Download Therapeutic exercise foundation and techniques

Therapeutic Exercise
Foundations and Techniques
Part I
General Concepts
Chapter 01
Therapeutic Exercise: Foundational Concepts
Therapeutic Exercise
Definition
Therapeutic exercise is the systematic, planned performance of
bodily movements intended to provide a patient/client with the
means to
•prevent impairments
•Improve, restore, enhance physical function
•Prevent or reduce health-related risk factors
•Optimize overall health status
patient and client
•Patient
• is an individual with impairments and functional
limitations
•Client
•is an individual without diagnosed dysfunction
who engages in physical therapy services to
promote health
Aspects of Physical Function:
Definition of Key Term
Aspects of Physical Function:
Definition of Key Terms
Balance.
Aspects of Physical Function:
Definition of Key Terms(Contd)
Cardiopulmonary fitness.
Aspects of Physical Function:
Definition of Key Terms(Contd)
Coordination
Aspects of Physical Function:
Definition of Key Terms(Contd)
Flexibility.
Aspects of Physical Function:
Definition of Key Terms(Contd)
Mobility.
Aspects of Physical Function:
Definition of Key Terms(Contd)
Muscle performance.
Power
Endurance
Aspects of Physical Function:
Definition of Key Terms(Contd)
Neuromuscular control.
Aspects of Physical Function:
Definition of Key Terms(Contd)
Stability.
Types of Therapeutic Exercise
Intervention
Aerobic conditioning
Muscle performance exercises:
Joint mobilization techniques
Neuromuscular control, inhibition, and facilitation
posture awareness training
Postural control, body mechanics, and stabilization
Balance exercises
Relaxation exercises
Breathing exercises
Task-specific functional training
Exercise Safety
FACTORS FOR EXERCISE SAFETY
•Patient’s health
•Medications can adversely affect a
patient’s balance and coordination
•Environment
•Execution of the correct movement
patterns i.e. intensity, speed, and
duration.
Models of Disablement
The first two schema developed were
• Nagi model
• International Classification of Impairments,
Disabilities, and Handicaps (ICIDH) model for
the World Health Organization
• The National Center for Medical Rehabilitation
Research (NCMRR) integrate above both
model, develop own model
ICF MODEL
ICF model
• Bio psycho social model
• It has two parts
1. Functioning and disability
– body function and structure
– activities and participation
2. Other factors
– Environmental factors
– Personal factors
ICF model
Health conditions( pathological
conditions)
• Impairment
• Functional limitation
• Disability
Impairments
• Impairments are the consequences of pathological
conditions; that is, signs and symptoms that reflect
abnormalities at the body system, organ, or tissue
level
Types of Impairment
• Anatomical
• Physiological
• Psychological
Impairment(contd)
•
•
•
•
Musculoskeletal
Neuromuscular
Cardiovascular/pulmonary
Integumentary
Common Physical Impairments
Managed with Therapeutic Exercise
Musculoskeletal
• Pain
• Muscle weakness/reduced torque production
• Decreased muscular endurance
• Limited range of motion due to
• Restriction of the joint capsule
• Restriction of periarticular connective tissue
• Decreased muscle length
• Joint hypermobility
• Faulty posture
• Muscle length/strength imbalances
Common Physical Impairments
Managed with Therapeutic
Exercise(contd)
Neuromuscular
• Pain
• Impaired balance, postural stability, or control
• Incoordination, faulty timing
• Delayed motor development
• Abnormal tone (hypotonia, hypertonia, dystonia)
• Ineffective/inefficient movement strategies
Cardiovascular/Pulmonary
• Decreased aerobic capacity (cardiopulmonary endurance)
• Impaired circulation (lymphatic, venous, arterial)
• Pain with sustained physical activity (intermittent claudication)
Integumentary
• Skin hypomobility (e.g., immobile or adherent
Functional Limitations
They are the result of impairments
•characterized by the reduced ability of a
person to perform actions or components
of motor skills in an efficient or typically
expected
Types of Functional Limitations
•ADL
•Bathing
•Dressing
•Feeding
•IADL
•more complex tasks
•Occupational tasks
•School-related skills
•Housekeeping
•Recreational activities
•community mobility
Common Functional Limitations
Related to Physical Tasks
Limitation of
• Reaching and grasping
• Lifting and carrying
• Pushing and pulling
• Bending and stooping
• Turning and twisting
• Throwing and catching
• Rolling
• Standing
• Squatting and kneeling
• Standing up and sitting down
• Getting in and out of bed
• Crawling, walking, running
• Ascending and descending stairs
• Hopping and jumping
• Kicking
Disability
Disability is the inability to perform or participate
in activities or tasks related to one’s self, the
home, work,
recreation, or the community
•Physical impairments and functional limitations
directly contribute to disability
General Categories of Activities
Relevant to Disability
• Self-care
• Mobility in the community
• Occupational tasks
• School-related tasks
• Home management
• Caring for dependents
• Recreational and leisure activities
• Community responsibilities and service