Intro to the Role of PTA & Dutton Charter 1

• Study notes for exam units 1-6 are as follows.

Dutton Charter 1

• Evidence-based practice involves integrating research, clinical expertise, and patient values.
• The role of a PTA includes being knowledgeable, service-oriented, adaptive, reflective, and ethical.
• Patient education is important so the patient to understand their condition.
• Patient privacy and dignity need to be maintained and permission requested before any action.

Intro to the Role of PTA

• Health-related quality of life is a broad concept that includes mental and physical health.
• Health promotion empowers individuals or groups or individuals to pursue prevention and wellness.
• Wellness includes all dimensions of human existence, including social connectivity.
• Health literacy is the ability to understand health information to make appropriate decisions.
• Health is a state of well-being, not merely the absence of disease.
• Well-being is a positive outcome meaningful for people across society.

Dutton Chapter 2

• Planes of motion include sagittal, frontal, and transverse.
• Epithelial tissue is found throughout the body as membranous and glandular layers.
• Nervous tissue helps motor, peripheral, and nervous systems.
• Connective tissue supports cells, tissues, organs, and binds cells.
• Muscle tissue is responsible for movement.

Muscle Contraction

• Type I muscle fibers twitch slowly and are oxidative, for endurance and posture.
• Type II muscle fibers twitch fast and are for strength and power.
• Type IIA fibers are aerobic, fast-twitch, and intermediate in size.
• Type IIAB fibers are fast-twitch with a large diameter and are anaerobic.
• Type IIB fibers are very large, fast-twitch, anaerobic, and for explosive movements.
• Agonist muscles contract to produce the desired movement.
• Antagonist muscles return the limb to its initial position and oppose the chosen movement.
• Synergist muscles perform or assist in performing joint motions.
• Neutralizers help cancel out extra motion to make sure the force generates ok.
• Stabilizers provide support for the muscles.

Kinesiology

• Compression/approximation is a squeezing force.
• Traction/distraction is a pulling or stretching force.
• Shear is a sliding force parallel to a surface.
• Torsion is a twisting force.
• The toe region is where collagen fibers have a wavy appearance at rest.
• Elastic deformation is when a structure’s original shape is recoverable.
• Plastic deformation is permanent and results in progressive failure.
• A force couple exerts a resultant moment force through forces.
• Levers/Mechanical Advantage are the efficiency of force being used.
• 1st class levers put the fulcrum between the effort and load.
• 2nd class levers put the load between the fulcrum.
• 3rd class levers put the load at the end of the lever.
• Active insufficiency is when the muscle shortens.
• Passive insufficiency is when the muscle lengthens.
• Osteokinematics are bone movement/
• Arthrokinematics are movements at the joint.

Immobilization

• Muscle atrophy and stiffness are effects of immobilization.

Decision-Making for PTA

• Correcting therapeutic exercise progression needs to ensure exercises advance safely.
• Contraindications to manual therapy can occur when hands should not be on techniques.
• Bacterial, localized infections, malignancy, fractures, cellulitis, fever, hematoma, open wounds, osteomyelitis, or unrelieved pain are all contraindications.

Therapeutic Exercise

• Open and closed kinetic chain exercises involve movement with or without fixed points.
• Phosphagen is anaerobic and used for short-term, high-intensity exercise.
• Glycolysis is carbohydrate breakdown for moderate duration.
• Oxidative is using a low-intensity, aerobic system for long durations.
• The RPE Borg scale determines perceived exertion and is graded 1-10 points.
• Multiplying RPE by 10 gives an approximate heart rate.
• Stages of motor learning include cognitive, associative, and autonomous.

Improving Mobility

• Indications and Contraindications must be followed for improving mobility.
• Elasticity is a temporary stretch.
• Viscoelasticity allows for permanent deformation over time.
• Plasticity is the stretch force and ability for soft tissue to assume a new, greater length.
• Muscle spindle - when a stretch is applied, the intrafusal muscle of the muscle.
• Golgi tendon organ – when a stretch is produced in a muscle, particularly a prolonged stretch.
• PROM moves the patient through ROM to a new range.
• AROM moves the patient through their own ROM
• AAROM has the patient use external force to move through ROM.
• Static stretching increases pliability when tissues shorten due to injury or immobility.
• PNF stretching hold/relax involves holding and contracting at a new range.
• Pnf requires a concentric muscle contraction.
• Hold/relax with agonist contraction involves moving the limb in the direction being stretched and then holding.

Muscle Strengthening

• Differentiate between strength, power, and endurance.
• Overload increases the challenges over time.
• SAID has the body adapt to the stress being applied.
• Reversibility loses gains from training stops.
• Methods of strengthening can be isometric, concentric, and eccentric.
• Isometric is where the muscle contracts but there is no movement
• Concentric involves muscle shortening.
• Eccentric involves muscle lengthening.
• Proprioceptive neuromuscular facilitation
• Stabilization exercises
• DeLorme increases resistance to progressively overload the muscle.
• Oxford reduces load during the session during progression.
• DAPRE increases reps in the third set to increase weight for the fourth set.
• Considerations need to be made for strength training.
• Contraindications to strength training include certain heart conditions, hypertension, angina, dysrhythmias, and retinopathy.

Chapter 15

• Safety first
• Normal exercises increase heart rate, stroke volume, and cardiac output.
• Systolic blood pressure increases, but diastolic blood pressure stays the same.
• The FITT principle involves frequency, intensity, time, and type.
• AAMHR and Karvonen are HR max formulas and cut offs.
• Moderate-intensity 60%-75%, and vigorous-intensity ranges 85%.
• Types of cardiovascular conditioning include continuous steady state and discontinuous intervals.

Kahoot questions

• Evidence-based practice includes research, clinical expertise, and patient values.
• Health literacy is the ability to use health information.
• Connective tissue offers tensile strength via collagen fibers.
• A sellar joint is convex on one plane and concave on another.
• Type IIb muscle fibers do quick, explosive anaerobic actions.
• Torque is the measure of rotary force.
• The toe region is where collagen fibers unfold.
• Active insufficiency occurs when actin and myosin overlap.
• The first objective is to address the intervention principles by controlling swelling and pain.
• Petrissage is kneading the muscles.
• Joint mobs are contraindicated via PROM with pta abnormal feel.
• Grade 1-2 mobilizations modulate pain and improve nutrition.
• Grade 4 mobilizations involve small, fast oscillations into tissue resistance.
• The phosphagen system of energy provides ATP for short-term, high-intensity activities.
• The borg scale measures perceived exertion and is proportional to heart rate.
• Refining skills requires increased complexity to facilitate associative motor learning.
• Slight discomfort is not a contraindication to stretching at full intensity.
• Autogenic inhibition occurs when GTO senses tension.
• SAID is an exercise principle where the body adapts dependably.
• Hypertension is not a contraindication for strength training.
• DOMS muscle soreness appears after 24-56 hours.
• You should perform moderate-intensity cardiovascular exercise 60-75% of max heart rate.
• Exercise is contraindicated blood pressure and exceeds 190/100mmHg.
• The normal response to exercise is for diastolic blood pressure to stay or drop slightly.
• Compensations warrant discontinuing exercise.

Study notes on evidence-based practice, the role of a PTA adapting to be reflective, health-related quality of life, health promotion, patient values, and patient's rights. This module focuses on integrating all elements of health and well-being.