[PT29] Foundational Concepts 1 & 2***

Therapeutic

"relating to the *treatment of disease* or disorders by remedial agents or methods."

"having a *beneficial effect* on the body or mind."

Exercise

Is *any bodily activity* that enhances or maintains *physical fitness* and *overall health* and wellness.

It is performed for various reasons, to aid growth and improve strength, preventing *aging*, developing *muscles* and the *cardiovascular system*, honing *athletic* skills, *weight loss* or maintenance, *improving health* and also for *enjoyment*.

Therapeutic Exercise

is the *systematic, planned* performance of bodily movements, postures, or physical activities intended to provide a patient/client with the meants to: remediate or *prevent impairments*, *enhance physical function*, prevent or *reduce health-related risk factors.*, *Optimize overall health* status, fitness, or sense of well-being.

Patient

An individual *with impairments* and functional deficits diagnosed by a physical therapist and is receiving physical therapy care to improve function and prevent disability.

Client

An individual *without diagnosed dysfunction* who engages in physical therapy services to promote health and wellness and to prevent dysfunction.

Physical Function

is the ability to perform both basic and instrumental activities of daily living.

Balance

*Components of Physical Function*

The ability to align body segments against gravity to maintain or move the body (center of mass) within the available base of support without *falling*; the *ability to move the body in equilibrium* with gravity via interaction of the sensory and motor systems.

Cardiopulmonary Fitness

*Components of Physical Function*

The ability to perform moderate intensity, repetitive, total body movements (walking, jogging, cycling, swimming) over an extended period of time.

Coordination

*Components of Physical Function*

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

Flexibility

*Components of Physical Function*

The ability to *move freely*, without restriction; used interchangeably with mobility.

Mobility

*Components of Physical Function*

The *ability of structures* or segments of the body *to move or be moved* in order to allow the occurrence of range of motion (ROM) for functional activities.

Muscle Performance

*Components of Physical Function*

The capacity of muscle to produce tension and do physical work. Muscle performance encompasses *strength*, *power*, and *muscular endurance*.

Neuromuscular Control

*Components of Physical Function*

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 subsequently, *to work in correct sequence to create coordinate movement*.

Stability

*Components of Physical Function*

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.

Balance, Cardiopulmonary Fitness, Coordination, Flexibility, Mobility, Muscle Performance, Neuromuscular Control, Stability

*Components of Physical Function* (8)

(separate with comma and space and Order based sa PPT)

International Classification of Impairments, Disabilities, and Handicaps

ICIDH \= ?

World Health Organization

WHO \= ?

International Classification of Functioning, Disability and Health

ICF \= ?

Functioning

characterized by the integrity of body functions and structures and the ability to participate in life's activities.

Disability

is the result of impairments in body, functions and/or structures, activity limitations, and participation restrictions.

Impairments in body function

Problems associated with of body systems (including physiological and psychological functions.)

Impairments in body structure

Problems with the anatomical features of the body, such as significant deviation or loss, affecting all body systems.

Activity limitations

Difficulties an individual may have in executing actions, tasks, activities.

Participation restrictions

Problems an individual may experience in involvement in life situations, including difficulties participating in self care, responsibilities in the home, workplace, or the community, and recreational leisure and social activities.

Environmental factors

*Contextual Factors that affects functioning*

Physical, social, and attitudinal environment in which people conduct their lives; factors may *facilitate* function or *hinder* functioning and contribute to disability.

Personal factors

*Contextual Factors that affects functioning*

Features of the individual that are not part of the health condition or health state; includes age, gender, race, lifestyle habits, coping skills, character, affect, cultural and social background, education, etc.

Impairment

Consequences of pathological conditions and encompass the signs and symptoms that reflect abnormalities at the body system, organ, or tissue level.

Impairment of Body Structure

*Two Divisions of Impairment*

Includes joint swelling, scarring, open wound, and lymphedema or amputation of a limb, adhesions, muscle spasm, and joint crepitus.

Impairment of Body Function

*Two Divisions of Impairment*

Pain, reduced sensation, decreased ROM, deficits in muscle performance (strength, power, and endurance), impaired balance or coordination, abnormal reflexes, and reduced ventilation.

Primary and Secondary

*2 Types of Impairments*

(answers separated by *and*)

Primary Impairments

*2 Types of Impairments*

Direct Impairments that may arise from the health condition.

Secondary Impairments

*2 Types of Impairments*

Indirect Impairments that may be the result of preexisting impairments

Composite Impairments

The result of multiple underlying causes and arises from a combination of *primary and secondary* impairments.

Musculoskeletal Impairment

Impairment with:

- Pain
- Muscle Weakness
- Limited Range of Motion
- Joint Hypermobility
- Faulty Posture
- Muscle Length/Strength Imbalances

Neuromuscular Impairment

Impairment with:

- Pain
- Impaired balance
- Incoordination
- Delayed Motor Development
- Abnormal Tone

Cardiovascular/Pulmonary Impairment

Impairment with:

- Decreased aerobic capacity
- Impaired circulation
- Pain with sustained physical activity

Integumentary Impairment

Impairment with: Skin hypomobility

Activity Limitations (Functional Limitations)

Occur when a person has difficulty executing or. is unable to perform tasks or actions of daily life.

Basic ADL

Activities: bathing, dressing, or feeding

Instrumental ADL

Activities: occupational tasks, school-related skills, housekeeping, and recreational activities, or community mobility.

Participation Restrictions

defined as problems a person may experience in his or her involvement in life situations as measured against social standards.

Disability (Nagi Model)

used to describe the inability to participate in activities or tasks related to one's self, the home, work, recreation, or the community in a manner or to the extent that the individual or the community as a whole perceive as "normal"

Primary, Secondary, Tertiary

3 Categories of Prevention

(separate by comma)

Primary Prevention

*3 Categories of Prevention*

Activities such as health promotion designed to prevent disease in an at-risk population.

Secondary Prevention

*3 Categories of Prevention*

Early diagnosis and reduction of the severity or duration of existing disease.

Tertiary Prevention

*3 Categories of Prevention*

Use of rehabilitation to reduce the degree or limit the progression of existing disability and improve multiple aspects of function in persons chronic, irreversible health conditions.

Biological Factors

*Factors*

Age, Sex, Race
Height/Weight Relationship
Congenital Abnormalities or Disorders
Family History of Disease; genetic predisposition.

Behavorial/Psychological/Lifestyle Factors

*Factors*

Sedentary Lifestyle
Cultural Biases
Use of tobacco, alcohol, other drugs
Poor nutrition

Socioeconomic Factors

*Factors*

Low level of education
Inadequate access to health care
Limited family or social support.

Clinical decision-making

refers to a dynamic, complex process of reasoning and analytical (critical) thinking that involves making judgements in the context of patient care.

Evidence-based practice

"the conscientious, explicit, and judicious use of current best evidence in making decisions about the care of an individual patient."

also involves combining knowledge of evidence from well-design research studies with the expertise of the clinician and the values, goals, and circumstances of the patient.

Patient Management Model

The systematic series of steps and decisions for the purpose of helping a patient achieve the highest level functioning possible.

Assessment, Evaluation, Diagnosis, Prognosis with plan of care, Interventions

(5) Five Basic Components of the Patient Management Model

(separate with comma)

Intervention

A component of patient management, refers to any purposeful interaction a therapist has that directly relates to a patient's care

Coordination, communication, and documentation; Procedural interventions; Patient-related Instruction

(3) Three Broad Areas of Intervention

(separate with *;*)

Outcomes

are results

Collection and analysis of date related to health-care services are necessities.

Motor learning

is a complex set of internal processes that involves the acquisition and relatively permanent retention of a skilled movement or task through practice.

Discrete, Serial, Continuous

(3) Types of Motor Tasks

(separate with comma)

Discrete Task

*(3) Types of Motor Tasks*

involves an action or movement with a recognizable beginning and end.

Serial Task

*(3) Types of Motor Tasks*

a series of discrete movements that are combined in a particular sequence.

Continuous Task

*(3) Types of Motor Tasks*

involves repetitive, un-interrupted movements that have no distinct beginning and ending.

Cognitive, Associative, Autonomous

(3) Stages of Motor Learning

(separate with comma)

Cognitive Stage

*(3) Stages of Motor Learning*

When learning a skilled movement, a patient first must figure out what to do\-- that is, the patient must learn the goal or purpose.

The patient tries to get the "feel" of the exercise.

Associative Stage

*(3) Stages of Motor Learning*

At this stage, the patient requires infrequent feedback from the therapist and, instead, begins to anticipate necessary adjustments and make corrections even before errors occur.

Autonomous Stage

*(3) Stages of Motor Learning*

Movements are automatic in this final stage of learning.

The patient does not have to pay attention to the movements in the task.