ch13: therapeutic exercise prog Flashcards
(24 cards)
steps when dev a therapeutic exercise prog
- assess the present lvl of func and dysfunc
- organize and interpret the assessment
- dev and supervise the tx plan
- reassess the progress of the plan and just as needed
effects of immobilization
- muscle tension, m./lig atrophy, dec circulation, loss of motion
effects of immobilization on muscle
- loss of strength within 24h
- dec m. fiber size
- dec total muscle weight
- dec size and number of mitochondria
- nerves less efficient
effects of immobilization on articular cartilage
- greater impact
- loading and unloading of synovial jnts is necessary to ensure the proper metabolic exchange
- softens and dec in thickness
- > 30days = osteoarthritis
effects of immobilization on ligaments
- weaker and more compliant
- dec tensile strength
- dec jnt stability
jnt mobilization benefits
- breaking up adhesion and reliving capsular restrictions
- distracting impacted tissues
- increasing lubrication for normal articular cartilage
- reducing pain and muscle tension
- restoring full ROM and facilitating healing
Maitland scale
I: small amplitude of mvt at the beginning of available ROM
- dec pain and spasm
II: large amplitude of mvt within avail ROM
- dec pain and spasm
III: large amplitude of mvt up to the pathological limit in the ROM
IV: small- amplitude, at the very end of ROM
- inc ROM
V: smapp-amplitude, quick thrust delivered at the end ROM
muscle spindle
- lie parallel to muscle fibers, they stretch w/ the m. stimulated = muscle contracts reflexively inhibiting a stretch
- muscle contracts reflexively inhibiting a stretch
Golgi tendon
- connected in a series of fibers located in tendons and lig
- respond to tension stretch longer then 6-8s
- reflex inhibit in antagonist muscles, protects the musculotendinous unit from excessive tensile forces that could damage muscle fibers
jnt mechanoreceptors
- Ruffini corpuscles
- Golgi-receptors
- pacinian corpuscles
- free nerve endings
jnt mechanoreceptors: Ruffini corpuscles
sensitive to intra-articular pressure and stretching of the jnt capsule
jnt mechanoreceptors: Golgi receptors
- intra ligamentous
- become active when lig are stressed at the end ranges of jnt mvts
jnt mechanoreceptors: pacinian corpuscles
sensitive to high frequency vibrations and pressure
jnt mechanoreceptors free nerve endings
sensitive to high mechanical stress and the deformation and loading of soft tissues that comprise the jnt
physiology of muscular endurance tx
- density in the capillary beds inc
- providing greater blood supply
- greater oxygen supply
when to start power tx
when injured limb has regained at least 80% of the muscle strength
CV endurance
- detraining within 1-2wks
- HR max = 220-age
categories of coordination
- gross motor mvt
- fine motor mvt
CV endurance tx guidelines
- mod-intensity PA for minimum of 30 min/session 5+ days/week
-or vigorous PA minimum of 20min/session 3+ days/week - bone health: 30-60min of weight bearing cv 3-5x/week, resistance exercise 2-3x/wk
phases of therapeutic exercise program
1: control inflammation
2: restore motion
3: dev muscular strength, power and endurance
4: RTP
to pass phase 1
- control inflammation w/ minimal edema, swelling, m. spasm, and pain
- ROM , jnt flex, muscular strength, endurance, and power are maintained in the unaffected uninjured areas of the body
- CV fitness is maintained at the preinjury lvl
to pass phase 2
- inflammation and pain are under control
- ROM within 80% of unaffected side
- B jnt flexibility is restored, and proprio regained
- CV endurance and general body strength are maintained at preinjury lvl
to pass phase 3
- B ROM and jnt flex restored
- muscular strength, endurance, and power in the affected limb are equal or near equal to those in the unaffected side
- CV endurance and gen body strength are equal to or better than the preinjury lvls
- score Y balance test < 4cm and four hop testing scores at 80-90%
- sport specific func pattern are completed using mild to mod resistance
- indv is psychologically ready to return to protected act
to passs phase 4
- coord and balance are normal
- sport-specific func pattern are restored in the injured extremity
- m. strength, endurance is equal or greater to un injured
- cv same or greater then before injury
- quantitive testing done
- indv received clearance to return to participation by supervising physician
