Physiotherapy Study Notes

Analysis of Movement

  • Knowledge through experience

  • Observation skills

  • Palpation

    • Definition: Feel and assess body parts through touch.

  • Evidence and Research

    • Importance of scientific backing in physiotherapy to validate techniques and practices.

Observational Analysis

  • Method: Most therapists utilize observational analysis.

  • Suggested Framework:

    • The starting position.

    • The movement.

    • The finishing position.

Observation Parameters

  • Symmetry

  • Joint Position

    • Assessments focus on the alignment of joints during movements.

  • Effect of Muscle Length and Alignment

  • Acceptance of Support

    • Patient's willingness and need for support during movement.

  • Comfortable or Ready to Move

    • Ensuring the patient is not in discomfort and is prepared for movement.

Handling Considerations

  • Preparation: Consider the following aspects:

    • Comfort of the Patient:

    • Position should allow for full range of motion (ROM).

    • Freeing the Region from Restrictions:

    • Remove any restrictive clothing, linens, splints, or dressings.

    • Positioning of the Therapist:

    • Use proper body mechanics to prevent injury.

    • Movement Execution:

    • Move the joint through its full anatomical range but not beyond limits.

    • Ensure movement is smooth and rhythmic.

    • Proximal Stabilisation:

    • Stabilizing the region closest to the joint being mobilized.

Practical Session Considerations

  • Safety Check:

    • Clear space of hazards such as bags or shoes that could cause trips.

    • Ensure the bed height is safe for both patient and therapist.

  • Handling:

    • Placement of hands for control and effectiveness.

    • Avoid causing discomfort or triggering a ticklish response in the patient.

  • Communication and Professionalism:

    • Consent:

    • Explain procedures clearly; ensure patient understanding.

    • Monitoring Patient's Response:

    • Regularly check in; ask questions if necessary.

Passive Movements

  • Definition:

    • Movement performed by another person or apparatus without muscle activity from the patient.

  • Types of Passive Movements:

    • Physiological Movements:

    • Movements the patient can actively perform themselves, often involving rotation about an axis.

    • Accessory Movements:

    • Movements a patient cannot perform actively but can be performed by another, often involving gliding.

Muscle Work

  • Understanding Force of Musculature:

    • Types of Muscle Work:

    • Isometric: No change in muscle length but increases in tension (e.g., anti-gravity muscles).

    • Isotonic: Dynamic muscle contraction.

      • Eccentric: Muscle lengthens during contraction.

      • Concentric: Muscle shortens during contraction to produce force.

Observational Analysis Framework: Types of Movement

  • Physiological Movement Types:

    • Passive

    • Active

    • Active Assisted

    • Resisted

Anatomical Planes and Axes

  • Anatomical Planes:

    • Frontal (Coronal) Plane: Divides body front to back (dorsal to ventral).

    • Sagittal Plane (Longitudinal Plane): Divides body into left and right halves.

    • Transverse Plane (Horizontal or Axial Plane): Divides the body into cranial (upper) and caudal (lower) parts.

  • Axes:

    • Frontal Axis (Transverse): Line goes through body horizontally.

    • Sagittal Axis: Line goes from anterior to posterior (front to back).

    • Vertical Axis (Longitudinal): Line extends from top to bottom of the body.

Active Movement Tasks

  1. Active Movements:

    • Patient/Model: Lie on back (supine).

    • Physiotherapist instructions:

      • Hip: Flexion and Abduction.

      • Knee: Flexion and Extension.

      • Ankle: Dorsiflexion and Plantarflexion.

  2. Active Assisted Movement:

    • Provide assistance for patient to perform movements (simulate patient weakness).

  3. Active Movements with Overpressure:

    • Apply slight overpressure at the end range to assess joint capability and handling.

Learning Outcomes

  • By the end of the session, students should be able to:

    • Apply movement descriptive terminology to sit-to-stand and stand-to-sit activities.

    • Describe and discuss the observed activities.

    • Identify and explain the effects of handling techniques on the model.

    • Provide constructive feedback regarding handling and facilitation to partners.

Models of Movement

  • Phases of Movement:

    • Phase 1: Sitting to standing transition.

    • Phase 2: Momentum transfer.

    • Phase 3: Extension phase.

    • Phase 4: Stabilization phase.

    • Details about the phases:

    • Flexion Phase: Initiation of trunk flexion.

    • Momentum Transfer Phase: Forward momentum generation to assist standing.

    • Extension Phase: Completion of the standing movement.

    • Stabilization Phase: Achieving balance post standing.

Velocity and Ground Reaction Force in Movement

  • T1: Point of initiation of trunk flexion.

  • T2: Point at vertical force reaches maximum on force plates during movement.

  • T3, T4: Measurement of velocities related to movement dynamics (shoulder marker and greater trochanter marker).