Rehabilitation

Question 1

What conditions can physiotherapy exercise treat?

Answer 1

Arthritis
sprains/strains
fractures
post surgert 
Non-specific LBP
Tendinopathies 
pre and post-natal
cardiac patients 
neuro patients 
COVID-19

Question 2

What are the effects of Reduced Activity

on Muscle

Answer 2

Reduction in muscle size, mass and muscle
tension (tone)
• Loss of strength and endurance capability
• Atrophy of both type I and type II fibres. The
contractile ability of type I fibres is more
adversely affected than type II
• Changes in the mechanical properties of the
myo-tendinous junction – injury risk
• Increased fatigability
• Increased lactic acid production

Question 3

What are the rehabilitation phases ?

Answer 3

Acute/Initial (pain management) 
• Intermediate (getting range back)
• Advanced (strengthening)
• Return to
Sport/normal activity (conditioning/strength related to specific sport needs)

Question 4

What is treatment in the acute phase of injury?

Answer 4

KEY - PAIN MANAGEMENT

PEACE and LOVE
• Circulation exercises
• ROM Exs
• Maintain muscle activity
• Consider stability
program
• Maintenance of other
joints/muscles
• Correct abnormal
movement patterns

Question 5

What is treatment in the Intermediate phase of injury?

Answer 5

Week 2 ish

• Starting to build
strength
• Continue ROM,
Stretching
• Stability,
neuromuscular control
• Impact/agility

Question 6

What is treatment in the Advanced phase of injury?

Answer 6

• Strength especially
power
• Neuromuscular
exercises
• Agility • Functional exercises
and sports specific
exercises

Question 7

Rehabilitation plan Considerations for acute conditions?

Answer 7

• Exercise is appropriate for stage of healing

• Not in first 48 hours – allow bleeding and
swelling to subside.

• Close monitoring of symptoms
• Static to dynamic
• Consider weight bearing status
• Consider level of injury
• Orthopaedic instructions / protocols

Question 8

Benefits of exercise–

acute conditions

Answer 8

• Minimise muscle atrophy of other areas
• Minimise loss of cardiac fitness
• Maintain range of movement of other
areas
• Increase ROM
• Increase muscle function
• Reduced pain
• Reduced swelling

Question 9

Exercise Considerations–

chronic conditions

Answer 9

• Pathology
• Ability
• Cardiovascular fitness
• Comorbidities
• Exercise tolerance
• Motivation
• Yellow flags

Question 10

Benefits of exercise–

chronic conditions

Answer 10

• Reduction in pain
• Increase muscle strength
• Improve flexibility
• Improve proprioception / balance
• Improve biomechanics
• Improve cardiovascular fitness
• Improvement in health status
• Reduce / prevent obesity (BMI >30) due to reduced mobility
• Psychosocial – improve mood and energy levels
• Increased functional ability
• Increased bone mineral density

Question 11

Effects of immobilisation

Answer 11

Stiffness/reduced ROM
• Atrophy – loss of cross sectional area of muscle
• Weakness
• Reduced coordination
• Nervousness – Fear avoidance
• Skin/hair changes
• Sensation changes

Question 12

Benefits of Joint Range of Motion (ROM)

Answer 12

• Enhance normal
tissue healing
• Load soft tissues in
progressive way
• Increase soft tissue
extensibility
• Maintain or increase
joint ROM

Question 13

Pathology - when would you use Joint Range of Motion (ROM)?

Answer 13

Post-op
• Post fractures
• Arthritis
• Contractures
• Adhesions
• Pain/neural sensitivity

Question 14

What is Passive ROM?

Answer 14

Absence of voluntary
activity
• Produced by extrinsic
force
• Therapist / CPM

Question 15

What is active-assisted ROM?

Answer 15

Element of muscle activity
• Partially extrinsic with
element of intrinsic

Question 16

What is active ROM?

Answer 16

Free active exercises
• 100% of voluntary
mm activity
• Mobilising
• Strengthening

Question 17

Stretching types? (3)

Answer 17

Static stretching
• where a specific position is held with the muscle on
tension to a point of a stretching sensation

Dynamic stretching
• Active: moving a limb through its full range of motion
to the end ranges and repeating several times
• Ballistic: Bouncing at EOR. No longer recommended

Pre-contraction
• involves a contraction of the muscle being
stretched or its antagonist before stretching

Question 18

Static stretching –

recommendations

Answer 18

For a general fitness program ACSM
recommends:
• Stretching should be preceded by a
general warm up
• Hold 15-30 secs, 2-4 repetitions
• 2-4 times per week
• Elderly population should hold for 60 secs

Question 19

benefits of Resistance training

Answer 19

• Increase muscular strength and endurance
• Increase bone mass
• Reduce blood pressure
• Increase muscle and soft tissue cross
sectional area
• Reduce body fat
• Improve back pain, tendinopathy and other
pathologies.

Question 20

What happens during strength training?

Answer 20

• Muscle growth
• hypertrophy
• ? Hyperplasia
• Muscle strength increases
• High resistance, low reps and
full recovery between sets
• Type II fibres will increase more
readily than type I
• Normally takes a min of 4
weeks in untrained
individuals

Question 21

ACSM Guidance for Strength

Answer 21

Load:
60-70% 1RM novice/intermediate; 80-100 Advanced

Volume:
1-3 sets of 8-12 repetitions novice to intermediate;

2-6 sets of 1-8 repetitions for advanced

Rest period:
2-3 min for higher intense exercises that use heavier
loads; 1-2 minutes between the lower intense exercises with light loads

Question 22

ACSM guidance for Muscle

Endurance

Answer 22

Load:
lower than 70% of 1RM

Volume:
2-4 sets of 10-25 repetitions

Rest period:
30 seconds to 1-minute between each