Practical visit.

Wednesday was very important for me. We went with Marlena and Marysia in to the clinic in Haderslev in Nørregade 38D. It's physiotherapy clinic were work 5 physiotherapists. Main therapist there is Addi Søgaard. She showed us all clinic. Explain how does the physiotherapy work in Denmark. I saw many common things between Polish and Danish system of work in this profession. But there were also differences. I would like to write few words abut both:


Common things
---> clinic looks very similar to Polish clinic
--->similar equipment
--->gymnastic hall very similar to Polish
--->number of therapists
--->Danish and Polish therapists use the same methods like mobilization, McKenzie, Traction, Palpation Examination, massage, isometric relaxation, manual therapy and many many more

Differences:
--->to became physiotherapist in Denmark you have to study 3,5 year, in Poland it takes 5 years and than you became Master of physiotherapy
---> in Poland we use much more of electrotherapy than in Denmark
---> in Denmark if doctor decided - therapist can use his own project of individual therapy for patient, in Poland we still must follow doctor's recommendation
--->here therapist decide how much time he will work with patient (30-40 min), in my country we still have not enough time to work with patient (like 20 min)
--->most of patients must pay for treatment, insurance cover just some part, in Poland most of patients doesn't have to pay for treatment if they use it in hospitals or foundations which have agreement with National Health Fund
--->in Denmark patients come for therapy 2-3 times a week, in Poland it's every day
and therapy takes few weeks



These are more less differences which I saw during the practical day.
I want to describe a little bit more the physiotherapists treatment because it's the most important I think.
The main thing is that patient must feel comfortable and safe in the therapy room. He need to feel that therapist is experienced and he know what to do. I think that Danish as well as Polish therapist take care of that.
1st step - interview with patient
2cond step - therapy, treatment
3rd step - relaxation and conversation with patient
4th step - exercises which patient must do at home

Some of physiotherapists methods:
1. McKenzie Method
A central tenet of the McKenzie Method is that self-healing and self-treatment are important for the patient’s pain relief and rehabilitation. No passive modalities—such as heat, cold, ultrasound, medicine or needles—are used in the treatment.

The long-term goal of the McKenzie Method is to teach patients suffering from neck pain and/or back pain how to treat themselves and manage their own pain for life using exercise and other strategies. Other goals include:

* Reduce pain quickly
* Return to normal functioning in daily activities
* Minimize the risk of recurring pain (avoid painful postures and movements)
* Minimize the number of return visits to the spine specialist
2. Mulligan Concept
Brian Mulligan's concept of mobilisations with movement (MWMS) in the extremities and sustained natural apophyseal glides (SNAGS) in the spine have progressed physical therapist-applied passive physiological movements and accessory techniques in the treatment of musculoskeletal injuries.
3. PNF Method
PNF is way of thinking, observing and movement. When we use PNF concept, we become more acceptable, we feel more and we are conscious of that. PNF is simply harmony of knowledge, consciousness and movement.
NAME

Name of concept tells us which part of human body we should use during treatment for improvement of function.

P – Means proprioceptor (receptor which perceives changes in human body), through which the muscular contracting is stimulated (contraction). Main receptors used by PNF treatment are in muscle (muscular spindle and free nervous end), in tendom (Golgi's tendom organ), and in joints (corpuscles of Vater Pacini, Ruffini's corpuscles and free nervous ends). But beside proprioceptors we use also exeteroceptors (receptors which perceive changes in skin, eye, and ear). Proprioceptors and exteroceptors could be differently activated through basic PNF's principles, by contraction or relaxations of muscle/muscles.

N – Means neuromuscular connection and symbolizes motor unit. During the treatment we try to include optimal number of motor units (neuromuscular connections), because only in this way we could make movement light, coordinated, exact, strong,…

F – Facilitation means that the inflow on motor cell in spinal cord is from every direction and so strong, that optimal muscular activity become possible.


Looking at my mother which is physiotherapist, at many physiotherapists which I worked with, I can see that this profession is so important and needed. But it's hard job because you are not only physiotherapist - you are also psychology, doctor and very very often the only person, in front of who people reveal their problems.