Circulatory and breathing exercises
Upon general examination of the patient, limitation in breathing were noted, we also
decieded to perform circulatory exercises as the patient is expected to be ridden for a
while.
Circulatory exc
Principles of circulatory exc states that they should be done distal joints first followed by
the more proximal joints. They should also done actively by the patient. Circulatory exc”s
prevent the venous stasis which can be caused by the prolonged stay in bed due to
immobility, by promoting blood circulation as the active contractions in the muscles act as
muscle pumps and increasing blood flow. Circulatory exc’s also help to maintain ROM
during the period of immobility in hospital stays. Each movement was repeated 10 times.
Half sitting position on the bed, the patient was asked to perform all movement of the
ankle joint (dorsi flexion, planter flexion, eversion, inversion, circumduction)
Followed by movements in the knee joint (flexion, extension)
Then the hip joint exercises done from standing (flexion, extension, abduction, adduction,
internal rotation, external rotation)
From the same position the patient was instructed to proceed the exercises in the upper
limbs also by working actively, from distal to proximal.
Starting by fingers flexion and extension, followed by exercising the wrist (flexion,
extension, ulnar deviation, radial deviation)
Then the elbow joint (flexion, extension, pronation and supination)
Lastly, the patient was asked to perform the exercises usin the shoulder joint ( flexion,
extension, abduction, adduction, circumduction).
However, this patient suffers from Rt humeral dislocation and humeral shaft fracture, so
the Rt shoulder joint was excluded from the exercises and great care was taken while
exercising the Rt elbow also.
Breathing exercises
Our team decided it was best to teach the patient some of the breathing exercises as
preoperative measures and aslo in preparation for the bed ridden time during healing
process
1. Diaphragmatic breathing: while the patient is in crooked lying position, the therapist
places her hand on the patients stomach and asks the patient to take a deep breath
through her nose and fill up her abdomen like a balloon to raise my hands upwards
and expire from her nose with a sigh
2. Costal breathing: from the same position the therapist places her hands on the
patients chest with the thumbs touching and fingers fanning on the patients ribs. The
patient is then asked to take a deep breath through the nose and fill chest with air to
push the therapists hands outwards and upwards, then expire from moth with a sigh.
Refrence: Ercole Zanotti, Guido Felicetti, Maurizio Maini, Claudio Fracchia
Chest 124 (1), 292-296, 2003