passive to active exercise

Question 1

benefits of exercise

Answer 1

decrease stress, increase balance and co-ordination, decrease body fat, decrease cvd, decreased osteoporosis, relaxation, increased muscle strength/power/ tone, increased CR function, increased well being and confidence

Question 2

assessment for exercise

Answer 2

patients cognitive abilities, patients CR status, ROMs, strength, power, endurance, coordination, subjective, objective and functional markers, patients diagnosis and prognosis, patients perception of needs, patients expectations, patients and therapist agreed expectations, current treatments, contraindications precautions, outcome measures- pre/post exercise

Question 3

the exercise continuum- strength

Answer 3

0-1= passive movements, 1-2= active assisted exercise, 3-4- active exercise/ resisted movements,5- functional ability

Question 4

limitations to oxford scale

Answer 4

a lack of functional relevance- only relates to 1 muscle group, non-linearity- jumps vary in size, a patients variability with time, a degree of subjectively between assessors, assessment of muscles acting only concentrically, the difficulty of applying the scale to all cases in clinical practice, interrater reliability

Question 5

passive exercises/ movements

Answer 5

passive movements- movements which are performed by the physio for the patient. may be performed at single or several joints

Question 6

passive exercises/ movements- types

Answer 6

mannual relaxed passive movements- performed by another person, auto-relaxed passive movement- performed by patient, mechanical relaxed passive movement- performed by machine

Question 7

effects of passive movements

Answer 7

maintain ROM, prevent contractures, maintain integrity of soft tissue, increase VR, increase synovial fluid production, increase kinaesthetic awareness- stimulate golgi tendon and muscle spindle, maintain functional movement patterns, reduced pain, CPM

Question 8

contraindications- passive movement

Answer 8

post injury- inflammation, early fractures- can cause displacement, pain- beyond patients tolerance, incomplete muscle or ligament tears where further damage may occur, hypermobile joints, when circulation may be damaged

Question 9

active assisted exercise

Answer 9

is a type of assisted exercise use a type of AROM in which assistance is provided manually or mechanically, by an outside force because the prime mover muscles need assistance to complete the motion, when the prime movers aren’t strong enough to perform the full ROM

Question 10

effect of active assisted exercise

Answer 10

maintain physiological elasticity and contractility of participating muscles, provide sensory feedback for contracting muscles, provide stimulus for bone and joint tissue integrity, increase circulation and prevent thrombus formation, develop coordination and motor skills for functional activities later

Question 11

precautions and contraindications- active assisted

Answer 11

when it disrupts healing process, however, early moment may limit adhesion formation, may decrease recovery time, reduce risk of thrombosis formation, reduce pain
after acute tears/fractures/ surgery, if exercises caused increase pain and inflammation, UL exercises may be contraindicated after MI, brest/ CABG surgery and coronary angioplasty

Question 12

principles of application active assisted exercise

Answer 12

examination/ evaluation/ treatment planning, communication, remove restrictive clothing, clear workspace, starting position of the patient- work across gravity, your position, demonstrate with passive movements first- then ask patient to join in, provide assistance as needed, the exercise is performed within the available ROM

Question 13

types of active assisted exercise

Answer 13

manual active assisted, auto-assisted, mechano-assited- sliding boards, poles (stick/wands/ t-bars), reciprocal. pulleys, stationary bike, gym ball, wall, hoops, small balls

Question 14

progression from active-assited exercise

Answer 14

once the patient has gained sufficient control and strength of their movement, they can be progressed onto free active exercise (3/5) and then resisted exercise (4/5), resisted exercise will help to improve muscle performance for a return to functional activities

Question 15

active movements

Answer 15

active exercise is used to promoted ROM and/or muscle strength

Question 16

indication for active exercise

Answer 16

when the muscle is able to contract actively and move a segment without resistance, when the muscle is weak and able to move joint through ROM against gravity but not against it (grade 3 or above)

Question 17

limitations for active exercise

Answer 17

for strong muscles, active exercise does not maintain increase strength- need to add resistance, it also doesn’t develop skill or coordination except in the movement pattern used

Question 18

what is gravity

Answer 18

an invisible force pulling objects to the centre of earth or the force by which all objects are attracted to earth. this force can be used a resistance for active exercise- done in functional positions

Question 19

types of active exercise

Answer 19

rhythmical, pendular, single/ patterned, short or long levers, open chain (feet off floor) or closed chain (feet on floor), localised or general, individual or in a class, circuit

Question 20

effects of active exercise

Answer 20

not isolated to one group, maintains muscle length/ joint range, muscle strength, improve CR efficiency, increase rate of protein synthesis, producing more actin/ myosin (hypertrophy), CT stronger, increase joint ROM/nutrition, decrease pain, increase muscle strength- greater stability to a joint, repetition of pattern facilitates neuromuscular pathway, increase patient confidence,

Question 21

what happens if active exercise performed rhythmically

Answer 21

may promote relaxation of surrounding muscles and increase ROM if restriction was due to muscle spasm