Therapeutic Exercise Intervention Flashcards
(42 cards)
Rehabilitation program =
primary emphasis is restoration of muscular strength, endurance, flexibility
Physical Fitness =
improvement, CV fitness, body composition
risk factors for chronic disease
physical inactivity and sedentary behaviour smoking nutrition high blood cholesterol overweight and obesity alcohol high BP
health risks of obesity
low self esteem social isolation depression heat intolerance SOBOE fatigue
Heart disease and stroke abnormal blood lipids & metabolic syndrome hypertension diabetes cancer gallbladder disease & gall stones OA & gout Respiratory conditions infertility, incontinence, PCOS
Physical inactivity
associated with poor health outcomes and increased mortality
increased risk of diabetes, CV disease, cancer
Regular physical activity and high CV fitness decrease mortality
Benefits of regular physical activity
reduces risk of premature mortality reduces risk of death from CV disease reduces risk of stroke reduces risk of developing diabetes reduces risk of developing bowel cancer helps to control weight helps to build and maintain healthy bones, muscles, joints decreased risk of falls, improved mobility (elderly) Reduces depression/anxiety/stress levels promotes psychological wellbeing reduces cognitive decline & dementia
Immediate short term goals
- provide first aid + mgmt - swelling
- reduce or minimise pain
- restore full ROM
- establish core stability
- reestablish neuromuscular control
- improve postural stability and balance
- restore or increase muscular strength/endurance/power
- maintain cardiorespiratory fitness
- Incorporate functional progressions
Functional progression
graduated progressive activities to prepare return to specific activity or function
skills are broken down into components
advance if no additional pain or swelling
Stage 1 : stabilisation
muscle, joint, nerve, postural control and stability deficits addressed correct imbalances recondition injured structures prepare tissues for physical demands prevent tissue overload improve work capacity improve stabilisation strength
progress from isometric to incorporating movement
Improve neuromuscular efficiency, core stability, functional strength, functional flexibility
Stage 2: strength
enhance stabilisation strength and endurance
high volume resistance exercises
goal is to achieve adaptive changes by challenging NM system
- increase in muscle size
- increase fatigue resistance
-increased stabilisation strength to control joint translation
Stage 3 : power
important for return to high level activity
30-45% of max strength, accelerating through ROM
Goal : enhance NM efficiency and power production by increasing motor neurone excitability and speed strength throughout ROM
Consider healing factors
Injury extent - response is determined by extent effusion and or oedema haemorrhage poor vascular supply separation of tissue muscle spasm atrophy steroid use keloid or hypertrophic scars infection health/age/nutrition wound healing conditions
Establishing core stability
stabilises entire kinetic chain during FXN
maintains normal length - tension relationship of agonists + antagonists
normal force couple relationships in lumbo-pelvic -hip
Allows for optimal lumbo-pelvic-hip complex during functional kinetic chain movements
proximal stability - efficiency in limb movements
Revise core anatomy
42
Range of motion and stretching
Flexibility = movement through full, unrestricted painfree ROM
Open chain =
distal segment is mobile, hand or foot not fixed or in contact with the ground/surface
Closed chain =
Distal segment fixed, hand or foot is weightbearing
Closed chain
safer, less stress and force to healing joints
co-contraction of agonist-antagonist decreases shear forces on joint
enhances joint stability
Open chain
isolated to single joint
strength and ROM
Useful when closed chain is not possible
Neuromuscular control
Reestablishing brains interpretation of proprioceptive and kinaesthetic info
retrain conscious control of specific movement
successful repetition - automatic
functional strengthening, closed chain kinetic
critical during early stages to prevent re-injury
Four crucial elements of neuromuscular control
- proprioceptive and kinaesthetic sensation
- dynamic joint stabilisation
- reactive neuromuscular control
- functional activity
Open and closed chain activities, balance training, eccentric + high rep/low load strengthening, reflex facilitation, plyometrics, biofeedback
Postural control and balance
ability to maintain stability and balance requires proprioception and kinesthesia decreased? - poor neuromuscular control -muscular weakness -ROM limitations -Vestibular, visual deficits
poor postural control - risk of re-injury
combination of open and closed chain
Postural control and balance
safety first train in multiple planes of motion consider multisensory progress - static, bilateral, stable surface > dynamic, unilateral, unstable surface progress towards sports specific
Strength, power, endurance
goal - work in full pain-free ROM Multiplanar : concentric, isometric, eccentric consistent, increasing effort against progressively increasing resistance isometic -early stage of rehab - limitation in ROM -Minimise atrophy -decrease swelling
