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Ther Ex I > Chapters 1-2 (both books) > Flashcards

Chapters 1-2 (both books) Flashcards

0
Q

What is Therapeutic Exercise?

A

The systemic, planned performance of bodily movements, postures, or physical activities intended to provide a patient/client with the means to accomplish a positive outcome.

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1
Q

What details are included in a POC?

A
  • Goals
  • Outcomes
  • Predicted improvement & length of time to reach that level
  • Specific Interventions
  • Proposed frequency/duration of interventions
  • Discharge Goals
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2
Q

What are the purposes of Therapeutic Exercise?

A
  1. Remediate or prevent impairments
  2. Improve, restore or enhance physical function
  3. Prevent or reduce health-related risk factors
  4. Optimize overall health status, fitness or sense of well-being
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3
Q

What is balance?

A

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.

The ability to move the body in equilibrium with gravity via interaction of the sensory and motor systems.

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4
Q

What is Cardiopulmonary Fitness?

A

The ability to perform moderate-intensity, repetitive, total body movements (walking, jogging, cycling, swimming) over an extended period of time.

A/K/A Cardiopulmonary Endurance

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5
Q

What is coordination?

A

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 level.

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6
Q

What is flexibility?

A

The ability to move freely, without restriction; used interchangeably with mobility.

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7
Q

What is mobility?

A

The ability of structures or segments of the body to move or be moved in order to allow the occurrence of ROM for functional activities (functional ROM).

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8
Q

What is mobility dependent upon?

A

Soft tissue extensibility.

Active mobility also requires neuromuscular activation.

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9
Q

What is muscle performance?

A

The capacity of muscle to produce tension and do physical work.

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10
Q

What 3 things are encompassed in muscle performance?

A
  1. Strength
  2. Power
  3. Endurance
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11
Q

What is neuromuscular control?

A

Interaction of the sensory and motor systems
that enables
synergists, agonists and antagonists, & stabilizers to
anticipate or respond to proprioceptive and kinesthetic information
and, subsequently to work in correct sequence
to create coordinated movement.

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12
Q

What are
Postural Control
Postural Stability &
Equilibrium?

A

Interchangeable terms used with static or dynamic balance.

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13
Q

What is stability?

A

The ability of the neuromuscular system
through synergistic mm actions
to hold a proximal or distal body segment in a stationary position or to control a stable base during superimposed movement.

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14
Q

What is Joint Stability?

A

The maintenance of proper alignment of bony partners of a joint by means of passive and dynamic components.

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15
Q

What are the 8 areas of physical function which describe the groundwork for all movement necessary to perform at an optimal level?

A

Balance

  1. Cardiopulmonary Fitness
  2. Coordination
  3. Flexibility
  4. Mobility
  5. Muscle Performance
  6. Neuromuscular Control
  7. Postural Control / Postural Stability / Equilibrium
  8. Stability
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16
Q

What are the 5 basic components of patient management?

A
  1. Examination
  2. Evaluation
  3. Diagnosis
  4. Prognosis
  5. Interventions
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17
Q

What is the goal of Therapeutic Exercise?

A

For the patient to achieve an optimal level of symptom free movement during basic to complex physical activities.

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18
Q

Is Gait Training considered therapeutic exercise?

A

No

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19
Q

What 9 types of interventions are considered therapeutic exercise?

A
  1. Aerobic conditioning and reconditioning
  2. Mm performance ex
  3. Stretching techniques
    Includes: mm lengthening, joint mobilization/manipulation
  4. Neuromuscular control, inhibition & facilitation techniques & postural awareness training
  5. Postural control, body mechanics, and stabilization exercises
  6. Balance ex and agility training
  7. Relaxation ex
  8. Breathing ex & ventilatory mm training
  9. Task-specific functional training
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20
Q

What are 2 ways we know the best practices in developing effective treatment procedures to assist our patient in achieving the goals set forth in the POC?

A

Clinical Decision-Making
and
Evidence Based Practice

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21
Q

What are 3 reasons evidence based practice is important?

A

Help stay current with treatments
Ensure Effectiveness of treatments
Facilitates best possible outcome for the patient

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22
Q

What section of a SOAP note should include HEPs?

A

Objective

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23
Q

List the 4 “No Fail” references for PTAs

A

APTA
AzPTA
ARS & Rules
AZ PT Board of Licensure

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24
Q

What are open ended questions?

A

Questions that require more than a yes/no answer

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25
Q

What is the purpose of open ended questions?

A

They encourage patients to share feelings, thoughts, concerns and opinions.

Ex: “Tell me about your pain.”
“What do you think about this exercise?

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26
Q

What kinds of questions are used in close-ended questions?

A

Who
Which
When
Where

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27
Q

What is the purpose of close ended questions?

A

They are for finding facts, obtaining specific responses and filling in details.

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28
Q

What is a summary statement?

A

Information that is given about the avg performance of several repetitions of a motor skill (K&C)

It checks a patient’s understanding, helps patients clarify thinking and they provide direction for the clinician (Shankman)

Ex: “So your back only hurts at night?”

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29
Q

When is it appropriate to use summary statements when interviewing patients?

A

When trying to elicit information needed for an objective assessment.

30
Q

What is the difference between prompting and cuing?

A

Prompting can be viewed like presenting a question (the patient has to think about what to do and come up with a solution).

Cuing is more of a direction - telling the patient specifically what you want them to do.

31
Q

What is patient-related instruction?

A

The means by which a therapist helps a patient learn how to reduce his/her impairments and functional deficits to get better by becoming an active participant in the rehabilitation process.

Important for patient to understand how they can best get better and to help with the process.

32
Q

What 4 things does Therapeutic Exercise work on?

A
  1. Remediate or prevent impairments
  2. Improve, restore, or enhance physical function
  3. Prevent or reduce health-related risk factors
  4. Optimize overall health status, fitness, or sense of well-being
33
Q

What are impairments in body function?

A

Problems associated with body systems including physiological & psychological functions

34
Q

What are impairments in body structure?

A

Problems with the anatomical features of the body, such as significant deviation or loss, affecting all body systems.

35
Q

What are activity limitations?

A

Difficulties an individual may have in executing actions, tasks, or activities.

36
Q

What are participation restrictions?

A

Problems an individual may experience in involvement in life situations including difficulties participating in self care, responsibilities in the home, workplace, or the community, and recreational, leisure and social activities

37
Q

What are Contextual Factors?

A

The entire background of an individual’s life and living situation

Composed of Environmental and Personal Factors

38
Q

What are Environmental Factors?

A

Factors associated with the physical, social, and attitudinal enviornment in which people conduct their lives; factors may facilitate functioning (facilitators) or hinder functioning and contribute to disability (barriers).

39
Q

What are Personal Factors?

A

Features of the individual that are not part of the health condition or health state.

Includes: age, gender, race, lifestyle habits, coping skills, character, affect, cultural and social background, education, etc.

40
Q

List the types of Musculoskeletal impairments managed with therapeutic exercise

A
  1. Pain
  2. Muscle weakness/reduced torque production
  3. Decreased muscular endurance
  4. Limited ROM due to:
    • Restriction of the joint capsule
    • Restriction of periarticular connective tissue
    • Decreased mm length
    • Joint hypermobility
    • Faulty Posture
      Mm length/strength imbalances
41
Q

List 6 Neuromuscular impairments managed with therapeutic exercise?

A
  1. Pain
  2. Impaired balance, postural stability, or control
  3. Incoordination, faulty timing
  4. Delayed motor development
  5. Abnormal tone (hypotonia, hypertonia, dystonia)
  6. Ineffective/inefficient functional movement strategies
42
Q

List 3 Cardiovascular / Pulmonary impairments managed with therapeutic exercise

A
  1. Decreased aerobic capacity (cardiopulmonary endurance)
  2. Impaired circulation (lymphatic, venous, arterial)
  3. Pain with sustained physical activity (intermittent claudication)
43
Q

Why would therapeutic exercise be used to manage an integumentary problem?

A

Skin hypomobility

Ex: Immobile or adherent scarring

44
Q

List 9 areas of functioning associated with participation restrictions and disability:

A
  1. Self-Care
  2. Mobility in the Community
  3. Occupational Tasks
  4. School-Related Tasks
  5. Home management (indoor & outdoor)
  6. Caring for dependents
  7. Recreational & leisure activities
  8. Socializing with friends & family
  9. Community responsibilities and service
45
Q

What are 4 biological risk factors for disability?

A
  1. Age, sex, race
  2. Height / weight relationship
  3. Congenital abnormalities or disorders
  4. Family history of disease (genetic predisposition)
46
Q

List 8 Behavioral/Psychological/Lifestyle Factors which are risk factors for disability:

A
  1. Sedentary Lifestyle
  2. Cultural Biases
  3. Use of tobacco, alcohol, other drugs
  4. Poor Nutrition
  5. Low level of motivation
  6. Inadequate Coping Skills
  7. Difficulty Dealing with Change or Stress
  8. Negative Affect
47
Q

What are 2 physical environment characteristics which are risk factors for disability?

A
  1. Architectural barriers in the home, community, and workplace
  2. Ergonomic characteristics of the home, work or school
48
Q

List 4 Socioeconomic factors which are risk factors for disability

A
  1. Low economic status
  2. Low level of education
  3. Inadequate access to health care
  4. Limited family or social support
49
Q

What is the difference between Discharge & Discontinuation?

A

Discharge - goals were met

Discontinuation - cessation of services prior to achieving goals

50
Q

What is Primary Prevention?

A

Preventing a target problem or condition in an individual or in a community at risk.

Ex: Fitness program for children to prevent obesity

51
Q

What is Secondary Prevention?

A

Early diagnosis and reduction of the severity or duration of existing disease and sequelae.

Ex: Developing resistance programs for individuals with osteoporosis

52
Q

What is Tertiary Prevention?

A

Use of rehabilitation to reduce the degree or limit the progression of existing disability and improve multiple aspects of function in persons with chronic irreversible health conditions.

Ex: Developing fitness programs for individuals with spinal cord injuries

53
Q

What factors may influence a patient’s safety during exercise?

A 
Health conditions (known & unknown)
Medications
Environment
Accuracy of exercise performance
Fatigue
54
Q

What is the difference between a patient Goal vs Outcome?

A

Goals are directed at reducing or eliminating physical s/s of pathology and impairments of body function and/or structure which are limiting a patient’s functions
vs.
Outcomes are associated with the improvement of functional deficits and participation restrictions to the greatest extent possible.

55
Q

List 2 examples of task-specific functional training.

A

Sit-to-Stand

Stairs

56
Q

What is the implication of disablement as it pertains to PT?

A

It allows the therapist to shift the focus from the strict treatment of the disease process to the IMPACT of the disease on the patient’s overall level of function.

57
Q

How does a PTA know if an intervention has been effective?

A

Must be a decrease or elimination of the functional deficit
AND
a decrease in the risk of future dysfunction

58
Q

List 7 examples of determinants of patient satisfaction

A
  1. Interpersonal attributes of the therapist
  2. Perception of a therapist’s clinical skills
  3. Extent of functional improvement during the episode of care
  4. Extent of participation in goal setting in the POC
  5. The acuity of the patient’s condition (higher satisfaction in acute conditions)
  6. Convenience of access to service
  7. Administrative issues, such as continuity of care, flexible scheduling, wait time, duration of tx, and cost of care
59
Q

What 2 conditions are frequently associated with musculoskeletal imvolvement?

A

Inflammation & Pain

60
Q

What are the stages of motor learning?

A

Cognitive
Associative
Autonomous

61
Q

What is a Discrete motor task?

A

It involves an action or movement with a recognizable beginning and end - isolates and contracts a specific mm group

Ex: quad setting, grasping object, push-ups, locking w/c, kicking a ball, lifting and lowering weights, self-stretching

62
Q

What is a Serial motor task?

A

It is composed of a series of discrete movements that are combined in a particular sequence.

Ex: Eat w/fork, w/c transfers

63
Q

What are Continuous motor tasks?

A

They involve repetitive, uninterrupted movements that have no distinct beginning and ending.

Ex: walking, ascending and descending stairs, cycling

64
Q

What is a closed environment?

A

Objects around the patient and the surface on which the task is performed do not move.

65
Q

What is an open environment?

A

Objects or other people are in motion or the support surface is unstable during the task. The movement is not under the control of the patient.

Ex: Maintaining sitting or standing balance on a movable surface
standing on a moving train or bus, ascending/descending stairs in a crowded stairwell, crossing a street at a busy intersection

66
Q

What happens in the cognitive stage of motor learning?

A

The patient learns what to do - the goal/purpose and the requirements of the exercise or functional task. How to do the motor task safely and correctly.

The patient needs to think about each component or sequencing

67
Q

What happens in the Associative stage of motor learning?

A

Fine tuning
Producing most consistent and efficient movements
Timing and distances are moved
slight variations and modifications of movement
Different environmental conditions
Self-correction
Limited feedback from PT/PTA

68
Q

What happens during the Autonomous stage of motor learning?

A

Movements are automatic.
Patient does not have to pay attention to the movements.
Patient adapts to variations in task demands and environmental conditions.
Little if any instruction

69
Q

What is Intrinsic Feedback?

A

It comes from all of the sensory systems of the learning (not the therapist

70
Q

What is Augmented Feedback?

A

Information about the performance or results of a task in addition to intrinsic feedback which comes from a therapist.

The therapist has control of the type, timing, and frequency of the feedback.

71
Q

What is knowledge of performance?

A

Therapist feedback which focuses on the quality of the patient’s performance of a task.

Feedback is ongoing throughout the performance

72
Q

What is Knowledge of Results?

A

Feedback from the therapist directing the patient’s attention to the outcomes of the movements (not the details of the movements themselves)

Study indicates that patients retain the motor skill better this way.

Ther Ex I (5 decks)

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