foundation handout for physical therapy students in olfu

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.

age 1 of 3!opyright "#$%

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



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

$T%&TE'IE$ (!% E((E#TI)E E*E%#I$E

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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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P%E2 P%&#TI#E #!+$IDE%&TI!+

• 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




&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


foundation handout for physical therapy students in olfu

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