0 - Intro to Therapeutic Exercise

International Classification of Functioning, Disability, and Health (ICF)

• Focuses on how the disease affects someone’s life

• Provides a common language for healthcare professionals

• Impairment-based diagnosis guides treatment

• Used with ICD to classify and code medical conditions

• ICD 10 code

Impairment

A consequence of a pathological condition

Impairments in body function

Includes:

• Decrease strength

• Decrease balance

• Abnormal reflexes

• Reduced ventilation

Impairments in body structure

• Can be seen on visual inspection or palpation

• Ex. joint edema, open wounds, muscle spasms, joint crepitus

Primary impairment

The direct result of a health condition (asthma)

Secondary impairment

The result of a preexisting impairment (ex. open wound not healing due to DM)

Composite impairments

Result of multiple underlying causes and has primary and secondary impairments

Activity/functional limitations

• Difficulties doing a task or inability to do a task/ADL

• Ex. washing hair

Participation restriction/disability

• Restrictions someone has fulfilling personal and social responsibilities and obligations concerning societal expectations in the home, workplace, and/or community

• Not being able to pay the rent because you cannot work

The levels of disability prevention

• Primary: prevent disease

• Secondary: early dx and reduction of the severity or duration of existing disease

• Tertiary: use of rehab to reduce the severity or limit the progression of the disability and improve function with someone who has chronic, irreversible condition

Environmental factors

External influences on someone (physical, social, attitudinal) that inhibit or facilitate function in someone’s life (ex. someone having $ for a RW)

Personal factors

Internal influences of someone (gender, age, habits, culture, education, etc); ex. motivation, coping skills

Risk factors

Characteristics that predispose a person to impaired function and potential disability; ex. smoking sedentary lifestyle, obesity

Coordination

• Occurs at a conscious or automatic level

• The correct timing and sequencing of muscle firing combined with the appropriate intensity of muscular contraction leading the effective initiation guiding and grading of movement

Flexibility

The ability to move freely, without restrictions

Mobility

The ability of structures or segments of the body to move or be moved to achieve the ROM needed for functional activities

Muscle Performance

• The capacity of muscle to produce tension and do physical work

• Encompasses strength, power, and endurance

Neuromuscular control

Interaction of the sensory and motor systems that enables synergists, agonists, and antagonists, as well as stabilizers and neutralizers, to anticipate or respond to proprioceptive and kinesthetic information and then to work in correct sequence and magnitude to create coordinated movement

Balance

• The ability to align body segments against gravity to maintain or move the body within the available BOS without falling

• The ability to move the body in equilibrium with gravity via interaction between the sensory and motor systems

Stability

The ability of the neuromuscular system through synergistic muscle actions to hold a proximal or distal body segment in a stationary position or to control a stable base during superimposed movement

Parameters to exercise

• Frequency

• Intensity

• Duration

• Movement quality

Types of therapeutic ex. interventions

• Aerobic conditioning

• Strengthening exercises

• Stretch exercises

• Postural awareness

• Relaxation tech

• Breathing and balance ex.

Goals of therapeutic exercise

• Inc strength, flexibility, endurance, coordination balance and relaxation

• Dec pain

5 components to PT practice

• Examination

• Evaluation

• Diagnosis

• Prognosis and POC

• Intervention

Intensity

How difficult the exercise is (wt/no wt used); how much energy is used

Frequency

How often an exercise is done; days per week, etc.

Duration

How long an exercise is performed (or how long rest breaks are)

Movement quality

an individual's ability to perform a specific task or movement pattern in a controlled or optimal way