Evaluation Process - Part 3 Plan Flashcards

1
Q

Purpose of plan:

A
  • to manage the process (recovery)
  • to return client back to health
  • to return client to stated PA
  • to achieve client’s stated or set goals
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2
Q

Steps to success for a plan:

A
  1. effective evaluation
  2. setting goals
  3. essential considerations of exercise component
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3
Q

Essential considerations of exercise component includes:

A
  • concepts and principles of rehab programming

- concepts and principles of exercise programming

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4
Q

Goal setting should be…

A
  • unique to client
  • established, stated, clarified
  • reasonable and attainable
  • have progressive steps
  • may often change with progress
  • should encourage meeting sequential challenges
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5
Q

Use ____ and ____ findings to set goals.

A
  • subjective

- objective

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6
Q

Short term goals to address (directly or pertaining to CC):

A
  • treatment of lesion site
  • prevention of secondary complications
  • pain
  • ROM
  • strength
  • neuromuscular control (education, proprioception, balance)
  • posture and core stability
  • CV fitness
  • psychological readiness
  • RTA
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7
Q

Lesion site:

A

area of abnormal damage or change in the tissue

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8
Q

Secondary complication:

A
  • occurs post injury
  • ex. infection, secondary inflammation, secondary cell injury
  • affects tissues that were not directly related to the initial insult, pain
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9
Q

How to address goal of treatment of lesion site and prevention of secondary complications:

A
  • may be related to first aid care (PRICE)
  • injury management rehab with MD, emergency
  • acute injury rehab (clinic based) with HCP
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10
Q

Extent of pain is dependent on:

A
  • severity of the injury
  • individual response and perception of pain
  • the circumstances in which the injury occurred
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11
Q

How to address goal of pain control:

A
  • modalities
  • medications
  • modifications of movement or activity
  • healing
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12
Q

Pain may interfere with the _____ process and dictate the rate of _____.

A
  • rehab

- progression

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13
Q

Limited or loss of ROM is associated with some of the following:

A
  • resistance of musculotendinous units
  • connective tissue stretch contractures; tissue scarring
  • muscle imbalances; postural imbalances, neural tension
  • joint dysfunction
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14
Q

How to address physiological movement constraints and accessory motion deficits:

A
  • must be determined and treated accordingly

- stretching, joint mobilization, traction, movement, strength

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15
Q

Muscular strength, endurance, and power are essential to…

A

restoring pre-injury status

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16
Q

With muscular strength, endurance, and power, working through a full ____ ____ ROM should be emphasized.

A

pain free

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17
Q

Return to train should incorporate both…..

A
  • single plane force production movements

- functional activities that stress tri-planar motion

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18
Q

With muscular strength, endurance, and power, combinations of muscle contractions should be emphasized in a variety of ways:

A
  • isometric, concentric, eccentric
  • open kinetic, closed kinetic
  • functional movement
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19
Q

Isometric strength is used during ….

A

initial stages of rehab

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20
Q

Isometric strength is useful when…

A

training through a full ROM is contraindicated

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21
Q

Isometric strength serves to increase _____ strength.

A

static

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22
Q

Isometric strength serves to decrease _____.

A

atrophy

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23
Q

Isometric strength looks to create muscle ____ to reduce ____/_____.

A
  • pump

- edema/swelling

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24
Q

Isotonic strength incorporates what type of equipment?

A
  • free weights
  • machines
  • tubing
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25
Q

Isotonic strength utilizes what types of contractions?

A
  • concentric

- eccentric

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26
Q

Isokinetic strength is used in ____ ____ of rehab.

A

later stages

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27
Q

Isokinetic strength uses ____ speeds with ______ resistance.

A
  • fixed

- accommodating

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28
Q

Isokinetic strength provides _____ resistance through ____ ROM.

A
  • maximal

- full

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29
Q

Isokinetic strength is commonly used as ____ for return to ____ ____.

A
  • criteria

- functional activity

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30
Q

Plyometric strength is incorporated into ___ ____ of rehab.

A

later stages

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31
Q

Plyometric strength relies on quick ____ ____ to facilitate a subsequent _____ contraction.

A
  • eccentric stretch

- concentric

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32
Q

Plyometric strength is a ____ movement with ____.

A
  • dynamic

- power

33
Q

Joint position sense is mediated by ______.

A

mechanoreceptors

34
Q

Neuromuscular control relies on the ____ to interpret and integrate _____ and ____ information, translating it into ____ motion. ____ injury alters this ability.

A
  • CNS
  • proprioceptive and kinesthetic
  • coordinated
  • MSK
35
Q

Early stages of rehab involves regaining previously established _____ _____.

A

sensory patterns

36
Q

Posture and core stabilization is essential for ____ ____ and reacquiring ____ ___ _____ (dynamically stabilize the ____ ____).

A
    • functional strength
  • complex motor tasks
  • kinetic chain
37
Q

Posture and core stabilization enables ____ segments to function optimally and efficiently during ____ and ____ generation.

A
  • distal
  • force
  • power
38
Q

Posture and core stabilization involves integration of…

A
  • muscular forces
  • neurologic sensory information
  • biomechanical information
39
Q

Most neglected part of rehab:

A
  • CV fitness

- decreases rapidly during periods of inactivity

40
Q

How to address goals of CV fitness:

A
  • alternative activities

- consider UBE for LE injuries

41
Q

Psychological aspect:

A
  • critical factor that is often neglected and overlooked
  • injury/illness produce a variety of emotional responses
  • play an important role in the performance enhancement or return to work
42
Q

How to address goals of psychological readiness:

A
  • education: pain, goals, compliance

- refer: competitiveness, coping, depression, anger, fear, guilt

43
Q

How to begin return process:

A
  • gradually progressive PA designed to prepare for functional return
  • skill progression and re-acquisition within limitation of injury and rehab/treatment plan
  • progression based on injury response to functional movements
44
Q

Functional exercise progressions will help injured client return to…

A
  • normal pain free ROM

- strength and neuromuscular control

45
Q

How to address RTA goal:

A
  • education on what can do, what can’t do yet (limitations, restrictions, tissue healing)
  • steps: return to train, return to sport, return to performance
46
Q

RTA:

A
  • full complete recovery
  • unrestricted full participation
  • cleared
  • discharged
47
Q

Return is determined by criteria:

A
  • restoration to normal function (has met tissue repair)
  • philosophy of health care team
  • choices and context for/of the client
  • criteria or markers or measurable (tests)
48
Q

Return is determined by variety of members:

A
  • physician clearance
  • employer criteria
  • RTP rules in a sport
  • coach criteria
  • client’s level of performance
49
Q

2 concepts and principles of prescription:

A
  1. rehabilitation (treatment) plan

2. rehabilitation exercise programming

50
Q

Rehab (treatment) plan:

A
  • approaches to rehab
  • pathomechanics of injury
  • tissue response to injury and tissue repair (healing process)
51
Q

Rehab exercise programming:

A
  • types of exercises
  • FITT
  • SAID
  • functional movements (kinetic chain)
52
Q

Aggressive rehabilitation:

A
  • competitive nature necessitates aggressive approach

- pushing too hard or not hard enough may have negative impact on client’s return (tight-rope approach)

53
Q

Conservative rehabilitation:

A
  • management approach of RTA utilizing non-surgical treatment options
  • can be aggressive in a conservative rehab
  • refers to therapy, medications, exercises
54
Q

Rehab plan based on pathomechanics of injury:

A
  • factors affecting tissue repair, healing response and treatment
  • due to injury, normal joint and anatomic function is compromised (adaptive changes occur resulting in alterations in biomechanics)
55
Q

Knowledge and background in ___ ____ and _____ is critical in defining and designing a rehab program.

A
  • functional anatomy

- biomechanics

56
Q

Must have the ability to identify ____ or ____ actions resulting from injury and correct the pathomechanics.

A
  • adaptive

- compensatory

57
Q

progression through the PLAN should be based on:

A
  • the tissue injured (site, structure, severity)
  • tissue repair process and the healing properties of the tissue
  • tissue repair and healing timelines: signs and symptoms identify the phase
58
Q

Must create a environment conducive to the ___ ____.

A

healing process

59
Q

Components of rehab exercise programming (prescription):

A
  • principles of fitness and training
  • specificity
  • overload
  • progression
  • regression
60
Q

Principle of fitness and training:

A

in order to improve, continually work harder to adjust in order to increase fitness

61
Q

Specificity:

A

target specific goals

62
Q

Overload:

A

amount of load or resistance providing a greater stress than is normally accustomed to in order to increase

63
Q

Progression:

A

way in which increase the load

64
Q

Regression:

A

way in which decrease the load

65
Q

SAID:

A
  • specific adaptations to imposed demands
  • ability of the body to adapt to stress and the overload imposed on it
  • as healing progresses, exercise intensity increases
  • address in prescription for exercise
66
Q

Indications of having applied too much stress on tissue:

A
  • pain
  • swelling
  • loss of range
  • increased laxity in healed ligaments
67
Q

Frequency:

A
  • # of exercise sessions per week

- goals and objectives, injury factor, intensity of exercise

68
Q

Intensity:

A
  • rate of work

- %, RPE

69
Q

Time:

A

duration or length of work period

70
Q

Type:

A
  • activity to target goal

- resistance training, endurance, an/aerobic etc.

71
Q

Borg scale:

A

6-20

72
Q

Principle of progression

A

you should increase overload, which can be achieved by using FITT when your body adapts to its present routine

73
Q

Specificity principle:

A

only targeted exercises will improve specific fitness goals

74
Q

Program exercise rehab with respect to ___ ____.

A

tissue repair

75
Q

Use of the FITT principle in rehab setting for exercise prescription:

A
  • start: what weight, ROM
  • progression: how, when to increase, decrease
  • type of exercise (equipment), specificity
76
Q

Rule to approaching rehab:

A
  • do no harm to injured site
  • communicate and collaborate with managing HCPs
  • goal directed approach to programming (be aware of potential de-training)
  • respect the tissue repair and its phase healing
  • comprehensive exercise rehab plan
77
Q

Comprehensive exercise rehab plan:

A
  • program is functionally applicable
  • function of the kinematic chain (malfunctioning systems result in compensatory overload)
  • addresses muscle imbalances, altered arthrokinematics, neuromuscular re-education
78
Q

Legal considerations:

A
  • licensure and/or certification
  • laws vary with regard to a providers ability to conduct rehab programs
  • documentation
79
Q

Documentation in rehab:

A
  • detailed records (injury evaluations, treatment records, progress notes)
  • lawsuits and malpractice
  • record keeping is critical for third-party billing