PHYISOTHERAPY

Physiotherapy, or Physical Therapy, is a Healthcare profession concerned with the assessment, maintenance, and restoration of the physical function and performance of the human body. It involves rehabilitation and improving the functional potential of individual with disease/ dysfunction or injury .We at National heart institute and research centre provide high quality or treatment and rehabilitation

Physiotherapy specialties offered at NHI:

• CARDIO-RESPIRATORY PHYSIOTHERAPY
• PEDIATRIC PHYSIOTHERAPY
• SPORT PHYSIOTHERAPY/SPORTS INJURY PHYSIOTHERAPY
• WOMEN'S HEALTH PHYSIOTHERAPY/ GYNAE PHYSIOTHERAPY
• PELVIC FLOOR PHYSIOTHERAPY
• NEURO PHYSIOTHERAPY
• VESTIBULAR PHYSIOTHERAPY / VERTIGO PHYSIOTHERAPY

All therapists are skilled professionals who are registered with Delhi council of Physiotherapy and occupational therapy (DCPTOT) and with Indian Association of Physiotherapy (IAP).

• 

  Ms. Zarleen Choungtham

  Physiotherapy

  Ms. Zarleen Choungtham

  • Speciality
    Physiotherapy
  • Degrees
    BPT, MPT, DCPT, MIAP
  • Designation
    Consultant Physiotherapist
  • Office
    49-50 East Of Kailash, Nationl Heart Institute
  • Work days
    Monday to Saturday

Cardiac rehabilitation programs aim to limit the psychological and physiological stresses of CVD, reduce the risk of mortality secondary to CVD, and improve cardiovascular function to help patients achieve their highest quality of life possible. Accomplishing these goals is the result of improving overall cardiac function and capacity, halting or reversing the progression of atherosclerotic disease, and increasing the patient's self-confidence through gradual conditioning
Cardiac rehabilitation is a customized program of exercise and education. The goals of cardiac rehabilitation include establishing a plan to help you regain strength, prevent your condition from worsening, reduce your risk of future heart problems, and improve your health and quality of life.

Phases of cardiac Rehabilitation:

• Phase 1: Acute, In Hospital Patient Period
  Patients with acute heart conditions, such as those recovering from heart surgery or a heart attack, may be referred to a cardiac rehab team while still in hospital. This phase will likely last between 2 and 5 days, depending on your physical condition.
  
  Goals for Phase 1:
  The main goal for the first phase of cardiac rehabilitation is to enable you to leave the hospital and return home as quickly and safely as possible. You will work with doctors, nurses, and physical therapists or other specialists to design a safe and appropriate discharge plan. By the end of this phase, you should have:
  
  • A safe, limited exercise plan that you can follow at home
  • A clear understanding of your condition and your cardiac rehabilitation program
  • Knowledge about self-care for your wounds (if you have had open heart surgery)
  • An assistive device, such as a cane or walker, if needed
  • Access to home oxygen therapy, if needed
• Phase 2: Sub acute Outpatient Care (Post-discharge, Pre-Exercise Period)
  Phase 2 takes place after you leave the hospital, at an outpatient care facility. This second phase will last between three and six weeks.
  
  Goals for Phase 2:
  
  • Reinforce learning from Phase 1
  • Move towards independent self-care
• Phase 3: Intensive Outpatient Rehab
  If you have experienced a severe cardiac event or surgery, you will probably need to complete phases 1 and 2 before you are moved into Phase 3, a full cardiac rehabilitation program. Some patients with less intense cardiac conditions may enter Phase 3 directly. Phase 2 is very closely supervised and is aimed at patients who are still very severely affected by their heart condition, whereas Phase 3 introduces more independent exercises and self-monitoring.
  
  Goals for Phase 3:
  

  The main goal for Phase 3 of cardiac rehab is to give you the tools to manage your heart condition on your own and live a longer, happier and healthier life.

• Phase 4: Maintenance
  If you have completed the previous three stages of cardiac rehabilitation, you should have a clear grasp of your heart condition and how best to manage it. Phase 4 essentially continues for the rest of your life.
  

Pulmonary rehabilitation is a program of education and exercise to increase awareness about your lungs and your disease like Asthma, COPD, cystic fibrosis, TB, and now covid-19 etc You will learn to achieve exercise with less shortness of breath. The skills and knowledge learned in the program will help you feel better and manage your lung disease. You’ll become stronger by increasing your level of fitness. Exercising your lungs and your muscles helps you be more active. Pulmonary rehabilitation may even decrease the need for hospital visits. Pulmonary rehabilitation is a supervised program that includes exercise training, health education, and breathing techniques for people who have certain lung conditions or lung problems due to other conditions. The Physiotherapy department has been an essential part in treatment of covid patients during pandemic in Icu, ward and post covid rehabilitation

• Phase I: This begins while you are in the hospital. A pulmonary rehabilitation staff member will be part of your in-hospital care team. This team member will teach you and your family about your condition, your health and how to make the best food choices. Phase I may also include light exercise and walking.
• Phase II: This is a 10 to 12 week outpatient therapy program. At the beginning of the program, you will be asked to complete a six-minute walk test. This test provides a starting point to determine your beginning exercise prescription.
  Patients attend rehabilitation two days each week. During rehabilitation sessions, your heart rate and oxygen saturation (O2 sat) will be monitored with telemetry (real-time monitoring) while you exercise.
  At your last therapy session, you will have another walk test. This test will measure your improvement. In addition, a staff member will give your post-rehabilitation exercise recommendations.
• Phase III: This is a voluntary lung health maintenance program. Phase III is designed to help you become more independent and responsible for your own exercise program. It offers moderate monitoring and help from medical professionals.

It combines therapeutic modalities and exercise in order to return the individual to normal function.
Some of the conditions that may benefit from musculoskeletal rehabilitation may include, but are not limited to, the following:
Osteo-arthritis, Frozen shoulder, Tennis Elbow, Low Back Ache, Post fracture stiffness etc
Trauma injuries, such as sprains, strains, joint dislocations, and Arthritis ,Bone tumors,Repetitive stress injuries, such as tendonitis and carpal tunnel syndrome,Joint injury and replacement etc
The department has electrotherapy modalities for treatment and managing pain and to restore function like TENS ,Ultrasound, IFT, combination therapy ,cryotherapy ,laser etc.

It focuses on understanding, preventing and treating sports and exercise-related injuries and musculoskeletal conditions such as ligament injury/ tear, sprain, strain etc
5 Stages of Injury Rehabilitation:

• Phase 1: Protection and Offloading.
• Phase 2: Protected Reloading and Reconditioning.
• Phase 3: Sport Specific Strength, Conditioning and Skills.
• Phase 4: Return to Sport.
• Phase 5: Injury Prevention.

Neurological physiotherapy is the treatment of patients who have a neurological disorder. Neurological disorders are those affecting the brain, spinal cord and nerves; such as stroke, MS and Parkinson's disease. Treatment in neurological conditions is typically based upon exercises to restore motor function through attempting to overcome motor deficits and improve motor patterns. Rehabilitation program includes Range of motion exercises, strengthening exercises, use of PNF patterns, Balance training, achievement of functional independence and improvement in quality of life

Physiotherapy is an important intervention that prevents and mitigates the adverse effects of prolonged bed rest and mechanical ventilation during critical illness. Rehabilitation delivered by the physiotherapist is tailored to patient needs and depends on the conscious state, psychological status and physical strength of the patient. It incorporates any active and passive therapy that promotes movement and includes mobilization. Early progressive physiotherapy, with a focus on mobility and walking whilst ventilated, is essential in minimizing functional decline.

• Short-term Goals: Early activity - Both passive and active to maintain integrity of musculoskeletal system Positioning patients: To allow gravity to help sputum drain from the lungs and prevent pressure sores. Manual techniques such as shaking and vibrations: These are applied to the ribs to try to loosen and clear the sputum. Suction: By placing a small tube into the lungs to suck out the excess sputum. They play a vital role in weaning a patient off ventilation.
• Long-term Goals: They plan an extensive rehabilitation program to integrate and re-initiate the patient into society. They set goals in conjunction with the other team to rehabilitate the patient. These include strengthening, gait training, functional independence and improving the quality of life.

Physiotherapy rehabilitation in OPD

Physiotherapy program at OPD includes treatment/management of Orthopedic conditions: joint pain, sprain, strain, fractures etc Cardiac and respiratory rehab: pre and post CABG, valve replacement, post pacemaker implantation, COPD, asthma, ILD, TB etc Neurological rehabilitation: stroke, motor neuron disease, head injury, Parkinsonism, cerebral palsy etc Women’s health: urinary incontinence, pelvic floor exercise, pregnancy and post pregnancy rehab etc Post general surgery: hernia, post gall bladder surgery, liver surgery, burns management etc