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Relaxation Flashcards

(52 cards)

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1
Q

What Is Stress?

A

Stimulus-An outside force that puts demands on you.
Response-A physical response going on within you.
Transaction-An exchange between a stimulus, our perception of it, and the response it causes.
Holistic Phenomenon-Describes stress as part of a larger whole taking into account lifestyles and other circumstances.
Stressor- Stimuli which causes a stress response.
Stress Response- A set of physiological adaptations of the body to regain homeostasis in the face of threat, harm, or loss.

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2
Q

Homeostasis

A

Is a state of “normalcy or balance.”

BP, heart rate, hormone levels and other vital functions are maintained within a narrow range.

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3
Q

General Adaptation Syndrome

A

Alarm Phase- (Fight-or-Flight reaction) the body mobilizes energy to meet the demands of stressors.
Resistance Phase- The body attempts to maintain homeostasis.
Exhaustion Phase- A body part or system breaks down as a result of the energy demands of chronic stress.

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4
Q

Alarm Phase:Fight-or-Flight Response

A

Endocrine system releases hormones (cortisol, epinephrine, norepinephrine)
Hearing & vision becomes acute.
Heart rate accelerates to pump more oxygen.
Liver releases extra sugar to provide energy boost to muscles.
Perspiration increases to cool the skin.
Endorphins are released to relieve pain in case of injury.
Increased metabolic rate.
Decreased digestive activity.

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5
Q

Cortisol Response

A

Decreased immune function
changes in glucose metabolism
changes in neurochemistry
changes in cardiovascular status

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6
Q

Physical Therapist Role

A

Most common symptom: tension related pain
Disorders related to increase tension/stress:
Heart attacks
Cerebrovascular injuries
Chronic musculoskeletal problems
Peripheral and neurovascular syndromes

Recognize Signs of Tension
Within scope of practice, treat signs of tension
Relaxation is a key to reducing muscle tension, anxiety, nervousness and stress
Relaxation is not a Magic Button and does NOT cure joint dysfunction or other musculoskeletal trauma

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7
Q

Contributors to Increase Muscle Tension

A 
Emotional tension
Physical trauma
Infection
Immobilization
Other stressors

Cycle of pain, muscle guarding,Retained metabolites, and restricted motion

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8
Q

Managing Stress

A 
Social Support
Exercise
Proper Nutrition
Time Management
Cognitive Techniques
Clear Communication
Relaxation Techniques
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9
Q

Relaxation

A

Definition:
transitive verb
1: to make less tense or rigid : slacken
2: to make less severe or stringent : modify
3: to deprive of energy, zeal, or strength of purpose
4: to relieve from nervous tension

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10
Q

intransitive verb

A

1: to become lax, weak, or loose : rest
2: to become less intense or severe
3: of a muscle or muscle fiber : to become inactive and lengthen
4: to cast off social restraint, nervous tension, or anxiety
5: to seek rest or recreation
6: to relieve constipation
7: to attain equilibrium following the abrupt removal of some influence (as light, high temperature, or stress)

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11
Q

Physical Signs of Tension

A 
HR
BP
Increased muscle tone
Altered breathing pattern
“agitated” or “fidgety”
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12
Q

Examination for Tension

A 
PMH:
	Cardiovascular and respiratory symptoms
	Eye, ear, nose and throat symptoms,
	Headaches or head pain 
	TMJ dysfunctions
	Digestive disorders
	Endocrine imbalances
	Muscle tension pain

Symptoms patient may relate:
Increased eating, smoking, drinking
Difficulty falling asleep, waking up feeling exhausted, keyed up and jittery during the day

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13
Q

Observation: Signs of agitation, signs of anxiety or restlessness

A 
Chewing of lips 
Grinding or clenching teeth
Biting fingernails
Pacing
Clenching, unclenching of hands
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14
Q

Assessment of Stress

A 
One tool: symptoms of stress checklist
0-7 = low
8-14 = moderate
15-21 = high
22+ = very high
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15
Q

How do we treat tension?

A 
Massage
Modalities:
	Moist Heat
	Ultrasound
	Electrical Stimulation
	TENS
Muscle Re-education
	Progressive Relaxation
	Biofeedback
	Autogenic training
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16
Q

Approaches to Treatment

A

Cognitive or mental

Somatic or physical

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17
Q

Cognitive or mental approach

A

Meditation
Sensory awareness techniques
Autogenic training

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18
Q

Somatic or physical approach

A 
Passive distraction (Jacobson’s techniques)
Active or dynamic distraction (Feldenkreis Techniques, Tai chi)
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19
Q

Passive Relaxation Strategies

A

Deep Breathing
Meditation
Visual Imagery
Autogenic Training
Sit in the meditative posture and scan the body
“my right arm is heavy”
“my arms and legs are heavy and warm” (repeat 3 or more times)
“my heartbeat is calm and regular” (repeat 3 times)
“my solar plexus is warm” (repeat 3 times)
“my forehead is cool”
“my neck and shoulders are heavy” (repeat 3 times)
“I am at peace” (repeat 3 times)

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20
Q

Active Relaxation Strategies

A 
Systematic Muscle Relaxation
Yoga
Static Stretching
T’ai Chi
Massage
Hobbies & recreational activities
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21
Q

Patient/Client-Related Instruction

Study These Flashcards
A

Process of educating, informing, or training
Patients, clients, family members, significant others, or care givers
Promote and optimize physical therapy services

22
Q

Types of Instruction

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A 
Current condition
Enhancement of performance
Health wellness and fitness programs
Plan of care
Risk factors for pathology
Transitions across settings
Transitions to new roles
23
Q

Patient Learning

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A

Cognitive: information and facts
Affective: attitude and motivation
Psychomotor: motor programs and exercise programs

24
Q

Perceptions

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A

Physical Therapists believe they educate 80-100% of their patients in some manner
Most education is in one of the following:
Current condition
Diagnosis
Plan of care

25
Less likely to educate on...
Relationships between symptoms and patients daily routines Expected response to exercise Stress management Health and wellness
26
Literature Results
Studies have shown that patients adherence to physical therapy exercise programs depends on the time spent educating the patient on prognosis and expectations from rehab. With education, there can be as much as an 80% change in attitudes and behaviors
27
Why there’s need for patient education
Patients are discharged quicker Patients are sicker when discharged Patients require more education for home than they use to. Pro: limits the development of an external focus = patient dependence on the therapist for management of condition
28
Skill Set for Effective Communication
Active listening skills Reflection on patient replies Providing appropriate feedback
29
Active Listening
Close observation of words Intonation Body language Eye contact with affirmation
30
Reflection of Patient Report
Seeks to clarify what the PT heard Allows patients to change or modify comments Validates patient report – I heard what you are saying Helps to build rapport with patient Clarify how progress is defined (pain, time, movement)
31
Providing appropriate feedback
Sluijs et al: lack of positive feedback is one of the primary factors related to adherence to a rehab exercise program Need to learn how much feedback to give, when to give it and what type to give. Response of patient: listen to it and adjust feedback accordingly
32
Adherence and Motivation
Best designed program will do nothing for the patient if the patient isn’t compelled to participate Sluijs et al: % patients who fully comply: 37% % patients who partially comply: 76%
33
Lack of Compliance or Adherence
``` Affective Domain Barriers to Adherence Lack of positive feedback Feeling of helplessness Less educated: more likely to have adherence to a program No gender differences with compliance ```
34
Theories on Patient Behavior
Health Belief: stresses elimination of behaviors Health Locus of Control Self Efficacy
35
``` Trans theoretical: stages of change Pre-contemplation Contemplation Preparation Action Maintenance ```
``` Pre-contemplation Contemplation Preparation Action Maintenance ```
36
Pre-Contemplation
No intention of changing | See no need for change
37
Contemplation
Considering change, haven’t initiated it yet Plan to make a change within 6 months Patients are usually here
38
Preparation
Planning to change within the month No action yet Patients are usually here
39
Action
Have reached a certain criterion level which demands change for the individual We want our patients here!
40
Maintenance
Reached criterion level Maintained at least months Habit breaking
41
Application to Patient Education
What stage is the patient in? Listen for cues Help patient identify barriers to participation Input from the patient – what would it take to remove the barriers? Pro’s of participation need to outweigh the cons of participation
42
If pre-contemplation
Help patient identify goals that could be achieved
43
If contemplation
Encouragement Provide information Help patient to perceive a relationship among an injury or pathology, exercise and expected outcome
44
If Action
Engage in a plan of care Identify barriers Positive reinforcement
45
Motivation is the Key
What motivates the patient? Identify the motivators and tutor the program to the motivators Non specific programs, not geared for a patient’s goal, will result in adherence issues for the patient. Exercise program should reflect patient goals
46
Developing a Home Program
Design a program that requires the fewest lifestyle changes – increases adherence Choose exercises that can be incorporated into a patient’s daily activates when possible
47
Sluijh identified three things that contribute to adherence/compliance
Self motivation Scheduling concerns Biggest concern Pain tolerance
48
HEP Issues
``` Type of learner: visual, auditory, kinesthetic Cultural barriers: language, background Clarity of instruction Education around exercise program Pictures or drawings, arrows “Canned” program vs Individualized Communication: written and verbal Organize, cluster exercises together to minimize position changes ```
49
Psychomotor Learning Skill Phases
Cognitive Phase Associative Phase Autonomous Phase
50
Cognitive Phase
attention to task is necessary Gross motor skills are developed Overcorrection Exaggerated movements
51
Associative Phase
Refinement of gross motor skills Efficient Less overcorrection Less exaggeration
52
Autonomous Phase
Motor program is activated | Little cognitive input is needed

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