Intro to Intervention

Question 1

Intervention

Answer 1

Act of interfering with the outcome of course especially of a condition or process (as to prevent harm or improve functioning)

Question 2

Step One

Answer 2

Identify the problem and its underlying cause

Question 3

Introduction

Answer 3

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.

Question 4

Therapeutic exercise

Answer 4

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

Question 5

Flexibility (lack of motion)

Answer 5

-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

Question 6

Indications of Passive Exercise

Answer 6

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

Question 7

Benefits of Passive Exercise

Answer 7

-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

Question 8

Goals or AROM & AAROM

Answer 8

-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

Question 9

Application of AROM

Answer 9

-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

Question 10

Stretching

Answer 10

-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

Question 11

Isotonic Contractions

Answer 11

-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

Question 12

Isometric Contraction

Answer 12

-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)

Question 13

Resistance Exercise

Answer 13

-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

Question 14

Goals or Resistive Exercise

Answer 14

Overall goal=improve function
Specific goals:
1. Increase strength
2. Increase muscular endurance
3. Increase Power

Question 15

Strength Training

Answer 15

-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

Question 16

Increase Muscle Endurance

Answer 16

-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

Question 17

Increase Power

Answer 17

-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

Question 18

Overload principle

Answer 18

-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

Question 19

Contraindications to Resistance Exercise

Answer 19

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

Question 20

Precautions for Resistance Training

Answer 20

-Avoid valsalva manuever
-Avoid substitute motions (bad form)

Question 21

Alignment & Stabilization

Answer 21

-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

Question 22

Intensity

Answer 22

-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

Question 23

Components of Exercise RX

Answer 23

-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