1.

Most important health indicators in physiotherapy

Quality care indicators are a fundamental tool for improvement.

continues from a clinical management unit, such as a rehabilitation service.

The clinical management unit (UGC) can coincide with a clinical service, with a unit
functional or with a care unit. It can be multidisciplinary or not. Management is delegated in it.
responsibility for both the activity of the personnel and the appropriate use of resources that
assigned, in order to improve the health level of users. The healthcare professional is
actively and responsibly involved in the management of tasks, actions, and resources used in their
practice.

An indicator results in a numerical variable that allows us to:

● Measure and quantitatively express aspects of attendance, organization or the

management.
Know the functioning of different services and organizations.
Facilitate comparisons over time and space.
Evaluate and plan improvements.

The indicators must meet a series of fundamental characteristics:

They must be valid: they must reflect the aspect of quality for which they were established.
●Be reliable: they must show the same result under the same circumstances.
They must be easily understood.
Be simple: to facilitate their explanation, application, and administration.

Likewise, the indicators must be supported by good information systems that

facilitate the collection and analysis of data and ensure its validity

2. Health program in physiotherapy

A physical therapy program consists of a series of coherent, organized activities.

integrated aimed at achieving specific and previously defined objectives to improve the
health status of a population or person.

An appropriate rehabilitation program helps the patient regain their self-esteem and can
be the difference between a situation of autonomy and confinement. In fact, with the help of these
programs, one year after the stroke, one third of the patients who survive return to their
previous work, half do not need any help for their daily activities, 20% need
help only in certain situations and another 20% is dependent to a greater or lesser extent.
Most patients who have suffered a stroke need rehabilitation at a certain
number of areas. The intensity and duration of the program will vary according to the severity of the disability.
Typically, rehabilitation programs integrate physical and occupational therapy and, in those
cases that require it, the rehabilitation of language.

Techniques used in physiotherapy

The techniques used in physiotherapy are multiple and varied, although a general categorization can be made.
classification according to the tools and means used.

Manual therapy

One of the main tools of physiotherapists is their own hands, which is why there are
a series of techniques that can be grouped within manual therapy:

1. Massage therapy: It includes different techniques or modalities of massage, such as therapeutic massage.
sports massage, connective tissue massage or cryomassage (application of cold) and techniques
such as therapeutic manual lymphatic drainage or neuromuscular manual techniques.

2. Kinesiology: Healing method based on active or passive movements of

body of a part of it. This is achieved by applying an external force that
It will produce a movement without the individual making a voluntary muscle contraction. It is
indicated in processes where joint mobility is compromised.

3. Orthopedic manual therapy: It focuses on the diagnosis and treatment of injuries.

musculoskeletal (injuries of hip, shoulder, or knee and pain in neck and back).

4. Manual methods of postural re-education: It consists of the execution of

stretching exercises, called postures, that protect the joints and eliminate the
harms derived fromcontracturesand muscle blockages, spinal deformities (scoliosis) o
sequelae of trauma.

5. Analytical stretches: Therapeutic maneuvers aimed at stretching soft tissue structures.

shortened to increase the range of motion. This practice is indicated for contractures.
muscular, burns and retractable scars or in prolonged immobilization.

6. Neurological physiotherapy: It is based on a set of therapies to treat conditions of the system.

nervous about the end of educating or re-educating postural tone, synergies, and neuromotor patterns
pathological. It is indicated in brain lesions (Parkinson), peripheral injuries (paralysis of
peripheral nerves), spinal cord injuries (spina bifida, multiple sclerosis, ELA) o
childhood neurological syndromes.
7. Respiratory physiotherapy: It consists of carrying out a series of procedures for the
airway clearance, respiratory re-education, and adaptation to effort
the goal of improving the functioning of the muscles of the respiratory system and the exchange of
gases, as well as increase resistance. Respiratory physiotherapy is recommended in cases of
neuromuscular diseases such as dystrophies, multiple sclerosis or ALS, and also after
surgical interventions.

8. Obstetric physiotherapy: It consists of a series of hypopressive gymnastic exercises.

aimed at strengthening the pelvic floor. Its name comes from the fact that the exercises are performed
in hypopression, that is to say, nullifying the pressure exerted by the diaphragm and the abdominal muscles
about the pelvic floor muscles.

[Link] taping and neuromuscular taping: Functional taping consists of the application of
elastic or inelastic adhesive strips whose purpose is to limit the movements that affect the
damaged structures without restricting other movements. Neuromuscular taping is performed through
cotton tapes with an acrylic adhesive that sell the muscle from its birth until its
insertion. The goal is to raise the skin to increase the subcutaneous space and thus help reduce the
extravasation of fluids to reduce inflammation and pain.

10. Diacutaneous fibrolisis: Technique that consists of applying hooks on the skin to alleviate.
the discomfort caused by the destruction of adhesions of the membranes that surround the
muscles, like the aponeurosis; the hook helps to unite and fix these structures. Each hook has a
different sizes and curvature to fit the contours of the body.

Therapy using physical agents

The other type of tools used by physiotherapy specialists are those related to
physical and natural agents:

1. Electrotherapy and ultrasonotherapy: They are techniques that consist of the application of currents.
electrical ultrasound predetermined body parts with the aim of enhancing the action
neuromuscular, improve trophism (development, nutrition, and maintenance of tissues) and that act
as anti-inflammatory and analgesic.

2. Thermotherapy and cryotherapy: Therapeutic methods that use heat (thermotherapy) and cold.
(cryotherapy) to alleviate acute and chronic rheumatic pain and visceral colic. Cryotherapy
it also acts as an anti-inflammatory and analgesic in injuries such as sprains, and also as
destructive method for treating skin tumors.

3. Hydrotherapy: Techniques that use water as a therapeutic method; it includes the

thalassotherapy (use of the marine environment and climate) and hydrokinetotherapy (performing exercises in)
the water). Thehydrotherapyit helps reduce inflammation and pain, dilate blood vessels and
relax the muscles, in addition to having an antispasmodic effect.
4. Mechanotherapy and pressotherapy: Mechanotherapy refers to those treatments in the
the use of mechanical devices is necessary, as in patients with disabilities, patients with
need for prostheses or orthotized children. Pressotherapy is performed using a machine that does
compressive massage through special leggings that help expel the excess of
liquid and improve circulation; it is indicated in the case of edema,varicesand postphlebitic syndrome.

5. Magnetotherapy and phototherapy: Magnetotherapy involves the development of a treatment to

through electromagnetic fields that act by helping to eliminate contractions, it is antispasmodic
y antiinflamatorio. La fototerapia es el tratamiento de lesiones mediante laaplicación de luz
ultraviolet or infrared; it is indicated for skin pathologies and diseases, such asacne, the
psoriasispressure ulcers and physiological jaundice in newborns.

3. Indicators of social participation

Likewise, the intermediate factors are composed of:

Material resources: such as employment conditions (labor situation, precariousness)

and work (physical and ergonomic risks, organization and psychosocial environment); the workload of jobs not
remunerated home and personal care workers; the income level and the economic situation and
heritage; the quality of the housing and its facilities, and the neighborhood or area of residence and its
characteristics.

The psychosocial factors and behavioral and biological factors: these resources, along with
the position of power has an impact on health both directly and indirectly, influencing
psychosocial processes such as lack of control, self-actualization, or stressful situations; and in the
behaviors influencing health.

Healthcare services: although in themselves, they do not constitute the main factor of
generation of health inequalities; they can have both a multiplier effect and
buffer of inequality, depending on whether access, utilization, and quality of them are
less than, equal to or greater than for the lesser advantaged social groups. (n/p).

All these factors, according to the conceptual framework of the health inequalities observatory,
determine the opportunities that an individual or population may have to enjoy a high degree of
well-being or quality in the provision of healthcare services, where it highlights the
inequality in health matters due to purchasing power, access to material resources,
healthy and safe working conditions, geographical location, among other variables that can
to influence the issue of inequality directly or indirectly.

Thus, these models allow for the formulation of public health policies to improve
the conditions and lifestyles of a population, through the participation of the team
interdisciplinary health, to achieve more effective, efficient, and sustainable results in favor of
creation of a support environment that allows people to lead a healthy life. Therefore, it is
important, primary care which provides better health to populations and individuals, with
greater equity in health in the poorest sectors and at low costs, understanding assistance
both scheduled and emergency health care, prevention days, promotion, surveillance, in
health matter up to basic rehabilitation where the participation of the physiotherapist comes into play.

4. Primary care in physiotherapy

The physiotherapy service in Primary Care aims at prevention and

health promotion, in addition to the treatment of existing ailments in the patient.

Therefore, the population that can benefit from the unit's programs is
those that present risk factors for a certain pathology, but have not yet
developed. It can also apply to those who do present the pathology, whether it is a process
acute or chronic.

This attention can be both in the rooms enabled within health centers and in
the patients' addresses. The choice of treatment location depends on the characteristics of
each patient, from the general organization of the units of each Autonomous Community or from the internal organization
of the unit