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1

Goal of therapeutic exercises

-achievement of symptom-free movement and function
-carefully graded stresses and forces applied to body
-applied in controlled,progressive and appropriately planned manner

2

Prognosis

- a prediction of the patient's optimal level of function expected at the end treatment
-anticipated length of time needed to reach the specified functional outcome

3

factors that influence prognosis

-complexity, severity,acuity or chronicity of problem
-general health
-patient goals
Patient's motivation
- safety issues
- extent of support

4

3 types of motor tasks

-discrete task
-serial Task
-continuous task

5

Discrete task

movement with a recognizable beginning and end
Ex: doing a push up, lifting a weight

6

Serial task

-composed of a series of discrete tasks combined in a particular sequence
Ex: eating with a fork = appropriate grasp, proper positioning, scoop up food, move fork to mouth

7

Continuous task

repetitive, uninterrupted movements with no distinctive beginning or end
Ex: cycling, walking up and down stairs

8

stages of motor learning

cognitive stage
associative stage
autonomous stage

9

Cognitive stage of motor learning

requires a great deal of thinking
-patient thinks about sequence or each component
-errors in performance common
-Pt easily distractible
-requires a lot of feedback

10

associative stage of motor learning

- patient makes infrequent errors
- concentrates on fine-tuning the motor task
- patient tries to become more efficient and consistent
- use of problem solving skills
-modifies activities depending on environment
-decrease in need for feedback

11

autonomous tsage of motor learning

- movements are automatic
-patient can do multiple tasks at once
- easily adapts to variations in task demand
-very little feedback or instruction requires
-patients often discharged before this stage...

12

What affects ROM?

structure of joint
integrity of tissue
flexibility of soft tissue

13

Joint range

amount of motion usually measured in degrees that can occur at a joint, the junction between two bones

14

muscle Range

Functional excursion of a muscle or the distance a muscle can shorten from full elongation

15

active vs. passive insufficiency

relates to multi joint muscles
-active: no power because too short
-passive: no power because too long

16

What are the 3 types of ROM?

-passive
-active
-active-assistive A-AROM

17

why do PROM?

acute inflamed tissue
where soft tissue is too weak
coma
paralysis
complete bed rest

18

Why do AROM?

patient has enough muscle strength to go through available range
aerobic condition
maintain mobility above and below immobilized region

19

Why so A-AROM?

when the muscles are too weak to make it through the full range
attempts to achieve the same goals as AROM

20

Limitations of PROM

will not prevent muscle atrophy
will not increase strength or endurance
will not assist circulation as much as AROM

21

Limitation of AROM

for strong muscles, it will not increase strength or maintain strength

limited development of skill or coordination

22

General guidelines for Continuous Passive motion CPM

-can be applied after surgery
-establish available ranges
- start with low arc 20-30 degrees
-increase arc 10-15 degrees per day as tolerated
-rate of 1 cycle per 45 sec or per 2 min depending on patient tolerance
-Duration: 24 hours or 1 hour 3x/day
-initiate muscle setting and AAROM during off times from CPM
-usually used for less than 1 week

23

which form of range of motion testing gives you more precise information about joint mobility as compared to muscle pathology?

PROM

AROM,A-AROM, and resistive range of motion all involve the use of contractile tissue.

24

in normal function, muscles must be able to:

Produce
sustain
regulate muscle tension

25

Muscle strength

ability of contractile tissue to produce tension and a resultant force based on the demands placed upon the muscle

26

muscle power

related to strength and speed of movement

27

muscle endurance

ability of a muscle to contract repeatedly against a load, generate and sustain tension

28

how would you increase strength?

systematic approach
use muscle groups to lift/ lower, control heavy loads
-low reps
-short duration
-no more than 10 reps
-minimum of 66% of 1RM
- recovery time 1 min for isotonic and isometric
---2-4 min for isokinetic

29

How to increase power?

-muscle strength needs to be available already
-increase work performed over a specific period of time
-or reduce the period of time the worj is done in (pIyometrics)

30

How to increase endurance?

muscle endurance- ability to repeatedly contract against load, sustain tension and resist fatigue
-important for postural control
-low load
-high reps 20-50 for 2-3 sets
-prolonged duration