Intro

what is the correct sequence of progression?

1. PROM: Passive ROM 2. AAROM: Active Assistive ROM 3. AROM: Active ROM 4. Motor Control: Repetitive AROM in purposeful movement patterns/postures - When the movement pattern is correct... 5. Endurance: High repetition (20-30 reps) with low resistance (<60% 1-RM) 6. Strengthening: Low repetition (5-15 reps) (>70% 1-RM) 7. Power: High Speed Resistive Movements 8. Plyometrics

principle 4

If effusion, then NO gain in "strength" (Arthrogenic inhibition of muscle)

rehabilitation pyramid - what are the 4 pillars?

psycho well-being CV endurance nutrition pt education

How is Therapeutic Exercise different from Fitness?

PT has a physiologic effect to heal or remediate AND prevent further problem

principle 7

PT programs (due to the presence of tissue injury, pathology, or abnormal movement patterns) focus on HIGH REPS at <70% of the 1-RM. Thus, it falls into the motor control/endurance area of Holten's Curve.

principle 12

Posture affects Function - need to pay attention to the patient's overall POSTURE. Trunk stabilization, head posture and the extremity positions

principle 10

Quality over Quantity. Doing the wrong movement only engrains improper movement patterns. "Sweat the Details"

Strength

Strength "is a broad term that refers to the extent that the contractile elements of muscle produces force

How do you Foster Patient Compliance (Adherence)?

The NEED behind the NEED motivation rationale "...here's why" exercise into their daily life no more than 6 exercises

principle 13

The SAID Principle always applies. Specific Adaptation to Imposed Demands. Goal - appropriate loading/Physical Stress Theory

principle 6

The majority of the muscle force increases associated with physical therapy comes from Neural Adaptation rather than true muscle hypertrophy. SEE #7 Holten's Curve

principle 2

Therapeutic Exercise should be INDIVIDUALIZED based on the patient function and the patient's goals. Keep in mind the standard of care

principle 1

Therapeutic Exercise should be guided by Tissue Healing Constraints (when present) - what you cannot/should not do/contraindications/precautions

principle 8

Treatment Progression should occur in a logical sequence

standard of care

What an otherwise reasonable and prudent physical therapist with similar education/training would do in the same or similar circumstance.

rehabilitation pyramid - what are the components of the foundation?

diagnosis acute care management surgical intervention rehab skill

Primary Prevention

educational session (to normal public person)

Secondary Prevention

in clinic work for tx problems

Therapeutic Exercise

purposeful movements, postures, or activities under the direct supervision of PT - intended to decrease, eliminate, or prevent impairments AND improve function in those w/ pathological condition or movement dysfunction.

Strength Training

systematic practice of using muscle force to raise, lower, or control external loads for a relatively low number of repetitions or over a short period of time. Goal = hypertrophy

Tertiary Prevention

very specific and specialized (ex. MS) to improve QoL and function

rehabilitation pyramid - what are the components of the 7 steps?

1. pre injury status 2. tissue healing constraints 3. flexibility and stability 4. strength, power, and endurance 5. balance and proprioception 6. motor control and skill acquisition 7. functional activity progression

2 components to strength training

1.Muscle Fiber Size Increase (Hypertrophy) 2.Neural Adaptation (Motor Control)

according to principle 12, _______% increase in supraspinatus force with scapular retraction

14-29% increase in supraspinatus force with scapular retraction

20-30 mL of fluid in the knee reduces strength by _____%

60%

principle 9

Always encourage intrinsic (patient generated) movement rather than extrinsic (therapist generated) movement.

principle 15

Always promote independence, self-efficacy, and patient adherence. PT is a radio, turn me up or down when needed!

principle 16

Documentation of Outcomes and Patient Function pays the Bills Show that pt progress is related to your intervention

principle 11

Dose-Response Curve: Too little --> No effect; Too much -->Bad effects

principle 14

Function is multifactorial. Not every patient needs every component, but we should consider every component in every patient.

principle 3

If pain, then NO gain in "strength" (Neurogenic inhibition of muscles)

principle 5

Motor Control should precede/come prior to "muscle hypertrophy"