Lecture 1 Flashcards
What are the 7 significant predictors for positive outcomes?
- sudden onset of acute LBP of short duration
- single pain sites,
- with previous episodes,
- good health
- no psychological issues
- who constituted the vast majority of practice
- 85% present this way
What was the conclusion for the effectiveness of exercise interventions to prevent sports injuries: meta-analysis of RCTs?
- Consistently favourable estimates were obtained for all injury prevention measures except for stretching.
- Strength training reduced sports injuries to less than 1/3 and overuse injuries could be almost halved.
Making Physical Activity Counselling a Priority in Clinical Practice, are there any benefits? ##
- Overwhelming evidence indicates that regular physical activity is one of the most powerful health-promoting practices that physicians and other health care professionals can recommend for patients.
- No other single intervention or treatment is associated with such a diverse array of benefits.
- Advice from health professionals significantly influences adoption of healthy lifestyle behaviours, including regular physical activity, and can increase satisfaction with medical care
Does physical activity help enhance brain function?
Yes, moderate levels of physical activity enhance neuroplasticity in the visual cortex of adult humans
How does companionship lead to happiness?
People who spend more time with friends and loved ones are happier than people who are solitary. Feeling isolated lets feelings of insecurity and self-doubt blossom.
How does control lead to happiness?
A sense that you have no control over your circumstances. Find things you can control, even if they’re little things. Clean the desk. Do small things that you chose to do.
How does “ new things “ lead to happiness?
It releases dopamine
How does “do-gooding” lead to happiness?
Volunteering, giving a gift, sending a note of praise to someone — all of these selfless gestures give you a connection to other people and make you feel good about yourself.
How does exercise lead to happiness?
Physical activity releases endorphins and serotonin in your brain
Give 5 examples of soft tissue lesions (musculoskeletal disorders)?
- Strain
- Sprain
- synovitis
- contusion
- tendinopathy
Name 5 clinical conditions resulting from
trauma or pathology?
- Joint Dysfunction
- Contracture
- Adhesions
- Reflex Muscle Guarding
- Muscle weakness
What are the 5 actions to “plan for care” for your patient during the acute phase?
- Educate the patient
- Control pain oedema and spasm
- Main soft tissue and joint integrity and mobility
- Reduce joint swelling if symptoms are present
- Maintain integrity and function of associated areas
What are the management guidelines for acute or protection phase in regards to specific interventions and dosage?
- Passive range of motion
– Low-dosage joint mobilization techniques
– Muscle setting
– Massage
What are the management guidelines for acute or protection phase in regards to interventions for associated areas?
– Range of motion
– Resistance exercise
– Functional activities
In the inflammatory tissue response what are the three processes of the acute phase
– Cellular
– Vascular
– Chemical
– 4 to 6 days
In the proliferation, repair and healing tissue response what is the process in the subacute phase
– 10 to 17 days (14 to 21 days after onset of injury); but may last up to 6 weeks
– Synthesis and deposition of collagen
In the maturation and remodelling tissue response what is the process in the chronic phase
– Maturation of tissue
– Remodeling of tissue
In the chronic inflammation tissue response, what is the process?
– Inflammatory process is perpetuated
– Weakening effect
– Limitation of motion
What are 5 contributing factors of tissue injury?
- Imbalance between the length and strength of the
muscles - Rapid or excessive repeated eccentric demand
- Muscle weakness
- Bone malalignment or weak structural support
- Change in the usual intensity or demands
The truth about healing! ##
No injury can be made to heal faster than its natural rate but
healing can be prolonged by inappropriate therapy and
activity. Explain to the patient, “I would expect that this is a
simple soft tissue – deep tendon injury and may take up to X weeks
What are the 4 steps involved in healing of a soft tissue injury?
- Restore Biomechanical Integrity / Mobilization (Mobility)
- Stabilization (Neuromuscular adaptation/control)
- Strength and Endurance
- Power and/or Functional Integration
What is involved in the phase of restoring biomechanical Integrity and Mobilization (Mobility)
- Myofascial and connective tissue length and flexibility
- Arthrokinematic deficits
- ROM
- Promote increased vascularity
- Manipulation and mobilization
What is the classification of muscle tightness?
0 = no tightness, normal end feel at end PROM
1= slight tightness, Lack of springy end feel end PROM
2=tightness, Lack of end feel very early in within PROM,
weaker?
What is muscle tightness and what things can cause it?
-It is an adaption to functional overloading, rebuilding of muscle connective tissue
- Caused as a result of joint deviation / restriction
- End of ROM there is hard resistance
- No spontaneous pain but tender to palpation
- Changed elasticity
- Lowered irritability threshold – Upper traps, lev scap
What is involved in the phase of stabilization
Neuromuscular adaptation/control?
- The patient cognitively performs these corrective exercises
- These are rehearsed until they become automated
When should a patient progress rehabilitation
exercises for motor control?
The ability to perform and progress exercises typically follows established stages of motor learning: conscious awareness; associative; and autonomous control.
What is involved in the phase of strength and endurance?
- Exercise intensity; sets; repetitions; and exercise technique are purposely designed in order to achieve appropriate functional gains
What is involved in the phase of power and/or functional integration?
- Design the exercises to improve the rate of force
production, and/or include functional performance components that mimic as closely as possible the actual ADL, work or sport requirements of the patient - The mother
-The elite athlete - The taxi driver
Rehab hints, read this! ##
Begin rehabilitation exercises using the following prescription:
• Approximately 30-40% intensity;
• 1 set twice daily or 2 sets once daily;
• 6-15 repetitions per set;
• Isometric holds of 5-10 seconds per repetition, and/or movements occurring over 5-10 seconds per repetition.
When progressing rehabilitation exercises, consider the following:
- Lower intensity (70%) and lower repetitions (6-8) typically
trains strength.
Facts for patient education, what are they? ##
Educate patients that rehabilitation will facilitate recovery
- Muscle strength is lost at a rate of 1 - 3% per day with rest
- Muscle strength improves at a rate of 0.5 - 1% per day with
training
- Approximately 6 weeks to 3 months are necessary to re-educate motor control in patients
- Treatment with manipulation, medication, injection, or surgery will not rehabilitate or condition the muscles needed to either improve stability or enhance performance
Something to really consider when constructing a rehab program for your patient! ##
“ When an intervention interferes with everyday
life and appears to be ineffective or too difficult to implement, people make a reasoned decision to discontinue………….people are likely to prefer and participate in exercise or training programs and activities that are
designed with consideration of their preferences, circumstances, fitness levels, and exercise experiences”
Name the three grades of muscle injury?
Grade 1: mild swelling, local tenderness, pain with tissue stress
Grade 2: moderate pain, stop activity, pain on palpation and stress, some fibres are torn with some increased ROM
Grade 3: Near or complete avulsion of tissue with severe pain and joint instability
What are the 5 stages of inflammation and repair?
- Acute stage: inflammatory reaction
- Subacute stage: repair and healing
- Chronic stage: maturation and remodelling
- Chronic Inflammation
- Chronic pan syndrome
In the acute stage what are the characteristics, clinical signs an interventions?
Characteristics: vascular changes and clot formation
Clinical signs: inflammation and pain before tissue resistance
Interventions: RICE, PROM
In the subacute stage what are the characteristics, clinical signs an interventions?
Characteristics: collagen formation and granulation tissue
Clinical signs: decreasing inflammation, pain synchronous with tissue resistance
Intervention: controlled motion, promote mobile scar
In the chronic stage what are the characteristics, clinical signs an interventions?
Characteristics: remodelling of scar tissue, maturation of connective tissue
Clinical signs: absence of inflammation, pain after tissue resistance
Interventions: return to function
