strategies for effective exercise intervention, instruction & HEP development Flashcards
week 2
What is a high priority when first selecting an exercise to prescribe?
- pt’s goals, “why”
- available equipment
- pt safety
what else must be considered when selecting exercise?
tolerance and load
what are the different variables with load?
- mode
- intensity
- volume
- frequency
- duration
how is pt tolerance determined?
- our clinical reasoning/judgement
with tolerance and load established how are therapeutic conditions determined?
tissue characteristics
exercise capacity
pt characteristics
how is exercise safely progressed?
assess regularly
- baseline capabilities, current state adn desired outcomes
load target is slightly greater tha ncurrent capacity
- load is manipulated to move pt capacity closer to target laod and therby desired outcome
what are differnt types of manipulation you can do with progression of exercise?
- dosage
- equipment used
- speed
- contraction type
- patient position
what are some green lights for condition tolerance to exercise (pain related)?
pain behavior:
- harm check: no change in ROM, strength, function
- pain spikes during the activity
- pain is no worse after activity and back to baseline with different parameters for different times
green light is safe pain = no harm
green light for exericse if pain is no worse after activity and back to baseline within ?
A. if you are 4-8 wks post injury/onset
B. if you are 8-16 weeks post injyr/onset
C. if you are 16 wks - year post injury/onset
A. 30 minutes
B. 2 hours
C. 24 hrs
what is the only intervention category taht is specified to be used for EVERY patient through the ENTIRE episode of care
patient education
should also be include: family members, caregivers, other health professionals
how program considerations
- keep it
- clear insutrctions
- cues most helpful for patient
What is commonplace and can affect the overall outcome of rehabilitation?
poor adherence to HEP
what 3 factors influence patient adherence?
- patient related factors
- facotrs related to condition/impairments
- exercise program related factors
What are some patient related factors to HEP adherence?
- understanding the health conditon, impairments or exercise program
- leel of motivtion, self discipline, attentiveness, memory andwillingness and receptivity to change
- degree of fatigue or stress
- availability of time
- beliefs and attitudes about exercise (value placed on ex.)
- socioecomonic and cultural background
- available resources
factors related to the condition/impairment for pt adherence to HEP
- status of health condition and related impairments
- comorbiditeis
- pain
- kinesiophobia
exercise program-related factors contributing to pt adherence of HEP
- complexity
- time commitment
- quality of instructioin, supervision and feedback
- continuity of care
- alignment with pt’s interests and needs
What strategies can be used to foster adherence?
- identify barriers to adherence
- understand pt’s beliefs about exercise
- help the pt identify benefits of exercise adherence
- provide an exercise log
- highlight progress
- encourage pt feedback
- explain the “why” of each exercise and how this aligns with pt’s goals
- identify how exercise can be incorportated into everyday life
what is physical stress theory
the amount and type of physical stress applied to specific tissues will result in predictable outcome to that tissue
