Lecture 1 - Intro to rehabilitation principles Flashcards
Roles reserved to ATs (3)
- On site injury assessment and management
- First responder certification
- Supportive taping and bracing
Roles reserved to physios (3)
- Cardiorespiratory rehabilitation
- Community health initiatives
- Neurological rehabilitation
Roles both ATs and physios share (2)
- Orthopedic assessment and rehabilitation
- Concussion assessment and rehabilitation
Timeframe for acute injury
7-10 days
Timeframe for subacute injury
10 days - 7 weeks
Timeframe for chronic injury
7+ weeks
What is an acute on chronic injury?
Injured tissue is re-injured/irritated
Name the phases of soft tissue healing
- Inflammatory phase
- Proliferative phase
- Remodelling or maturation phase
Timeframe for inflammatory phase
0 up to 6 days
Timeframe for proliferative phase
Days 3 to 21
Timeframe for remodelling or maturation phase
2 weeks to 1 year
What happens in the proliferative phase of tissue healing?
Structures are rebuilt and regeneration occurs
Type III collagen is formed
How does the proliferative phase ends?
With the beginning of wound contracture and shortening of margins of the injured area
What is the tricky part with the proliferative phase?
The absence of pain may tempt the athlete to return to training or competition before the injured tissue has been fully rehabilitated
What happens during the maturation phase?
Remodelling of collagen to improve the functional capabilities of the tendon, ligament and muscle + orientation of the fibers
Aims of treatment are to improve/increase what? name a couple
- pain
- guide inflammation
- decrease risk of secondary complications
- ROM/Flexibility/mobility
- proprioception
- strength/endurance
- CV fitness
- core/posture
- psychological readiness
- education
On what do you base your decision on what’s most important for your aims of treatment? (4)
- Stage of healing
- Injury type
- Ax findings
- Pt complaints
Pyramid of evidence - Meta-analyses
Examination of data from independent studies to determine a trend
Pyramid of evidence - Systematic reviews
Summarizes results of carefully designed studies (typically RCT)
Pyramid of evidence - Randomized controlled trials
People are randomly assigned intervention groups (double blind **)
Pyramid of evidence - Cohort studies
Look at group to determine cause of disease (identify risk factors)
Pyramid of evidence - Case-controlled studies
Compare people with and without outcome and look back at exposure to determine relationship to risk factors
Pyramid of evidence - Case reports
Detailed report on S/S, diagnosis, treatment and follow up of 1 person
Progressing your program - Inflammation phase findings
Decreased swelling, no heat felt, pain should be decreased
Progressing your program - Proliferative phase findings
Complete exercises with proper technique, full strength (for that exercise), full ROM (for that exercise), and no pain
Progressing your program - Maturation phase
Complete sport specific exercise/drills with control, full strength, full ROM and confidence
** Injured tissue is at least 90% the strength of uninjured tissue
Soreness rules - If sore more than 1 hour after hitting or the next day, ____
take 1 day off and repeat the most recent hitting program workout
Soreness rules - If sore during warm-up but soreness is gone within the first 15 hits, ___ . If “shoulder” becomes sore during this workout, ____. On return to hitting, ____
- Repeat the previous workout
- Stop and take 2 days off
- Drop down 1 step
Soreness rules - If no soreness, ____
advance 1 step every hitting day
