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Textbook of Physiotherapy for Obstetric and Gynecological Conditions
GB Madhuri
CHAPTER 1:
Anatomy
BONES AND JOINTS
MUSCLES
Abdominal Muscles
Rectus Abdominis
Transverse Abdominis
Oblique Muscle
Muscles of Pelvic Floor
Structure
Pubococcygeus
Iliococcygeus
Coccygeus
FEMALE REPRODUCTIVE SYSTEM
Ovaries
Uterine Tube (Fallopian Tube)
Uterus
Vagina
Vulva
Perineum
Mammary Glands
Internal Structure
CHAPTER 2:
Physiology
FEMALE REPRODUCTIVE SYSTEM
Female Reproductive Cycle
HORMONAL REGULATION
Estrogen
Progesterone
Inhibin
Relaxin
PHASES OF FEMALE REPRODUCTIVE SYSTEM
Menstrual Phase (Menstruation)
Preovulatory Phase
Ovulation
Postovulatory Phase
CHAPTER 3:
Women's Health and Role of Physiotherapy
INTRODUCTION
ROLE OF PHYSIOTHERAPY DURING PREGNANCY
1. Prevention of Musculoskeletal Problems
2. Giving Information and Advice on Management of Physical Discomforts during Pregnancy
3. Optimal Physical Fitness, Preparation for the Changes during Pregnancy, Postnatal Period
4. Assessment and Treatment of Musculoskeletal Disorders
5. Physical Coping Up Skills for Labor
6. Promotion of Health and Healthy Lifestyle Both for the Present and the Future
7. Creating an Awareness of the Physical Changes which will be Experienced After the Baby is Born
8. Ergonomic Aspect of Life with a Newborn Baby or Young Child
CHAPTER 4:
Pregnancy Tests and Investigations
URINE TEST
ROUTINE TEST
ROUTINE BLOOD TEST
SPECIFIC BLOOD TESTS
ULTRASOUND
AMNIOCENTESIS
CHORIONIC VILLUS SAMPLING
ESTRIOL TESTS
FETAL MOVEMENTS RECORDING KICK CHART
ANTENATAL CARDIOTOCOGRAPHY
CHAPTER 5:
Biomechanics
SACRAL REGION
MOTIONS AT SACROILIAC JOINTS
Nutation
COUNTERNUTATION
FUNCTIONS OF SACRAL REGION: STABILITY AND MOBILITY
Posture
CHAPTER 6:
Kinesiology
DEFINITION
AIMS OF KINESIOLOGY
Lower Body Exercises
Quadriceps
Half Squats
Straight Leg Extension
Hamstring
Toe Pull-ups or Foot Lifts
Side-leg Lifts
Lying on Side
Heel-Raises
Upper Body Exercises
Press-ups
Triceps
Lateral Pulls
Trapezius
The Abdominal Muscles
Function
Static Abdominal Contraction—Pelvic Tilt: On Bed
Pelvic Floor
Role of Pelvic Floor
Pelvic Floor Muscles
Superficial Muscle Layer
Exercising the Pelvic Floor
CHAPTER 7:
Ergonomics
DEFINITION
AIMS OF ERGONOMICS
Factors Causing Risk
Risky Areas
Lifting and Its Risk
Causes of Injury
ERGONOMICS APPLICATION
ERGONOMIC SOLUTION
SAFETY MEASURES
CHAPTER 8:
Physiological Skeletal Changes during Pregnancy
PREGNANCY WEIGHT GAIN
PELVIC VISCERA, FASCIAE AND LIGAMENTS
URINARY SYSTEM
PULMONARY SYSTEM
CARDIOVASCULAR SYSTEM
MUSCULOSKELETAL SYSTEM
THERMOREGULATORY SYSTEM
POSTURE AND BALANCE CHANGES
Center of Gravity
Balance
CHAPTER 9:
Physiotherapy Assessment Chart
HISTORY
Medical History
Obstetric History
INVESTIGATIONS
PREVIOUS MANAGEMENT AND EFFECTS
SUBJECTIVE ASSESSMENT
OBJECTIVE ASSESSMENT
PHYSIOTHERAPY MANAGEMENT DURING
Antenatal Period
Perinatal Period
Puerperium
Postnatal Period
CHAPTER 10:
Relaxation
DEFINITION
PRACTICING RELAXATION
RELAXATION TECHNIQUES
WHOLE BODY RELAXATION (FIG. 10.1)
Procedure
Upper Limb
Lower Limb
Back
Abdomen Chest and Throat
Head
ADVANTAGES
TRAINING FOR LABOR
CHAPTER 11:
Breathing Techniques
DEFINITION
IMPORTANCE OF BREATHING TECHNIQUES
TECHNIQUE-1
TECHNIQUE-2
Advantages
Second Method
TECHNIQUE-3
Breathing during Labor
CHAPTER 12:
Massage
DEFINITION
CLASSIFICATION
INDICATIONS
CONTRAINDICATIONS
MASSAGE TECHNIQUES
Stroking
Effects
Effleurage
Effects
Kneading
Effects
Hacking
Effects
MASSAGE SESSION
SELF-MASSAGE
Face
Neck and Shoulders
Legs
CHAPTER 13:
Embryonic and Fetal Development
THE FETUS
Fetus Physiology
Fetal Growth
Placental Size and Function
Sex
Maternal Nutrition
Fetal Circulation
Renal Function
Central Nervous System
Peripheral Nervous System
Skin Physiology
Alimentary Tract
Respiratory System
Placental Transfer
Water Transfer
Gas Transfer
Fetal Hypoxia
Carbon Dioxide Transfer
Amino Acid Transfer
Fat Transfer
THE FIRST MONTH
Mother
Baby
Total Weight Gain
THE SECOND MONTH
Mother
The Placenta
Baby
THE THIRD MONTH
Mother
Baby
THE FOURTH MONTH
Mother
Baby
THE FIFTH MONTH
Mother
Baby
THE SIXTH MONTH
Mother
Baby
THE SEVENTH MONTH
Mother
Baby
THE EIGHTH MONTH
Mother
THE NINTH MONTH
Mother
Baby
CHAPTER 14:
Relieving Pregnancy Discomfort
ANEMIA
Cause
Treatment
BLEEDING GUMS
Cause
Treatment
BREATHLESSNESS
Cause
Treatment
CONSTIPATION
Cause
Treatment
CRAMP
Cause
Treatment
INDIGESTION AND HEART BURN
Cause
Treatment
NAUSEA OR MORNING SICKNESS
Cause
Treatment
EDEMA
Cause
Treatment
PASSING WATER
Cause
Treatment
PILES
Causes
Treatment
PRE-ECLAMPSIA OR TOXEMIA
Cause
Treatment
VAGINAL DISCHARGE
Cause
Treatment
VARICOSE VEINS
Cause
Treatment
VULVAL VARICOSITIES
Cause
Treatment
GESTATIONAL DIABETES
Cause
Treatment
HEMORRHOIDS
Cause
Treatment
BACKACHE
Cause
Treatment
TENDER BREAST
Cause
Treatment
CARPAL TUNNEL SYNDROME
Cause
Treatment
INSOMNIA
Cause
Treatment
CHAPTER 15:
Identification of High Risk Woman
IDENTIFICATION OF HIGH RISK WOMAN
CAUSES FOR HIGH RISK OF PREGNANCY
5. Addiction
Tobacco
Drugs
6. Chronic Hypertension
7. Cardiac Disease
8. Pulmonary Disease
9. Renal Disease
10. Diabetes
11. Thyroid Disease
12. Rheumatic Disease
13. Hematological Disorders
14. Genetic Disorders
Consanguinity
15. Pituitary Disorders
16. Liver Disease
17. Venous Thromboembolic
18. Infectious Disease
19. Family History
CHAPTER 16:
Labor and Delivery
DEFINITION
THE SHOW
THE WATERS
CONTRACTIONS
SIGNS OF FALSE LABOR
THE FIRST STAGE
Baby
STAYING UP RIGHT
THE BABY'S POSITION
INDUCTION
NATURAL PAIN RELIEF
Breathing
Relaxation
TENS
PHARMACOLOGICAL PAIN RELIEF
Pethidine
Effect on Mother
Effect on Baby
Entonox
Effect on Mother
Effect on Baby
Epidural Anesthesia
Effect on Mother
Effect on Baby
FETAL MONITORING
TRANSITION
THE SECOND STAGE
EPISIOTOMY
ASSISTED DELIVERY
A CESAREAN BIRTH
THE THIRD STAGE
CHAPTER 17:
Breastfeeding
GETTING STARTED
FEEDING TIMES
A DIET TO HELP MOTHERS
EQUIPMENT
BREASTFEEDING PROBLEMS
Sore or Cracked Nipples
Blocked ducts
Mastitis
BOTTLEFEEDING
Bottlefeeding Equipment
COLIC
CHAPTER 18:
Assessment and Handling of Newborn
APGAR SCORE(TABLE 18.1)
MEASURING THE BABY
LATER CHECKS
COMMON MUSCULOSKELETAL DISORDERS
Congenital Dislocation of Hip
Treatment
Physiotherapy Treatment
Talipes Equinovarus
Physiotherapy Treatment
Strapping
Metatarsus Adductus
Physiotherapy Treatment
Talipes Calcaneus Valgus
Brachial Plexus Injury
Physiotherapy Treatment
Sternocleidomastoid Tumor
CHAPTER 19:
Exercise Therapy Regime
AIMS OF OBSTETRIC PHYSIOTHERAPY
PRINCIPLES
The Concentration
The Breath
The Girdle of Strength
The Back
Abdomen
Buttock
Relaxation
IMPORTANCE OF EXERCISE SESSION
EXERCISE PROGRAM
AIMS OF PHYSIOTHERAPY
GUIDELINES FOR EXERCISE DURING PREGNANCY
CONTRAINDICATIONS
EFFECTS AND USES OF EXERCISES
AIMS AND PLANS DURING PREGNANCY
First Trimester
Posture Awareness
Pelvic Floor
Breathing Exercises (Fig. 19.1)
Rib Awareness (Fig. 19.2)
Head Roll and Head Tilt (Figs 19.3A and B)
Shoulder Lifts and Circles (Figs 19.4A to D)
Arm Stretches (Figs 19.5A to C)
Side Stretch (Fig. 19.6)
Forward Bend (Fig. 19.7)
Pillow Squeeze (Fig. 19.8)
Relaxation Sequence (Fig. 19.9)
Alternating the Breath
Second Trimester
Curl-ups
Knee to Chest
Opposite Arm and Leg Stretch
Arm Reaches
Hip Rolls
Knee Drops to Side
Leg Slides
Hamstring Stretch
Leg Stretchers
Leg Lift
Posture Awareness
Squatting Against a Wall
The Quadruped Position (Figs 19.10A to C)
Pillow Squeeze
Relaxation Sequence
Third Trimester
Foot Arching
Ankle Exercises
Hand and Wrist Exercises
Arm Raises
Legs Against the Wall
Spinal Twist
Sitting with Legs Wide Apart
Leg Raises with Pillow Support
Child Pose with Pillow Support
POSTNATAL PERIOD
Aims and Plans of Physiotherapy
First Three Months After the Birth
Flexing the Feet (Figs 19.11A and B)
Arm Exercisers (Figs 19.12A to C)
Bottom Walking (Fig. 19.13)
The Pelvic Floor (Fig. 19.14)
Side Rolls (Fig. 19.15)
Buttock Squeeze (Fig. 19.16)
Heel Lifts (Fig. 19.17)
Arm and Leg Stretches
Gluteal Muscles
Standing Side Stretch
Twist Exercise (Figs 19.18A and B)
Feet and Ankle Exercise
Foot Exercise
Cushion Squeeze
Relaxation Sequence
Three to Six Months After Birth
Knee Bends
Quadriceps Stretch (Fig. 19.19)
Hamstring Stretch
Gluteal Stretch (Fig. 19.20)
Pelvic Tilts (Figs 19.21A and B)
Single Leg Stretch (Fig. 19.22)
Variation
Abominal and Pelvic Floor Exercise
Inner Thigh Lifts (Fig. 19.23)
Arm Stretching
Windmill Arms (Figs 19.24A and B)
Quadripued with a Leg Stretch (Figs 19.25A and B)
Stretch to Release Tension (Figs 19.26A and B)
Ankle Circles (Figs 19.27A and B)
Leg Toning with Weights
Squeeze
Relaxation Sequence
Six Months Plus
Sit-ups
Oblique Sit-ups
Advanced Pelvic Tilts
Stretch for Abdominal, Gluteal and Back Muscles (Fig. 19.28)
Side Stretches (Fig. 19.29)
Triceps Exercise (Fig. 19.30)
The Abdominal Exercise
Double Leg Stretch
Roll Downs with a Swing
Armside Stretches
Variation
Wide Leg Circles (Figs 19.31A to C)
Bridging (Fig. 19.32)
Sitting Forward Stretch (Fig. 19.33)
Shoulder Release
Pillow Squeeze
Relaxation Sequence
CESAREAN SECTION
Preoperative Physiotherapy
Aims and Plans
Postoperative Physiotherapy
Aims and Plans
HIGH RISK PREGNANCY
Aims and Plans
CHAPTER 20:
Electrotherapy
DEFINITION
THE MODALITIES
Muscle Stimulator
Uses
Interferential Therapy (Fig. 20.1)
Indication
Uses
Transcutaneous Electrical Nerve Stimulation (Fig. 20.2)
Indication
Uses
Microwave Diathermy (Fig. 20.3)
Indication
Uses
Ultrasound Therapy (Fig. 20.4)
Indication
Uses
Shortwave Diathermy (Fig. 20.5)
Indication
Contraindications
Uses
Infrared Radiation (Fig. 20.6)
Indication
Uses
Laser Therapy (Fig. 20.7)
Types
Indication
Contraindication
Uses
Cold Therapy
Indications
Effects
Massage Therapy
Indication
Modalities Used during Antenatal Management
Carpal Tunnel Syndrome
ELETROTHERAPY DURING LABOR
TENS (Fig. 20.8)
Technique
Parameters
Uses
ELECTROTHERAPY DURING POSTNATAL PERIOD
Pain Relief
Electrode Placement
Cesarean Section
Acute Perineal Trauma
Ultrasound (Fig. 20.9)
Parameters
Short-Wave Diathermy
Position of the Patient
Parameters
Effects
Low Level Laser Therapy (LLLT)
Position of Patient
Technique
Caution
Dosage
Effects
Infrared Radiation
Cracked Nipples
Chronic Perineal Healing
Ultrasound Therapy
Parameters
Effects
Pubic Symphysis Diastasis
Ice Application
Ultrasound
Parameters
Technique
Effects and Uses
Sacroiliac Joint Pain/Coccydynia
Ice Application
Ultrasound Therapy
Parameters
Technique
Breast Engorgement
Heat Treatment
Cold Treatment
Ultrasound
Parameter
Application
Sterilization
Effects and Uses
Continuous Mode
Pulse Mode
Mastitis
Treatment
Ultrasound
Parameters
Blocked Ducts
Treatment
Ultrasound Treatment
Precaution
Application
Contraindications
PELVIC FLOOR DYSFUNCTION
Aims of Pelvic Floor Dysfunction
Causes
Type of Nerve Damage
Type of Machine
ACUTE STIMULATION OR SHORT-TERM BY MAXIMUM INTENSITY
Effects
Electrodes
Electrode Placement
Care
Contraindications
Detrusor Instability
CHAPTER 21:
Complications of Pregnancy
HEMOGLOBIN STATUS
PELVIC FLOOR PROBLEMS (FIG. 21.1)
BACKACHE
SACROILIAC PAIN
PUBIC SYMPHYSIS JOINT SUBLUXATION
SACROILIAC JOINT DISCOMFORT
SEPARATION OF THE RECTUS ABDOMINIS(FIG. 21.2)
CESAREAN SECTION DELIVERY
BREASTFEEDING (FIG. 21.3)
TIREDNESS
WEIGHT GAIN
SPINAL PAIN
Physiotherapy Treatment
NERVE COMPRESSION SYNDROME
PAINFUL PERINEUM
PUERPERAL INFECTION
BREAST INFECTION
VENOUS COMPLICATIONS OR THROMBOPHLEBITIS
DEEP VEIN THROMBOSIS OR PHELEBOTHROMBOSIS
INCONTINENCE
Assessment
Cause
Types of Incontinence
Stress Incontinence
Genuine Stress Incontinence
Urge Incontinence
Overflow Incontinence
Reflex Incontinence (Neurogenic)
Continuous Incontinence
Frequency
Re-education of Pelvic Floor
Pelvic Floor Laxity
Assessment of the Pelvic Floor Muscles
Method
Routine for Exercises
Follow-up Appointments
Group Therapy
Exercises
Bladder Retaining
DIASTASIS RECTI
Treatment
CHAPTER 22:
Infection Control for Physiotherapist Working with Women's Health
INFECTION CONTROL PROGRAM FOR PHYSIOTHERAPIST
Universal Precaution
Protect from Infection
Use of Gloves
Handwashing
Cleaning
Cleaning Vaginal Weights and Catheter
Vaginal and Anal Electrodes
Perineometer
Ultrasound Head and Interferential Electrodes
Glossary
Bibliography
INDEX
TOC
Index
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