passive to active exercise Flashcards
benefits of exercise
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
assessment for exercise
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
the exercise continuum- strength
0-1= passive movements, 1-2= active assisted exercise, 3-4- active exercise/ resisted movements,5- functional ability
limitations to oxford scale
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
passive exercises/ movements
passive movements- movements which are performed by the physio for the patient. may be performed at single or several joints
passive exercises/ movements- types
mannual relaxed passive movements- performed by another person, auto-relaxed passive movement- performed by patient, mechanical relaxed passive movement- performed by machine
effects of passive movements
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
contraindications- passive movement
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
active assisted exercise
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
effect of active assisted exercise
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
precautions and contraindications- active assisted
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
principles of application active assisted exercise
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
types of active assisted exercise
manual active assisted, auto-assisted, mechano-assited- sliding boards, poles (stick/wands/ t-bars), reciprocal. pulleys, stationary bike, gym ball, wall, hoops, small balls
progression from active-assited exercise
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
active movements
active exercise is used to promoted ROM and/or muscle strength
indication for active exercise
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)
limitations for active exercise
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
what is gravity
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
types of active exercise
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
effects of active exercise
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,
what happens if active exercise performed rhythmically
may promote relaxation of surrounding muscles and increase ROM if restriction was due to muscle spasm
