Intro - Stretching Flashcards
Physical therapy affects the following systems
Cardiopulmonary
Integumentary
Neuromuscular
Muscleskeletal
Common impair mg’d w/ Therex (Go by syst)
MSK: (P), weakness, hpyermobility, posture, length/strength imbalance, v|: torque pdn, endurance, ROM, periarticular CT, muscle length
NM: (P), impared bal/post ctrl, incoordin/timing, delayed moto dev, abn tone (hypo, hyper, dyst), ineffect func mvmt
CV/Pulm: v| aerobic capacity (CP end), circ (lmp, ven/art), (P) w/ sustained activ
Integume (hypomobil - e.g. immobil/adherent scar)
Composite impairment: defn + ex
Result of mult underly, combo of 1st or 2nd impair. E.g. severe inv sprain, talofib lig tear - immobil. Balance imparitment due to chronic lig lax (structural), impared ankle proprio from injur or weakness (functional)
Primary vs secondary impairment
Primary -> direct result of area of complaint
2ndary -> due to pre-existing condition (e.g. preexist postural impair)
Risk factor categories for disability
Bio, (e.g. height/weight, congential, gene pred)
Behavioral/psycho/lifestyle (cul. bias)
Physical environment (archit barr)
Socioeconomic (lim support)
Req for Clinic Decision Making during Pt mgmt
Relevant data via strateg examination
Cogni+ psychomotor (palp) to get data of unfamiliar issue
Efficient info-gath/process style (intake fm)
Prior exp w/ similar prob
Recall, integrate new and prior knowhow, Obtain quality evid from lit,
Critically synth info,
Form working hypothesis abt prob + soln
Pt value+ goal
Option analysis
Reflect+ self-monitor for adj
Evidence-based practice steps:
Pt Mgmt 5 basic components
1) Pt problem -> Question
2) Collect scientific, clinical evidence re: Q
3) Critically analyze abt quality in applicability of evidence to Q
4) Integrate evidence review w/ expertise + pt circumstances for decisions
5) Findings -> pt mgmt
5) Assess intervention outcome + adj
1) Examination
2) Evaluation
3) Diagnosis - impairments (activity + participation)
4) Prognosis + tx plan
5) Intervention
Pt Mgmt Step 1: Examination 3 distinct component
Pt health history (interview, other HCP report)
Systems relevant: CP, MSK, NM, Intg, GI/GU (genitouri), Cog+social/emo, gen/misc (unexplained weight loss, persistent fatigue)
Specific tests+measure: multiple lvl of function, data specific to support or reject hypo, help type fo int.
Pt Mgmt Step 2: Eval components
Gen health (pre-existing/comorbidities - DM) -> current/pot function
Acuity/severity of conditions
Extent of struct/func impairment -> funct abil (stability or progression)
Which impairmt-> limitations
Current/overall lvl of physical func:desired/needed func abilities
Impact of phy dys -> social/emo func
Impact of phys envi+ social support-> current, desired function
Pt Mgmt Step 3: Diagnosis defn for PT
PT classify dysfunction (mvmt or conseq of dys), Dr identifies disease
PT diag Class for MSK sysm patterns:
Primary prev/risk v| for skel demin (4A) Impaired post (4B) Imp'd muscle per (4C) Imp'd jt mobil, motr func, muscl perf, ROM due to: -C.T dys (4D) -Localized inflam (4E) -Spinal dys (4F) -fracture (4G) -joint arthroplasty (4H) -bony/soft tis surgery (4I) -amputation (4J), also re: gait, locomotion _ balance
Pt Mgmt Step 4: Prognosis + Tx Plan depends on:
1) Complexity + expected course of pathology, impairmt
2) Pt gen health, comorbidities
3) Prev lvl of function
4) Living environ
5) pt goal
6) Adher_ motiv, resp to prev intv
7) safety concerns
8) Ext of supp (phys, emo, soc)
Pt Mgmt Step 5: Q’s
Of problems, which do you want to try to elim or minimize?
What would make you feel you were making progress in achieving your goals?
How soon do you want to reach them?
PT’s Outcomes assessed:
Lvl of physical funct, and perceived disability
Extent of reduced risk of reoccurence
General health status
Degree of pt satisf
Stages of motor learning (3)
Cognitive (learn how + think each step), Associative (some errors), Auto
