Exam 1 Flashcards
1
Q
15 Contraindications to Exercise
A
- Dyspnea at rest
- Chest pain at rest
- Pulmonary embolism
- Arrhythmias
- Use of anti-arrhythmias
- Pericarditis
- Moderate to severe valvular disease
- Temporary pacemaker
- Hypotension
- Orthostatic Hypotension
11, 12, 13 Uncontrolled hypertension, DM, CHF - Fever of 101 or more
- Severe joint pain
2
Q
Signs to Decrease Level of Activity
A
1,2 Exercise induced chest pain and dyspnea
- Significant heart arrythmias
- Heart rate exceeding target heart rate
- ST segment displacement 2 mm or more
- Decrease in systolic BP over 20 mmHg or more
- Intermittent claudication
- Ataxia, confusion, or other cerebral symptoms
3
Q
Signs and Symptoms to Warrant Cessation of Exercise
A
- Angina
- Dyspnea
- Arrhythmias
- HR increase of 20 BPM or more
- Palpitations
- Nausea
- Diaphroesis
4
Q
4 goals of therapeutic exercise
A
- Remediate or prevent impairments
- Improve or restore physical function
- Prevent or reduce health-related risk factors
- Optimize overall health status, fitness, and well-being
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
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
7
Q
Common physical impairments managed with TE
A
Musculoskeletal
Cardiopulmonary
Neuromuscular
Integumentary
8
Q
Primary prevention
A
Prevent disease through health promotion
9
Q
Secondary prevention
A
Early diagnosis and reduction of severity of disease
10
Q
Tertiary prevention
A
Limit progression of existing disability and improve aspects of chronic, irreversible disease
11
Q
Discrete task
A
Action has recognizable beginning and end
12
Q
Serial task
A
Series of discrete movements
13
Q
Continuous task
A
Repetitive uninterrupted movements that have no distinct beginning and end
14
Q
Cognitive motor learning
A
Pt learns the goal/purpose/requirements of the task. Pt gets feel for exercise and is easily distracted
15
Q
Associative motor learning
A
Pt makes infrequent errors and concentrates on fine-tuning motor task
16
Q
Autonomous
A
Movements are automatic. Pt is able to multitask and adapt to different demands
17
Q
Pre-practice considerations that influence motor learning
A
- Understanding of doing exercise
- Ability to focus on task
- Demonstration of tasks
- Pre-practice verbal instructions
18
Q
Blocked practice order
A
Same task or series of tasks is performed repeatedly in a predictable order
19
Q
Random order practice
A
Slight variations of same task are carrier out in an unpredictable order
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
21
Q
PROM indications
A
- Area where there is acute, inflamed tissue
2. When a patient is not able to actively move a body segment
22
Q
ROM Contraindications
A
- Motion is disruptive to healing process
2. When the patient response or condition is life threatening
23
Q
PROM Precautions
A
- Motion during early phases or healing benefit healing and early recovery
- Signs of too much or wrong motion (pain and inflammation)
- Carefully initiated to major joints to minimize venous stasis
24
Q
PROM Goals
A
- Minimize the effects of contractures
- Maintain joint and CT mobility
- Maintain mechanical elasticity of muscle
- Maintain patient’s awareness of movement
- Assist circulation and vascular dynamics
- Assist with healing process
- Decrease complications that would occur with immobilization
- Decrease or inhibit pain
- Enhance synovial movement for cartilage nutrition
25
PROM limitations
1. Does not prevent muscle atrophy
2. Does not increase strength or endurance
3. Does not assist circulation to extent that active ROM does
26
AROM Indications
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
27
AROM Precautions
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
28
AROM Goals
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
29
AROM limitations
1. Does not maintain or increase strength of strong muscles
| 2. Does not develop skill or coordination except in movement patterns used
30
Flexibility
Ability to move a single joint or series of joints smoothly and easily through unrestricted painfree ROM
31
Myogenic contracture
Muscle tightness; No specific muscle pathology present. No decrease in individual sarcomere length
32
Pseudomyostatic contracture
Involved muscle seems to be in a constant state of contraction (muscle guarding and pain, CNS lesion, SCI, TBI)
33
Arthrogenic contracture
Intra-articular pathology
34
Periarticular contracture
develops when CT that cross or attach to a joint or joint capsule lose mobility
35
Fibrotic contracture
Fibrous changes in CT of muscle and periarticular structures
36
Interventions to increase mobility of soft tissue
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
Indications for stretching
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
Contraindications to stretching
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
Precautions of stretching
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
Goals of stretching
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
Elasticity
Ability of soft tissue to return to its pre-stretch length after a short duration stretch has been removed
42
Plasticity
Tendency of soft tissue to assume a new and greater length after stretch force has been removed
43
Determinants of stretching interventions
Alignments, Intensity, Duration, Stabilization, Mode, Frequency, Speed
44
Frequency of stretch dependent on
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
Indications to Joint Mobilization
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
Contraindicatiosn to joint mobilization
1. Hypermobility
2. Joint effusion
3. Inflammation
47
Precautions to Joint Mobilization
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
Physiological Movement
movements patient can do voluntarily
49
Accessory movements
movements in the joints and surrounding tissues that are necessary for normal ROM but cannot be actively performed by patient
50
Component Motions
motions that accompany active motions but are not under voluntary control
51
Effects of joint motion
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
Resting position for GH joint
55 abd/30 horizontal add/neutral rotation
53
GH Inferior glide
Increase abduction
54
GH Posterior glide
Increase flexion and IR or ER
55
GH Anterior glide
Increase ER
56
HU resting postion
70 flex/10 supination
57
HU Distal glide
flexion
58
HU Radial Glide
Flexion
59
HU ulnar glide
Extension
60
Proximal RU resting position
70 flexion/35 sup
61
Proximal RU volar glide
Increase supination
62
Proximal RU dorsal glide
Increase pronation
63
HR resting position
full extension and sup
64
HR dorsal glide
increase extension
65
HR ventral glide
flexion
66
HR compression
Pulled elbow
67
Distal RU resting position
10 sup
68
Distal RU volar glide
pronation
69
Distal RU dorsal glide
supination
70
Radiocarpal resting position
Neutral
71
Radiocarpal dorsal glide
Flexion
72
Radiocarpal ventral glide
Extension
73
Radiocarpal ulnar glide
Radial deviation
74
Radiocarpal radial glide
Ulnar deviation
