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Kinesiology Exam Two > Treatment > Flashcards

Treatment Flashcards

1
Q

What are the ultimate goals of treatment?

A
  1. Help individuals develop skills to perform ADLs (and IADLs) as independently as possible. 2. symptom-free movement and function.
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2
Q

Name the main positive effects of Therapeutic Exercise and Activities.

A
  1. Prevention of dysfunction2. Improvement / restoration of ROM, strength, coordination and skill.
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3
Q

What goals can be achieved with ROM?

A

IMPROVE ROM: - enhance pt. positioning- ease caregiver’s job- enhance ability for ADLs- prepare for strengthening MAINTAIN ROM: - same focus as above, but maintenance typically done by trained family member / caregiver rather than therapist

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4
Q

What goals can be achieved with strengthening?

A
  1. DEVELOPMENT OF STRENGTH2. ENHANCEMENT OF STRENGTH3. MAINTENANCE OF STRENGTH (to enhance self-care/ADLs.)4. IMPROVE MUSCULAR AND CARDIOVASCULAR CONDITIONING (to enhance self-care / ADLs)
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5
Q

Define coordination/skill

A

using the right muscles at the right time with correct intensity

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6
Q

How does coordination affect movement?

A

It is the basis of smooth and efficient movement. It requires an intact neuromuscular system.

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7
Q

How do you use therapeutic exercise to improve neuromuscular coordination?

A
  • constant repetition of few motor activities- use of sensory cues (visual, tactile, etc.) to enhance motor performance - increase speed of a given activity
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8
Q

Name 3 causes of decreased ROM

A
  1. systemic, joint, neurological or muscular disease2. surgical / traumatic insult3. inactivity / immobilization
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9
Q

Why are ROM activities administered?

A

to maintain existing joint and soft tissue mobility and prevent/minimize development of contracture

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10
Q

What is the difference between PROM and passive stretching?

A

PROM is movement by external forse through the UNRESTRICTED range. Movement is produced by external force (gravity, machine, therapist, or even the patient). Stretching goes (carefully!) beyond unrestricted range.

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11
Q

When is PROM used?

A
  1. For individuals who are comatose or paralyzed. 2. For individuals on complete bed rest.3. When active ROM is painful. 4. To decrease complication of immobilization (i.e. if in a cast) by: maintaining joint integrity and muscle elasticity, minimizing contracture formation, decreasing pain and maintaining person’s awareness of movement in or around the immobilized part.
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12
Q

How do you administer PROM to a segment of the body that is immobilized?

A

Administer to regions above and below.

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13
Q

Name 4 limitations of PROM

A
  1. It is difficult to obtain with innervated muscle and a conscious pt. (because they want to “help”)PROM will not: 2. prevent muscle atrophy3. increase strength or endurance4. assist with circulation.
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14
Q

precautions / contraindications of PROM

A

Precaution: Stay within range and speed of patient’s tolerance, and monitor patient’s pain tolerance. Contraindication: when motion is disruptive to healing.

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15
Q

ROM procedures (7 steps)

A
  1. Pt comfortable and free of restrictions (tight clothing, etc.) 2. Therapist positioned to use proper body mechanics. 3. Control movement by grasping around joint. Modify grip based on pt feedback/complaint. 4. Move through pain-free range; do not force. 5. Perform motions smoothly 5-10 times. 6. Monitor pt during and after procedure (vitals, pain)7. Document observable and measurable reactions.
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16
Q

What is strengthening (resistance exercise)?

A

Resistance exercise is any active exercise in which muscular contraction is RESISTED by an outside force. Force can be manual (therapist) or mechanical (equipment).

17
Q

Name 3 goals of resistance exercise.

A
  1. Increase strength. (resistance applied to muscle as it contracts results in increased strength over time.) 2. Increase endurance. (Generally as strength increases, endurance increases.)3. Increase power. (Strength plus speed.)
18
Q

Precautions of resistance exercise (3)

A
  1. CARDIOVASCULARRemind cv pts to breathe and counsel them to avoid Valsalva maneuver (which causes a rapid rise followed by a rapid fall in b.p.) 2. FATIGUELocal muscle fatigue is normal, but general exhaustion is not and means adjust therapy. 3. OSTEOPOROSISResistance must be applied and progressed carefully to avoid possibility of fractures.
19
Q

Contraindications of resistance exercise (2)

A
  1. INFLAMMATION: Resistance ex. with inflammation can lead to damage.2. PAIN: If pain occurs during therapy or for more than 24 hrs after, resistance should be reduced or eliminated.
20
Q

What is isotonic exercise and how is it used in strengthening?

A

Isotonic exercise is dynamic: muscle shortens (concentric contraction) or lengthens (eccentric contraction) through available ROM against a load (i.e. doing bicep curls with a weight). FOR THERAPYFor weak muscles, begin with eccentric muscle contraction against light resistance. As strength increase, move to concentric. Finally, use both contractions.

21
Q

What is isometric exercise and how is it used in strengthening?

A

Isometric ex is static: muscle contracts against load without change in length or joint motion (i.e. holding a glass of water or pushing against a wall). FOR THERAPY: Can be done if pt too weak for other exercise. It builds strength and power but not endurance. Pt must hold for at least 6 seconds. Develops strength only at position in which performed, so must be done at different points throughout ROM.

22
Q

Steps before initiating resistance exercise (6)

A
  1. Evaluate ROM and strength to establish baseline and determine amount of resistance over what range. 2. Explain and demonstrate exercise to pt.3. Place pt in comfortable position. 4. Use good body mechanics to stay safe. 5. Ask pt to give max effort. 6. Ensure no breath holding or Valsalva.
23
Q

Steps during resistance exercise (6)

A
  1. Apply resistance to distal end of muscle segment. (for greatest force with least effort)2. Determine direction of resistance. 3. Stabilize proximal end of muscle to avoid substitution. 4. Apply resistance, smoothly and painlessly.5. Change site / decrease resistance if - pt unable to complete full range- site is painful- substitution occurs- tremor develops6. Establish # of reps. (8-12 is good to fatigue muscle)
24
Q

What do you use stretching in therapy?

A

When shortening of soft tissue around joint leads to decreased ROM. (prolonged immobilization, connective tissue or neuromuscular disease, trauma, bony deformities.

25
Q

Define stretching and the two ways it is applied

A

a maneuver designed to lengthen pathologically shortened soft tissuePASSIVE - external force applied with pt relaxedACTIVE INHIBITION - patient participates in stretching to inhibit tone

26
Q

Define contracture

A

shortening of muscle or other tissues that cross a joint resulting in limited joint motion

27
Q

How is contracture described/labeled?

A

Contracture is described by the muscle action that is tight. If pt has tight elbow flexors and cannot extend elbow, she has elbow flexion contracture. If pt has tight hip adductors and cannot abduct leg, he has hip adduction contracture.

28
Q

How is contracture caused?

A
  • shortened muscle- scar tissue adhesions in muscles, tendons, joint capsules or skin
29
Q

How does irreversible, or fixed, contracture happen?

A

When soft tissue is replaced by non contractile tissue and permanent loss of ROM occurs. (can only be fixed surgically at that point)

30
Q

How is passive stretching used to elongate contractile and non contractile tissue?

A
  • Therapist applies external force to stretch pt beyond unrestricted range. HOLD FOR 30 SECONDS.- Warm tissue first - low intensity ex / therapeutic heat. - Adjust duration / intensity to pt tolerance and therapist. endurance.
31
Q

How is active inhibition used therapeutically?

A

Pt reflexively relaxes muscle to be stretched before stretching (like when we touched our toes, then did a squat to relax hams, then touched toes again and went further). - Works bc relaxed muscle gives less resistance to stretch. - only possible in innervated muscle (cannot be done in paralysis or neuromuscular dysfunction)

32
Q

Indications for stretching

A
  • ROM limited by contractors, adhesions, scar formation- Contractures interfere with function or care
33
Q

goal of stretching

A

to regain normal ROM and mobility

34
Q

Stretching procedure

A
  • Explain / demo to pt. Emphasize relaxation. - Position patient. Apply heat.- Move extremity slowly to point of restriction. - Grasp proximal and distal to joint. Move distal segment. - Apply gentle traction to avoid joint compression. - Apply sustained stretch, taking joint to point of tightness and then just beyond. Won’t be comfortable but should not hurt pt. - Hold 30 seconds. Move a bit further as tension decreases.
35
Q

Precautions of stretching

A
  • Do not force beyond normal ROM- Be careful with osteoporosis- guard newly united fractures- if pain or muscle soreness > 24 hrs, it was too much.
36
Q

Contraindications of stretching

A
  1. If joint motion limited by bony block2. after recent fracture3. if acute inflammation around joint4. if pt has sharp, acute pain with joint movement5. if hematoma present6. if contracture is providing stability

Kinesiology Exam Two (8 decks)

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