Intervention Rationale Intensity Instructions Phase 1 (week 0-3) Phase 2 (week 3-6) Phase 3 (week 6-9) Phase 4 (week 9-12) Home exercise program Elevation with the help of a pillow to the right lower limb To enhance the circulation of blood and the healing process The angle at which the limb is elevated and the duration are decided as per the tolerance level of the patient The patient was asked to relax and inform the therapist if discomfort occurred; the pillow under the limb is usually at 30° of elevation 10° of elevation/two hourly and then relaxation of 15 mins 20° of elevation/two hourly and then relaxation of 15 mins 25° of elevation/two hourly and then relaxation of 15 mins 30° of elevation/two hourly and then relaxation of 15 mins 30° of elevation/two hourly and then relaxation of 15 mins Ankle toe movements For enhancing the proper circulation of blood and the healing process As per the tolerance level of the patient and the need for an intervention The patient was asked to dorsiflex and plantar flex the foot as if pedaling a bicycle Five reps – one set/thrice a day – gravity-eliminated position – supine 10 reps – one set/thrice a day – gravity-eliminated position – supine 10 reps – one set/thrice a day – gravity-assisted and gravity-resisted position – bedside sitting 10 reps – one set/thrice a day – gravity-assisted and gravity-resisted position – with minimal resistance by therapist’s hand – bedside sitting 10 reps – one set/thrice a day – gravity-assisted and gravity-resisted position – with moderate resistance by therapist’s hand or a theraband – bedside sitting Isometric contraction for right hamstrings For strengthening the hamstring As per the tolerance of the patient The patient was asked to apply half of his muscle power, and the therapist applied a similar amount of muscle force but in the opposite direction so that there was not any movement but strengthening occurred Five reps with 5-sec hold – thrice a day Seven reps with 5-sec hold – thrice a day Seven reps with 10-sec hold – thrice a day 10 reps with 10-sec hold – thrice a day 15 reps with 10-sec hold – thrice a day Isometric contraction for right quadriceps For strengthening the quadriceps As per the tolerance of the patient The patient was asked to apply half of his muscle power, and the therapist applied a similar amount of muscle force but in the opposite direction so that there was not any movement but strengthening occurred Five reps with 5-sec hold – thrice a day Seven reps with 5-sec hold – thrice a day Seven reps with 10-sec hold – thrice a day 10 reps with 10-sec hold – thrice a day 15 reps with 10-sec hold – thrice a day Isometric contraction for right gluteus muscles For strengthening the right gluteus muscles As per the tolerance of the patient The patient was asked to apply half of his muscle power, and the therapist applied a similar amount of muscle force but in the opposite direction so that there was not any movement but strengthening occurred Five reps with 5-sec hold – thrice a day Seven reps with 5-sec hold – thrice a day Seven reps with 10-sec hold – thrice a day 10 reps with 10-sec hold – thrice a day 15 reps with 10-sec hold – thrice a day Active resisted exercises for upper limbs For preventing contractures and for maintaining the ROM as well as the strength As per the tolerance of the patient The patient was asked to do it with the help of weight cuffs or theraband and as per the tolerance level Five reps – per set – thrice a day – against gravity Seven reps – per set – thrice a day – against gravity along with half kg weight cuff Seven reps – per set – thrice a day – against gravity along with half kg weight cuff 10 reps – per set – thrice a day – against gravity along with one kg weight cuff 10 reps – per set – thrice a day – against gravity along with one kg weight cuff Deep breathing exercises To relax the patient As per the comfort of the patient The patient was instructed to relax in a comfortable position, and then, the deep breathing exercises were taught to the patient by the therapist Five reps – per set – thrice a day, with 3-6-9 technique (3 secs – inspiration, 6 secs – hold the breath, 9 sec – expiration) 10 reps – per set – thrice a day, with 3-6-9 technique 10 reps – per set – thrice a day, with 3-6-9 technique 10 reps – per set – thrice a day, with 3-6-9 technique 10 reps – per set – thrice a day, with 3-6-9 technique Sit-to-stand activities To make the patient independent for his ADLs As per the pain tolerance of the patient The patient was instructed on how to progress from sitting to standing along with a mirror biofeedback The patient was undergoing strengthening exercises, which are prerequisites for sit-to-stand activities Five reps – one set – twice a day Five reps – one set – thrice a day 10 reps – one set – thrice a day 15 reps – one set – thrice a day Ambulation To make the patient independent for his ADLs As per the pain tolerance of the patient The patient was instructed and taught how to use assistive devices – a walker along with a mirror biofeedback The patient was undergoing strengthening exercises, which are prerequisites for ambulation One round of 50 meters – with a walker – thrice a day Two rounds of 70 meters – with a walker – thrice a day Two rounds of 100 meters – with a walker – thrice a day Three rounds of 100 meters – with a walker – thrice a day



Source link