Name of the Procedure

Physical or Manipulative Therapy
Common name(s): Physical Therapy, PT, Manipulative Therapy
Technical or medical terms: S8990 – Physical or manipulative therapy performed for maintenance rather than restoration

Summary

Physical or manipulative therapy for maintenance involves exercises, manual techniques, and various therapeutic modalities aimed at preserving a patient's functional status rather than restoring it to a higher level. It's a preventive approach designed to maintain current levels of function and slow down the progression of certain medical conditions.

Purpose

Medical Conditions or Problems It Addresses

• Chronic musculoskeletal conditions
• Neurological disorders such as Multiple Sclerosis or Parkinson's Disease
• Degenerative joint diseases
• Chronic pain management

Goals or Expected Outcomes

• Maintain current functional ability
• Prevent deterioration of physical skills and mobility
• Manage chronic symptoms
• Enhance quality of life

Indications

Specific Symptoms or Conditions

• Chronic conditions where improvement is not expected
• Conditions where ongoing therapeutic intervention is needed to maintain current abilities
• Elderly patients requiring assistance to stay functional
• Individuals with progressive neurological or musculoskeletal conditions

Patient Criteria or Factors

• Stable but chronic conditions
• Absence of acute injuries
• Non-rehabilitative patients who have reached a plateau in their functional restoration

Preparation

Pre-Procedure Instructions

• Wear comfortable, loose-fitting clothes
• Hydrate adequately
• Notify the therapist of any new symptoms or changes in medical condition

Diagnostic Tests or Assessments

• Initial physical assessment by a licensed physical therapist
• Review of medical history and any recent medical reports

Procedure Description

Step-by-Step Explanation

1. Initial Assessment: A physical therapist evaluates the patient's current physical status.
2. Warm-Up: Gentle warm-up exercises to prepare muscles and joints.
3. Main Therapy: Exercise routines or specific manipulations are performed based on the individual’s needs. This can include stretching, strengthening, balance activities, and manual therapy techniques.
4. Cool-Down: Light activities or stretching to reduce muscle stiffness and aid recovery.
5. Education: Instruction on home exercises or lifestyle modifications to maintain benefits.

Tools, Equipment, or Technology

• Resistance bands, weights, balance boards
• Therapeutic ultrasound or electrical stimulation devices
• Mats or therapy tables for manual techniques

Anesthesia or Sedation

• Typically, no anesthesia or sedation is required.

Duration

• Each session typically lasts between 30 to 60 minutes.

Setting

• Outpatient clinic
• Physical therapy office
• In some cases, home health settings

Personnel

• Licensed Physical Therapists (PT)
• Physical Therapy Assistants (PTA)

Risks and Complications

• Minor muscle soreness or fatigue
• Rarely, mild joint or ligament strain
• Small risk of exacerbating underlying conditions if not properly monitored

Benefits

• Preservation of current functional abilities
• Improved management of chronic symptoms
• Enhanced mobility and decreased risk of injury
• Better overall quality of life

Recovery

Post-Procedure Care

• Follow through with therapist-recommended home exercises
• Stay hydrated and maintain proper nutrition
• Monitor and report any unusual symptoms

Expected Recovery Time

• Maintenance therapy is ongoing with continuous assessment and adjustment.

Restrictions or Follow-Up

• Follow-up appointments typically on a weekly, bi-weekly, or monthly basis depending on patient's condition and plan

Alternatives

Other Treatment Options

• Pharmacological management
• Alternative therapies like acupuncture or chiropractic care
• Lifestyle modifications and self-directed exercise programs

Pros and Cons

• Physical Therapy: Personalized, proactive maintenance but requires commitment and regular attendance.
• Medications: Can manage symptoms but may have side effects.
• Alternative Therapies: Can be effective for some but may not replace the need for consistent physical intervention.

Patient Experience

During the Procedure

• Mild discomfort during exercises or manual manipulation
• Generally, a supportive and constructive environment

Pain Management and Comfort

• Techniques aimed at minimizing pain and discomfort, such as gradual progression and modification of exercises.
• Use of hot/cold therapy as needed.

Patients are typically encouraged to communicate any discomfort or pain during therapy so adjustments can be made to their routine.