Intro to TherEx Flashcards
Define impairment
Losses or abnormalities of an anatomical, physiological, mental or emotional nature. (Nagi)
Examples of impairments in physical therapy
Limited ROM muscle weakness impaired balance decreased sensation limited circulation
Define pathology
interruption or interference with normal process and the simultaneous body efforts to heal itself or regain a normal state. (Nagi)
Define functional limitation
abnormalities or limitations in an individual’s ability to carry out a meaningful action, task, or activity.
Examples of functional limitation
ADL’s: moving in bed, transferring from one surface to another, rising from a chair, ambulating, dressing, bathing
Define disability
the inability or limitation in performing socially defined roles and tasks that would normally be expected of an individual within a given culture or environment. (Nagi)
Define intervention
an act that alters the course of a disease. (internet)
List the goals of therapeutic treatment***
Development, improvement, restoration, or maintenance of normal/functional:
- Muscular strength and endurance
- Mobility and flexibility- prevent contractures, decrease muscle tone, prevent injury
- Cardiovascular fitness/endurance
- Coordination, skill, balance, functional ability
- Stability
- Relaxation
What are the three phases of healing?
Phase 1: Inflammatory Response- Acute
Phase 2: Repair and Regeneration- Subacute
Phase 3: Remodeling and Maturation- Chronic
What are the signs and symptoms of the inflammatory response- acute phase of healing?
Signs of inflammation still present.
ROM painful throughout
What are the signs of inflammation?
Redness, swelling, heat, pain, and loss of function
Why is ROM painful throughout during the acute phase?
Altered chemical state irritating nerve endings.
Edema increasing tissue tension.
Muscle guarding.
What is the duration of the inflammatory response- acute phase?
4-6 days
What are the signs and symptoms of the repair and regeneration- subacute phases?
Signs of inflammation decreasing to absent.
ROM painful at end ranges only.
Muscle weakness
What is the duration of the repair and regeneration- subacute phase?
10-17 days in length (14-21 days from injury)
up to 6 months
What are the signs and symptoms of the remodeling and maturation- chronic phase?
No signs of inflammation.
Stretch pain at end ranges.
Possible muscle weakness, endurance, decreased motor control.
What is the duration of the remodeling and maturation- chronic phase?
lasts up to 6 months to 1 yr
How do you manage soft tissue injuries in the Acute State?
- patient education
- Protection of injured tissue (RICESupport)
- prevention of secondary complications (tissue specific vs general movement)
- Specific interventions (PROM, Grade 1 &2 jt mobilizations, muscle setting, massage)
- interventions for associated areas (ROM, m. strength, functional, circulation)
What is the principle of the acute state?
Protection phase
What is muscle setting in the acute state?
wimpy, very light isometric exercises
What is contraindicated during the acute state?
stretching and resistance exercises at site of inflamed tissue.
What are the precautions for the acute state?
must use proper dosage of rest and movement
What are the signs of too much movement in the acute state?
increased pain or increased inflammation
How do you manage soft tissue injury in the Sub-acute phase?
- patient education
- management of pain and inflammation
- initiation of Active Exercise (multi angle, and submaximal isometrics, AROM, m. endurance, protected weight bearing- closed chain)
- initiation or progression of stretching
- Correct contributing factors (posture, strength, flexibility)
What is the principle of the sub-acute phase?*
Controlled motion
What are the techniques of stretching?
- warm tissue
- inhibition techniques
- jt mobilization
- stretching
- Massage
- Strengthen new ROM
How do you manage soft tissue injury in the chronic phase?*
- patient education
- progression of stretching
- Progression of muscle performance (strength, endurance, power)
- Return to function
What are the signs of over/excessive stress?***
- Soreness that does not decrease after 4 hours and is not resolved after 24.
- Exercise or activity pain that comes on earlier or is increased over the previous session.
- Progressively increased feelings of stiffness and decreased ROM.
- Swelling, redness, and warmth in the healing tissue
- Progressive weakness over several exercise sessions
- Decreased functional usage of the involved part
Define Wolff’s Law?
“The skeletal system adapts to the forces placed upon it” kisner and colby
What are the effects of prolonged bedrest?
- Decubidi
- Atrophy
- Orthostatic hypotension
- Edema
- Reduced lung volume
- reduced motivation
- Venous Thrombosis
- Atelectasis (collapsed lung)
- Disturbance of sleep/wake cycle
- Metabolic alteration
- Decreased strength of 1-1.5% per day
What are the effects of deconditioning (from lack of activity)?
- increased heart rate
- decreased physical work capacity
- decreased adaptation to position change
- decreased circulating blood volume
- Decreased lung volume and vital capacity
- decreased contractile strength of muscle
- Decreased metabolic rate
What is therapeutic exercise?
Systematic and planned performance of bodily movement, postures or physical activities intended to provide a patient a means to:
- remediate or prevent impairments
- improve, restore, or enhance physical function
- prevent or reduce health related risk factors
- Optimize overall health status, fitness, and/or sense of well being.
Are all energy systems used at a given time during activity?
Yes! The extent to which each is used depends on intensity and duration of activity
What is a sprain?
Severe stress, stretch, or tear of soft tissues, such as joint capsule, ligament, tendon, or muscle.
Frequently used to refer specifically to injury of a ligament and graded 1st, 2nd, 3rd degree
What is a strain?
Overstretching, overexertion, overuse of soft tissue: tends to be less sever than a sprain.
Frequently used to refer specifically to some degree of disruption of the musculotendinous unit.
What is a dislocation?
Displacement of a part, usually the bony partners of a joint, resulting in a loss of the anatomical relationship and leading to soft tissue damage, inflammation, pain, and muscle spasm.
What is subluxation?
An incomplete or partial dislocation of the boney partners in a joint that often involves secondary trauma to surrounding soft tissue.
What is synovitis?
inflammation of the synovial membrane: excess of normal synovial fluid in a joint or tendon sheath cause by trauma or disease.
What is hemarthrosis?
bleeding into a joint, usually due to severe trauma
What is a ganglion?
Ballooning of the wall of a joint capsule or tendon sheath. May arise after trauma, and sometimes occur with RA
What is a contusion?
bruising from a direct blow, resulting in capillary rupture, bleeding, edema, and an inflammatory response
What is overuse syndrome?
Repeated, submaximal, overload and/or frictional wear to a muscle or tendon resulting inflammation and pain.
What are factors that affect healing of soft tissue?
- length and strength imbalances
- rapid/excessive eccentric demands
- Muscle weakness
- Structural mal-alignment/weak support
- Change in intensity/demands of an activity
- Too rapid return to activity
- Sustained awkward postures/motions
- environmental factors
- Age-related factors
- Training errors
(pg. 326 kisner & colby)
