Integumentary Physical Therapy For Ailments Connected To The Skin

The integumentary system, which includes the skin, hair, and nails, serves a number of functions. Its primary function is to serve as a barrier against the entry of microbes and viruses, and to also prevent water and loss. Just like any other system in the body, the integumentary system is prone to disease. The integumentary system also plays a role in homeostasis; homeostasis is the ability of an organism or cell to maintain internal equilibrium by adjusting its physiological processes.

Different Interventions For Treatment Of Skin Wounds

When the skin and its components like hair and nails are in trouble, integumentary physical therapy is necessary, and physical therapists have a wide variety of interventions from which they can choose in the treatment of patients with skin wounds. Some of these intervention strategies will include:

  • wound dressing
  • strengthening exercises
  • manual therapy for lymphatic drainage
  • electrical stimulation
  • patient education on risk factors and plan of care

The Physical therapists are licensed professionals who treat conditions using physical methods. Things like electrical stimulation, whirlpool treatments, massage, ultrasound treatments, biofeedback, and the application of heat or ice are used in the different treatments to manage pain and to assist the patient towards being able to function properly.  The therapies involve treatment of conditions that have to do with the skin, of which there is a broad range. It is a particular specialty under physiotherapy and its aim is towards the physical rehabilitation of the skin.

The role of the physical therapist is the management of those people with chronic wounds. Things like whirlpool baths and wet to dry dressing changes form part of the treatment. The therapist will need an understanding of the physiological events in integumentary repair to manage those with dermal wounds.

Each Patient Is Assessed

The therapist will first assess and evaluate the patient and get an idea of their pain levels, their strength, mobility, flexibility, balance and co-ordination. Once they have established that they will develop a treatment program to assist the patient by restoring physical function through therapy.

Electrical Stimulation For Ulcers

HVPC or high-voltage pulsed current is for patients who have pressure ulcers. Sometimes these ulcers are very slow in healing and the patient may not be able to leave hospital till they are healed. Patients can achieve complete healing of their ulcers.  Electrical stimulation makes use of an electrical current to transfer energy to a wound. Treatment involves the transfer of electric current through an applied surface electrode pad that is in wet contact with the wound. With electrical stimulation, it is important to distinguish the waveform used and even though there are many waveforms available on electrotherapy equipment, HVPC is the most thorough and consistent.

Vacuum assisted closure, or VAC is a sophisticated procedure making use of vacuum assisted drainage to remove blood and fluids from a wound. A piece of foam with an open-cell structure is introduced into the wound. The area is covered with a transparent adhesive membrane, firmly secured to the healthy skin around the wound margin. When the drain tube is connected to a vacuum source, fluid is drawn from the wound through the foam and into a container for disposal.

Different Tests For Each Patient

There are a number of tests available to the therapist who will assist with the examination of the patient but not all tests are used on one patient.  Integumentary Physical Therapy includes the therapist taking a medical history from the patient and treating the patient with a selection of tests based on the information they have collected. If the findings of the tests reveal that the wound is of arterial origin, a thorough examination of the peripheral vascular system will be called for. For patients with wounds, a selected category would be integumentary integrity. When the therapist examines the wound, they will look for:

  • signs of infection
  • activities and posture that are aggravating the wound
  • wound characteristics like bleeding, drainage, shape and size of wound
  • wound scar tissue characteristics which will include pliability, sensation and texture

Monitoring A Wound

Monitoring the depth of the wound is important to ensure that the wound doesn’t close prematurely. Wound dressings provide a moist environment to promote cellular proliferation as the wound advances through the different stages of healing. The dressings are designed to absorb pus, blood and fluids from the wound and to maintain the level of moisture the wound needs to heal. The objective of the dressings is to keep the wound moist, and more frequent dressing changes will be needed.

The Skin Is Part Of The Immune System

Most of us don’t consider the skin as part of the immune system, when in fact it is an impenetrable barrier and the first line of defense against invaders. The integumentary physical system includes the skin and its associated structures such as nail, hair and glands. It plays many roles in maintaining the internal conditions which are essential to the function of the body.

Heat and cold receptors are located in the skin, and when the body temperature rises, the hypothalamus signals the sweat producing skin glands to produce water to cool the body. On the other hand, when the body temperature falls, the sweat glands constrict and the production of sweat decreases.  The skin is composed of three layers; the epidermis, the dermis and the hypodermis which is the third layer. The layers are made up of fat, nerves, hair, sweat glands and blood vessels. Sometimes, the skin flares up and certain diseases take place in the integumentary system. Some of these are:

  • Pityriasis Rosea – this is a skin condition where scaly pink patches form on the chest or back, occurring mostly in younger people between the ages of 10 and 35. Later the rash can develop on the legs and arms as well.  Itchiness and tiredness are symptoms of this skin condition. You can try and control the itchiness with lotions and fortunately the skin starts returning to normal after six to eight weeks.
  • Intertrigo – this is a skin rash which occurs in the folds of the skin, caused by yeast and fungus. Those people who have diabetes or who are overweight are more prone to get this condition. The rash is reddish brown in color and the armpit, underneath the breasts and skin folds of the neck are typical areas where this condition occurs. Intertrigo is often associated with an itch and unpleasant odor.
  • Alopecia areata – the immune system of the body attacks the hair follicles which results in hair loss. Hair follicles all over the body can be affected, but it is more common on the scalp, starting with bald patches on the scalp and continuing until the person is bald. Males and females of any age can be affected.
  • Athlete’s foot – this is a fungal infection. The fungus lives in moist places like showers and people who don’t wear rubber slip slops in a public shower at a gym for instance will be more prone to the fungal infection. It occurs on the feet, but can spread to the groin and other parts of the body.

The Skin Has Many Functions

The skin is a fantastic organ and amongst its many important function, it also synthesizes melanin and carotenes, which give it its color. Skin color for instance, can provide information about the functional status of the circulatory system. The color of the mucous membrane, the nail beds as well as the lips can also provide the therapist with information about oxyhemoglobin concentration. Apart from that, the skin also assists in the synthesis of vitamin D, without which rickets would occur.  The skin has also been used to heal, as in when medical patches are used to administer medical drugs.

Physical therapists can specialize in the treatment of the integument system as well as the conditions associated with the system. The system is also responsible for maintaining the temperature of the body, flushing toxins, and allowing a person to experience the sense of touch and pain.

The skin is the largest organ of the body and acts as the outermost line of defense against bacteria and other foreign organisms. The skin contains nerve endings that alert the brain of sensations like heat, cold, pain and pressure.

Physical Therapist Training

Therapists who specialize in Integumentary Physical Therapy will have had post-graduate training to equip them with the skills necessary to provide care. The Bachelor degrees in Physical Therapy is on its way out and students need a four-year degree to enter a Master’s or Doctoral Physical Therapy degree program which takes two to four years to complete. The therapist will need to examine various integ. diagnoses and make physician referrals where necessary. Physical therapy programs vary in structure among the different schools and each college or university has their own curriculum structured to meet the needs of student. Even so, there are areas of study which are found in all physical therapy programs and to graduate from an accredited school, the student will have to demonstrate competency in the particular areas of study.  Foundation courses will introduce students to the basics of the profession.

Most courses will introduce key practice patterns and guidelines recommended for patients diagnosed with pathologies or impairments to their integumentary system, and students will learn to examine the integumentary system for pathologies in a variety of patient settings. These pathologies can include abscesses, burns, ulcers, vascular disease, surgical wounds and contusions.

The Internet offers valuable information and you will be able to select the right program and compare the physical therapy programs among the physical therapy schools you are considering.

Program Scholarships Available For Therapists

Physical therapy scholarships are offered to students and they are a fantastic way to help finance your Physical Therapist Education. Always check with your Physical Therapy schools you are applying to because they offer scholarships to students. Remember to complete a FAFSA because it is the free application needed to apply to federal college financial aid programs. You make yourself eligible to receive low-interest federal student loans for your Physical Therapist Assistant education, as well as federal grants to help pay for your Physical Therapist Assistant education.  The University of Wisconsin-Madison for instance offers their physical therapy students scholarships. Some of these are:

  • Barbara Ellen Gerlich-Hoefeyzer Scholarship – this $800 scholarship is awarded to first- and second year Physical Therapy students with financial need, but who have exceptional academic merit and leadership potential.
  • Margaret Kohli Scholarship – a $2,000 scholarship also based on high academic achievement and leadership as well as community service.
  • Rebecca Irene Sande Scholarship Fund – All first year Physical Therapy students are encouraged to apply. It is a $3,000 scholarship award.
  • American Physical Therapy Association –
  • The Tylenol Scholarship Fund –


The integumentary system is the largest organ system, protecting the internal body and preventing disease, and for this reason it needs to be functioning properly all the time. When injury and illness cause it to malfunction, physical therapists can play a role in restoring the system again. Disorders can get triggered by any number of things. Melanoma for instance is a dangerous form of skin cancer, affecting the skin cells called melanocytes, which are responsible for producing the skin pigment melanin. Most times it starts as a mole which changes in appearance.

Physical therapists are experts in the health care field; treating problems that affect a person’s ability to function. These abilities are driven by different systems in the body of which integumentary is just one. The physical therapists are well education and certified to cope with all kinds of patients who need to learn to use their limbs again after an injury or illness. They work with patients from newborns to the very old and always in a variety of settings.

All therapists pass a national examination and are licensed. They provide therapeutic exercises and also educate patients on how to continue with their own therapy and how to care for themselves.  They make use of electrotherapy, ultrasound, ice and hot packs to bring about functionality to their patients.

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