Lecture #1 (Concepts of Rehab)

Question 1

Who are the primary team members of the reahb team? (x8)

Answer 1

Rehab clinician (AT, PT, OT), physician (ortho, podiatrist, opthalmologist), patient, psychologist/counselor, students, parents/family/spouse, coach/CSCS/personal trainer, and the school nurse

Question 2

Who are the secondary rehab team members? (x11)

Answer 2

Orthotist, pharmacist, kinesiologist/biomechanist/exercise physiologist, nutritionist, attorney, work supervisor/employer, case manager, peers/team members, teachers, equipment managers, athletic administer

Question 3

What is the rehab clinician?

Answer 3

The medical professional who rehabilitates musculoskeletal injuries–they coordinate the work/program with the primary and secondary members

Question 4

True or false:

Family can play a huge role in the rehab of their loved one.

Answer 4

True. They can be more involved with serious injuries, minors, may need to assist with the exercise programs at home, and can help ensure that the patient is compliant with rehab

Question 5

True or false:

The physician doesn’t have to be updated regularly on a patient’s treatment and progress.

Answer 5

False: they do need to be updated regularly. There may be protocols after the injury or surgery that need to be followed and they assist in important decisions (RTP, RTwork, etc)

Question 6

True or false:

A coach can be an ally in the rehab process.

Answer 6

True: they can help to make sure that the player still feels like a part of the team, and they can help make RTP s smoother and easier transition.

Question 7

Who is the focus of the rehabilitative team and how is the coordinator?

Answer 7

Focus= patient (*should be self-motivated to RTP but may be somewhat fearful as well)
Coordinator= rehab clinician (*must interact appropriately with other team members in the best interest of the patient)

Question 8

What are some reasons for why a patient may not be progressing with rehab?

Answer 8

Non-compliance, lack of motivation, nutrition choices, they smoke, etc.

Question 9

Who is the center of communication for the rehab team?

Answer 9

Clinician

Question 10

True or false:

Physicians don’t want the clinician asking them questions in regards to a patient’s rehab.

Answer 10

False. They do want the communication! They would rather answer your questions than have you do something that is wrong.

Question 11

How often is written communication usually required in order to keep the physician informed of a patient’s progress?

Answer 11

Every 2-4 weeks

Question 12

True or false:
Patients over 18 have to give consent for there to be communication with parents, regardless if the parent’s insurance is paling for the rehab

Answer 12

True

Question 13

True or false:

The clinician doesn’t need to be active in gaining CEUs.

Answer 13

False…it is very good for them to continue their education so as to use evidence-based practice medicine. It is also good for them to become specialized in certain techniques and different procedures.

Question 14

True or false:

The patient is always in charge of their rehabilitation.

Answer 14

True. When the patient says no, it means no. Try to encourage and explain why it’s important or why you’re doing it, or try different exercises or modify the program. But the patient does have the ability to say no.

Question 15

When is consent from a patient assumed during a rehab program?

Answer 15

Consent is assumed until the patient says otherwise

Question 16

What has been shown to improve outcomes by showing the patient that you care about them?

Answer 16

The power of touch

Question 17

What is touch necessary for (besides showing the patient that you care)?

Answer 17

Determining the extent of the injury, assessing progress, assisting with exercises, and just about every aspect of rehabilitation

Question 18

What is the mnemonic for the seven principles of rehab?

Answer 18

ATC IS IT

Question 19

What are the seven principles of rehab?

Answer 19

Avoid aggravation
Timing
Compliance
Individualization
Specific sequencing
Intensity
Total patient

Question 20

What is the general guideline for the first priniciple of rehab (avoid aggravation)?

Answer 20

“Do no harm”–it is important to know how the body responds to injury, healing, and the rehab process. There is also always something that can be worked on during rehab besides the injury (cardiovascular system, kinetic chain)

Question 21

How much strength is lost per week of inactivity?

Answer 21

3-4%

Question 22

Why is early exercise crucial after injury?

Answer 22

Avoid prolonged immobilization and loss of strength, and to help speed up the rehab process and RTP

Question 23

What does compliance mean?

Answer 23

That the patient attends rehab and does what is asked of the clinician to the best of their ability. It also means following the exercise regimen outside of the rehab setting

Question 24

What is the specific sequence that the rehab process follows in order to follow the physiological healing process of the body? (x10)

Answer 24

ROM
Flexibility
Muscular strength
Muscular endurance
Muscular power
Balance
Coordination
Agility
Plyometrics
Functional exercise

Question 25

What is cross talk?

Answer 25

When a limb is immobilized, atrophy can be battled by performing exercises on the other side of the body

Question 26

True or false:

It is important to rehab the complete kinetic chain.

Answer 26

True because limbs function as a whole kinetic chain, and they must all be rehabed together to help avoid deconditioning and atrophy from a lack of use due to the injury (for example, the hand, wrist, and elbow after a shoulder injury)

Question 27

True or false:

Goals should be challenging but achievable.

Answer 27

True–these will help the keep the motivation high from the patient

Question 28

How should goals be formed?

Answer 28

They should be objective and measurable and should be discussed with the patient to receive their input

Question 29

What time-frame would be considered a short term goal?

Answer 29

1 day to 4 weeks

Question 30

What would be considered a long term goal?

Answer 30

Full return to previous or current maximal level

Question 31

How often should STGs be reassessed?

Answer 31

Daily or every two weeks

Question 32

How often should LTGs be reassessed?

Answer 32

Every four weeks or when the STGs are met

Question 33

What are the two main elemetns of rehab?

Answer 33

Therapeutic exercise (more important) and therapeutic modalities

Question 34

What needs to be addressed to have a successful rehab program?

Answer 34

ROM and flexibility
Strength and muscular endurance (power too)
Proprioception (balance, coordination, agility)
Functional progression