Chapter 16 - Using Therapeutic Exercise in Rehabilitation Flashcards Preview

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Flashcards in Chapter 16 - Using Therapeutic Exercise in Rehabilitation Deck (38):
1

RAMP

rehab goals
management of Acute responses
restoration of mobility
successful completion of performance goals

2

effects of immobilization on muscle

atrophy and fiber type conversion (mostly type 1 - slow twitch)

prevent with e-stim and iso contraction

decreases neuromuscular efficiency (returns within 1 week)

3

effects of immobilization on joints

loss of normal compression
decrease in lubrication
degneration

prevent: passive motion, e-stim, hinged casts

4

effects of immobilization on ligaments and bone

weakening

preventing: high freq, short duration endurance exercise
may take 12 months of rehab

5

effects of immobilization on cardiorespiratory system

resting heart rate increases .5 bpm for each day

stroke volume, max oxygen uptake, vital capacity decrease w/ increase in heart rate

6

major components of rehabilitation program

minimizing initial swelling

controlling pain

restoring range of motion

restoring muscular strength, endurance, power

regaining postural stability and balance

maintaining cardiorespiratory fitness

incorporation function progressions

7

minimizing swelling

RICE
reduce secondary cell death

8

controlling pain

RICE, medications

9

restoring range of motion

attributed to contracture of CT or resistance to stretch .

restore physiological and accessory movements

10

restoring muscular strength, endurance, and power

isometric
PRE
Isokinetic exercise
testing strength, endurance, and power

11

isometric

early rehab phase
increase static strength
decrease atrophy

12

PRE

Progressive Resistance Exercise

free weights, machines, tubing , etc
isotonic contractions
concentric and eccentric contractions

13

isokinetic exercise

later stages of rehab, fixed speed with accommodating resistance to provide maximal resistance throughout ROM

calculate torque, average power, total work, ratios of torque to body weight

14

testing strength, endurance, and power

evaluations though manual muscle tests, resistance exercise, isokinetic dynamometers

15

re-establishing neuromuscular control, propioception, kinesthesia, joint position sense

mind's attempt to teach the body conscious control of a specific movement

-several reps, same movement, progression from simple to complex

-functional strengthening, re-learning sensory pattern, dynamic stability, preparatory and reactive muscle characteristics,

16

propioception

ability to determine the position of a joint in space

mediated by mechanoreceptors (muscles and joints) and by cutaneous, visual, and vestibular input

17

kinesthesia

ability to detect movement

18

joint mechanoreceptors

in ligaments, capsules, menisci, labrum, and fat pads.

19

muscle mechanoreceptors

muscle spindle (changes in length) and Golgi tendon organ (changes in tension)

20

regaining postural stability and balance

integrating muscle, neuro, and biomechanical info

positioning the body's center of gravity within the base of support

21

Phases of injuries

acute inflammatory response stage (1-4 days)

fibroblastic repair phase

Maturation-remodelign phase

22

rehab during acute phase

control swelling and

modulate pain

RICE

rest for only the injured body part

day 3-4: active mobility exercise, pain free ROM, progressively bear more weight

NSAIDS

23

rehab during fibroblastic repair phase

maintain cardio, restore full ROM, increase strength, re-establish neuromuscular control

modalities to control pain and swelling (cryotherapy, e-stim)

24

rehab during maturation phase

goal: RTP
fibers realign according to tensile stress placed upon them

aggressive AROM and strengthening

sport specific activities

dynamic functionality

plyometric strengthening

thermal modalities

25

CKC

closed kinetic chain

forces begin at ground
forces absorbed by various structures

offer more functionality

26

contract-relax

move part passively until resistance is felt;

athlete contracts antagonistic muscle
isotonically

(movement resisted by AT for 10 seconds or until fatigue);

athlete relaxes for 10
seconds;

limb is passively moved to a new stretch position (repeat process 3 times)

27

hold-relax

move part passively until resistance is felt;

athlete contracts antagonistic muscle
isometrically (movement resisted by AT for 10 seconds or until fatigue);

athlete relaxes for 10 seconds;

limb is either actively or passively moved to a new stretch position (repeat process 3 times)

28

slow-reversal-hold-relax

athlete actively moves body part to point of resistance and holds position;

muscles are isometrically resisted by AT for 10 seconds.

Athlete relaxes for 10 seconds, thus relaxing the antagonist while the agonist is contracted, moving the part to a new limited range

29

repeated contraction

used for general weakness or weakness at one specific point. Athlete moves limb isotonically against manual resistance until fatigue (at time of fatigue, stretch is applied at that ROM to facilitate greater force production)

30

slow-reversal

athlete moves thru complete ROM against maximal resistance (examiner reverses resistance as movement pattern reverses) = promotes normal reciprocal coordination of agonist/antagonist muscle groups

31

rhythmic initiation

progressive series of passive movement 􏰀 active assistive movement 􏰀 active movement through an agonist pattern (helps athletes with limited ROM regain strength)

32

rhythmic stabilization

uses an isometric contraction of the agonist, followed by an isometric contraction of the antagonist muscles

33

PNF flexibility techniques

contract-relax
hold-relax
slow-reversal-hold-relax

34

PNF strength techniques

repeated contraction
slow reversal
rhythmic initiation
rhythmic stabilization

35

repeated contraction

used for general weakness at one specific point

move limb against resistance isotonically against manual resistance until fatigue then apply stretch at time of fatigue

36

slow-reversal

athlete moves thru complete ROM against max resistance (reverse resistance as movement at pattern reverses)

promotes normal reciprocal condition of agonist/antagonist

37

rhythmic initiation

progressive series of passive movement --> active assistive movement--> active movement through an agonist pattern

helps with limited ROM and to regain strength

38

Rhythmic stabilization

uses an isometric contraction of the agonists, followed by an isometric contraction of the antagonist muscles