Intro to Intervention Flashcards
Intervention
Act of interfering with the outcome of course especially of a condition or process (as to prevent harm or improve functioning)
Step One
Identify the problem and its underlying cause
Introduction
Goals of exercise Rx:
-What are you trying to achieve and why?
-How are you going to achieve the established goals?
-What modifications or progressions need to be made?
-How will you decide this?
Tie your interventions to the impairments and functional limitations identified in your examination.
Therapeutic exercise
The systemic, planned performance of bodily movements, postures or physical activities designed to provide a patient/client with the means to:
-remediate or prevent impairments
-improve, restore, or enhance physical function
-Prevent or reduce health related risk factors
-optimize overall health status, fitness or sense of well-being
Flexibility (lack of motion)
-Muscle length
-Passive exercise is the movement of a joint or body segment by a force external to the body
-No voluntary muscle contraction by the patient
Indications of Passive Exercise
When a patient is unable to perform any form of active contraction/exercise
-Paralysis
-Comatose
-Recovery from surgery or trauma/precautions/protocols
-healing fx
Contraindicated when passive movement significantly increases the patient’s symptoms
Benefits of Passive Exercise
-Preserves and maintains ROM
-Minimizes contracture formation
-Minimizes adhesion formation
-Maintains mechanical elasticity of muscle
-Promotes and maintains local circulation (not as much as AROM or AAROM)
-Promotes awareness of joint motion
-Evaluates joint integrity and motion
-Enhances cartilage nutrition
-Inhibits or reduces pain
Does Not: prevent atrophy or increase muscle strength or endurance
Goals or AROM & AAROM
-Maintain physiological elasticity and contractility of participating muscles
-Provide sensory feedback from the contracting muscles
-Provide a stimulus for bone and joint tissue integrity
-Increase circulation to prevent thrombus (clot) formation
-Develop coordination and motor skills for functional activities
Application of AROM
-Demonstrate the motion to the patient using PROM or visual cues, and then ask the patient to perform the motion
-Provide assistance only as needed for smooth motion -less is more
-verbal or tactile cues are appropriate feedback
-Motion is performed within the available range
Stretching
-Exercises designed to elongate the contractile and non -contractile components of muscle-tendon units and periarticular structures
-Provide appropriate alignment and stabilization
-Mode: Static, dynamic, ballistic
-Intensity: slow, low load, prolonged stretch
-Duration: 15-60 sec, for 2-5 reps
-Frequency: depends on age, chronicity, pathology, meds 3-5 times per week
-Warm up soft tissues to be stretched
-Direction of stretch is exact opposite to restricted motion
-Move slowly through range to point of resistance and the just a little beyond
-Force: create tension but not pain
-Two joint muscles should be stretched one joint at a time progressing to full length
-Release stretch gradually
-Allow few sec rest between reps
-If patient cant tolerate 30-60 sec, use slow intermittent stretches
-Stretch after exercise to reduce DOMS
-Stretch improves ROM not strength
Isotonic Contractions
-Visible joint motion when the muscle contracts
-Ecc and/or concentric contractions
-Open or close chained
-Used to maintain or increase strength, power, and endurance
-Promote circulation
-Enhance cardiovascular efficiency
-Create hypertrophy of muscle fibers
-Maintain physiological elasticity of a muscle
-Maintain joint motion
-Maintain or enhance coordination
Isometric Contraction
-Produces little or no observable joint motion and no significant change in length of the muscle
-With or w/o external resistance
-Useful as a means to avoid pain associated with joint motion but still want to work on strength
-Useful when initiating muscle activity in a very weak muscle (or one that has shut down)
Resistance Exercise
-Any form of active exercise in which a dynamic or static muscular contraction is restisted by and outside force (manually or mechanically)
-If resistance is applied to a muscle as it contracts, the muscle will adapt and become stronger over time
-therapeutic use of resistance is an integral part of a patient’s plan of care
Goals or Resistive Exercise
Overall goal=improve function
Specific goals:
1. Increase strength
2. Increase muscular endurance
3. Increase Power
Strength Training
-Muscle or muscle group lifting, lowering, or controlling heavy loads for a relatively low number of reps or over a short period of time
-Results in increased muscle strength due to increase in muscle fiber size
Increase Muscle Endurance
-Endurance= ability to perform low-intensity repetitive exercise over a prolonged period of time
-Muscle endurance= ability of a muscle to contract repeatedly against a load, generate and sustain tension, and resist fatigue over an extended period of time
-Strength and muscle endurance do not always correlate well with each other
-The key elements are always low intensity contraction, high reps, and prolonged time
Increase Power
-Related to strength and speed
-Work per unit of time
-Either a single burst of high-intensity activity, or by repeated bursts of less intense muscle activity (climbing flight of stairs)
-The greater the intensity of exercise and the shorter the time period taken to generate force, the greater is the muscle power
Overload principle
-If muscle performance is to improve, a load that exceeds the metabolic capacity of the muscle must be applied
-Progressive loading of muscle achieved by altering the weight (resistance) or repetitions & sets
-Strength training: resistance increased
-Endurance training: emphasis on reps/sets
Contraindications to Resistance Exercise
Pain with resistance (discomfort ok)
-full understanding of the pain origin must be determined
Inflammation
-Precipitation of greater joint or muscle damage
-Low level isometrics if no pain
Severe cardiopulmonary disease
-resistance training should be postponed up tp 12 weeks after MI or CABG
Precautions for Resistance Training
-Avoid valsalva manuever
-Avoid substitute motions (bad form)
Alignment & Stabilization
-Alignment of segments of body during exercise, avoid substitute movements (load too heavy, muscle fatigue, O2 demands)
-Stabilization of proximal or distal joints to prevent substitution
Intensity
-The extent to which a muscle is loaded or how much weight is lifted, lowered, or held
-Level of resistance is lower in rehab programs for persons with impairments that om conditioning programs for healthy individuals
Components of Exercise RX
-Mode-type of exercise
-Intensity- how hard or at what level the exercise occurs (how to monitor?)
-Frequency- how often
-Duration- how long
-Progression/modification-this is the hard part
