Support delivery Flashcards
Support the delivery and monitoring of physiotherapy programs for mobility
Preparing for the client’s physio program:
Each of the clients that you assist will have an individualised rehabilitation program.
At the beginning of each session with a client you must read, and understand, what they will need to undertake for that session.
Confirm your interpretation of what is in the client’s medical history, and any additional information they have provided to you, with the physiotherapist prior to commencing the session.
Tasks to complete before starting a session with client:
1) Read and understand individual’s program
2) Confirm understanding with AHP
3) Organise equipment required (as per AHP’s instructions)
4) Prepare area: clean; hazard-free; enough space; items from previous session removed.
5) Confirm client’s availability and ability. Are they well; did they recover from last session; do they think they can do today’s tasks. Attendance does not equal consent; client needs to be informed.
6) Inform client about proposed tasks. Does client consent? Familiarise client with any equipment (particularly if new to them)
(upper?) “6-pack” muscle:
muscle joining groin to knee:
muscle just above knee, medially:
rectus abdominus
gracilis
vastus medialis
Goals of “active functional exercise”:
Enable ambulation; Improve coordination; Improve respiratory capacity; Reduce rigidity; Mobilize joints; Improve balance; Improve circulation; Promote relaxation; Release contracted muscles, tendons, and fascia; Improve exercise performance and functional capacity (endurance)
Therapeutic exercise:
bodily movement prescribed to correct an impairment, improve musculoskeletal function, or maintain a state of well-being.
Therapeutic exercise might be from highly selected activities restricted to specific muscles or parts of the body, or general and vigorous activities that can return a convalescing patient to the peak of physical condition.
Therapeutic exercises aimed at achieving and maintaining physical fitness fall into three major categories: endurance, resistance and/or flexibility
“FIIT”:
Frequency (how often to be done)
Intensity (how hard to perform eg moderately)
Time (how long/duration of exercises)
Type (what specific exercise)
Exercise program phases:
Preparation:
when the athlete or client undertakes general development of their fitness. This is both general aerobic fitness and strength training. The second part of preparation is when the athlete or client is undertaking training for a specific activity either sporting or rehabilitation.
Conditioning:
when the athlete or client is undertaking an exercise program for a specific sport or activity.
Recovery:
time to specifically recover from the rigors of training and competition. Generally there is no specific training plan and usually the coach just gives guidelines to maintain some fitness.
Adaptation:
the body grows and becomes stronger and fitter in response to the training / exercise load.
Repetitions:
Sets:
the number of times an exercise is undertaken per set
the frequency/no. of times a group of repetitions is performed
Single set to failure:
a single set per exercise that is taken to the point of failure. This means that the client is using weights and repetitions that are high enough that they will not be able to complete the set. This training method is known as high intensity training (HIT).
Matrix training:
a form of weight training exercise. When we normally exercise it is just in one plane. In other words we are either moving the body up and down or side to side. The goal of Matrix exercise is that the body moves through a series of exercises that are based on a pattern of partial movements designed to activate muscles at multiple points that aren’t otherwise worked effectively.
Some medical conditions that can have a negative impact on mobility:
Arthritis can affect walking, using stairs, prevent kneeling;
Joint injuries can affect balance and coordination;
Low blood pressure (dizziness) can affect balance and coordination;
Circulation disorders (swelling) can limit movement.
The treating health professional will take these conditions into consideration when they are assessing the client and prescribing a rehabilitation program.
AHAs need to be aware of the presence of these conditions and the potential impact they will have on the client and their mobility so that appropriate assistance and supervision can be provided.
Risks for decreased mobility:
Medical conditions:
Medical conditions such as arthritis, joint injuries, low blood pressure, and circulation disorders can all have a negative impact on the client’s ability to ambulate (walk), use stairs or even walk on sloping surfaces.
Self-limitations:
Low confidence, previous falls, and even poor eye sight can lead to a client self-limiting their mobility due to a belief that they are unable to walk safely.
Lack of resources:
Lack of resources to access walking aids can prevent clients from using these appliances to assist them with their mobility.
Weight bearing and post fracture implications:
Weight bearing is usually described as a percentage of the total body weight, because each leg of a healthy person carries the full body weight when walking, in an alternating fashion.
During rehabilitation after a fracture a small amount of weight may be supported by the affected leg. The weight may be gradually increased up to 50% of the body weight, which would permit the affected person to stand with his body weight evenly supported by both feet (but not to walk).
After a fracture, weight bearing will depend on the healing process – each fracture will be different and will heal at different rates. Pain tolerance during weight bearing and X-rays are used to assess healing and the treating health professional will decide how much weight bearing the client should undertake during the healing process.
Some of the time plastic cast walkers will be used to assist with recovery as they assist with weight bearing during rehabilitation.
Assisting with exercise program:
Your duties might include:
preparing equipment for the session;
greeting clients;
evaluating client ability to participate in the session;
monitoring client activity;
providing feedback to clients and the physiotherapist;
writing case notes in the client medical record after the session has finished.
When you are preparing for a rehabilitation session with the client you will need to confirm that they understand what exercises they will be undertaking, and are able to perform these activities.
How to confirm client understands exercises and is able to perform:
Speak with the client, explaining what each of the exercises are;
Demonstrate the exercises;
Get the client to perform the exercises for you to assess their ability;
Provide feedback and correction as needed.