PT 856 lecture 1: therapeutic exercise

What is the movement system?

- Integration of body systems that generate and maintain movement at all levels of bodily function

Aspects of the movement system

- Nervous

- CV

- Pulmonary

- Integumentary

- Musculoskeletal

- Endocrine

Components of physical function

- Balance and posture

- Cardiopulmonary endurance

- Neuromuscular control and coordination

- Mobility and flexibility

- Muscle performance

- Stability

What is physical fitness composed of?

- Metabolic fitness (body function at rest)

- Performance based motor fitness

What is therapeutic exercise?

- The performance or execution of planned physical moments and activities to provide the patients a means to

o Remediate or prevent impairments

o Enhance function

o Reduce risk

o Optimize overall health

o Enhance fitness and wellbeing

Therapeutic exercise billing code

- 97110

ICF model components

- Body function and structure

- Activity

- Participation

- Environmental factors

- Personal factors

Strategies for effective exercise intervention

- Determine specific goals

- Selecting and advancing interventions

Types of motor task

- Discrete

- Serial

- Continuous

Describe each type of motor task

- Discrete: an action or motion with a recognizable beginning and end

- Serial: composed of a series of discrete movements combined in a particular sequence

- Continuous: involved receptive un-interrupted movements that have no distinct begging and end (arm-bike)

Closed vs open environment

- Closed: objects around patients and surface on which performed do not move

- Open: objects or other people in motion or support surface is unstable

Intertrial variability (absent vs present)

- Absent: environment in unchanged

o Repetitively lifting the same box from floor to shelf

- Present: demands change with repetitions

o Loading a truck with different weight packages

Stages of motor learning

- Cognitive

- Associative

- Autonomous

Describe the stages of motor learning

- Cognitive: learning the task, goal or purpose

- Associative: fine tuning, some hits and misses with problem solving

- Autonomous: the movement becomes automatic

Dosing exercise (FITT)

- Frequency

- Intensity

- Time

- Type

ACSM and CDC recommendations of exercise

- 150 minutes of moderate intensity aerobic activity every week

- 2 X muscle-strengthening activities a week that hit all major muscle groups

What is a repetition maximum?

- The greatest amount of weight or load that can be moved with control through full range of motion, a specific number of times before fatigue

Time exercise duration details

- 6-12 weeks for significant muscle changes

- 1-2 month to return to function

o Depends on patient

muscle strength definition

Force generated during a single maximum effort

Power definition

- Related to strength and speed of movement

Power formula

- Work/ time

- (Force X distance) / time

To increase power...

- Increase the work (force or distance)

- Decrease time

Endurance definition

- The ability to perform repetitive or sustained activity over a prolonged period of time.

Types of muscle contraction

- Dynamic

o Concentric

o Eccentric

- Static

o Isometric

Open vs closed chain position

- Open: distal segment is free during movement

- Closed: when the distal segment is fixed

Anaerobic energy system

- High intensity over low reps (rapid fatigue)

- Quick burst of activity

Aerobic energy system

- Low intensity, high reps, over extended time

- Muscle and CP endurance

Short vs long arc

- Short: partial ROM

o Pain, instability, protection after injury or surgery

- Full: full ROM

Exercise principles

- Overload

- Specific adaptations to impose demand

- Reversibility

Overload principle

- To improve muscle performance, resistance load that exceeds the metabolic capacity of the muscle must be applied

SAID principle

- To Improve a specific muscle performance element, the resistance program should be matched to the element's constructs

- your body adapts to the specific demands placed upon it. So, if you train for a particular sport or skill, your body will adapt and get better at that specific skill.

Reversibility principle

- Reducing in muscle performance begins 1-2 weeks after cessation of resistance exercise