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Therapeutic Exercise > Concepts & Approaches > Flashcards

Concepts & Approaches Flashcards

1
Q

What is RANGE OF MOTION (ROM)?

A

Can be used for the examination of movement & for incorporating movement into a therapeutic intervention program.

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2
Q

What factors affect the amount of motion at a joint?

A

Joint structures and the integrity and flexibility of soft tissues that cross over the joints affect the amount of motion at the joint.

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3
Q

What regional structures are affected by joint mobility?

A

• Muscles
• Joint surfaces
• Capsules
• Ligaments
• Fasciae
• Vessels
• Nerves

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4
Q

What tool is commonly used to measure joint mobility?

A

A goniometer is commonly used to measure joint mobility.

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5
Q

What is required for proper mobility?

A

Mobility requires a functional range of motion.

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6
Q

What is Full/Normal Range of Motion (ROM)?

A

Full/Normal ROM refers to the average or typical range of motion for a joint.

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7
Q

What is Passive/Anatomical ROM?

A

Passive ROM is the end range of motion that is achieved without active muscle contraction; it is subjective and can vary based on the physical therapist’s assessment.

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8
Q

What is Active ROM?

A

Active ROM refers to the range of motion achieved using active muscle contraction.

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9
Q

What is Functional ROM?

A

Functional ROM is the range of motion required to perform activities of daily living (ADLs).

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10
Q

What is Passive Range of Motion (PROM)?

A

PROM is the movement of a segment within the unrestricted range of motion that is produced entirely by an external force.

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11
Q

What are the indications for using PROM?

A

• Acute, inflamed tissue
• After injury or surgery
• When the patient is unable or not supposed to actively move
• Conditions such as being comatose, paralyzed, or on complete bed rest

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12
Q

What are the goals of PROM?

A

• Decrease cartilage degeneration, adhesions, contracture formation, and poor circulation following immobilization
• Maintain joint and connective tissue mobility
• Maintain mechanical elasticity of muscle
• Decrease or inhibit pain
• Assist with the healing process

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13
Q

What are the limitations of PROM?

A

PROM does NOT:
• Prevent muscle atrophy
• Increase strength or endurance
• Assist circulation to the extent that active muscle contractions do

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14
Q

What is Active Range of Motion (AROM)?

A

AROM is the movement of a segment within the unrestricted range of motion that is produced by active contraction of a muscle.

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15
Q

What is Active-Assistive Range of Motion (AAROM)?

A

AAROM is active movement where assistance is provided manually or mechanically because the prime-mover muscles need help to complete the motion.

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16
Q

What are the indications for using AAROM?

A

• When the patient is able to contract the muscles actively.
• AAROM is used to gain control of their range of motion and progressively move to AROM.
• When a segment of the body is immobilized, AROM is used for regions above and below to maintain normal conditions.
• AROM relieves stress from sustained postures.

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17
Q

What are the goals of AROM?

A

• Same as PROM if there is no inflammation or contraindications present.
• Maintain physiological elasticity and contractility of participating muscles.
• Provide sensory feedback from the contracting muscles.
• Provide stimulus for bone and joint tissue integrity.
• Increase circulation and prevent thrombus formation.
• Develop coordination and motor skills for functional activities.

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18
Q

What are the limitations of AROM?

A

AROM does NOT:
• Maintain or increase strength.
• Develop skill or coordination except in the movement patterns used.

19
Q

What is Active-Resisted AAROM?

A

Active-resisted AAROM involves applying assistance to help with movement, such as using a device to aid in walking or mechanical support (e.g., a bike pushing the feet into movement).

20
Q

What does AR-ROM involve?

A

AR-ROM is movement with a weight.

21
Q

What is the first step in the Range of Motion Progression Approach?

A

AROM to the surrounding joints/structures (above and below) to maintain integrity.

22
Q

What is the second step in the Range of Motion Progression Approach?

A

PROM to the affected joint to maintain and gain range of motion (ROM).

23
Q

What is the third step in the Range of Motion Progression Approach?

A

AAROM to the affected joint to maintain and gain control of existing ROM.

24
Q

What is the fourth step in the Range of Motion Progression Approach?

A

AROM to the affected joint/structures to maintain, gain, and develop coordination control of existing ROM.

25
Q

What is the fifth step in the Range of Motion Progression Approach?

A

AR-ROM to the affected joint/structures to maintain or increase strength through strengthening exercises.

26
Q

What is mobility in the context of a therapeutic exercise program?

A

Mobility is the ability to perform active or passive movement of structures or segments of the body through a functional range of motion.

27
Q

What is stability in a therapeutic exercise program?

A

Stability is the ability to provide a stable foundation from which to move.

28
Q

What does controlled mobility/neuromuscular control/motor control refer to?

A

It refers to the ability for synergists, agonists, and antagonists to move within joints and between limbs following the optimal path of instant center of rotation (PICR). It includes the ability to anticipate or respond to proprioceptive and kinesthetic information, resulting from the interaction between sensory and motor systems working in the correct sequence to create coordinated movement. It is a combination of stability and mobility.

29
Q

What is skill in the context of a therapeutic exercise program?

A

Skill is the ability to maintain consistency in performing functional tasks with economy of effort.

30
Q

What is The Performance Pyramid?

A

The Performance Pyramid is used as a guideline on how to progress an exercise treatment plan.

31
Q

What is the first step in using The Performance Pyramid effectively?

A

Conduct a thorough assessment to identify what is necessary and what is of priority.

32
Q

What is the ultimate goal of using The Performance Pyramid in a treatment plan?

A

The ultimate goal is to help the patient become functional—specifically, can they move and can they use it?

33
Q

What is the principle stated by Gray Cook, PT, regarding exercise progression?

A

“Mobility before stability, stability before movement, movement before strength.”

34
Q

How can the Range of Motion Progression Approach be incorporated into The Performance Pyramid?

A

The Range of Motion Progression Approach can be integrated as a systematic method to progress through the levels of mobility, stability, and strength outlined in The Performance Pyramid.

35
Q

What type of other interventions or techniques can be used in conjunction with The Performance Pyramid?

A

Other interventions may include strengthening exercises, proprioceptive training, flexibility exercises, functional task practice, and neuromuscular control techniques.

36
Q

What is the ultimate goal of Functional Progression?

A

The ultimate goal is to help the patient return to activities of daily living (ADLs) through functional exercises.

37
Q

What do functional exercises mimic?

A

Functional exercises mimic everyday activities and tasks (ADLs).

38
Q

How do functional exercises benefit muscle groups?

A

Functional exercises teach muscle groups to work together rather than isolating one muscle or one group of muscles. They involve complex, multidirectional movements that require coordination among all muscles functioning as desired.

39
Q

What does compensation indicate in the context of functional progression?

A

Compensation indicates functional dysfunction.

40
Q

What are key components to consider in functional progression?

A

Neuromuscular control and coordination are key components to consider.

41
Q

Your patient is a 26 year-old football player (Cam), as quarterback. He experiences pain and limited ROM in his right shoulder. His ultrasound report indicates he has a slight tear in the right supraspinatus and a tendinitis in the biceps long head.

He comes to see you during week 2 of his initial injury. You notice some slight swelling and inflammation around his shoulder and limited range of motion and strength while initiating movement. Which of the following exercise is most appropriate to introduce?

a. PROM of the GH joint
b. Muscle setting for the shoulder girdle
c. A ROM of the surrounding structures/joints
d. All of the above are appropriate

A

d. All of the above are appropriate

42
Q

Your patient is a 26 year-old football player (Cam), as quarterback. He experiences pain and limited ROM in his right shoulder. His ultrasound report indicates he has a slight tear in the right supraspinatus and a tendinitis in the biceps long head.

After 4 weeks of treatment, he has full pain-free PROM in all directions, but pain and weakness with AROM between mid-end range. Which of the following exercises is most appropriate to prescribe?

a. PROM and stretching exercises
b. Isometric exercises at indicated angels
c. Dynamic active resisted exercises through full ROM
d. Active free ROM exercises from mid-end ranges

A

b. Isometric exercises at indicated angels

43
Q

Your patient is a 26 year-old football player (Cam), as quarterback. He experiences pain and limited ROM in his right shoulder. His ultrasound report indicates he has a slight tear in the right supraspinatus and a tendinitis in the biceps long head.

After another 2 weeks of treatment/recovery (Week 6), you would like to progress his self-care regime. You present to Cam your treatment plan for the next 6 weeks. Which of the following progression is most appropriate for his shoulder recovery.

a. Stability exercises, active assisted ROM exercises, functional exercises
b. Functional exercises, active assisted ROM exercises, stability exercises
c. Active assisted ROM exercises, functional exercises, stability exercises
d. Active assisted ROM exercises, stability exercises, functional exercises
e. A or D are both correct

A

e. A or D are both correct

Therapeutic Exercise (5 decks)

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