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
2
Q
Steps to success for a plan:
A
- effective evaluation
- setting goals
- essential considerations of exercise component
3
Q
Essential considerations of exercise component includes:
A
- concepts and principles of rehab programming
- concepts and principles of exercise programming
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
5
Q
Use ____ and ____ findings to set goals.
A
- subjective
- objective
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
7
Q
Lesion site:
A
area of abnormal damage or change in the tissue
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
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
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
11
Q
How to address goal of pain control:
A
- modalities
- medications
- modifications of movement or activity
- healing
12
Q
Pain may interfere with the _____ process and dictate the rate of _____.
A
- rehab
- progression
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
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
15
Q
Muscular strength, endurance, and power are essential to…
A
restoring pre-injury status
16
Q
With muscular strength, endurance, and power, working through a full ____ ____ ROM should be emphasized.
A
pain free
17
Q
Return to train should incorporate both…..
A
- single plane force production movements
- functional activities that stress tri-planar motion
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
19
Q
Isometric strength is used during ….
A
initial stages of rehab
20
Q
Isometric strength is useful when…
A
training through a full ROM is contraindicated
21
Q
Isometric strength serves to increase _____ strength.
A
static
22
Q
Isometric strength serves to decrease _____.
A
atrophy
23
Q
Isometric strength looks to create muscle ____ to reduce ____/_____.
A
- pump
- edema/swelling
24
Q
Isotonic strength incorporates what type of equipment?
A
- free weights
- machines
- tubing
25
Isotonic strength utilizes what types of contractions?
- concentric
| - eccentric
26
Isokinetic strength is used in ____ ____ of rehab.
later stages
27
Isokinetic strength uses ____ speeds with ______ resistance.
- fixed
| - accommodating
28
Isokinetic strength provides _____ resistance through ____ ROM.
- maximal
| - full
29
Isokinetic strength is commonly used as ____ for return to ____ ____.
- criteria
| - functional activity
30
Plyometric strength is incorporated into ___ ____ of rehab.
later stages
31
Plyometric strength relies on quick ____ ____ to facilitate a subsequent _____ contraction.
- eccentric stretch
| - concentric
32
Plyometric strength is a ____ movement with ____.
- dynamic
| - power
33
Joint position sense is mediated by ______.
mechanoreceptors
34
Neuromuscular control relies on the ____ to interpret and integrate _____ and ____ information, translating it into ____ motion. ____ injury alters this ability.
- CNS
- proprioceptive and kinesthetic
- coordinated
- MSK
35
Early stages of rehab involves regaining previously established _____ _____.
sensory patterns
36
Posture and core stabilization is essential for ____ ____ and reacquiring ____ ___ _____ (dynamically stabilize the ____ ____).
- - functional strength
- complex motor tasks
- kinetic chain
37
Posture and core stabilization enables ____ segments to function optimally and efficiently during ____ and ____ generation.
- distal
- force
- power
38
Posture and core stabilization involves integration of...
- muscular forces
- neurologic sensory information
- biomechanical information
39
Most neglected part of rehab:
- CV fitness
| - decreases rapidly during periods of inactivity
40
How to address goals of CV fitness:
- alternative activities
| - consider UBE for LE injuries
41
Psychological aspect:
- 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
How to address goals of psychological readiness:
- education: pain, goals, compliance
| - refer: competitiveness, coping, depression, anger, fear, guilt
43
How to begin return process:
- 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
Functional exercise progressions will help injured client return to...
- normal pain free ROM
| - strength and neuromuscular control
45
How to address RTA goal:
- 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
RTA:
- full complete recovery
- unrestricted full participation
- cleared
- discharged
47
Return is determined by criteria:
- 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
Return is determined by variety of members:
- physician clearance
- employer criteria
- RTP rules in a sport
- coach criteria
- client's level of performance
49
2 concepts and principles of prescription:
1. rehabilitation (treatment) plan
| 2. rehabilitation exercise programming
50
Rehab (treatment) plan:
- approaches to rehab
- pathomechanics of injury
- tissue response to injury and tissue repair (healing process)
51
Rehab exercise programming:
- types of exercises
- FITT
- SAID
- functional movements (kinetic chain)
52
Aggressive rehabilitation:
- competitive nature necessitates aggressive approach
| - pushing too hard or not hard enough may have negative impact on client's return (tight-rope approach)
53
Conservative rehabilitation:
- management approach of RTA utilizing non-surgical treatment options
- can be aggressive in a conservative rehab
- refers to therapy, medications, exercises
54
Rehab plan based on pathomechanics of injury:
- 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
Knowledge and background in ___ ____ and _____ is critical in defining and designing a rehab program.
- functional anatomy
| - biomechanics
56
Must have the ability to identify ____ or ____ actions resulting from injury and correct the pathomechanics.
- adaptive
| - compensatory
57
progression through the PLAN should be based on:
- 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
Must create a environment conducive to the ___ ____.
healing process
59
Components of rehab exercise programming (prescription):
- principles of fitness and training
- specificity
- overload
- progression
- regression
60
Principle of fitness and training:
in order to improve, continually work harder to adjust in order to increase fitness
61
Specificity:
target specific goals
62
Overload:
amount of load or resistance providing a greater stress than is normally accustomed to in order to increase
63
Progression:
way in which increase the load
64
Regression:
way in which decrease the load
65
SAID:
- 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
Indications of having applied too much stress on tissue:
- pain
- swelling
- loss of range
- increased laxity in healed ligaments
67
Frequency:
- # of exercise sessions per week
| - goals and objectives, injury factor, intensity of exercise
68
Intensity:
- rate of work
| - %, RPE
69
Time:
duration or length of work period
70
Type:
- activity to target goal
| - resistance training, endurance, an/aerobic etc.
71
Borg scale:
6-20
72
Principle of progression
you should increase overload, which can be achieved by using FITT when your body adapts to its present routine
73
Specificity principle:
only targeted exercises will improve specific fitness goals
74
Program exercise rehab with respect to ___ ____.
tissue repair
75
Use of the FITT principle in rehab setting for exercise prescription:
- start: what weight, ROM
- progression: how, when to increase, decrease
- type of exercise (equipment), specificity
76
Rule to approaching rehab:
- 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
Comprehensive exercise rehab plan:
- program is functionally applicable
- function of the kinematic chain (malfunctioning systems result in compensatory overload)
- addresses muscle imbalances, altered arthrokinematics, neuromuscular re-education
78
Legal considerations:
- licensure and/or certification
- laws vary with regard to a providers ability to conduct rehab programs
- documentation
79
Documentation in rehab:
- detailed records (injury evaluations, treatment records, progress notes)
- lawsuits and malpractice
- record keeping is critical for third-party billing
