Intro to Therapeutic Exercise Flashcards

1
Q

Steadman’s Medical dictionary definition of movement system

A
  • the movement system is a physiological system that functions to produce motion of the body as a whole or of its component parts
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2
Q

What is the 4 element movement system model

A
  • motion
  • force
  • energy
  • control
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3
Q

Define CASSS

A
  • Control: smoothness, coordination, & timing of movement
  • Amplitude: amplitude of movement at each joint
  • Speed: acceleration, deceleration, controlled
  • Symmetry: bilateral tasks, gait
  • Symptoms: pain, clicking, dyspnea, fatigue, instability, urinary incontinence
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4
Q

Common tests/measures for motion

A
  • ROM
  • specific tests for muscle length
  • accessory motion tests
  • soft tissue mobility tests assessed by palpation
  • skin mobility
  • neurodynamic tests
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5
Q

Common interventions for motion

A
  • active/passive stretching
  • hold/relax stretching
  • manual therapy
  • low load prolonged stress via static positioning or splinting
  • neural gliding and tensioning techniques
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6
Q

Common tests/measures for force

A
  • MMT
  • hand held dynamometry
  • rep max testing
  • isokinetic testing
  • functional performance testing
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7
Q

Common interventions for force

A
  • force generating capacity
  • force control
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8
Q

Common tests/measures for energy

A
  • aerobic capacity/endurance
  • vital signs
  • ventilation and respiration including respiratory rate and pulse oximetry
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9
Q

Common interventions for energy

A
  • therapeutic exercise
  • functional training including gait & mobility training
  • airway clearance techniques
  • patient instruction
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10
Q

Common tests/measures for control

A
  • performance based measures of capability
  • assess task initiation, execution, & termination
  • feedforward control: measure speed, accuracy, & kinematics
  • feedback control: determine response to unexpected perturbations
  • sensory perceptual & cognitive testing
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11
Q

Common interventions for control

A
  • impairment restitution to provide resources for task execution
  • task practice
  • targeted treatments to improve perception & cognition in context of task practice
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12
Q

Benefits of exercise for children

A
  • improved bone health & weight status
  • improved cognitive function
  • fewer symptoms of depression
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13
Q

Benefits of exercise for adults (18-65)

A
  • lower incidence of bladder, kidney, stomach, & lung cancers
  • reduced risk of dementia
  • improved cognitive function following bouts of aerobic activity
  • improved QOL
  • improved sleep
  • reduced feelings of anxiety & depression
  • reduced risk of excessive weight gain
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14
Q

Benefits of exercise for older adults (65+)

A
  • reduced incidence of fall related injuries
  • improved physical function in older adults with or without frailty
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15
Q

Benefits of exercise for individuals with pre-existing medical conditions

A
  • reduced risk of breast, colorectal, & prostate cancer mortality
  • decreased pain in osteoarthritis (OA)
  • reduced risk of progression of CVD & increased BP over time in HTN patients
  • DM II has reduced risk of CV mortality & reduced progression of disease indicators: hemoglobin A1c, BP, blood lipids, & BMI
  • MS has improved walking & physical fitness
  • improves cognition in dementia patients & people with impaired executive function
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16
Q

Activity level recommendations for the population

A
  • 150 minutes of aerobic exercise per week of moderate to vigorous intensity with 2+ days of resistance training that work the major muscle groups: legs, hips, back, abdomen, chest, shoulders, & arms
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17
Q

Reasons why occupational physical activity (OPA) does not confer the cardiovascular health benefits that leisure time physical activity does

A
  • too low of intensity for too long to improve cardio
  • increased 24 hour HR
  • heavy lifting or static postures increase 24 hour BP
  • insufficient recovery time
  • increases levels of inflammation
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18
Q

Define client

A
  • an individual without diagnosed dysfunction who engages in physical therapy services to promote health & wellness & to prevent dysfunction
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19
Q

Define patient

A
  • an individual with impairments & functional limitations diagnosed by a physical therapist who is receiving physical therapy care to improve function & prevent disability
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20
Q

Define diagnosis

A
  • process & product of a clinical investigation related to the pathology underlying a patient/client’s symptoms & signs & results in a label
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21
Q

What is the role of a diagnosis

A
  • physical therapists use diagnosis to determine whether physical therapy services are indicated to address the patient’s condition
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22
Q

Example of a pathoanatomical diagnosis

A
  • medical community, physician diagnoses a patient with significant knee OA & orders TKA
23
Q

Example of a pathokinesiology diagnosis

A
  • a physical therapist diagnoses a patient with impaired quadriceps strength, limited knee ROM, & impaired gait due to recent joint replacement
24
Q

Example of a kinesiopathology diagnosis

A
  • a patient with significant knee OQ is fearful to have a TKA & restricts her movement over the next 5 years & becomes obese with HTN & DMII
25
What is therapeutic exercise
- systematic planned performance of physical movements, postures, or activities intended to erode a patient/client with the means to: 1) remediate/prevent impairments of body functions & structures, 2) improve, restore, or enhance activities & participation, 3) prevent or reduce health related risk factors, 4) optimize overall health, fitness, or sense of well being
26
What are the foundations of function
- muscle performance - cardiopulmonary/endurance - mobility/flexibility - neuromuscular control/coordination - stability - balance/postural equilibrium
27
Principles of decision making: individualization
- clinical decision making is dynamic - selection, implementation & modification of therapeutic exercise interventions are based on the unique patient/client - improved decision making is enhanced through the development & implementation of clinical prediction rules (CPRs) & clinical practice guidelines (CPG)
28
FITT-VP principle
- Frequency - Intensity - Time - Type - Volume - Progression
29
What is the rehab cycle
- identify problems & needs --> relate problems to modifiable & limiting factors --> define target problems & target mediators, select appropriate measures --> plan, implement, coordinate interventions --> assess effects --> identify problems & needs
30
How do you know if the intervention(s) are working
- measure outcomes
31
What outcome measures will best capture the change a patient should expect during this episode of care
- a good rule of thumb to have both self report & performance based outcome measures
32
5 elements of shared decision making
- at least 2 participants have to be involved - both parties have to take steps to participate in the process of treatment decision making - information sharing is a prerequisite to shared decision making - deliberation has to take place by discussing the treatment preference of both parties - a treatment decision has to be made & both participants have to agree upon the decision
33
Define impairments in body function
- problems with physiology of body systems (includes psychological functions)
34
Define impairments in body structure
- problems with anatomical features of the body
35
Define activity limitations
- difficulties an individual may have in executing actions, tasks, and activities
36
Define participation restrictions
- problems experienced in life situations, self care, home/work/community responsibilities
37
Define primary impairments
- impairments arise directly from the health condition
38
Define 2ndary impairments
- impairments are the result of preexisting impairments
39
Role of physical therapist in impairments
- often the role of the physical therapist is to treat the primary impairment, but also to prevent further complications or secondary impairments
40
Define contextual factors
- patient's background, life, and living situation - environmental factors and personal factors
41
Define environmental factors
- factors associated with the physical, social, and attitudinal environmental - can facilitate or inhibit
42
Define personal factors
- features of individual that are not a part of the health condition or health state including: age, gender, race, lifestyle habits, coping skills, character, affect, cultural, and social background, & education
43
Common tasks related to activity limitations
- reaching & grasping - lifting, lowering, & carrying - pushing/pulling - bending/stooping - turning/twisting - throwing & catching - rolling - sitting or standing tolerance - etc.
44
Areas of functioning associated with participation restrictions
- self care - mobility in the community - occupational tasks - school related tasks - home management - caring for dependents - recreational or leisure activities - socializing with friends/family - community responsibilities & service
45
What is the ABCDEF of goal writing
- Audience - Behavior - Condition - Degree - Expected duration - Function
46
What is the fundamental consideration
- safety - review patient's health history, current status, medication review, & other risk factor review
47
What must a physical therapist ensure
- accuracy of movement/exercise - proper alignment & posture of the body - execution of correct movement patterns - performance with appropriate speed, intensity, & duration - fatigue/rest for recovery
48
Therapeutic exercise interventions
- aerobic conditioning & reconditioning - muscle performance exercises: strength, power, & endurance training - stretching techniques including muscle lengthening procedures & joint mobilization/manipulation techniques - neuromuscular control, inhibition, & facilitation techniques & posture awareness training - postural control, body mechanics, & stabilization exercises - balance exercises & agility training - relaxation exercises - breathing exercises & ventilatory muscle training - task specific functional training
49
Stair snacking
- vigorously climbing a few flights of stairs (3 flights) on your coffee or bathroom break during the day seems to be enough to boost fitness in people who are otherwise sedentary - in addition to being more fit, the stair climbers were also stronger compared to their sedentary counterparts & generated more power during a maximal cycling test
50
What is the compendium of activities & how can this database be used to promote physical activity
- it is a database full of free resources of updated MET codes with published evidence
51
Examples of self report outcome measures
- Activities-Specific Balance Confidence Scale - Patient Specific Functional Scale
52
Examples of performance based outcome measures
- Single Limb Hop Tests
53
Key questions to establish patient goals
- Of the activities you are finding difficult to do or cannot do at all at this time, & which ones would you like to be able to do better or do again? - Of the problems you are having, which ones do you want to try to eliminate or minimize first? - In what areas do you think you have the biggest problems during the activities you would like to do on your own? - What are your goals for coming to physical therapy - What would make you feel that you were making progress in achieving your goals? - How soon do you want to reach your goals?