Elements of the movement system & impaired mobility Flashcards
what are the 4 goals of therapeutic exercise intervention ?
- 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
what is considered for dosage
Intensity Speed Frequency Duration Environmental Sequences
What is considered for activity
Posture
Mode
Movement
What are the elements of the movement system?
Support Base Modulator Biomechanical Cognitive/ Affective
What is under support
Cardio-vascualr, pulmonary, metabolic
What is under base
Integumentary
Musculoskeletal
Nervous system
What is under modular
Neuromuscular
What is under biomechanical
Kinetics
Kinematics
What is under cognitive or affective
Psychological
Emotional
considerations for dosage
- Pt./client goals
- Anatomical site involved
- Physiological status of all the systems including the tissue(s) involved
- Pt/client learning capability and affect
Parameters of dosage
- type of contraction
- Intensity
- Speed
- Duration
- Frequency
- Sequencing
- Environment
- Feedback
Causes of impaired Mobility
- trauma
- Surgery
- Joint diseases
- Neuromuscular disorders
- Congenital abnormalities
Effects of impaired mobility
- dysfunction
- Contractures
- Adhesions
- Reflex muscle guarding
- Intrinsic muscle spasm
- Muscle weakness
Physiological effects of immobilization of muscle
loss of muscle mass/ atrophy or strength .
Muscle strength is lost more during immobilization due to?
neuro activity
Slow twitch fibers
More efficient at using oxygen that fast twitch,
allows for longer muscle contraction over a longer time
What muscle group has a lot of slow twitch fibers?
spinal muscles
Position of immobilization in shorten position
lost of sarcomere; muscle stiffness
Position of immobilization in lengthened position
increase in sarcomere reorganization of connective tissue. adapt to new length
physiological effect of immobilization of the tendon
collagen: disorganized
Fiber orientation
Decrease in size, # and strength
Immobilization has a physiological effect on what?
- muscle
- tendon
- ligament
- Bone
- Articular cartilage
physiological effect of immobilization of the ligament causes what?
collagen degradation (lose strength)
physiological effect of immobilization of the bone
mineral loss (non weight bearing)
physiological effect of immobilization of the articular cartilage
Potential for irreversible joint damage
Range of motion
the amount of angular motion allows at a joint between any two boney levers
PROM
movement of a joint entirely by external fore, no voluntary actions
what is the purpose of passive range of motion
- assessment of joint and soft tissue
- Patient instruction for a desire motion
- Preparation for stretching
What can PROM do when active movement is not possible
- Prevent joint contractures
- assist circulation
- decrease or inhibit pain
how can PROM prevent joint contractures?
- Maintain soft tissue integrity
- Maintain joint integrity; enhance synovial movement & cartilage nutrition
3 limitations of PROM
-will not prevent atrophy, will not increase strength, will not promote weight lost
benefits of continuous passive motion
- prevent adhesions, stiffness
- increase synovial fluid lubricaiton
- Quicker return of ROM
AROM
produced by an active contraction of a muscle crossing the joint
AAROM
assistance is provided by outside force
AAROM assistance can be
mechanically or manually
Benefits of AROM/AAROM
- Increase strength & muscular endurance
- Provide a stimulus for bone & joint tissue integrity
- Assist with increasing cardiopulm endurance
- Provide sensory feedback
- Increase circulation & help prevent thrombus formation
Limitations for AROM/AAROM
- for strong muscles, will not maintain or increase strength
- Will not develop skill or coordination except in movement pattern performed
Precautions & contraindications
- avoid disruption to the healing process (ROM at fx site)
- Evidence to support early PROM within a pain-free range, but stay within the range, speed and tolerance of pt
- Careful monitoring HR BP of patients after MI CABG or other cardiac conditions
