Lecture 1 - Intro to rehabilitation principles

Question 1

Roles reserved to ATs (3)

Answer 1

• On site injury assessment and management
• First responder certification
• Supportive taping and bracing

Question 2

Roles reserved to physios (3)

Answer 2

• Cardiorespiratory rehabilitation
• Community health initiatives
• Neurological rehabilitation

Question 3

Roles both ATs and physios share (2)

Answer 3

• Orthopedic assessment and rehabilitation
• Concussion assessment and rehabilitation

Question 4

Timeframe for acute injury

Answer 4

7-10 days

Question 5

Timeframe for subacute injury

Answer 5

10 days - 7 weeks

Question 6

Timeframe for chronic injury

Answer 6

7+ weeks

Question 7

What is an acute on chronic injury?

Answer 7

Injured tissue is re-injured/irritated

Question 8

Name the phases of soft tissue healing

Answer 8

1. Inflammatory phase
2. Proliferative phase
3. Remodelling or maturation phase

Question 9

Timeframe for inflammatory phase

Answer 9

0 up to 6 days

Question 10

Timeframe for proliferative phase

Answer 10

Days 3 to 21

Question 11

Timeframe for remodelling or maturation phase

Answer 11

2 weeks to 1 year

Question 12

What happens in the proliferative phase of tissue healing?

Answer 12

Structures are rebuilt and regeneration occurs
Type III collagen is formed

Question 13

How does the proliferative phase ends?

Answer 13

With the beginning of wound contracture and shortening of margins of the injured area

Question 14

What is the tricky part with the proliferative phase?

Answer 14

The absence of pain may tempt the athlete to return to training or competition before the injured tissue has been fully rehabilitated

Question 15

What happens during the maturation phase?

Answer 15

Remodelling of collagen to improve the functional capabilities of the tendon, ligament and muscle + orientation of the fibers

Question 16

Aims of treatment are to improve/increase what? name a couple

Answer 16

• pain
• guide inflammation
• decrease risk of secondary complications
• ROM/Flexibility/mobility
• proprioception
• strength/endurance
• CV fitness
• core/posture
• psychological readiness
• education

Question 17

On what do you base your decision on what’s most important for your aims of treatment? (4)

Answer 17

• Stage of healing
• Injury type
• Ax findings
• Pt complaints

Question 18

Pyramid of evidence - Meta-analyses

Answer 18

Examination of data from independent studies to determine a trend

Question 19

Pyramid of evidence - Systematic reviews

Answer 19

Summarizes results of carefully designed studies (typically RCT)

Question 20

Pyramid of evidence - Randomized controlled trials

Answer 20

People are randomly assigned intervention groups (double blind **)

Question 21

Pyramid of evidence - Cohort studies

Answer 21

Look at group to determine cause of disease (identify risk factors)

Question 22

Pyramid of evidence - Case-controlled studies

Answer 22

Compare people with and without outcome and look back at exposure to determine relationship to risk factors

Question 23

Pyramid of evidence - Case reports

Answer 23

Detailed report on S/S, diagnosis, treatment and follow up of 1 person

Question 24

Progressing your program - Inflammation phase findings

Answer 24

Decreased swelling, no heat felt, pain should be decreased

Question 25

Progressing your program - Proliferative phase findings

Answer 25

Complete exercises with proper technique, full strength (for that exercise), full ROM (for that exercise), and no pain

Question 26

Progressing your program - Maturation phase

Answer 26

Complete sport specific exercise/drills with control, full strength, full ROM and confidence
** Injured tissue is at least 90% the strength of uninjured tissue

Question 27

Soreness rules - If sore more than 1 hour after hitting or the next day, ____

Answer 27

take 1 day off and repeat the most recent hitting program workout

Question 28

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, ____

Answer 28

• Repeat the previous workout
• Stop and take 2 days off
• Drop down 1 step

Question 29

Soreness rules - If no soreness, ____

Answer 29

advance 1 step every hitting day