Physiotherapy

Physiotherapy

OLANREWAJUN O.O (BMR (IFE), MSC (LAGOS), MPPA (BUK), MDS (BUK)
DEPUTY DIRECTOR OF PHYSIOTHERAPHY
HEAD OF DEPARTMENT
PROFILE
Mr Olanrewaju Olawale Olawoyin was born into the family of Mr and Mrs D.   O. Olanrewaju natives of Modakeke in Ife East Local Government of Osun State on 6^th of July 1962.
He had his primary school education at St John’s Anglican Primary school and proceeded to St Charles Grammar School Osogbo in 1978. He completed his secondary school education in 1983.
He secured admission to the then University of Ife now Obafemi Awolowo University Ile – Ife in 1985 to study Physiotherapy. He graduated with Bachelor Degree in Medical Rehabilitation (BMR) with specialization in Physiotherapy in 1989.
He was posted to Kano State for his one year compulsory National Youth Service and served in National Orthopaedic Hospital Dala Kano. He was offered employment in 1990 immediately he finished his NYSC by the same hospital as Physiotherapist II.
He rose through the ranks to the present post of Deputy Director of Physiotherapy. Neurological Rehabilitation and management of Orthopaedic conditions are his areas of interest.
He obtained Masters Degree in Physiotherapy from the University of Lagos, Masters Degree in Public Policy and Administration (MPPA) from Bayero University Kano and Masters Degree in Development Studies (MDS) from Bayero University, Kano. He has Certificate in Sports Medicine from International Olympic Committee.
His hobby include reading and long distance walking.

FOCUS ON PHYSIOTHERAPY DEPARTMENT
INTRODUCTION
The orthopaedic treatment does not end at merely fixing the fracture efficiently, but pre-injury functional status of the individual has to be restored back and further complications prevented (Ebnezar, 2011).  This is where the specialty of physiotherapy steps in, to bridge the gap in the management of orthopaedic patients.  A perfect blending of the art of the orthopaedic and physiotherapy is what is required to put the patient back to the pre-injury status. Apart from the therapeutic role, physiotherapy has a restorative role in restoring the lost function and also preventive role in preventing the recurrence of the problem and secondary complications from setting in.  The role of physiotherapy in orthopaedic practice can not be over emphasized. HISTORICAL BACKGROUND
Physiotherapy has its root in Europe especially in ancient Greece and Rome in about 460BC. It was organized into a professional group in Sweden in 1813 and in Britain in 1894. Physiotherapy was introduced into Nigeria in 1946 by British physiotherapists to rehabilitate wounded soldiers of the Second World War at Royal Orthopaedic Hospital, Igbobi now National Orthopaedic Hospital, Igbobi, Lagos. Physiotherapy services started in Ibadan in 1948 later in other parts of Nigeria.
In National Orthopaedic Hospital Dala, physiotherapy department started operation together with the hospital as a whole when it was commissioned in 1959. The hospital was under the Institute of Health, Ahmadu Bello University (ABU), Zaria, so also the physiotherapy department.  The first HOD of the physiotherapy department of the Institute was Mr. Bermie (a Briton) overseeing the physiotherapy departments at ABUTH, NOHD Kano and Malumfashi.  While Mr. Bermie was the overall head of the three departments, Mallam Halilu Mohammad was the head of Physiotherapy department at National Orthopaedic Hospital, Dala-Kano. After Mr. Bermie left, Mr. Gani Ikilama became the HOD supervising the three departments.  Later, the Fedral Government set up Orthopaedic Hospitals Management Board, Harvey Road, Lagos to oversee the affairs of the National Orthopaedic Hospitals in Lagos (Igbobi), Enugu and Kano.  With this arrangement, Mallam Halilu Mohammad became the first substantive indigenous HOD in Dala with Mr Komi (a Ghanaian) as the deputy. Mr. Komi left in 1988. Mrs. Dara Fawehinmi later joined NOHD as a Principal Physiotherapist in 1988.  She became deputy to Mallam Halilu.  In December 1989, Mrs. Adejumoke E. Foluwasade joined NOHD on transfer as a senior physiotherapist from Ogun State Health Management Board.  Mallam Halilu Muhammad retired from service on 23^rd April, 2004 and died on 3^rd April, 2012. Mrs. Foluwasade A E became the head of department when Mallam Halilu retired in 2004 till she also retired from service in February, 2015. Mr. Olanrewaju O. O was appointed by the hospital management as the substantive head of department in February, 2015 till date.
WHAT IS PHYSIOTHERAPY?
Physiotherapy is an autonomous healthcare profession which diagnoses, and treats individuals of all ages (from the newborns to the very oldest) with medical problems or health-related conditions that limit their abilities to move and perform functional activities of daily living. It is a dynamic profession with an established theoretical and scientific base and widespread clinical application in the restoration, maintenance and promotion of optimal physical function. It can also be defined as a healthcare profession dedicated to working with people to identify and maximize their ability to move and function throughout their lifespan. Restoration of proper functioning of the disabled or injured body parts is achieved by the use of physical means. Physiotherapists practice in many settings, such as outpatient clinics or offices, inpatient rehabilitation facilities, private homes, education and research centres, schools, hospices, industrial work places, fitness and sports training facilities.
SPECIALITIES IN PHYSIOTHERAPY
-Cardiopulmonary
-Geriatrics
-Neurology
-Women’s health
-Ergonomics
-Integumentary
-Sports
-Orthopaedics
-Paediatrics
-Community/Itinerant services
ORTHOPAEDIC PHYSIOTHERAPY
PHYSICAL MODALITIES USED IN PHYSIOTHERAPY
To achieve his goals, the physiotherapist employs physical modalities which can be broadly classified into thermotherapy, electrotherapy, cold therapy, therapeutic exercise, hydrotherapy, massage, sound therapy, light therapy e.t.c. The primary role of these modalities is to prepare the muscles and joints of the body for exercises. Physical modalities are used as adjuncts to a comprehensive therapy program that includes exercise and patient education. Modes of operation can be broadly divided into the following areas:
-Thermotherapy
-Electrotherapy
-Hydrotherapy
-Manual therapy (traction, manipulation e.t.c)
-Light therapy (ultraviolet radiation and laser)
-Cryotherapy/Cold therapy
-Exercise therapy/Therapeutic exercise
-Massage
TENS APPLICATION

ELECRICAL MUSCLE STIMULATION

INTERFERENTIAL MACHINE

INFRARED LAMP

PARAFIN BATH

SHORTWAVE DIATHERMY

HYDROTHERAPY

FRICTIONAL MASSAGE

COLD SPRAY

CRYOTHERAPY

ISOMETRIC EXERCISE

TREADMILL

MULTIGYMN

TYPES OF THERAPEUTIC EXERCISES
Passive range of motion (PROM) exercises are done for the patient by the PT. PT does the ROM exercises because the patient cannot do them by himself and the aim is to prevent stiffness and contracture. Active exercises (AROM) are done by a patient who can do the exercises all by himself. Active assisted exercises (AAROM) are used when the patient has very weak muscles or when joint pain limits movement.
Resistive exercises are done by a patient using several modalities for example making use of various sizes of weighs and also movement against gravity, elastic bands and the major aim is to increase muscle strength.
Isometric exercise is a form of exercise involving the static contraction of a muscle without any visible movement at a joint. The length of the muscle does not change.
Isotonic exercise – Isotonic contraction in which the contraction strength does not change but the joint angle does.
PATIENT EDUCATION
-We teach patients lifting techniques to avoid injury to the back
-We educate patients proper sitting posture
-We encourage patients to live active lifestyle
-We also tell them the danger of obesity
LIFTING TECHNIQUE

LIFTING TECHNIQUE

BENEFITS OF EXERCISES
-Control your weight
-Reduce your risk of some cancers
-Strengthen your bones and muscles
-Improve your mental health and mood
-Increase your chances of living longer
-Reduces your risk of cardiovascular diseases
-Reduce your risk for type 2 diabetes
-Greater quality of life
BENEFITS OF EXERCISE

PAST & PRESENT ACHIEVEMENTS
When the two (2) renowned orthopaedic surgeons/ consultants by names Dr. Olabumuyi and Dr. Ikhile were in the services of the Hospital, the physiotherapy department was running two (2) clinics namely spinal and polio clinics.
During the clinics, all the professionals managing these two conditions came together to plan the best way to help the patients.  The physiotherapy department hosted the clinics from inception to the time the two clinics collapsed, when the two surgeons left the hospital for greener pastures outside Nigeria.
Another major achievement recorded by the department is in the area of training.  The physiotherapy students from Bayero University Kano (BUK) and other universities in the country that have passed through the department have great stories to tell about the level of exposure to orthopaedic physiotherapy.  The department is still involved in the training of physiotherapy students, School of Nursing students, Post Basic Orthopaedic Nursing School, Post Basic Accident and Emergency Nurse students, Plaster Cast Technology School students etc.
For several years the department has been conducting educative departmental seminars on monthly basis.  It has been an avenue to brain storm about several conditions that we see in the department.  Not only in the department, but also get involved in the hospital clinical seminar, which holds every Wednesday then but now on Fridays.
HUMAN CAPACITY DEVELOPMENT
In the year 2008, the Hospital Management approved for the first time, sponsorship of Physiotherapists for M.Sc programme in physiotherapy.  Many of our staff had obtained their M.Sc degrees. This is a welcome development and should be maintained.  Many of our physiotherapists have on their own attended international conferences like WCPT (African Region), American Physical Therapy Association (APTA).  The Management has also sponsored therapists for the NSP conferences and workshop.  The Hospital Management is also encouraging sub-specialty training as one of the staff development programmes.
OUR ACTIVITIES
Physiotherapy department is essentially a clinical department involved in the treatment and management of various medical conditions.  Being an orthopaedic/trauma hospital, our specialty is in the orthopaedic/sports/trauma fields. Majority of our patients come with orthopaedic/sports/trauma cases, we still manage medical, paediatric and geriatric cases.
In the past two decades, it is recorded that the department had treated or managed thousands of patients with various health challenges but mostly orthopaedic conditions.
Apart from this function, the department is also one of the major revenue generating departments of the hospital.
STAFFING:
At present the department has a total number of 14 physiotherapists and one NYSC physiotherapist. Below is the breakdown based on different cadre.
-Deputy Director   1
-Assistant Directors   5
-Chief Physiotherapist  1
-Principal Physiotherapist  1
-Senior Physiotherapist  1
-Physiotherapists  5
-NYSC Physiotherapist  1
From inception, the department has always been understaffed, especially the physiotherapists cadre, which forms the senior staff of the department
Presently, there has been no improvement in the staff strength of the senior staff. Fourteen physiotherapists attending to almost all the patients on admission and numerous patients coming for treatment on outpatient basis is grossly inadquate. We receive many patients from private health facilities and from neighbouring states.
MODE OF OPERATION
Physiotherapy department is known for her orderliness and organization of her activities both clinical and administrative.
Clinical work is organized into two main sections – Outpatient and In-patient sections.  Each section has five main clinical teams namely;
-Pink team
-White team
-Blue team
-Green/Purple team
-Burns & Plastic/Paediatric team
Total senior staff (therapists) working is 14 including the HOD minus the NYSC.  The NYSC therapists stay for only one year.  From this figure, it can be seen that, there has been no improvement in the staff strength since the early 1990s.
Shortage of staff has been a great constraint we have been facing for over two decades.
JUNIOR STAFF