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Interventions 2 > Exam 1 > Flashcards

Exam 1 Flashcards

1
Q

15 Contraindications to Exercise

A
  1. Dyspnea at rest
  2. Chest pain at rest
  3. Pulmonary embolism
  4. Arrhythmias
  5. Use of anti-arrhythmias
  6. Pericarditis
  7. Moderate to severe valvular disease
  8. Temporary pacemaker
  9. Hypotension
  10. Orthostatic Hypotension
    11, 12, 13 Uncontrolled hypertension, DM, CHF
  11. Fever of 101 or more
  12. Severe joint pain
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2
Q

Signs to Decrease Level of Activity

A

1,2 Exercise induced chest pain and dyspnea

  1. Significant heart arrythmias
  2. Heart rate exceeding target heart rate
  3. ST segment displacement 2 mm or more
  4. Decrease in systolic BP over 20 mmHg or more
  5. Intermittent claudication
  6. Ataxia, confusion, or other cerebral symptoms
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3
Q

Signs and Symptoms to Warrant Cessation of Exercise

A
  1. Angina
  2. Dyspnea
  3. Arrhythmias
  4. HR increase of 20 BPM or more
  5. Palpitations
  6. Nausea
  7. Diaphroesis
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4
Q

4 goals of therapeutic exercise

A
  1. Remediate or prevent impairments
  2. Improve or restore physical function
  3. Prevent or reduce health-related risk factors
  4. Optimize overall health status, fitness, and well-being
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5
Q

Types of TE interventions

A 
Aerobic conditioning
Muscular performance
Stretching (muscle-lengthening and joint play)
Neuromuscular control 
Postural control
Balance and agility 
Relaxation exercises 
Breathing exercises 
Task-specific exercises
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6
Q

Factors that must be considered for TE to be safe

A 
Health history and current health status
Medications list and medical clearance 
Environment 
Know a patient can accurately perform an exercise
PT uses proper body mechanics
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7
Q

Common physical impairments managed with TE

A

Musculoskeletal
Cardiopulmonary
Neuromuscular
Integumentary

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8
Q

Primary prevention

A

Prevent disease through health promotion

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9
Q

Secondary prevention

A

Early diagnosis and reduction of severity of disease

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10
Q

Tertiary prevention

A

Limit progression of existing disability and improve aspects of chronic, irreversible disease

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11
Q

Discrete task

A

Action has recognizable beginning and end

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12
Q

Serial task

A

Series of discrete movements

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13
Q

Continuous task

A

Repetitive uninterrupted movements that have no distinct beginning and end

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14
Q

Cognitive motor learning

A

Pt learns the goal/purpose/requirements of the task. Pt gets feel for exercise and is easily distracted

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15
Q

Associative motor learning

A

Pt makes infrequent errors and concentrates on fine-tuning motor task

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16
Q

Autonomous

A

Movements are automatic. Pt is able to multitask and adapt to different demands

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17
Q

Pre-practice considerations that influence motor learning

A
  1. Understanding of doing exercise
  2. Ability to focus on task
  3. Demonstration of tasks
  4. Pre-practice verbal instructions
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18
Q

Blocked practice order

A

Same task or series of tasks is performed repeatedly in a predictable order

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19
Q

Random order practice

A

Slight variations of same task are carrier out in an unpredictable order

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20
Q

Random/Blocked order practice

A

Variations of the same task are performed in a random order but each variation is performed more than once

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21
Q

PROM indications

A
  1. Area where there is acute, inflamed tissue

2. When a patient is not able to actively move a body segment

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22
Q

ROM Contraindications

A
  1. Motion is disruptive to healing process

2. When the patient response or condition is life threatening

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23
Q

PROM Precautions

A
  1. Motion during early phases or healing benefit healing and early recovery
  2. Signs of too much or wrong motion (pain and inflammation)
  3. Carefully initiated to major joints to minimize venous stasis
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24
Q

PROM Goals

A
  1. Minimize the effects of contractures
  2. Maintain joint and CT mobility
  3. Maintain mechanical elasticity of muscle
  4. Maintain patient’s awareness of movement
  5. Assist circulation and vascular dynamics
  6. Assist with healing process
  7. Decrease complications that would occur with immobilization
  8. Decrease or inhibit pain
  9. Enhance synovial movement for cartilage nutrition
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25
Q

PROM limitations

A
  1. Does not prevent muscle atrophy
  2. Does not increase strength or endurance
  3. Does not assist circulation to extent that active ROM does
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26
Q

AROM Indications

A
  1. When patient can use muscles actively
  2. When a segment of body is immobilized for a long period of time, mobilize segment above and below
  3. Aerobic conditioning programs and to relieve stress from sustained posture
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27
Q

AROM Precautions

A
  1. When motion during early phases of healing has been shown to benefit healing and early recovery
  2. . Signs of too much or wrong motion
  3. AROM to ankles and feet to minimize venous stasis and thrombus formation
  4. After MI, CABG, and transluminal coronary angioplasty AROM of UE and limited walking are tolerated under careful monitoring of symptoms
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28
Q

AROM Goals

A
  1. Maintain physiological elasticity and contractility of muscles
  2. Provide sensory feedback from contracting muscles
  3. Provide stimulus for bone and joint tissue integrity
  4. Increase circulation and prevent thrombus formation
  5. Develop coordination and motor skills for functional activities
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29
Q

AROM limitations

A
  1. Does not maintain or increase strength of strong muscles

2. Does not develop skill or coordination except in movement patterns used

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30
Q

Flexibility

A

Ability to move a single joint or series of joints smoothly and easily through unrestricted painfree ROM

31
Q

Myogenic contracture

A

Muscle tightness; No specific muscle pathology present. No decrease in individual sarcomere length

32
Q

Pseudomyostatic contracture

A

Involved muscle seems to be in a constant state of contraction (muscle guarding and pain, CNS lesion, SCI, TBI)

33
Q

Arthrogenic contracture

A

Intra-articular pathology

34
Q

Periarticular contracture

A

develops when CT that cross or attach to a joint or joint capsule lose mobility

35
Q

Fibrotic contracture

A

Fibrous changes in CT of muscle and periarticular structures

36
Q

Interventions to increase mobility of soft tissue

A
  1. Stretching
  2. Self-stretching
  3. Neuromuscular facilitation and inhibition
  4. Muscle energy techniques
  5. Joint mobilization/manipulation
  6. Soft tissue moblization
  7. Neural tissue mobilization
37
Q

Indications for stretching

A
  1. ROM is limited because soft tissues have lost their extensibility
  2. Restricted motion leads to structure deformities
  3. Muscle weakness and shortening of opposing tissues
  4. Component of fitness or sports specific program
  5. Used prior to and after vigorous exercise to reduce soreness
38
Q

Contraindications to stretching

A
  1. Bony block
  2. Fracture or incomplete bony union
  3. Acute inflammatory or infections process that can be disrupted
  4. Sharp, acute pain with movement
  5. Hematoma or indication of tissue trauma
  6. Hypermobility
  7. Shortened soft tissue providing joint stability
  8. Shortened soft tissue enables a patient with paralysis or severe muscle weakness to perform function
39
Q

Precautions of stretching

A
  1. Do not passively force beyond range
  2. Cautious of patients with osteoporosis
  3. Protect newly united fractures
  4. Avoid vigorous stretching of muscle and CT that has been immobilized for an extended period of time
  5. Progress dosage gradually
  6. Avoid stretching edematous tissue
  7. Avoid overstretching weak muscle
40
Q

Goals of stretching

A
  1. Restore and increase extensibility of muscle in order to regain flexibility and ROM required for functional activities
  2. Become part of exercise routine
  3. Reduce DOMS
  4. Prevent soft tissue injury
  5. Enhance physical performance
41
Q

Elasticity

A

Ability of soft tissue to return to its pre-stretch length after a short duration stretch has been removed

42
Q

Plasticity

A

Tendency of soft tissue to assume a new and greater length after stretch force has been removed

43
Q

Determinants of stretching interventions

A

Alignments, Intensity, Duration, Stabilization, Mode, Frequency, Speed

44
Q

Frequency of stretch dependent on

A
  1. Cause
  2. Quality and level of healing tissues
  3. Chronicity and severity of contracture
  4. Age
  5. Use of corticosteroids
  6. Previous response to stretch
45
Q

Indications to Joint Mobilization

A
  1. Painful joints
  2. Muscle guarding
  3. Muscle spasm
  4. Reverse joint hypomobility
  5. Diseases that progressively limit motion
  6. functional immobility
  7. Positional faults and subluxations
46
Q

Contraindicatiosn to joint mobilization

A
  1. Hypermobility
  2. Joint effusion
  3. Inflammation
47
Q

Precautions to Joint Mobilization

A
  1. Malignancy
  2. Bone Disease
  3. Unhealed fracture
  4. Total joint replacement
  5. Excessive pain
  6. Hypermobility
  7. Newly formed or weakened CT
  8. Systemic CT disease
  9. Elderly individuals with weakened CT and diminished circulation
48
Q

Physiological Movement

A

movements patient can do voluntarily

49
Q

Accessory movements

A

movements in the joints and surrounding tissues that are necessary for normal ROM but cannot be actively performed by patient

50
Q

Component Motions

A

motions that accompany active motions but are not under voluntary control

51
Q

Effects of joint motion

A
  1. Moves synovial fluid providing nutrients to articular cartilage
  2. Extensibility and tensile strength of articular and periarticular tissues are maintained with joint motion
  3. Joint motion provides sensory input
52
Q

Resting position for GH joint

A

55 abd/30 horizontal add/neutral rotation

53
Q

GH Inferior glide

A

Increase abduction

54
Q

GH Posterior glide

A

Increase flexion and IR or ER

55
Q

GH Anterior glide

A

Increase ER

56
Q

HU resting postion

A

70 flex/10 supination

57
Q

HU Distal glide

A

flexion

58
Q

HU Radial Glide

A

Flexion

59
Q

HU ulnar glide

A

Extension

60
Q

Proximal RU resting position

A

70 flexion/35 sup

61
Q

Proximal RU volar glide

A

Increase supination

62
Q

Proximal RU dorsal glide

A

Increase pronation

63
Q

HR resting position

A

full extension and sup

64
Q

HR dorsal glide

A

increase extension

65
Q

HR ventral glide

A

flexion

66
Q

HR compression

A

Pulled elbow

67
Q

Distal RU resting position

A

10 sup

68
Q

Distal RU volar glide

A

pronation

69
Q

Distal RU dorsal glide

A

supination

70
Q

Radiocarpal resting position

A

Neutral

71
Q

Radiocarpal dorsal glide

A

Flexion

72
Q

Radiocarpal ventral glide

A

Extension

73
Q

Radiocarpal ulnar glide

A

Radial deviation

74
Q

Radiocarpal radial glide

A

Ulnar deviation

Interventions 2 (6 decks)

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