Physical Therapy Implications: A Case Study

Physical Therapy Implications: When treating a patient with HZ, it is important that physical therapist must observe the proper infectious disease policy. The CDC (2011) recommended that airborne precautions must be utilized for patients with a disseminated herpes zoster. Furthermore, placing the patient in an airborne infection isolation room, hand washing before and after touching the patient, using personal protective equipment such as fit-tested N-95 respirator mask, gloves, and gowns are an important safety measure to protect the health care provider from infection and the patient as well. A hospitalized patient with HZ including a complication of PHN suffers from debilitating pain. As a result, they feel weak, deconditioned and does not have the desire to perform any functionally related activity, not to
mention the effect of depression is causing changes in the patient's mood. Irwin, Olmstead, and Oxman (2007, p. 511) describes the impairment and reduction in quality of life from the pain of PHN similar to those detected with congestive heart failure, type II diabetes, and major depression. Physical therapy intervention is essential to restore mobility, improve overall strength and functional abilities including reduction of PHN pain.
Barbarisi et al. (2010, p. 571) completed a research study investigating the effectiveness of a transcutaneous nerve stimulator (TENS) a non-pharmacologic analgesic method that stimulates the spinal endogenous opioids receptors, which in turn reduces neuropathic pain. The combination of TENS and Pregabalin (a pain medication approve for PHN) shows a 40% reduction of PHN pain. Therefore, the treatment approach for PHN pain is more efficient in a multidisciplinary approach. In addition to pain management, encouragement, and positive re-enforcement is needed to increase the patient’s activity participation and exercise tolerance. Furthermore, complementary alternative therapy as illustrated by Irwin, Olmstead, and Oxman (2007, p. 516), conducted a random controlled trial on the effectiveness of Tai Chi on cellular mediated immunity (CMI) to VZV and health performing in older adults. The study has two arms of research, the tai-chi group, and the health education group. The Tai-Chi group positively shown an increased in the CMI, increases the participants physical activity and decreases the sympathetic activity, therefore,
enhances the immune system function. Consequently, the health education group has shown diminished in the health functioning scores as demonstrated by an increased in the severity of the depressive symptoms. Limitations of this study are as follows: First, subjects are in good health, unknown if this result has similar effects on subjects with co-morbidities. Second, the volunteers mostly came from a higher socioeconomic class with higher income and therefore the compliance with treatment is high and finally, subjects are non-blinded therefore chance of bias is high. [Here is another sentence where you ‘splice’ together several sentences without clear punctuation. How might you use a coordinating conjunction or semicolon to help clarify the relationship between your ideas about the subjects in this study? You should ensure clear sentence structure so that readers can follow your writing at that level.] Nevertheless, this study still has good outcome despite the flaws listed above.
Conclusion
As can be seen above, herpes zoster is an infectious disease that is more susceptible on elderly and immunocompromised individuals. Serious complication such as PHN can cause a severe disabling pain. Fortunately, medication such as opioid analgesics, a tricyclic antidepressant and the combination of gabapentin and TENS can resolve pain associated with PHN. Physical therapy may assist the patient with HZ and PHN regain functional mobility independence through the therapeutic exercise program, and modalities to relieve PHN pain. Finally, HZ vaccination is the key to preventing this disease from causing havoc to the elderly and immunocompromised individuals reducing or eliminating the