INFORMED CONSENT
GENERAL PHYSIOTHERAPY
INTRODUCTION
Informed consent is the process to which everyone is entitled to receive medical and health care, according to which the health professional is required to inform the appropriate techniques to be applied, the effects to be achieved, possible side effects and the consequences of such treatment.
This documentation has been prepared in accordance with the provisions contained in the Health Act (14/1986 of April 25) and Law 41/2002 of November 14, the latter regulating the rights and obligations of information and documentation clinic.
GENERAL CONCEPT OF PHYSIOTHERAPY
Treatment of the individual to assess, prevent, correct, alleviate and limit or reduce disability, impaired movement, function and posture, and pain resulting from disorders, congenital and conditions of aging, injury or illness (damage or surgical procedure). Physiotherapy most significant aims to restore physical functions lost or damaged.
Use as treatment agents and physical means such as electricity, movement, massage or manipulation of tissues and joints, water, light, heat, cold, etc., and depending on the agent that is used is called:
• Therapies and manual procedures, defined as the location and treatment of disorders of the locomotor system using hands to unlock joints and fasteners and reflex muscle through the application of techniques and therapeutic models of soft tissue. Includes all cinesiterapia, massage therapy and its derivatives.
or Cinesiterapia which is defined as the set of therapeutic procedures aimed at treating disease by the movement, whether active, passive or communicated by some external means.
or Massage / Massage therapy is the set of manipulations, usually practiced without the aid of instruments, over part or all of the body (muscles, ligaments, tendons, fascia, joint capsules ...), in order to mobilize the tissues to cause the body modifications direct or reflex order to be translated into therapeutic effects. Has a drainage or emptying effect and decrease the muscle tone. Although usually a harmless technique, sometimes you have to exert pressure deep (eg. Massage Cyriax transverse) that may be painful, sometimes superficial bruises appear and the area remains "agujetosa" for about 48 hours. If done next to great pains should be taken into account that could decrease excessive muscle tone and therefore performance.
or Stretching: involves the elongation of different muscles, which when subjected to intense work, they are shortened. They are intended to stop the muscle in a more relaxed, with the possibility of extended and also favor a vascular drainage. A very intense stretching could leave in the days following the feeling of "stiffness".
• Thermotherapy, Cryotherapy is the application of heat or cold, respectively. Heat decreases muscle tone and increases blood flow to the area of application and the cold reduces inflammation and slows the transmission of painful stimuli. Cold, as heat, can cause chemical burns.
• Mecanotherapy is therapeutic and hygienic use mechanical devices designed to provoke and direct body movements regulated force, trajectory and amplitude.
• Electrotherapy is defined as the treatment of certain diseases by electricity or electromagnetic radiation on the body to improve the state of the tissues (trophic effects), to relieve pain (analgesic effect), and help motor recovery (excitomotor effects ).
or Ultrasound is a sound wave at a high frequency that is not even audible.
Electric currents or low and medium frequency: There are many types of these currents with different effects: basically two objectives, or cause a muscle contraction either strengthen it (electrostimulation), to relax you or to drain, or cause a decrease in pain or analgesia (TENS currents). A very intense contraction can cause muscle damage. When we analgesia should follow the instructions of the therapist as it mutes the mechanism that the body has to tell us that something is wrong and injuries occur to no pain. Galvanic accidents can also occur are those that range from mild irritation to the skin to appearance of electrical burns and ulcers.
• osteopathic manipulations: passive mobilization techniques are low-amplitude, high-velocity joints aimed at the disabled. Act in two ways: mechanically separating the articular surfaces and reflected way, thanks to rapid stretching causes an inhibition of the contraction of the muscles involved in the joint fixing. They are indicated in cervico-dorsal-back pain, neuralgia, certain viscera functional problems, some headaches, and many painful processes. Being conducted often hear a "crunch" articulate, that does not mean anything is broken but have separate facet joints. They can have unintended consequences either temporary during treatment or in the days following such as musculoskeletal pain or autonomic nature as hypotension, tachycardia, dizziness, sleepiness or tiredness, cold and / or malaise.
• Complementary and Alternative Therapies, as a more-used by physical therapists, as well as electrotherapy, Cinesiterapia, etc.. These therapies could be defined as the use of procedures that seek to regulate, stimulate or enhance the body's own natural balance, with a clearly biological (one's person is trying to regain their health potential, aided by the therapeutic procedure applied ). Among these we can include Acupuncture and Reflexology, among others.
• Global Postural Reeducation (RPG): A method of gentle stretching, progressive and active in restructuring the musculoskeletal system. It is based on global positions in order to stretch the muscle chains static and the patient is asked isometric contractions. Corrects imbalances avoiding static offsets. Passengers can generate undesirable effects as muscle fatigue, tingling or acorchamientos, sleep or feeling cold.
• Presoterapia: With a pair of pressure sleeves promotes drainage of blood from the legs or arms to aid the removal of waste substances from the muscle cells after great effort. High pressure can cause headaches during the following hours.
• taping: Techniques of immobilization or partial containment through plasters and bandages that allow injured structures protecting activity or in recovery. Friction can cause blisters and less frequently allergies to adhesive bandages.
RISKS
Physiotherapy has very few risks and the greatest dangers are their incorrect indication and poor execution. Therefore, it is necessary, especially in the more aggressive techniques, a perfect knowledge of its founders ¬ ments, the basis of use, completion techniques and their potential risks, so you should always be applied by professionals of Physiotherapy. In any case, it is refine some consequences that may occur during the development of treatments and the patient has to be aware, such as:
• Pain: You may experience muscle pain during and after treatment, being more common in the first sessions.
• Dizziness: Temporary symptoms such as dizziness and nausea can occur especially in cervical treatments such as back-back pain, due to the durability of sitting in the same position.
• Fracture / joint injury: in sporadic cases underlying physical defects, deformities or pathologies like weak bones from osteoporosis can return the patient susceptible to injury. When osteoporosis degenerated intervertebral disk, or other abnormalities are detected, the therapist will act with extra caution.
GENERAL CONTRA
Not all of these contraindications are all techniques, but only those that appear in parentheses. Therefore, your physiotherapist will choose one that can get the best results in your case, with the least risk and discomfort for you.
A) Absolute.
• Malignant tumors,
• Decompensated Heart disease, active endocarditis, blood disorders, tuberculosis (active exercise therapy).
• decompensated chronic bronchitis.
• Thrombosis or active bleeding.
• Pacemaker and / or intracardiac devices (Electrotherapy)
B) Relative.
• synovial effusion, recent injuries hemartrosi and soft tissue (passive movement therapy and thermotherapy).
• Infectious arthritis (hydrotherapy).
• Dermatology: fungal and pyogenic dermatitis.
• uncontrolled Epileptic and choreic syndromes.
• Any open wound in the area being treated.
• Hypertension and varices without control.
• Patients who can spread any infection due to pathology suffering.
• Acute illness with fever.
• United febrile and / or extreme weakness.
• Terminally ill (hydrotherapy and thermotherapy deep)
• sphincter incontinence (hydrotherapy)
• Skin diseases in the case of sulphated water (hydrotherapy)
• Internal metal implants such as stents, osteosynthesis material, etc., (Electrotherapy medium and high frequency).
• Changes in sensitivity (electrotherapy, hydrotherapy)
• Applications abdominal and lower back during menstruation (electrotherapy medium and high frequency)
RESULTS OF TREATMENT
There are beneficial effects associated with these treatment methods including decreased pain, improved function and mobility, and reduce muscle spasm. However, it is uncertain whether these benefits. Health practice, it is not an exact science and there is no guarantee on the accurate result of these methods.
This paper has summarized the main techniques and side effects that occur most often, so do not rule that can be given other much less common and are not listed here due to limited foresee all possible situations .
Both have the right to consent for treatment prior information as well as to consent without receiving information and, in any case, to withdraw consent at any time prior to the completion of the process or during it.