Musculoskeletal Rehabilitation Review Articles

Direct heat penetration is greatest at a depth of 0.5 to 2 cm from the skin surface and depends on the amount of adipose tissue. The more commonly used modes for musculoskeletal rehabilitation include hydro collars, whirlpools, and contrast baths. Hydro collar packs are made in three standard sizes and are heated in stainless steel containers in water with temperatures between 65 and 90°C. The highest temperatures found during use of the packs are at the skin's surface. Towels are applied with the packs to minimize skin trauma and to maintain heat insulation. The treatment sessions usually last 20 to 30 minutes. Hydrotherapy is heating via submersion of small or large body surface areas. The risk of elevating core body temperature exists when large body surface areas are heated. Water temperature should not exceed 40°C when large body surfaces are heated in a Hubbard tank as compared to up to 43°C when a patient submerges just a limb in a whirlpool. Hydrotherapy provides a gravity-eliminated environment which facilitates joint motion. Agitation created by the water flow provides sensory input. Clinical duties include monitoring and assessing cardiovascular and pulmonary exercise function, as well as muscle function. Additional clinical duties include writing exercise prescriptions for cardiopulmonary and musculoskeletal rehabilitation. Clinical research conducted by the exercise physiologist mainly focuses on the effect of exercise on burn squealer and the mechanisms by which exercise can reduce or reverse burn-induced catabolic and hyper metabolic conditions and improve a patient's quality of life.    

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