1 / 46

Therapeutic exercises Mazyad Alotaibi

Therapeutic exercises Mazyad Alotaibi. Out lines. Introduction Approach to patient evaluation and program development (SOAP) Posture. Introduction to therapeutic exercises. Physical therapy Therapeutic exercises: is on of physical therapy modalities

inezg
Télécharger la présentation

Therapeutic exercises Mazyad Alotaibi

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript

  1. Therapeutic exercisesMazyad Alotaibi

  2. Out lines Introduction Approach to patient evaluation and program development (SOAP) Posture

  3. Introduction to therapeutic exercises Physical therapy Therapeutic exercises: is on of physical therapy modalities The ultimate goal of any therapeutic exercise program is the achievement of symptom-free movement and function.

  4. Goals of therapeutic exercises The positive effects of therapeutic exercises include the prevention of dysfunction as well as the development, improvement , restoration, or maintenances of normal: Strength Endurance and cardiovascular fitness Mobility and flexibility Relaxation Coordination and skill

  5. In order to effectively administer therapeutic exercise to patient the therapist must: • know the basic principles and effects of the treatment • Be able to do a functional evaluation of the patient • Know the interrelationships between the anatomy and kinesiology • Have an understanding of the state of disability and its potential rate of recovery, complications, precautions, and contraindications

  6. Evaluation • Structure governs function • Anatomy is the structure • Biomechanics/physiology are the function

  7. Approach to patient evaluation and program development Patient care is a problem-solving process. it is feed bake loop Assess needs Develop plan Implement plan Evaluate plan

  8. Approach to patient evaluation and program development. Cont., Assess needs 1) Subjective information (the case history) Name , age, sex………. Ask questions to get the patient to: Describe how he perceives his symptoms. e.g. location, type, and nature of pain or symptom Describe the behavior of the symptoms through a 24-hour period. e.g. motions or positions cause and influence the symptom Briefly describe his general health, medications being taken…………….. Describe the previous history of the condition. Describe related history, such as any medical or surgical intervention.

  9. Approach to patient evaluation and program development. Cont., Assess needs 2) Objective data (clinical evaluation) a) Inspection (observation) The ADL such as gait- patient ability to stand, sit, or dress himself Use of any assistive aids Posture Shape of body parts such as contour changes, swelling, atrophy, hypertrophy, and asymmetry Appearance of the skin

  10. Approach to patient evaluation and program development. Cont., b) functionFunctional tests include: Active range of motion (AROM) Passive range of motion (PROM) Describe the end feel (normal –abnormal) Manual muscle testing Joint integrity tests

  11. Approach to patient evaluation and program development. Cont., c) Palpation Skin and subcutaneous tissue, temperature, Edema Muscles, tendons, trigger point…… Joint (effusion, tenderness, changes in position or shape) Nerve and blood supply d) Neurological tests e) Additional tests f) Cardiovascular status

  12. Approach to patient evaluation and program development. Cont., 3) Assessment Once the subjective and objective data about patient are gathered: List the problem area Determine major versus minor problems

  13. B.Develop Plane Goals or objectives of the treatment Each goal should be operational zed to include: A measurable outcome Specific conditions or tests The time expected to accomplish the goal

  14. Long term-goals: Are a final measurable outcome expected at the end of the treatment Are often described in functional terms Short term goals: Reflect the component skills needed to obtain the long term goals Are helpful in directing the decision-making process

  15. C. Implement plan D. Evaluate plan E . Home care program

  16. Assessment of Posture

  17. Overview • Definition of posture • Postural development • Common spinal deformities • HIPS

  18. What is posture? Defined: “The position of the body at a given point in time.” (Starkey) “A set of muscle contractions that place the body in the necessary location from which a movement is performed.” (Enoka) “The situation or disposition of the several parts of the body with respect to each other for a particular purpose.” (Webster)

  19. What is good posture? Ideal posture serves as a reference point. Ideal posture… Distributes gravitational stress for balanced muscle function. Allows joints to move in their mid range to minimize stress on ligaments and articular surfaces. Effective for the individual’s activities of daily living. Allows the individual to avoid injury.

  20. Postural Development • Birth • Entire spine concave forward (flexed) • “Primary curves” • Thoracic spine • Sacrum • Developmental (usually around 3 mos.) • Secondary curves • Cervical spine • Lumbar spine

  21. Postural Development • Factors affecting posture • Bony contours • Laxity of ligamentous structures • Fascial & musculotendinous tightness • Muscle tonus • Pelvic angle • Joint position & mobility

  22. Postural Development • Causes of poor posture • Positional factors • Appearance of increased height (social stigma) • Muscle imbalances/contractures • Pain • Respiratory conditions • Typically can be managed conservatively through therapeutic ex & education

  23. Postural Development • Causes of poor posture • Structural factors • Congenital anomalies • Developmental problems • Trauma • Disease • Not typically easily managed

  24. Example: Total Spinal Posture Ideal Head sits straight on shoulders nose in-line c/ manubrium, xiphoid, umbilicus Earlobes in-line with acromion process Shoulders and clavicles level are equal normal appearance of Shoulders Arms equidistant from trunk Normal spinal curves Iliac crests, ASIS’s & PSIS’s . ASIS sit lower than PSIS Gluteal folds and knee joints even Patellae point forward No Genu conditions noted Heads of fibula and all malleoli level Achilles tendons & heels appear to be straight Evident arches

  25. Good Spinal Posture

  26. What is bad posture? Any position that deviates from “good posture” Static Standing Sitting Sleeping Dynamic Running Throwing, etc.

  27. Correct posture • “Position in which minimum stress is placed on each joint.” • Faulty posture • Any position that increases stress on joints

  28. Common Spinal Deformities • Lordosis • Excessive anterior curvature of the spine • Exaggeration of normal curves in the cervical & lumbar spines

  29. Common Spinal Deformities • Lordosis causes: • Postural deformity • Lax muscles (esp. abs) • Heavy abdomen • Hip flexion contracture • Spondylolisthesis • Congential problems • Fashion (high heels)

  30. Common Spinal Deformities • Swayback deformity • Increased pelvic inclination (40) • Typically includes kyphosis

  31. Common Spinal Deformities • Kyphosis • Excessive posterior curvature of the spine • Round back • Humpback/gibbus • Flat back • Dowager’s Hump

  32. Common Spinal Deformities • Scoliosis • Nonstructural • “Functional” • May be related to leg length discrepancy • Structural • Lacks normal flexibility • Asymmetric movements

  33. Commonly Seen Postural Deviations Shoulder/Scapula Winging Scapula Head and C-Spine

  34. HIPS History Inspection Palpation Special (Functional) Tests

  35. Relevant History Identify factors that influence posture Overuse Neurological Problems Pain Lack of awareness Ms weakness/ Imbalance Hypermobile Jts Hypomobile Jts Flexibility Bony Abnormality Leg Length Disc.

  36. Inspection Use of a plumb line Anatomical reference 3 views Lateral (sagittal plane movements) Anterior (frontal/ transverse plane movements) Posterior (frontal/ transverse plane movements)

  37. Observation • Body type • Ectomorph • Mesomorph • Endomorph

  38. Lateral View Look for: @ ankle? @ knee? @ hip? @ shoulder? @ neck? @ head?

  39. Anterior view • Malleoli level • Arches • Foot rotation • Bowing of bones • Diastematomyelia (hairy patches) • Pigmented lesions • Café au lait spots • Anterior view • Head straight on shoulders • Shoulders level • Clavicles/AC joints • Sternum & ribs • Waist angles & arm positions • Carrying angles • Iliac crests • ASIS • Patellae • Knees • Fibular heads

  40. Posterior View Look for: @ heel? @ pelvis? @ lumbar spine? @ scapulae? @ neck? @ head?

  41. Palpation In assessment position (i.e., standing), palpate: Laterally ASIS vs. PSIS Anteriorly Patellae Iliac Crests ASIS heights Lateral Malleolar heights Fibular Head heights Shoulder heights • Posteriorly • PSIS positions • Spinal alignment • Scapular positions

  42. Functional Tests Assess muscular length ROM Resting muscle length

  43. Other Technology Video Analysis 3D Motion Analysis REBA Sway Measurement Tools Force Plate Biodex Stability System NeuroCom

More Related