Outpatient Physiotherapy

Outpatient physiotherapy is a setting in which you will receive an initial assessment from a physiotherapist. There are three ways you can receive outpatient physio treatment: You can be referred by a GP, self-referred, or referred as an inpatient. Depending on your condition or reason for referral you may continue to see that physiotherapist individually, or you may be referred on to an exercise class within that outpatients department or your community. The services available will depend on your needs, and these can include hydrotherapy, electrotherapy etc.

Some hospital departments also offer specialist outpatient services, e.g. respiratory, neurological. You should always make your physiotherapist aware if you’re pregnant or possess any implants.

What happens in an outpatients physiotherapy appointment?

The first stage of an outpatients exam is a subjective exam during which the physiotherapist will observe your gait. The therapist is unlikely to ask any questions about your gait as this usually makes patients self conscious and hence alter their gait and posture which isn’t indicative of their normal condition. Your physio will take a medical history, followed by a history of your present complaint. This will involve asking about how it started, the cause, whether it’s progressed, and whether you’ve taken any treatment for it. They will ask about what you’re experiencing, looking for any details on any pain you might be experiencing like the depth and nature of that pain. A number of more specific questions may follow depending on what you are being seen for, some may feel a bit personal in nature, but they are all asked to provide your therapist with as much information as possible from which to draw up a treatment plan. In addition your drug and social history will be investigated to cover all possible bases.

The final question a physio will ask is with regards to what you want from treatment, meaning what goals you would like to fulfil through therapy. Patient involvement is important to achieving the best possible results.

Following this rigorous questioning your physiotherapist will conduct an objective assessment. You are generally advised not to take pain killers before your appointment as these will affect the outcome of the assessment. The first step of this stage is to observe any discolouration, swelling, bruising, or scar tissue around the site of injury, this is followed by your physio feeling for any heat or tenderness in the same region.

The next stage is an observation of movement, both active (in which you move yourself) and passive (with the physiotherapist manipulating the movement while you relax), allowing for a better understanding of which specific structures are involved in the injury. Resistive movements is the next stage where your movement against resistance is studied, the physiotherapist will compare their findings to the normal side as everyone’s body works differently. Based on their findings thus far, your physiotherapist will decide whether you need a neurological assessment based on your reflexes and sensory facilities. In particular looking for areas of numbness, increased sensitivity, or muscular weakness.

Sometimes your physiotherapist will conduct joint manipulations for more information, these are based on how severe the injury is and a physiotherapist will be careful not to exacerbate your condition. Your balance and posture might also be observed, particularly when injuries of the core or lower body are involved. Lower limb injuries call for an examination of mobility and other functional movements, although this stage of investigation

There are many other specialist tests that may be performed for a more specific study of affected structures, but these vary and are dependent on their findings throughout the initial stages of assessment.

After assessment

Your physiotherapist will use the information they gather during the assessment to formulate a treatment plan based on the problems identified and the objectives you want to achieve through physiotherapy. The problem will be discussed along with treatment options and recommendations. Advice and education are very important parts of a physiotherapist’s role, and they will give you further resources to investigate to give you some level of control over your treatment. Further appointments, if necessary, will be arranged according to the plan, the physiotherapist, the severity of your condition, and the Trust.

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