Therapeutic Exercise stretching & strengthening

different types of exercise

flexibility (ROM), strengthening, aerobic (cardiovascular)

what is the goal of rehabilitative?

Goal is to improve deficits that impact occupational performance

ROM exercises (stretching)

-increases the resting length of the muscle

-single joint muscle: joints should be positioned opposite of the muscle's action

-multi joint muscle: muscle must be lengthening over all joints simultaneously

-Balance ROM exercises with positioning strategies

How long do you hold a ROM exercise for?

Hold 15-60 seconds

what is AROM (active)?

client moves actively

What is AAROM (Active Assisted)

active assisted ROMOTP assist client to achieve full range

what is PROM? (passive)

OTP moves the client through the ROM passively

what is the neuro application of AROM

client moves actively. can maintain ROM or be strengthening in weak individuals.

what is the neuro application of AAROM

client requires assist to achieve full ROM (typically due to weakness)

what is the neuro application of PROM

cleint unable to move limb and OTP completes exercises to maintain ROM

what is the ortho application of AROM

client safe to activate their muscles and move independently

what is the ortho application of AAROM

client can complete ROM with support to maximize range

what is the ortho application of PROM

therapist must move limb b/c client is unsafe to activate muscles (often due to surgical repair) OR client is clear for therapist to apply pressure to increase ROM

isometric contraction

muscle attachments do not move

gravity is not a factor

fixed speed and resistance

no joint motion

concentric contraction

muscle attachments move closer together (muscle shortens)

movements occur against gravity (raising motion)

variables speed, fixed resistance

eccentric contraction

muscle attachment move farther apart

movement occur with gravity (lowering motion)

decelerates movement caused by gravity

fixed speed variable resistance

closed chain

exercises where the distal end of the extremity is fixed to a stationary object (or surface)

open chain

allows the distal end of the extremity (chain) to move freely

endurance

designed to increased stamina lower intensity or resistance over more time or reps

strength

designed to increase strength higher resistance over fewer reps; (sets of 3x10)

what do you consider when deciding how much resistance to use for a patient?

MMT results, age, PLOA, clinical observations, pt feedback

what are isometric exercises?

tightening contractions with minimal joint movement

strengthening the muscle in only one position, so good for building stability and not dynamic strength

scapulohumeral rhythm

beyond 30 degrees flexion, the scapula and humerus move at a 1:2 ratio. full flexion or abduction of the shoulder involves approximately 60 degrees scapular rotation and 120 degrees flexions

What is subacromial impingement?

Compression of the soft tissues between acromion and humeral head

what is the goal for exercise?

30 mins 5 days a wk of moderate intensity exercise