Therapeutic Exercise

Dynamic Systems Theory (DST)

A framework where movement arises from the interaction of task, individual, and environment constraints; altering constraints changes movement patterns.

Task Constraints

Rules or requirements of a task that shape how movement is performed (difficulty, type, time).

Individual Constraints

Person-specific factors such as action capabilities, perception, cognition, motivation, and emotion that influence movement.

Environmental Constraints

External factors affecting performance, including regulatory features (must conform to) and non-regulatory features (may affect performance).

Emergent Movement

Movement that arises from the interaction of inputs within the system rather than being pre-programmed.

Uncontrolled Manifold Hypothesis

Idea that the brain tolerates variability in redundant degrees of freedom while maintaining task performance.

Motor Abundance / Degrees of Freedom

Multiple possible joint configurations to achieve the same movement goal.

Attractor Wells

States with low variability indicating stable patterns; the depth indicates how flexible a movement pattern is; deep wells do not force obligatory patterns.

Part Task

Practice focusing on components or steps of a larger task.

Whole Task

Practice of the entire task in one integrated attempt.

Blocked Practice

Repeating the same task for many trials before moving to another task; good for early KP/KR guidance.

Random Practice

Interleaving different tasks to enhance adaptability and transfer to new contexts.

Massed Practice

Long task trials with little rest; may lead to fatigue and performance issues.

Distributed Practice

Shorter task trials with rest periods; better for fatigue management and learning.

Constant Task

Practicing the task in the same way repeatedly to build a deep attractor well.

Variable Task

Practicing with many variations (time, speed, weight, distractions) to increase degrees of freedom.

Knowledge of Results (KR)

Feedback after task summarizing what happened and the outcome.

Knowledge of Performance (KP)

Feedback during the task focusing on movement quality and technique.

Balance

The ability to control the body so that the center of mass remains within the base of support.

Base of Support (BOS)

The area between the points of contact the body has with the ground.

Center of Gravity (COG/COM)

The vertical projection of the center of mass onto the ground; in humans, COM and COG are closely aligned.

Interaction of BOS and COG

If COG is within BOS, balance is maintained; outside BOS, balance is challenged; border cases are on the BOS edge.

Limits of Stability (LOS)

Also known as the cone of stability; the maximum sway angle without changing BOS (approximately 12–13° AP, 14–16° lateral).

Ankle Strategy

Small perturbations; distal-to-proximal muscle activation; typically used on firm surfaces.

Hip Strategy

Moderate perturbations; proximal-to-distal activation; used when ankle strategy is insufficient or surface is small/soft.

Stepping Strategy

Largest perturbations; stepping enlarges BOS to maintain upright posture; common in fall risk.

Static Balance

Ability to maintain postural stability with the body at rest on a fixed surface.

Dynamic Balance

Ability to maintain postural stability while moving or on a moving surface.

Anticipatory Postural Control

Predicts disturbances and uses pre-programmed responses to maintain position.

Reactive Postural Control

Responds to unanticipated disturbances to maintain stability.

Sensory Contributions to Balance

Vision, vestibular input, proprioception, mechanoreceptors feed CNS, which generates motor commands for balance.

Therapeutic Exercise

Movement prescribed to correct impairments and restore function; involves regular activity across modalities to improve health and resilience.

Home Exercise Program (HEP)

A set of exercises prescribed for patients to perform outside of clinical sessions to support rehabilitation.

HEP2go

An online platform for rehabilitation professionals to create, save, and print customized home exercise programs.

Care Team

The collaborative group involved in patient care, including patient, physician, PT, ATC, nurse, parents/family, coach, and others.

Joint-by-Joint Approach

Course structure focusing on each joint with lab sessions to develop psychomotor skills.

Primary Prevention

Strategies aimed at reducing risk factors and preventing disease before it occurs.

Secondary Prevention

Actions taken after disease onset to diagnose early, address acuity, and promote healing.

Tertiary Prevention

Efforts to decrease disability and improve function once a chronic disease is established.

ACSM Activity Guidelines

Recommended levels: at least 150 minutes/week of moderate-intensity aerobic activity plus muscle-strengthening on 2+ days/week for major muscle groups.

Moderate-Intensity Aerobic Activity

Activities that raise heart rate and breathing but allow conversation; examples include brisk walking.

ICF Model

International Classification of Functioning, Disability and Health; a framework linking health condition, body Functions/Structures, activity, participation, and contextual factors.

Health Condition

Illness, disorder, or injury as defined in the ICF model.

Body Functions and Structures

Anatomy and physiology involved; the impairments that can be observed.

Activity (ICF)

Tasks/activities that a person can or cannot perform; describes limitations.

Participation

Involvement in life situations such as work, social, and recreational activities.

Environmental Factors

External factors that can influence functioning, such as living conditions and social context.

Personal Factors

Intrinsic factors like age, sex, comorbidities, and psychological attributes.

Biopsychosocial Approach

A model that integrates biological, psychological, and social factors in rehabilitation.

Exercise is Medicine / Exercise as Therapy Concept

The idea that physical activity interventions are effective for mental and physical health across conditions.

Roadmap to Recovery From Musculoskeletal Pain

A framework proposed by Caneiro et al. (2022) for recovering from musculoskeletal pain; noted as more accurate but complex.

Patient Management

A dynamic, outcomes-focused process that coordinates examination, diagnosis, prognosis, plan of care, interventions, and re-examination to improve patient outcomes.

Outcomes

Results of a plan of care, indicating progress toward goals or barriers to improvement.

Referrals/Consultations

Getting input from or directing a patient to another professional when issues are outside PT scope or require additional services.

Intervention

Procedural actions and instructions used to influence the patient’s condition based on the diagnosis and prognosis.

Prognosis

Projection of the optimal level of function and the time frame for improvement, considering individual factors.

Plan of Care (POC)

A documented strategy detailing intervention frequency, duration, progression, and expected benefits.

Diagnosis (rehab-focused)

Identification of dysfunctions that guide intervention; may differ from a medical diagnosis and can include multiple working diagnoses.

Re-examination

Formal reassessment to evaluate progress and outcomes and to modify diagnosis, prognosis, and plan of care.

Evaluation

Interpretation of examination findings to determine diagnosis, prognosis, and plan of care; an ongoing process.

Examination

Systematic collection of history, systems review, and tests/measures to support hypotheses about the patient’s condition.

History of condition (Hx)

Chronology and context of the patient’s symptoms and health events relevant to the current problem.

Subjective

Information obtained from the patient, including demographics, onset, description of symptoms, goals, and prior function.

HPI (History of Present Illness)

Detailed description of the current symptoms and their evolution.

PLOF

Prior Level of Function—the patient’s functioning before the current problem.

Systems Review

Brief screen of major body systems (cardiovascular, pulmonary, integumentary, etc.) to identify factors influencing rehab.

Tests and Measures

Objective assessments (vital signs, ROM, strength, neuromuscular tests, special tests, outcomes, movement quality) used to support hypotheses.

ROM (Range of Motion)

Movement of a joint through its available range: PROM, AAROM, and AROM.

MMT

Manual Muscle Testing; bedside assessment of muscle strength.

Vitals

Vital signs: blood pressure, heart rate, SpO2, respiratory rate, temperature.

TUG (Timed Up and Go)

A mobility test measuring the time to stand, walk, turn, and sit; indicates functional mobility and fall risk.

6MWT

Six-Minute Walk Test; measures endurance by the distance walked in six minutes.

4-Stage Balance Test

A balance assessment involving four standing positions to evaluate static balance ability.

ODI

Oswestry Disability Index; a subjective measure of disability related to low back pain.

QuickDASH-9

A short form of the Disabilities of the Arm, Shoulder, and Hand; assesses upper-extremity function.

PHQ-9

Patient Health Questionnaire-9; a screening tool for depressive symptoms.

Yellow Flags

Psychosocial risk factors that can influence prognosis and treatment response; screening guides care.

PIPT

Psychologically Informed Physical Therapy; tailoring care to cognitive, emotional, and behavioral factors.

Perception vs Reality

Perception is the patient’s interpretation of their state; reality is the actual state; both inform management.

Kinesiophobia

Fear of movement or reinjury that can limit activity and hinder rehabilitation.

Behavior Change Stages

Precontemplation, Contemplation, Preparation, Action, Maintenance—stages describing readiness to change behavior.

Adherence

Patient’s continued engagement and compliance with the plan of care.

Individualized Care

Customized, flexible approach that adapts to the patient’s needs and context.

Direct Access

Patient access to physical therapy without a physician referral in some settings.

Interdisciplinary Care

Collaboration among different health professionals to manage a patient’s care.

Roadmap to Recovery

A simplified framework for musculoskeletal pain management referenced in current literature.

Rotator Cuff Tear (example)

A medical condition used to illustrate how rehab focuses on movement tolerance and function despite tissue tear.

Contusion

Bruise: soft-tissue injury from blunt force causing pain, swelling, and discoloration from bleeding; treatment typically rest and activity as tolerated.

Tendinopathy

Non-inflammatory overuse injury where tendon is repeatedly strained leading to microtearing; umbrella term for tendon injuries.

Tendinitis

Acute inflammatory tendinopathy due to overuse; inflammation of a tendon.

Tendinosis

Chronic degeneration of a tendon over time, often slower to resolve and requiring more intervention.

Rule of Too

Injuries often occur when doing too much, too fast, after too little for too long.

Eccentric loading

Rehabilitation loading where the muscle-tendon lengthens under tension; used to treat tendinopathy.

Heavy Slow Resistance (HSR)

Training approach using heavy resistance performed slowly to load tendons and related structures.

Stress injury

Overuse injury from repetitive tasks or sustained loads causing tissue strain.

Bone Stress Injury (BSI)

Bone overuse injury due to repeated loads, potentially progressing to a stress fracture.

Stress fracture

Overuse bone injury with microcracks from repetitive loading as muscles fatigue and bone is overloaded.

Bursitis

Inflammation of a bursa, often from repetitive motion or pressure; bursae reduce friction.

Bursa

Fluid-filled sac that reduces friction between tendons and bones/structures.

Sprain

Injury to ligaments or joint capsules due to overstress or tearing.