Intro (chap 1) Flashcards
Ther-ex
Systematic, planned performance of bodily movements, postures, and physical activities to
- Remediale or prevent impariements
- Improve, restore, or enhance physical function
- Prevent or reduce health related risk factors
- Optimize overa health status and well-being
* *skilled and individualized
Balance
The ability to align body segments against gravity to maintain or move the body (COM) within available base of support without falling
- the ability to move the body in equilibrium with gravity via interaction of the sensory and motor systems
Cardiopulmonary endurance (fitness)
The ability to perform moderate-intensity, repetitive, total body movements over an extended period of time
- walking, joggin, cycling, swimming
Coordination
The correct timing and sequencing of muscle firing combined with the appropriate intensity of musclular contraction leading to the effective initiation, guiding, and grading of movement
- basis of smooth, accurate, efficient movement and occurs at a conscious or automatic level
Flexibility (mobility)
The ability to move freely, without restriction
Mobility
The ability of structures or segments of the body to move or be moved in order to allow the occrrence of ROM for funcional activities
- active requires neuromuscular activation
Mm performance
The capacity of mm to produce tension and do physical work
- encompasses strength, power, and mm endurance
Neuromuscular control
Interaction of the sensory and motor systems that enables synergistic, agonists, and antagonists, as well as stabilizers and neutralizes, to anticipate or respond to proprioceptive and kinesthetic information.
- must work in correct sequence to reate coordinated movement
Stability
The ability of the neuromuscular system through synergistic mm actions to hold a proximal or distal body segment
- proximal stability (core) > distal mobility
Joint stability
The maintenance of proper alignment of bony partners of a joint by means of passive and dynamic components
- active: mm working
- passive: other structures
Goal = function (6)
- Mm performance
- Cardiovascular endurance
- Mobility and flexibility
- NMR and coordination
- Stability
- Balance and equilibrium
* safety
Ther-ex interventions (10)
- Aerobic
- Mm performance
- Stretching techniques
- Neuromuscular techniques
- Postural control
- Balance training
- Agility training
- Relaxation*
- Breathing exercises*
- Task-specific
*often missed
Considerations prior to tx
ICF model - pt management - clinical decision making
- pt specific - safe - understand roles and responsibilities - best practice
Clinical decision making
Dynamic, complex process of reasoning and analytical thinking that involves making judgments and determinations in the context of patient care
EBP
- identify the problem
- search literature and collect evidence
- analyze information found
- integrate evidence
- incorporate findings
- assess outcomes
Pt management model
Examination - evaluation - diagnosis - prognosis - intervention - outcomes
*referrals/consultations and re-examination throughout
Motor learning
Complex set of internal processes that involves the acquisition and relatively permanent retention of a skilled movement or task through practice
Motor performance
Acquisition of the ability to carry out a skill, (learning involves both acquisition and retention)
Discrete task
Involves an action or movement with a recognizable beginning and end.
- isolating and contracting a specific mm group
Serial task
Composed of a series of discrete movements that are combined in a particular sequence
- some require specific timing between each segment
- ex:
Continuous task
Involves repetitive, uninterrupted movements that have no distinct beginning and ending.
- ex: walking, stairs, cycling
Stages of motor learning
- Cognitive: pt must figure out WHAT to do and HOW to do it. Lots of thinking required
- Associative: pt makes infrequent errors and concentrates on fine-tuning the motor task. Timing, problem-solving, less cues add more anticipation
- Autonomous: movements are automatic, and possible to multitask (pt discharged before this stage)
Closed environment
Objects around the pt and the surface on which the task is performed do not move
- pt’s complete attention is on the task
Open environment
Objects or other people are in motion or the support surface is unstable during the task
- movement in environment is not under pt control
Pre-practice conditions
- pt’s understanding of / interest in the task - pt’s attention to task - proper demonstration - environment (safe, open or closed)
Practice conditions
- Part vs whole: break it down into simple tasks and then pul it together
- Order: part break down allows change in the order
Order (practice conditions)
- Blocked: same task, same order, same environment
- Random: slight variations
- Random/blocked: same task, different order. Pt completes more than 1 before changing the order
- Physical vs mental: mental rehearsal of a motor task reinforces the cognitive component of motor learning
4 main task dimensions in taxonomy
- The environment in which the task is performed (open or closed)
- The intertribal variability of the environment that is imposed on a task (absent = constant, present = demands change from one attempt)
- The need for a person’s body to remain stationary or to move during the task
- The presence or absence of manipulation of objects during the task (absent = requires UE)
Intrinsic feedback
Comes from all sensory systems of the learner.
- Proprioception and sense, direct result from completion task.
- Continuous source of information that provides knowledge of performance and knowledge of results
Extrinsic (augmented) feedback
Supplemental and not directly experience by the person.
- Therapist has control of the type, timing, and frequency that the pt receives
Knowledge of performance
Either intrinsic feedback sensed during a task or immediate, postask, augmented feedback (usually verbal) about the nature or quality of the performance of a motor task
Knowledge of results
Immediate, posttask, augmented feedback about the outcome of a motor task
Concurrent feedback
Occurs during the performance of a task
- real time feedback
- VC and TC
Immediate post response feedback
Infor that is given directly after a task is completed
Delayed feedback
Information that is given after a short interval of time has elapsed, allowing time for the learner to reflect on how well or poorly a task was executed
Summary feedback
Information that is given about the average performance of several repetitions of a motor skill
Variable feedback
Occurs irregularly, randomly during practice of a motor task
Constant feedback
Occurs on a regularly recurring, continuous basis during practice of a motor task
Factors that influence adherence
- Pt-related factors: health lit, motivation, self-discipline, memory, fatigue, stress, etc
- Health condition or impairments: acuity, chronicity, severity, stability, etc
- Program-related: complexity, supervision, feedback, continuity of settings, etc
Strategies to foster adherence
- Set a good example (posture, mechanics, communication)
- Expect pts not to follow plan
- explore and appreciate pt’s beliefs about exercise
- keep program brief
- identify barriers
- edu of each exercise and functional activity
- identify how each activity is goal oriented
- give pt a voice
Questions to ask yourself
- Does pt actually understand activity and able to complete accurately? *never prescribe activity you havent watched
- Do they understand medical barriers?
- Routine prior to injry?
- Do they understand how program will make them feel?
* *difference between pain and DOMS
* want to decrease annoyance, panic, and discouragement
- tell them what to expect!
Safety
Environment - equipment - mechanics - meds - PMH - CP health - performing activity accurately
