foundation handout for physical therapy students in olfu
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7/23/2019 Foundation handout for Physical Therapy students in OLFU
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Therapeutic Exercise: is the systematic, planned
performance of bodily movements, postures, or physical
activities intended to provide a patient/client with the
means to:
• Remediate or prevent impairments
• Improve, restore, or enhance physical function
• Prevent or reduce health-related risk factors
• Optimize overall health status, fitness, or sense
of
well-being
Patient vs. Client
Patient: An individual with impairments and functional
limitations
Client:Individual without diagnosed dysfunction who
engages in physical therapy services to promote health
and wellness and to prevent dysfunction.
Types of Therapeutic Exercise Intervention
• Aerobic conditioning and reconditioning
• Muscle performance exercises: strength, power,
and endurance training
• Stretching techniques including muscle-
lengthening procedures and joint mobilizationtechniques
• Neuromuscular control, inhibition, and
facilitation techniques and posture awareness
training
• Balance exercises and agility training
• Relaxation exercises
• Breathing exercises and ventilatory muscle
training
• Task-specific functional training
Exercise Safety
Consider the following.
Health Status
Environment
Equipment
Execution
Education on fatigue
Therapist safety.
PROCESS AND MODELS OF DISABLEMENT
Disablement:A term that refers to the impact(s) and
functional consequences of acute or chronicconditions, such as disease, injury, and
congenital or developmental abnormalities, onspecic body systems that compromise basichuman performance and an individual’s ability tomeet necessary, customary, expected, anddesired societal functions and roles.Disablement risk factors
1. Biological Factor
2. Behavioral/Psychological/Social factors
3. Physical Environmental Factors
4. Socioeconomic factors
Patient Management:
Clinical Decision Making
Refers to a dynamic, complex process of reasoning and
analytical (critical) thinking that involves making
judgments and determinations in the context of patient
care.
Evidence-Based Practice
“The conscientious, explicit, and judicious use of
current best evidence in making decisions about the care
of an individual patient.”
The process of patient management has five basic
components.
1. A comprehensive examination: The patient’s
health history A relevant systems review,
Specific tests and measures.
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Aspects of Physical Function
Balance.
The ability to align body segments
against gravity to maintain or move the
body (center of mass) within the
available base of support without
falling
Cardiopulmonary
fitness/Cardiopulmonary
endurance
The ability to perform low intensity,
repetitive, total body movements
(walking, jogging, cycling, swimming)
over an extended period of time.
Flexibility/Mobility
The ability of structures or segments of
the body to move or be moved in order
to allow the occurrence of range of
motion (ROM) for functional activities
(functional ROM).
Stability
The ability of the neuromuscular
system through synergistic muscle
actions to hold a proximal or distal
body segment in a stationary positionor to control a stable base during
superimposed movement
Neuromuscular
control/coordination
The correct timing and sequencing of
muscle firing combined with the
appropriate intensity of muscular
contraction leading to the effective
initiation, guiding, and grading of
movement. It is the basis of smooth,
accurate, efficient movement and
occurs at a conscious or automatic
Muscle performance The capacity of muscle to produce
tension and do physical work.
Includes: Strength, Power andEndurance
COLLEGE OF PHYSICAL THERAPY
Subject: Therapeutic Exercises 101
Semester: 2nd
SY: 2015- 2016
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2. Evaluationof data collected: a process
characterized by theinterpretation of collected
data.
3. Determination of aDiagnosis based on
impairments, functional limitations, and
disability4. Establishment of a prognosisand plan of care
based on patient-oriented goals : ; A prognosis
is a prediction of a patient’s optimal level of
function expected as the result of a course of
treatment and the anticipated length of time
needed to reach specified functional outcomes.
The plan of care, an integral component of the
prognosis, delineates the following anticipated
goals
5. &mplementation of appropriate
interventions:
Intervention a component ofpatient management, refers to any
purposeful interaction a therapist has thatdirectly relates to a patient’s care
!"T#!ME$
This is stated as the result
Monitored all throughout the course of PT
Outcomes are measured through:1.Physical Function
2.Prevention of risk
3.Level of health and wellness
4.Patient’s satisfaction
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M!T!% ,E&%+I+':
A complex set of internal processes that involves the
relatively permanent acquisition and retention of a s'illed
movement or tas' through practice.
Motor ,earning )s- Motor
Performance() Acquisition
() etention
() Acquisition
(*) etention
M!T!% T&$.
Types of Motor task
Discrete
A discrete task involves a movement
with a recognizable beginning and end.
Grasping an object, doing a push-
up, or locking a wheelchair are examples
of discrete motor tasks.
Serial task
Serial task is composed of a series of discrete
movements that are combined in a particularsequence
Continuous
task.
Continuous task involves repetitive,
uninterrupted movements that have no
distinct beginning and ending.
Examples include walking,
ascending and descending stairs, and
cycling.
#on/itions an/ Progression of Motor Tasks
1.The environment in which the task is performed;
2.The inter-trial variability of the environment thatis
imposed on a task
3.The need for person’s body to remain stationary or to
move during the task;
4.The presence or absence of manipulation of objects
during the task.
STAGES OF MOTOR LEARNING
+tage escription
#ognitive
stage
-he patient needs to thin' about
each component or sequence of the s'illed
movement.
-he patient tries to get the feel/ of
the exercise.
istraction may hinder learning.
0rrors are common.
&ssociative
stage
-he patient makes infre0uent
errors and concentrates on ne*tuning the
motor tas'.
-he patient explores slight variations
and modications of movement strategies
1hile doing the tas' under di2erent
environmental conditions inter2trial
variability
-he patient requires infrequent feed*
bac' from the therapist and, instead,
begins to anticipate necessary
adjustments and make corrections even
before errors occur.
&utonomou
s stage
• 3ovements are automatic.
• -he patient does not have to pay
attention to the movements in the
tas', thus ma'ing it possible to doother tas's simultaneously.
• () 4ariations
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• Attention
• Demonstration
• Pre-practice verbal instructions
P%&#TI#E
artial practice 4+. 5hole practice 678!90 4+. A:83 4+. A:83678!90
hysical practice 4+. 3ental practice
(EED4&#.
2.no6le/ge of performance .P : immediate,post*tas', augmented feedbac' (usually verbal) aboutthe nature or quality of the performance of amotor task
*.no6le/ge of results .%: &mmediate, post*tas',augmented feedbac' about the outcome of a motortas'
&ntrinsic ;
Augmented
!oncurrent
ost response
&mmediate
elayed
+ummary
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&ntermittent
!ontinous
&D5E%E+#E:
<actors a2ecting adherence
atient characteristics =ealth condition>impairment
rogram related variables
0:
+uggestion;
ead the -herapeutic 0xercise ?th edition by 9isner and
!olby for a more detailed discussions
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