TherEx Flashcards
What is therapeutic exercise
Systematic, planned performance of bodily movements, postures or physical activities intended to provide a patient with the means to:
• Remediate or prevent impairments
• Improve, restore or enhance physical
function
• Prevent or reduce health-related risk factors
• Optimize overall health status, fitness or sense of well-being
Aspects of physical function
Muscle performance Cardiopulmonary endurance Mobility/flexibility Neuromuscular control/coordination Stability Balance/postural equilibrium
Therapeutic exercise includes
- Aerobic and endurance conditioning • Flexibility exercises • Neuromotor development training • Relaxation techniques • Muscle performance exercises: strength, power and endurance exercises
SAID (specific adaptation to imposed demands) principle includes what
- Specificity of training (Muscles adapt over time to the stresses placed on
them)
• Strength versus muscular endurance
• Specific velocity of exercise
• Isometric versus concentric versus eccentric
• Specific joint angle
• Emphasis on task-specific practice
What is the reversibility principle
“Use it or lose it”
Adaptive changes due to strength, lower, or endurance training are transient
Detraining occurs within
1-2 weeks after cessation of training and continues until all training effects are lost
What is essential to maintain adaptive changes
Maintenance program
What is the overload principle
To improve muscle performance, a load that exceeds the
metabolic capacity of the muscle must be applied
• Focuses on progressive loading of a muscle by manipulating
intensity or volume
Key steps to develop a therapeutic exercise plan
- Identify impairments and functional limitations
• Develop goals to address impairments and
functional limitations
• Implement appropriate therapeutic exercises
• Continually assess progress towards goals and progress program appropriately
Component of effective exercise programs
- Safe
- Individualized
- Tailored to patient goals
- Appropriately challenging
- Functional/task-specific
- Implements evidence-based exercises
- Includes patient education
- Involves progressive overload and is constantly evolving
Indications of passive ROM
- In a region where a patient is unable or active movement is contraindicated
- To allow assessment of inert structures to determine limitations of normal motions at a joint
Goals of passive ROM
• decrease complications from immobility (cartilage
degeneration, adhesion and contracture formation)
• Maintain functional range of motion
PROM does not… (limitations)
- Prevent muscle atrophy
- Increase muscular strength or endurance
- Assistcirculation
Indications of AROM
Able to move desired segment without physical assistance
Indications of AAROM
Weak muscles require external or self assistance to move through desired ranges
Active rom is useful where in relation to an immobilized segment to maintain normal jt motions in the unaffected areas?
Above and below
Limitations to AROM
In strong muscles, it does not assist with maintaining or increasing strength
A shorter external moment arm will require ________ force
Greater
Gravity can have effects on AROM in 3 ways, what are they?
Gravity assisted
Gravity minimized/eliminated
Against gravity
What property would weighted supine knee extension or prone knee hang for increasing ROM follow?
Viscoelasticity (creep)
3 types of training for muscular performance
Strength
Power
Endurance
Strength training includes
Lowering or controlling heavy loads (resistance) for a relatively low number of reps or over a short period of time
What element of movement is the most manipulated for power training
Speed
What leads to the greatest muscle power
Greater the intensity and shorter the time taken to generate force
Typical endurance training involves
Contracting and lift or lower a light load form any reps or sustain a muscle contraction for an extended period of time
Bringing resistance moment arm closer to the axis of rotation ____________ load placed on a muscle
Decreases
You can use ___________ to initiate movement in pts with neurological impairments
Passive tension
Break down exercises into ____________ & ____________ vectors
Horizontal and vertical
If the vertical vector (against gravity is small, add _____________ or _____
Bands or pulleys
External stabilization can be applied…
Manually,
With equipment,
Or with a support surface
Internal stabilization comes from
Isometric muscle contraction
Ways to challenge balance
Narrowing BOS Stable vs unstable surface Eyes open vs eyes closed Controlled vs open environment Proactive vs reactive strategies
A therapeutic exercise program demonstrates a …
Logical, graded exercise progression with simple tasks and progressing to more complex tasks
PTs identify pts impairments through careful evaluation and prescribe a…
Graded application of physical stresses to the impaired body system
Therapeutic exercise should be performed in a ________, _______, and ______ manner to improve the patients function by the __________ of physical impairment
Controlled, progressive, and safe manner
Reduction of physical impairments
Progressions for ROM
PROM > AAROM > AROM
Gravity assisted > gravity eliminated > against gravity
How to progress strength
• Isometric ➔Concentric➔ Eccentric • Double-leg➔Single-leg • No weight ➔Body-weight ➔Weighted • Straight plane➔Lateral plane ➔Cutting • Controlled ➔Open environment
How to progress balance
- Double-leg➔Single-leg
- Wide BOS➔Narrow BOS
- Stable➔Unstablesurface
- Static➔Dynamic
- Controlled ➔ Open environment
- Eyes Open➔Eyes Closed
