Active assisted exercise

Question 1

What is the rationale behind using this treatment (Pain/Increase ROM/Strengthen etc)?

Answer 1

when the patient isn’t strong enough to perform active full ROM, reasons may include pain, rest, weakness and avoidance

Question 2

What are the physiological effects of the treatment?

Answer 2

maintaining ROM

maintaining soft tissue integrity

maintaining joint integrity

reduce pain

muscle activity

increases venous circulation

preserve proprioception

neuroplastic change (how the brain responds to the training of skills, which allows pt. to get better with practice)

Question 3

What structures are affected by the technique?

Answer 3

muscles

ligaments

tendons

vessels

joints

Question 4

What principles are used in carrying out the technique?

Answer 4

pt. position-making sure they are stable, safe and comfortable

motivation (keep working whilst tapping the muscle)

consent

if they need to go beyond 90 degrees, could sit them up so that gravity is not assisting

Question 5

Precautions and contraindications?

Answer 5

early unstable fracture

intolerable pain

incomplete muscle/ligament tear

immediately post injury

subluxation/dislocation

compromised circulation

consent

Question 6

How to progress and regress the movement?

Answer 6

could shorten the lever length to make it easier (regress) as less force needed

can also put in the transverse plane to eliminate gravity

Question 7

What is auto assisted exercise?

Answer 7

not relied on a physio (may do manual in the department and auto at home)

done by the pt.

emphasise to the pt. that most of the work comes from the affected side

cons are that it lacks consistency, pt. may need a lot of instruction

pros are that no equipment is needed, you can do it at home and have feedback on the pain

repeat until start fatiguing

make sure that mvmt is contracted on the way down

Question 8

What is mechanical assisted exercise?

Answer 8

done with equipment e.g. a towel or belt under the foot

can regress and progress by putting foot on and off the plinth

can also put talc underneath the foot when sliding on plinth to remove resistance

It can done on the plinth if they cant do it with the leg off the plinth

Question 9

What is manual assisted exercise?

Answer 9

someone else (therapist or carer does the mvmt)

firstly the limb is put through the ROM that they have passively to see the amount of ROM available

then you ask them to lift and say ‘you keep working/keep going’ over and over

have to consider whether gravity is assisting or not