PT 643: Physical Stress Theory (PST) - A Framework for Intervention Decision Making

what are the different types of intervention?

manual therapy

therapeutic exercise

patient education

therapeutic modalities

what are the different components of manual therapy?

soft tissue massage

manual mobilization, joints, muscles, tissues

manipulation

acupressure

what are the different components of therapeutic exercise?

flexibility exercise

strengthening exercise

neuromuscular reed

balance, coordination, proprioception

relaxation exercise

what are the different components of patient education?

body mechanics

pain relief

home exercise programs

wellness

risk reduction

what are the different components of therapeutic modalities?

thermal - heat and cold

mechanical - compression, traction, hydrotherapy

acoustic - US

electromagnetic - electrical stimulation, laser, light therapy, diathermy

what are the different tissues in the body?

muscle

nerve

connective

skin

what is stress?

physical quantity that expresses the internal forces that neighboring particles exert on each other

how is stress measured?

force per unit area

what is force?

vector quantity with magnitude, direction, point of application to the body

what is an external force?

gravity

what is an internal force?

muscle activity

what are the types of force acting on and in the body?

shear, compression, torsion, tension

what is the basic clinical idea of the physical stress theory?

physical stress applied to tissue -> tissue response -> adaptation

the response of the physical stress theory depends on what?

magnitude, duration, frequency, and type of stress, as well as the tissue's current capacity

what is the goal of the physical stress theory?

modify the patient's current response to stress

what are the goal of the PST in response to inflammation?

increase circulation, decrease edema, decrease pain

what are the goal of the PST in response to fibroblastic?

early movement, decrease edema if persistent, facilitate collagen synthesis

what are the goal of the PST in response to remodeling?

facilitate aggregation, orientation, and arrangement of collagen fibers

changes in the relative level of physical stress cause a predictable response in all ______

biological systems

what is general adaptation syndrome (GAS)?

alarm stage

resistance stage

exhaustion stage

what is the alarm stage of GAS?

body's resources are mobilized to prepare organism to deal with threat

what is the resistance stage of GAS?

body adapts to the continued presence of the stressor

what is the exhaustion stage of GAS?

if the threat and the body's response continues, possible irreversible damage to the body

biological tissues exhibit 5 characteristic responses to physical stress. each response is predicted to occur within a defined range along a continuum of stress levels. what are the 5 characteristics?

injury

increased tolerance (hypertrophy)

maintenance

decreased tolerance (atrophy)

death

physical stress levels that are lower than the maintenance range result in what?

decreased tolerance of tissues to subsequent stresses

physical stress levels that are in the maintenance range result in what?

no apparent tissue change

physical stress levels that exceed the maintenance range (overload) result in what?

increased tolerance of tissues to subsequent stresses

excessively high levels of physical stress result in what?

tissue injury

extreme deviations from the maintenance stress range that exceed the adaptive capacity of tissue result in what?

tissue death

the level of exposure to physical stress is a composite value defined by what?

magnitude, time, and direction of stress application

individual stresses combine in complex ways to contribute to the overall level of stress exposure. tissues are affected by what?

the history of recent stresses

excessive physical stress that causes injury can occur through what?

high magnitude stress applied for a brief duration

low magnitude stress applied for a long duration

moderate-magnitude stress applied to the tissue many times

regardless of mechanism of injury, inflammation occurs immediately following tissue injury and renders the injured tissue ___ tolerant of stress than it was prior to injury

less

the stress thresholds required to achieve a given tissue response may vary among individuals depending on what?

presence or absence of several modulating variables