Intro to Therapeutic Exercise Flashcards
1
Q
Steadman’s Medical dictionary definition of movement system
A
- the movement system is a physiological system that functions to produce motion of the body as a whole or of its component parts
2
Q
What is the 4 element movement system model
A
- motion
- force
- energy
- control
3
Q
Define CASSS
A
- Control: smoothness, coordination, & timing of movement
- Amplitude: amplitude of movement at each joint
- Speed: acceleration, deceleration, controlled
- Symmetry: bilateral tasks, gait
- Symptoms: pain, clicking, dyspnea, fatigue, instability, urinary incontinence
4
Q
Common tests/measures for motion
A
- ROM
- specific tests for muscle length
- accessory motion tests
- soft tissue mobility tests assessed by palpation
- skin mobility
- neurodynamic tests
5
Q
Common interventions for motion
A
- active/passive stretching
- hold/relax stretching
- manual therapy
- low load prolonged stress via static positioning or splinting
- neural gliding and tensioning techniques
6
Q
Common tests/measures for force
A
- MMT
- hand held dynamometry
- rep max testing
- isokinetic testing
- functional performance testing
7
Q
Common interventions for force
A
- force generating capacity
- force control
8
Q
Common tests/measures for energy
A
- aerobic capacity/endurance
- vital signs
- ventilation and respiration including respiratory rate and pulse oximetry
9
Q
Common interventions for energy
A
- therapeutic exercise
- functional training including gait & mobility training
- airway clearance techniques
- patient instruction
10
Q
Common tests/measures for control
A
- performance based measures of capability
- assess task initiation, execution, & termination
- feedforward control: measure speed, accuracy, & kinematics
- feedback control: determine response to unexpected perturbations
- sensory perceptual & cognitive testing
11
Q
Common interventions for control
A
- impairment restitution to provide resources for task execution
- task practice
- targeted treatments to improve perception & cognition in context of task practice
12
Q
Benefits of exercise for children
A
- improved bone health & weight status
- improved cognitive function
- fewer symptoms of depression
13
Q
Benefits of exercise for adults (18-65)
A
- lower incidence of bladder, kidney, stomach, & lung cancers
- reduced risk of dementia
- improved cognitive function following bouts of aerobic activity
- improved QOL
- improved sleep
- reduced feelings of anxiety & depression
- reduced risk of excessive weight gain
14
Q
Benefits of exercise for older adults (65+)
A
- reduced incidence of fall related injuries
- improved physical function in older adults with or without frailty
15
Q
Benefits of exercise for individuals with pre-existing medical conditions
A
- reduced risk of breast, colorectal, & prostate cancer mortality
- decreased pain in osteoarthritis (OA)
- reduced risk of progression of CVD & increased BP over time in HTN patients
- DM II has reduced risk of CV mortality & reduced progression of disease indicators: hemoglobin A1c, BP, blood lipids, & BMI
- MS has improved walking & physical fitness
- improves cognition in dementia patients & people with impaired executive function
16
Q
Activity level recommendations for the population
A
- 150 minutes of aerobic exercise per week of moderate to vigorous intensity with 2+ days of resistance training that work the major muscle groups: legs, hips, back, abdomen, chest, shoulders, & arms
17
Q
Reasons why occupational physical activity (OPA) does not confer the cardiovascular health benefits that leisure time physical activity does
A
- too low of intensity for too long to improve cardio
- increased 24 hour HR
- heavy lifting or static postures increase 24 hour BP
- insufficient recovery time
- increases levels of inflammation
18
Q
Define client
A
- an individual without diagnosed dysfunction who engages in physical therapy services to promote health & wellness & to prevent dysfunction
19
Q
Define patient
A
- an individual with impairments & functional limitations diagnosed by a physical therapist who is receiving physical therapy care to improve function & prevent disability
20
Q
Define diagnosis
A
- process & product of a clinical investigation related to the pathology underlying a patient/client’s symptoms & signs & results in a label
21
Q
What is the role of a diagnosis
A
- physical therapists use diagnosis to determine whether physical therapy services are indicated to address the patient’s condition
22
Q
Example of a pathoanatomical diagnosis
A
- medical community, physician diagnoses a patient with significant knee OA & orders TKA
23
Q
Example of a pathokinesiology diagnosis
A
- a physical therapist diagnoses a patient with impaired quadriceps strength, limited knee ROM, & impaired gait due to recent joint replacement
24
Q
Example of a kinesiopathology diagnosis
A
- a patient with significant knee OQ is fearful to have a TKA & restricts her movement over the next 5 years & becomes obese with HTN & DMII
25
Q
What is therapeutic exercise
A
- systematic planned performance of physical movements, postures, or activities intended to erode a patient/client with the means to: 1) remediate/prevent impairments of body functions & structures, 2) improve, restore, or enhance activities & participation, 3) prevent or reduce health related risk factors, 4) optimize overall health, fitness, or sense of well being
26
Q
What are the foundations of function
A
- muscle performance
- cardiopulmonary/endurance
- mobility/flexibility
- neuromuscular control/coordination
- stability
- balance/postural equilibrium
27
Q
Principles of decision making: individualization
A
- clinical decision making is dynamic
- selection, implementation & modification of therapeutic exercise interventions are based on the unique patient/client
- improved decision making is enhanced through the development & implementation of clinical prediction rules (CPRs) & clinical practice guidelines (CPG)
28
Q
FITT-VP principle
A
- Frequency
- Intensity
- Time
- Type
- Volume
- Progression
29
Q
What is the rehab cycle
A
- identify problems & needs –> relate problems to modifiable & limiting factors –> define target problems & target mediators, select appropriate measures –> plan, implement, coordinate interventions –> assess effects –> identify problems & needs
30
Q
How do you know if the intervention(s) are working
A
- measure outcomes
31
Q
What outcome measures will best capture the change a patient should expect during this episode of care
A
- a good rule of thumb to have both self report & performance based outcome measures
32
Q
5 elements of shared decision making
A
- at least 2 participants have to be involved
- both parties have to take steps to participate in the process of treatment decision making
- information sharing is a prerequisite to shared decision making
- deliberation has to take place by discussing the treatment preference of both parties
- a treatment decision has to be made & both participants have to agree upon the decision
33
Q
Define impairments in body function
A
- problems with physiology of body systems (includes psychological functions)
34
Q
Define impairments in body structure
A
- problems with anatomical features of the body
35
Q
Define activity limitations
A
- difficulties an individual may have in executing actions, tasks, and activities
36
Q
Define participation restrictions
A
- problems experienced in life situations, self care, home/work/community responsibilities
37
Q
Define primary impairments
A
- impairments arise directly from the health condition
38
Q
Define 2ndary impairments
A
- impairments are the result of preexisting impairments
39
Q
Role of physical therapist in impairments
A
- often the role of the physical therapist is to treat the primary impairment, but also to prevent further complications or secondary impairments
40
Q
Define contextual factors
A
- patient’s background, life, and living situation
- environmental factors and personal factors
41
Q
Define environmental factors
A
- factors associated with the physical, social, and attitudinal environmental
- can facilitate or inhibit
42
Q
Define personal factors
A
- features of individual that are not a part of the health condition or health state including: age, gender, race, lifestyle habits, coping skills, character, affect, cultural, and social background, & education
43
Q
Common tasks related to activity limitations
A
- reaching & grasping
- lifting, lowering, & carrying
- pushing/pulling
- bending/stooping
- turning/twisting
- throwing & catching
- rolling
- sitting or standing tolerance
- etc.
44
Q
Areas of functioning associated with participation restrictions
A
- self care
- mobility in the community
- occupational tasks
- school related tasks
- home management
- caring for dependents
- recreational or leisure activities
- socializing with friends/family
- community responsibilities & service
45
Q
What is the ABCDEF of goal writing
A
- Audience
- Behavior
- Condition
- Degree
- Expected duration
- Function
46
Q
What is the fundamental consideration
A
- safety
- review patient’s health history, current status, medication review, & other risk factor review
47
Q
What must a physical therapist ensure
A
- accuracy of movement/exercise
- proper alignment & posture of the body
- execution of correct movement patterns
- performance with appropriate speed, intensity, & duration
- fatigue/rest for recovery
48
Q
Therapeutic exercise interventions
A
- aerobic conditioning & reconditioning
- muscle performance exercises: strength, power, & endurance training
- stretching techniques including muscle lengthening procedures & joint mobilization/manipulation techniques
- neuromuscular control, inhibition, & facilitation techniques & posture awareness training
- postural control, body mechanics, & stabilization exercises
- balance exercises & agility training
- relaxation exercises
- breathing exercises & ventilatory muscle training
- task specific functional training
49
Q
Stair snacking
A
- vigorously climbing a few flights of stairs (3 flights) on your coffee or bathroom break during the day seems to be enough to boost fitness in people who are otherwise sedentary
- in addition to being more fit, the stair climbers were also stronger compared to their sedentary counterparts & generated more power during a maximal cycling test
50
Q
What is the compendium of activities & how can this database be used to promote physical activity
A
- it is a database full of free resources of updated MET codes with published evidence
51
Q
Examples of self report outcome measures
A
- Activities-Specific Balance Confidence Scale
- Patient Specific Functional Scale
52
Q
Examples of performance based outcome measures
A
- Single Limb Hop Tests
53
Q
Key questions to establish patient goals
A
- Of the activities you are finding difficult to do or cannot do at all at this time, & which ones would you like to be able to do better or do again?
- Of the problems you are having, which ones do you want to try to eliminate or minimize first?
- In what areas do you think you have the biggest problems during the activities you would like to do on your own?
- What are your goals for coming to physical therapy
- What would make you feel that you were making progress in achieving your goals?
- How soon do you want to reach your goals?
