension Distance was measured from the fingertip of the third finger and the distal palmar crease. Hand grip strength Pinch strength ( Devrimsel et al., 2015; page 28, left column)

Type of Study, Level of Evidence:

Type of Study, L evel of Evidence Type of study Randomized controlled Trial Level of Evidence Level 1

Strengths:

Strengths T he groups were randomly assigned T he members in each group had no significant difference in demographics The pre-measurment value s were not significantly different between groups The findings of this study were consistent with previous research studies (Devrimsel et al., 2015; page 28, left column)

Limitations :

Limitations Small sample size of only 60 participants W hirlpool or NMES treatment alone were never looked at, it was in combination with underwater ultrasound therapy and exercise therapy (Devrimsel et al., 2015; page 28, left column)

Significance of Study Outcomes :

Significance of S tudy O utcomes B oth interventions in Group 1 and Group 2 increased grip strength, three point and fingertip pinch strength, and ROM of the wrist after treatment I mprovements were significantly better for those patients in the whirlpool bath group (Group 1) compared to NMES group (Group 2) Whirlpool bath has been proven to reduce pain and edema in CRPS by improving regional perfusion, nutrition, and oxygen to the tissues, and softens the skin in patients with CRPS (Devrimsel et al., 2015; page 29, left column).

Implications for OT Practice :

Implications for OT P ractice CRPS limits patient’s functional performance because it prevents patients from completing activities of daily living. It is important to respect each patient's pain level, however to not let it distract from progression of the therapy session. The results can apply to the practice of OT by adding current consistent research to the growing use of whirlpool as a modality Due to the fact that CRPS physiopathology is unclear, CRPS is sometimes difficult to treat. Therefore, occupational therapists should use a variety of treatments that are evidenced based and proven to reduce pain and improve ROM.

Action Plan :

Action Plan As entry level practitioners, It is our job to continually research new evidence based treatments that we can use on clients to treat diagnoses such as CRPS. It is important to look at each patient holistically , and understand that each patient may respond differently to treatment . A variety of modalities can be used to decrease edema, and improve ROM. From the results of this study, we can continue to recognize the importance and success of whirlpool as a physical agent modality for CRPS.

References :

References Devrimsel , G., Turkyilmaz , A. K., Yildirim , M., & Beyazal , M. S. (2015). The effects of whirlpool bath and neuromuscular electrical stimulation on complex regional pain syndrome. Journal of Physical Therapy Science , 27 (1), 27-30. Cooper, C., (2014).   Fundamentals of hand therapy : Clinical reasoning and treatment guidelines for common diagnoses of the upper extremity , 2 nd edition.  St. Louis, Missouri.  Mosby.  

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