Kin 313 aquatic therapy mid term
The acronym FIT stands for what? and what ATE principle does it fall under
-Frequency, intensity, time -Progressive overload principle
Wolff's Law
-Human skeletal system adapts to force and stress placed on it ( both neuromuscular and CV systems) -A bone grows or remodels in response to the forces or demands placed upon it
Progressive overload principle
-a training adaptation only takes place if the magnitude of the training load is above the habitual level -continuous increased stimulus for optimal performance improvements -increasing level of intensity through time /weight/speed/etc
SAID principle
-stresses and overloads of varying intensities lead to gradual adaptation over time to overcome whatever demands placed
fluid pressure increases by _____________ per foot of depth
.43 psi
whats the density (specific gravity) of water
1.025 g/cm^3
Neck level PWB
10 percent
atmospheric pressure __________ at the surface
14.7 psi
Chest level PWB
20-30 percent
if a floating persons specific gravity is 0.97 what percent will be above or below the water?
3 % of the persons body will be above the water and 97 % will be below the surface
A cupped hand experiences _______ drag than a flat hand
30% more drag
swing phase ______ of a normal gait cycle. The foot ____________ bear weight as it moves forward
40 percent., does not
Pelvic level PWB
50 percent
the stance phase of the gait cycle constitutes _______ of a normal gait.
60 percent
the relationship between objects shape, velocity, and the amount of drag it experiences can be calculated by........
F(drag)=PCV^2A/ 2G
the body will rotate/spin if.....
CG and CB are not in vertical alignment
where is the COG and the COB?
COG: around the navel area; COB: at the chest
TBI: definition, cause, classification
Definition: external blunt force leading to altered state of consciousness which causes impaired cognitive and/or physical functioning Cause: falls, hit by object Classification: Mild, moderate, severe TBI
name each of the variables of the force of drag formula
F= force of drag, P=fluid density, C=coefficient of drag, V= velocity of object, A= frontal area of object, G=gravitational constant
what are the components we can change in order to better suit the progressive overload principle?
FIT components! frequency intensity and time
Bad Ragaz (hip Ab/Adduction): hold, levels
Hold: thoracic hold, Levels: passive, assistive, active resistance, isometric, active resistive
arthritis strikes ________ almost three times as often as _______
women; men
what are some examples of gross and fine motor skills
Gross (posture and gait) fine (dexterity)
how to calculate Hydrostatic pressure?
HS pressure = HPG
Bad ragaz Pre gait: Hold, purpose, Levels
Hold= plantar/dorsal, Purpose: to prepare the client for walking, Levels: passive, active, resistive
Bad Ragaz (spinal flexion aka Jack knife): hold, levels
Hold: double elbow, Levels: passive, assistive, active resistance, isometric, active resistive
Bad ragaz Pre weight bearing: hold, purpose, levels
Hold: plantar/dorsal, purpose: to prepare the client with weight bearing, levels: Double leg (passive, active), Single leg = affected limb is straight and experiencing weight bearing
during this phase of the gait cycle the _____________ lift the foot to prevent dragging. Knee flexors allow the leg to accelerate forward
Initial swing phase, dorsiflexors
Bad Ragaz (shoulder Ab/Adduction): hold, levels
Pelvic hold, Levels: passive, assistive, active resistance, isometric, active resistive
what are the 5 basic components of therapeutic exercise
ROM and flexibility, muscular strength and endurance, cardiovascular endurance, proprioception and balance, functional motor skills
the more specific the program relative to desired outcome, the better results is based off of which principle of ATE
SAID principle
what are the basic principles of ATE?
Wolff's Law, SAID principle, Progressive Overload principle
Long bones being thickest midway along the shaft is an example of which of the principles of ATE? explain
Wolff's Law; because that is the point at which the bending stress is the greatest and wolf's law states that the human skeletal system adapts to stresses and forces placed on it.
who is archimedes?
a greek mathematician and inventor; law of buoyancy
scissor gait
abnormal gait patter where the individual walks with their knees inward together -more prevalent within individuals with CP
equinus gait
abnormal gait pattern where the individual walks on their toes -more prevalent within individuals with CP
during the flat foot the contact foot is getting ready to _________________.
absorb the body's weight
Postural control
act of maintaining, achieving, and restoring the line of gravity within the base of support during any posture or activity
dynamic balance
active (BOS in motion), functional
an example of this is when a person places a limb in the water and it gets wet and drips when removed fro the pool
adhesion
force of attraction between neighboring molecules of different types of matter is __________
adhesion
what are the ABC's of proprioception
agility balance and coordination
balance dysfunction can result from..... (4)
aging process, sensory capabilities, neurological impairments, psychological conditions
Post polio syndrome: definition, classification, cause
an illness of the nervous system from polio, a highly contagious virus that attacks specific neurons in the CNS, that can appear 15-50 years after polio diagnosis -affects muscles and nerves by causing weakness, fatigue, and muscle or joint pain -Cause: damage left over from polio, weak immune system, fatigue of overworked nerve cells -Classification: national rehabilitation hospital PPS classification
due to this principle, in water one will experience two opposing forces: what is the principle and what are the two forces?
archimedes principle; gravity, buoyancy
what is the law of buoyancy also known as?
archimedes' principle
Base of support
area between supporting limbs
what type of rheumatic disease is one of the leading causes of disabilities in the US?
arthritis
AFYAP stands for
arthritis foundation YMCA aquatics program
any movement towards the surface of the water is _______
assistive
Buoyancy can be either _________ ___________ or _____________
assistive, resistive, supportive
aquatic balance exercises
balance beam, tandem standing/ walking, weight shifts, anything that manipulates BOS and COM
what are some reasons why refraction is a challenge for individuals with disabilities?
because pools appear shallower than they appear which could lead to a possible injury; limbs of people exercising in the water appear distorted so they cannot physically see how they are performing the movement or might lose balance as they are walking if they look down
Refraction
bending of a ray of light as it moves from one medium into another medium of a different density.
proprioception
bodies ability to transmit(position sense) , interpret(information), and respond (appropriate execution of posture and movement)
open kinetic exercise
body is not fixated and there is no weight bearing
specific gravity of a person depends on body composition. what part of the body (body tissue) has the highest specific gravity?
bone
what is the specific gravity of bone, fat, and muscle?
bone: 1.5-2, fat: 0.8, muscle: 1
goals of cardiovascular endurance
build stamina, increase resistance to fatigue
a client is using an aquatic noodle to perform a hip adductor flexibility exercise in an upright position, what type of equipment is the aquatic noodle? what type of exercise is this (supportive, assistive, resistive)
buoyant equipment; assistive
rheumatoid arthritis
caused by swollen/inflamed synovial membrane fluid which causes bone erosion
water at this level allows the person to bear only 25 percent of their weight
chest
research has found that aquatic exercise is beneficial for balance in ___________ and ___________
children and adults
contraindications for deep water exercises: (2)
chronic obstructive pulmonary disorder (COPD), water comfort level
force of attraction between neighboring molecules of the same type of matter is ___________
cohesion
refers to the force of attraction between neighboring molecules of the same type of matter
cohesion
we experience both___________ and _________________ which causes resistance in the water
cohesion; adhesion
viscosity increases as the temperature of the fluid gets .........
colder
This shape has the greatest coefficient of drag
concave
what are the body's proprioceptors?
cutaneous receptors, Muscle tendon receptors (muscle spindle)(GTO), joint receptors, CNS
multiple sclerosis : definition, cause, classification
definition: chronic, typically progressive disease involving damage to the sheaths of nerve cells in the CNF and PNF, not terminal but lifelong disease Cause: unknown, considered an autoimmune disease in which the body's immune system attacks its own tissues Classification: benign MS, relapsing MS (most common), secondary progressive MS, Primary progressive MS
facts about osteoarthritis
degenerative (overuse), 10 percent of US population, 30 percent of women 65+, some stiffness in the morning, pain in the evenings, activity= pain, weight bearing joints, (aging, obesity, genetic, injury)
what are some conditions that benefit from deep water exercise? (4)
degenerative disk disease, herniated disk, spinal stenosis, neurological disorders
specific gravity/ relative density
determines whether an object will float or sink in the water -the ratio of the weight of an object to the weight of an equal volume of water -the heaviness of a substance compared to that of water
5 checklist for flexibility exercise
direction of stretch, hand placement, client position, assistant position, communication
what are the two specific types of back problems?
disc pain and nerve pain
impairment
does not interfere with ADL's -interfering with normal function -any loss or change of psychological, physiological, anatomical or function
during the heel strike the __________ contract and the _________ are fully extended
dorsiflexors, knees
a modification of this water property could either make the clients exercises easier or harder........
drag
when an object is rotated to create greater frontal area of an object what force is increased
drag
warning signs for arthritis
early morning stiffness, recurring pain and tenderness in one or more joints, inability to move a joint normally (ROM), (inflammation, redness, warmth in one or more joints), (unexplained weight loss, fever weakness, combined with joint pain), if symptoms last more than two weeks contact a rheumatologist
the mid stance is characterized by _______________ over the whole foot
even weight distribution
what are the two treatments available for arthritis?
finger fusion, joint replacement
object <1 (float or sink)
float
object = 1 (float or sink)
float just below the surface
Pascals law
fluid pressure is exerted equally on all surfaces of an immersed body at a given depth
what are the two types of balance assessments?
functional balance assessments, computerized balance assessments
stiff knee gait
gait pattern where knee will not bend -CP
heat loss in water is much ____________ than in air
greater
functional motor skills (subcategories)
gross and fine motor skills
what is stride length
heel strike of your right foot to a heel strike of the same foot (R, L, R)
what is step length
heel strike to heel strike (R, L)
what are the 4 sub phases of the stance phase
heel strike, flat foot, mid stance, toe off
which muscles work against buoyancy during aquatic walking
hip extensors, resistive
what are the prime muscles used during the 3 swing phases?
hip flexors and knee flexors, initial swing, mid swing, terminal swing
Bad Ragaz (spinal lateral flexion): Hold, Levels
hold: elbow axilla hold, Levels: passive, assistive, active resistance, isometric, active resistive
flexibility
how much your muscles and tendons can elongate
this pressure is directly proportional to both depth and density of fluid
hydrostatic
physiological goals of arthritis exercise
improve performance of ADL's, decrease pain and stiffness, improve mobility and flexibility, improve posture and balance, improve coordination and ambulation
disability
inability to undertake normal ADL
Static balance
inactive (stable BOS)
what increases hydrostatic pressure?
increased depth!
what type of individual should not be immersed in deeper water?
individuals with COPD (chronic obstructive pulmonary disease) should NOT be at 85% immersion
Arthritis
inflammation of one or more joints, causing pain and stiffness that can worsen with age
facts about rheumatoid arthritis
inflammatory (autoimmune), 1 percent of US population, Women>men, pain in mornings especially stiffness, improves throughout the day, activity = pain relief, genetic
vestibular
inner ear, Crystal fluid inside the canals within your ear and we must maintain equilibrium, The bigger the wave you create in the crystal fluid the more disruption in balance
overview of AFYAP
is community based, emphasizes peer support, is recreational, non clinical, does not replace a prescribed regimen of therapeutic exercise, is designed to promote social and mental well being
if an object has a specific gravity >1 what will happen to it when placed in a pool of water?
it will sink
during this phase of the gait cycle the swing leg passes the weight bearing leg
mid swing
during the stance phase the ___________ acts as a shock absorber and support structure
knee
genu recurvatum gait
knee hyperextension while walking, -CP, MS, MD
Functional limitation
limitation from impairment not disabling yet interfering with normal function
psychosocial impact of arthritis
loneliness/fear of being alone, fear of future deformity/disability, uncertainty, helplessness, dependency, anger and grief about loss of function and changes in lifestyles, financial difficulties, accessibility problems caused by physical barriers and attitudes.
aquatic exercise is considered ________ impact activity
low
what are the different types of pool that the brown center contains?
main therapy pool, cool pool, movable floor pool, whirlpool spa
what is the formula for density?
mass/volume
muscular strength
maximum force exerted by the muscles
what is APA?
modified physical activity for people with special needs; strive for independence and improve ADL's
Plus AFYAP level
more active lifestyle, can maintain moderate intensity levels and longer periods of endurance exercise
benefits of exercise for individuals with arthritis
multiple studies show that mild to moderate exercise is beneficial for people with arthritis, low impact exercises highly advised, limit activities that have high impact on hips and knees, exercise may delay or prevent hip surgery (44 percent less likely to need hip replacement surgery)
spinal stenosis
narrowing of the spinal canal - When this canal narrows our nerves have trouble traveling down the back which leads to pain throughout the body
Nasa maintains a lab with _____ buoyancy so astronauts can practice for space missions
neutral
flexibility and range of motion, are they the same?
no
benefits of deep water exercise
no impact forces, spine experiences a mild traction effect (intervertebral disk pressure decreases, spinal canal size may increase), whole body resistance, eccentric contraction eliminated, improves endurance and muscular strength,
herniated disk
nucleus bulges out through the annulus -pressure in the disc is so great that a tear occurs in the disc wall leading to sciatic pain (numbness and tingling)
center of mass
objects mass is equally distributed in all directions
ROM
occurs at the joint; how much movement you have at a joint
crouch gait
older population who hold onto walkers, tight knee and dorsiflexors -CP
out of the 100 different rheumatic diseases name 4 of them that were mentioned in class
osteoarthritis, rheumatoid arthritis, septic arthritis, juvenile arthritis
vision
perceptual system in postural control -provides information regarding the position and motion of the head with respect to surrounding objects as well as a reference for verticality
circumduction
post stroke individuals because they cannot dorsiflex to clear the floor
computerized balance assessments
posturography, force plate
Hydrostatic pressure
pressure is directly proportional to both depth and density of the fluid
AFYAP is a recreational program which means they want to promote......
promote social and mental well being, you don't need a prescription
what are the sensory systems that are related to balance
proprioception, vision, vestibular
what are the benefits of aquatic gait training? (1)
provides more secure and confident when walking independently in water
clients need to rely more on their proprioception and oculomotor skills due to image distortion in the water due to.........
refraction
viscosity
resistance to movement through a fluid that is caused by friction between molecules of the fluid
any movement away from the surface of the water is ___________
resistive
what are the benefits of hydrostatic pressure?
returns blood to heart more effectively (from legs > heart), mild resistance of breathing in neck deep water is exercise itself, reduces edema, stabilizes unstable joints, improves circulation
hip hike
same as circumduction because you lift your hip in order to clear the floor -Stroke
Basic AFYAP level
sedentary lifestyle, seeking low intensity program
what is gait?
sequence of movements that characterizes an individuals walking/ running
in aquatic walking weight transference is from __________________ and _________________
side to side, forward to backward
object > 1 (float or sink)
sink
Handicap
social disadvantage results from the impairment or disability
what does the SAID principle stand for?
specific adaptation to imposed demands
the _______________ also indicates the portion of an objects volume that will be floating under water
specific gravity
what are the principles and properties of water? (7)
specific gravity/relative density, buoyancy, refraction, fluid resistance, force of drag, hydrostatic pressure, specific heat of water
if a persons CB and CG are not aligned the body will....
spin/rotate
benefit of DWE for the spine. Because of this what does this allow to happen?
spinal decompression inside the discs which aids in pulling nutrients, oxygen, and moisture back into the disc - spinal traction (elongation of the spine)
during this phase of the gait cycle the foot contacts surface and bears weight
stance phase
what is balance?
state of equilibrium, the ability to maintain the COM over the BOS
what type of balance is most appropriate for clients at the center?
static balance!
balance and proprioception
static vs dynamic balance; ABC's of proprioception (agility, balance, coordination)
what is cadence?
steps per minute
the more ________________ an object is, the lower the coefficient of drag
streamlined
during aquatic gait training, partial weight bearing compensates for deficits in __________,__________,____________
strength, balance, and coordination
what purpose do hydrocollars and buoyancy belts serve during a supine flexibility exercise(assistive, resistive, supportive)
supportive
when a person uses a noodle to maintain upright balance we refer to buoyancy as being ___________
supportive
when buoyancy equals the force of gravity this is ______________
supportive
a still lake looks like a mirror due to ________ tension
surface
force of attraction between the surface molecules of a fluid is __________
surface tension
what are the phases of the gait cycle?
swing, stance, double stance phase
during this phase of the gait cycle these two muscles work together to control the speed, swing and contact with the surface
terminal swing, quadriceps and hamstrings
muscular endurance
the ability of muscles to sustain a sub maximal force
buoyancy definition
the ability or tendency to float in water
cardiovascular endurance
the capacity of the CV system to deliver O2 to perform gross motor function over a period of time; resisting fatigue
how does buoyancy assist with aquatic walking?
the push off, flexion of hip and knee
during toe off the heel leaves the floor and prepares for ___________
the swing phase
what is the relationship between temperature and viscosity. Why is this beneficial for our clients?
they are inversely related, if temperature rises viscosity goes down due to the molecules being farther apart; its beneficial for smaller muscles and clients with weaker muscles so they can easily walk in the water without using too much muscular force
osteoarthritis
thinning cartilage causes bone to rub against one another in the joint capsule
who are the targets of AFYAP?
those living with arthritis, rheumatic diseases, related musculoskeletal conditions
functional balance assessments
tinetti balance test, berg balance scale
what is the goal of ATE
to rehabilitate and prevent secondary complications by working on the 5 basic components of therapeutic exercise
double stance phase occurs __________ during the normal gait cycle
twice
In individuals with pathological gait conditions the step length of the ________________ leg will be shorter
uninvolved (not affected)
Line of gravity
vertical line passing down through the COM to ground
________________ acts as a resistance to movement because molecules of a fluid tend to adhere to the surface of a body moving through it, known as _________________
viscosity, drag
an individual exercise program consists of what 6 subcategories?
warm up, stretching, muscular strength/endurance, cardiovascular, proprioception/balance, relaxation
what is the correct body alignment for deep water exercise (6)
water level at shoulder height, maintain upright position, buoyancy belt can be used, maintain 5 degree past vertical, neutral spine, head comfortably out of the water
what is the refraction measure of water and air?
water: 1 g/m^3; air: .001 g/m^3
when a body is fully or partially submerged in a fluid at rest, it experiences an upward thrust equal to the __________ of the fluid displaced
weight
what is the metacenter? and what is it in reference to?
when CG and CB are in vertical alignment; Buoyancy
archimedes principle
when an object (body) is fully or partially submerged in a fluid at rest it experiences an upward thrust equal to the weight of the fluid displaced
can gait abnormalities be improved? how can it be difficult to improve:
yes; joint fusion, severe bony abnormality, permanent nerve damage that has resulted in weakness or spasticity
