Kavita Rani

To begin with, outpatient department services was the first clinical exposure that I got in my early days during my initial days in hospital. It was often associated with collaborative goal setting with the patient which ultimately improve health outcomes of maximum patients. Most importantly we used to follow biopsychosocial model for each patient which depicts the health condition relation with biological, social, and psychological aspects. Some of the common patients that I used to treat comes under orthopaedic condition, consisting primarily of sprain, strain, cervical and lumbar issues. In case of chronic musculoskeletal issues, we use International Classification of Functioning, Disability and Health (ICF) to take an account of physiological response, activities and function of body in form of assessments clinically. Beside this, gynaecologist referrals were the second most frequent patients that used to visit for ante-natal and post-natal care. Urinary incontinence was the major issues in latter patients for which kegel exercises had been taught. Least we got to treat post-surgical patients in neurology who were hospitalised but still need special attention and care. Paediatrics patients used to come for either pre-natal or post-natal issues in which specialised exercises were performed using swiss ball and geriatrics patients comes with the postural issues such as neck pain and back aches.

Gradually, I started working inpatient department comprised of different specialities. Orthopaedic involves post-surgical patients such as knee replacements, hip replacements, Core decompression surgeries, deformity correction. Physical therapy visits start preoperatively in orthopaedic department and continues till the patient got independent with the walker and gain confidence.

Neurology department involves post-surgical with nerve compression like laminectomy, discectomy, or brain attacks (stroke). Such patients were treated manually and with electrotherapeutic modalities.

Gynaecology department involve post-surgical cases for either normal or C-Section deliveries in which mobilisation was the foremost thing to perform along with joint range of motion exercises.

Cardiothoracic department involve post-surgical cases for bypass surgeries or Video assisted thoracotomy surgery in which incentive spirometry and mobilisation were done on priority to increase and stabilise the saturation.

Pulmonology department involve patient under pneumonia, asthma, chronic bronchitis, emphysema, pleural effusion, and tuberculosis of lungs. Along with medical treatment, chest physiotherapy was performed.

ICU department involve patients with low Glasgow Coma Scale (GCS) in which chest and limb physiotherapy plays a crucial role. Along with this, I used to perform suction and positioning every 2 hourly for the bed-ridden patients.

At last, I used to do home rehabilitation for the patients who got discharge from the hospital and need physical therapy at home under supervision of physical therapist. I used to look after palliative care patients in which goal was to maintain range of motion along with strength and endurance. Gynaecology patients presenting with breech position were treated with proper trimester wise exercises for normal delivery and negligible complications. Orthopaedic patients undergoing replacement surgeries or post traumatic surgeries in which main goal was to make them independent and gain range of motion, strength, and endurance. Cardiology patients were usually treated with breathing exercises like diaphragmatic, pursed lip, glossopharyngeal and segmental along with ACBT (active cycle of breathing technique). Therefore, I used to look IPDs, OPDs and home visits together.