EHR 520 weeks 1

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Questions and Answers

What is an important factor to consider when designing a rehabilitation program?

The patient's age

The patient's height

The patient's psychological makeup and response to the injury (correct)

The patient's favorite food

It is always best to expect a patient to progress in the same manner as the last patient with the same injury.

False

What is the primary goal of a rehabilitation program?

To design a program based on the responses of each patient

The seven principles of rehabilitation include avoiding ______________ and ensuring proper timing.

aggravation Signup and view all the answers

Match the principles of rehabilitation with their descriptions:

Avoid Aggravation = Therapeutic exercise should not make the injury worse Timing = The therapeutic exercise portion should begin as soon as possible Compliance = The patient's participation in the program Individualisation = Designing a program based on the patient's responses Signup and view all the answers

What is the purpose of providing written instructions to patients?

To assure compliance Signup and view all the answers

A patient always has the last say in what is done with or to their body.

True Signup and view all the answers

According to the World Health Organisation, what is rehabilitation?

A set of measures that assist individuals who experience, or are likely to experience, disability to achieve and maintain optimal functioning in interaction with their environments. Signup and view all the answers

An AEP should always have ______________ present when dealing with a patient in an isolated situation.

another professional or someone else Signup and view all the answers

Match the following concepts with their definitions:

Rehabilitation = Responsibility for one's own progress Professionalism = Assuring compliance with treatment Ethical Standards = A set of measures that assist individuals with disabilities Evidence-Based Practice = Following a patient's wishes and respecting their autonomy Signup and view all the answers

What is the ideal scenario for sensitivity and specificity ratings?

Close to 1.0 or 100% Signup and view all the answers

A rehabilitation program should always prioritize the most significant problems or deficiencies last.

False Signup and view all the answers

What is the ultimate goal of therapeutic exercise?

The return of the patient to their optimal level of activity. Signup and view all the answers

Goals in a rehabilitation program should be ______________________ whenever possible.

objective and measurable Signup and view all the answers

Match the components of a rehabilitation program with their descriptions:

Problem list = A list of problems that should be addressed in the treatment program, prioritized by importance Goal setting = The process of creating objectives for resolving problems identified in the problem list Treatment program = A plan of action to address the problems and achieve the goals set Signup and view all the answers

What are the three factors that AEPs consider when deciding on rehabilitation techniques and applications?

Empirical evidence, their own clinical experience, and the goals of the patient Signup and view all the answers

Outcomes-based practice is only concerned with clinician-based outcomes.

False Signup and view all the answers

What is the purpose of outcomes tools in outcomes-based practice?

To assess a patient's overall physical, social, and emotional health before, during, and after treatment or rehabilitation program Signup and view all the answers

Outcomes tools can be categorized into ______________________ measurement tools and region-specific measurement tools.

general health status Signup and view all the answers

Match the types of outcomes with their descriptions:

Clinician-Based Outcomes = Deal with objective criteria such as changes in range of motion, strength and coordination Patient-Based Outcomes = Based on the patients’ perceptions of how well they perform within their own life requirements Signup and view all the answers

What happens to an individual's strength during the first week of immobilization?

It decreases by 3-4% each day Signup and view all the answers

Expecting a patient to progress in a program the same way as the last patient with a similar injury is a good approach.

False Signup and view all the answers

What is the key factor in ensuring a patient is compliant with a rehabilitation program?

Knowledge Signup and view all the answers

During the first week of immobilization, an individual's strength is lost at a rate of _______ % per day.

3-4 Signup and view all the answers

Match the following concepts with their descriptions:

Compliance = The patient's willingness to follow a rehabilitation program Individualisation = Tailoring a rehabilitation program to a patient's unique needs and responses Rest = A necessary but potentially detrimental component of the rehabilitation process Signup and view all the answers

What is the goal of tissue engineering?

To develop biological substitutes that restore, maintain or improve tissue function Signup and view all the answers

Exercise can hinder recovery if applied inappropriately at each stage of healing.

True Signup and view all the answers

What are the three main components of information to gather during a subjective examination?

General demographics, history of injury and symptoms, past medical history Signup and view all the answers

Polymers used in tissue engineering can be composed of organic molecules synthesised by ______________ forms.

living Signup and view all the answers

Match the following components of a subjective examination with their descriptions:

General demographics = Age, sex, race, primary language History of injury = Client's report of pain, onset and pattern of symptoms Past medical history = Medications, surgery, and other medical conditions Signup and view all the answers

What happens when exercise is applied to damaged tissues during the initial healing phase?

It exacerbates the injury, resulting in additional tissue damage Signup and view all the answers

During Phase 2 of rehabilitation, the focus is on strength training with heavy isotonic exercises.

False Signup and view all the answers

What are the consequences of misjudging the amount of stress applied or the tissue's ability to withstand it during a rehabilitation session?

The patient will report increased pain or swelling from that rehabilitation session. Signup and view all the answers

Any new bleeding during the initial healing phase will ______________________ the inflammation process.

restart Signup and view all the answers

Match the phase of rehabilitation with its characteristics:

Phase 2 = Pain and oedema are under control, focus on mobility and tissue flexibility Phase 1 = Pain and oedema are not under control, focus on reducing inflammation Signup and view all the answers

What type of trauma can cause muscle strains?

Both A and B Signup and view all the answers

Satellite cells can restore and replace muscle cells routinely damaged during activity.

True Signup and view all the answers

What happens to muscle tissue when a small muscle injury occurs?

Satellite cells replace injured muscle tissue with new muscle tissue. Signup and view all the answers

A Grade I muscle strain involves _______ fibres stretched or torn.

some Signup and view all the answers

Match the muscle strain grade with its description:

Grade I = Complete rupture with immense immediate pain. Grade II = A number of fibres are torn and active contraction is painful. Grade III = Some fibres stretched or torn. Signup and view all the answers

What is the nature of the resistance you feel at end-ROM for a capsular end-feel?

Firm, but not hard Signup and view all the answers

Special tests should be performed if a fracture or dislocation is suspected.

False Signup and view all the answers

What is the purpose of touch/palpation in assessment and examination?

To determine which structures and type of tissue is involved Signup and view all the answers

ROM or mobility of a joint can be normal, hypermobile (excessive) or ______________________.

hypomobile (less than normal) Signup and view all the answers

Match the following types of muscle strength testing with their descriptions:

Mid-range = Can be done at the midpoint of the range of motion End-range = Can be done at the end of the range of motion Full range = Can be done throughout the entire range of motion Signup and view all the answers

What is the median time difference for return to play between early intervention and delayed intervention groups?

21 days Signup and view all the answers

Each patient with the same injury will progress at the same rate in a rehabilitation program.

False Signup and view all the answers

What is the definition of self-management in the context of chronic conditions?

An individual’s ability to manage the symptoms, treatment, physical and psychological consequences and lifestyle changes inherent with living with a chronic condition. Signup and view all the answers

The early rehab group commenced rehab _______ days post-injury.

2 Signup and view all the answers

Match the following stages of rehabilitation with their descriptions:

Assessment and Examination = Week 2 - 76 Individualisation of Rehabilitation = Re-assess continually and challenge the client Concepts of Healing = Week 2 - 79 Signup and view all the answers

What happens to the flexibility of connective tissues such as ligaments, joint capsules, fascia, and tendons with immobilisation?

It reduces Signup and view all the answers

Prolonged immobilisation can result in irreversible damage to articular cartilage.

True Signup and view all the answers

What is agility characterized by?

Rapid changes of direction and sudden stopping/starting Signup and view all the answers

What are the effects of immobilisation on muscle tissue?

Immobilisation decreases fibre size, as well as myofibril and capillary numbers, and increases fibrous and fatty tissue within muscle, leading to atrophy. Signup and view all the answers

Early re-mobilisation prevents the formation of ____________________ in connective tissue.

cross-links Signup and view all the answers

Plyometric exercises are used to improve strength and flexibility.

False Signup and view all the answers

What should therapeutic exercises for proprioception gradually do?

increase in complexity and intensity Signup and view all the answers

Match the effects of immobilisation with the corresponding tissue:

Loss of ROM = All tissues Decreased fibre size = Muscle Irreversible damage = Articular cartilage Reduced flexibility = Ligaments, joint capsules, fascia, and tendons Signup and view all the answers

Plyometrics or 'stretch-shortening activity' involves the lengthening of muscle/tendon followed by rapid _______________

shortening Signup and view all the answers

Match the following exercises with their characteristics:

Lower-body exercises = standing balance, progress from eyes open to closed, stable to unstable surfaces Upper-body exercises = same principles, progress from single- to multi-planar movements, add resistance/WB exercises before activity-specific movements Signup and view all the answers

What happens to muscle tissue when a small muscle injury occurs?

The muscle tissue undergoes repair and remodelling Signup and view all the answers

Strength is the maximum force a muscle or group can exert.

True Signup and view all the answers

What is the main difference between isometric and isotonic muscle activity?

Isometric muscle activity occurs with no change in muscle length, while isotonic muscle activity involves muscle length changes. Signup and view all the answers

Muscles move joints and continually maintain posture against ______________________.

gravity Signup and view all the answers

Match the types of muscle strength with their descriptions:

Strength = Maximum force a muscle or group can exert. Power = Strength over a distance for a specific amount of time. Endurance = Continually produce force over a period of time. Signup and view all the answers

What is a key factor to consider when selecting a stretch in a rehabilitation program?

Tissues involved Signup and view all the answers

PNF stretching can be used in the first week of rehabilitation.

False Signup and view all the answers

What is important to consider when designing a plyometric and agility exercise program?

Increasing speed, distance, flat to hilly, and change of direction Signup and view all the answers

A patient can be considered ready to return to full participation if they demonstrate full ROM, normal strength, endurance, and CR fitness, but still have some pain or oedema.

False Signup and view all the answers

What is the primary goal when stretching two-joint muscles?

To stretch the muscle over both joints Signup and view all the answers

A stretched muscle should always be in a state of ______________________.

relaxation Signup and view all the answers

What are the four criteria that a patient must meet to be considered ready to return to full participation?

<ol> <li>No acute signs or symptoms of the injury are present and no pain or oedema; 2. Can demonstrate full ROM, normal strength, endurance, and CR fitness; 3. Can perform the skills at least as well as they could before the injury; 4. Has confidence in their ability to return to full activities without hesitation.</li> </ol> Signup and view all the answers

Match the following indications for stretching with their descriptions:

Decreased ROM due to scar tissue adhesions = Adaptive shortening of soft tissue due to immobilisation/movement restriction Fracture = Contraindication Infection = Contraindication Acute inflammation = Contraindication Signup and view all the answers

When progressing upper-extremity exercises, the therapist should progress from _________ to partial-WB to full-WB positions.

non-WB Signup and view all the answers

Match the following upper-extremity functional exercises with their descriptions:

Closed-kinetic chain = Fingers, hand, wrist, elbow, and shoulder work together Open-kinetic chain = Isolated movement of a single joint or muscle group Push-up = Full-WB position using the entire upper extremity Signup and view all the answers

What is the definition of posture?

The relative arrangement of the parts of the body Signup and view all the answers

Good posture is the state of muscular and skeletal balance that only protects the supporting structures of the body against injury.

False Signup and view all the answers

What is the primary goal of good posture?

To protect the supporting structures of the body against injury or progressive deformity Signup and view all the answers

Good posture is the state of muscular and skeletal balance that protects the supporting structures of the body against injury or progressive deformity, irrespective of the attitude (e.g._____, lying, squatting, and stooping) in which these structures are working or resting.

erect Signup and view all the answers

Match the following terms related to posture and body mechanics with their descriptions:

Good Posture = The state of muscular and skeletal balance that protects the supporting structures of the body against injury or progressive deformity Posture = The relative arrangement of the parts of the body Body Mechanics = The study of the structure, function, and movement of the body Signup and view all the answers

What is the primary focus of the Alexander Technique?

Improving posture and movement quality Signup and view all the answers

Pilates emphasizes building strength and balance from the core 'foundation'.

True Signup and view all the answers

What are the three components of information gathered during a subjective examination?

Chief complaint, history of present condition, and past medical history Signup and view all the answers

In a normal gait cycle, ______________________ joint ROM is required.

Specific ranges of Signup and view all the answers

Match the following concepts with their descriptions:

Pilates = Exercise focusing on core strength and fluid movement Alexander Technique = Improving posture and movement quality Clinical Gait Analysis = Assessing ambulation and ambulation aids Signup and view all the answers

What is characterized by a contralateral pelvic drop due to weak hip abductors?

Trendelenburg Gait Signup and view all the answers

In a normal gait, the trunk is rotated and the arms swing asymmetrically.

False Signup and view all the answers

What is the primary cause of a Quadriceps Gait?

Weakened quadriceps following knee surgery or injury Signup and view all the answers

A patient with an ankle injury may develop an ______________ Gait.

Ankle Lurch Signup and view all the answers

Match the following pathological gait patterns with their characteristics:

Trendelenburg Gait = Contralateral pelvic drop due to weak hip abductors Quadriceps Gait = Keeping knee extended during weight-bearing phase Ankle Lurch Gait = Hip hike and increased hip and knee flexion Antalgic Gait = Pain avoidance and shorter step length Signup and view all the answers

What is a characteristic of chronic pain when compared to acute pain?

It is maladaptive, not adaptive Signup and view all the answers

Chronic pain is characterised by evidence that structural or anatomical 'damage' contributes to the degree of reported pain.

False Signup and view all the answers

What is peripheral sensitisation, and at how many points can it occur?

Peripheral sensitisation can occur at two points: 1. First order afferent and axon terminal, and 2. (Answer not provided in the content). Peripheral sensitisation is an increase in the resting membrane activity, more neurotransmitter release for the same stimulus, and an increased number of receptor sites at the axon terminal. Signup and view all the answers

When compared to acute pain, chronic pain is characterised by being dominated by ___________ dimensions.

cognitive and emotional Signup and view all the answers

Match the following points with their characteristics of peripheral sensitisation:

First order afferent and axon terminal = An increase in the resting membrane activity Point not provided in the content = Increased number of receptor sites at the axon terminal Signup and view all the answers

What is a characteristic of chronic pain?

Over-activation of the sympathetic nervous system and under-activation of the parasympathetic nervous system Signup and view all the answers

Red Flags are used to identify psychosocial indicators or risk factors suggesting an increased risk of progression to long-term pain and disability.

False Signup and view all the answers

What is the purpose of discussing the neurophysiology of pain with patients?

It is more productive than discussing anatomy and structure Signup and view all the answers

Exercise intervention can help facilitate neuroplasticity, and subsequently a reduction in pain, through the release of _______.

BDNF Signup and view all the answers

Match the following flags with their descriptions:

Red Flag = Signs and symptoms found in either the patient history or clinical examination that indicate a potentially serious pathology Yellow Flag = Psychosocial indicators or risk factors suggesting an increased risk of progression to long-term pain and disability Signup and view all the answers

Study Notes

Ethical and Legal Standards - Personal Response and Needs

Everyone responds differently to an injury and rehabilitation program due to individual physiological and biochemical differences.
Non-physical variables that influence a patient's recovery include outside support, psychological makeup, and external pressures.
A rehabilitation program should be designed based on each patient's individual responses.

Components of a Rehabilitation Program: Principles, Objectives, and Goals

Principles

Seven principles of rehabilitation:
- Avoid aggravation
- Timing
- Compliance
- Individualisation
- Specific sequencing
- Intensity
- Total patient

Avoid Aggravation

Therapeutic exercises can exacerbate an injury if not administered correctly.

Timing

Rehabilitation programs should begin as soon as possible to prevent prolonged rest and delayed recovery.
Rest is sometimes necessary, but excessive rest can be detrimental to recovery.

Compliance

Patient compliance is crucial for a successful rehabilitation program.
Patients are more likely to comply with a program they understand and have a stake in.

Individualisation

Each person responds differently to an injury and rehabilitation program.
Providing personalized instructions and reinforcement can enhance compliance and progress.

Qualities of Professionalism

Being a Professional

Professionals should participate in their profession's society or association (e.g., ESSA for Exercise and Sports Science Australia).
Members' active participation is essential for the society or association's needs.

Ethical and Legal Standards

Rehabilitation

Rehabilitation aims to help individuals achieve maximal function, well-being, and independence.

Healthcare professionals must respect patients' autonomy and right to consent or refuse treatment.

Touch

Touch is an integral part of an AEP's duties, but it should always be purposeful and respectful of the patient's boundaries.
Patients should be informed about the purpose and nature of touch.

Problems and Goals

Problems

A list of problems to be addressed in the treatment program should be created, prioritizing the most significant issues.

Goals

Goals should be objective and measurable whenever possible.
The ultimate goal of therapeutic exercise is the return of the patient to their optimal level of activity.

Evidence-Based Practice

AEPs should base their rehabilitation techniques and applications on three factors: empirical evidence, clinical experience, and patient goals and needs.

Outcomes-Based Practice

Outcomes-based practice involves assessing treatment effectiveness based on clinician, patient, or stakeholder perspectives.
Outcomes tools, such as questionnaires, can be used to evaluate treatment outcomes.

Phases of Rehabilitation and Therapeutic Exercise

During the rehabilitation process, the damaged tissue is easily damaged by forces applied to it, and any new bleeding can restart the inflammation process, adding to the healing time.
Exercise applied to the damaged tissues during this time can exacerbate the injury, resulting in additional tissue damage.
Phase 2: Active Phase, pain and oedema are under control, with a focus on mobility, joint range of motion, and tissue flexibility.
In Phase 2, exercises are mostly passive with some gentle active exercises, and strength is developed through isometric and light isotonic exercises.

Ligament Sprains, Tendons, and Muscle Strains

Ligament sprains can occur due to macrotrauma or repetitive microtrauma.
Tendons are prone to ruptures and tendinopathy.
Muscle strains occur due to overstretch, being forced to contract against too great a resistance, and can damage the muscle, tendon, musculotendinous junction, or tendon-bone interface.
Precipitating factors for muscle strains include lack of flexibility, inadequate warm-up, insufficient strength/endurance, and poor coordination.

Muscle Tissue and Regeneration

Muscle tissue contains unique structures called satellite cells that enable it to regenerate.
Satellite cells are muscle stem cells that fuse with adjacent myofibres to repair and regenerate muscle tissue.
Satellite cells restore and replace muscle cells routinely damaged during activity.
Larger injuries, such as ruptures or severe lacerations, heal with scar tissue.

Muscle Strains and Grades

Muscle strains can be classified into three grades:
- Grade I: Some fibres are stretched or torn, with tenderness and pain on active ROM.
- Grade II: A number of fibres are torn, and active contraction is painful, with a palpable divot and swelling.
- Grade III: Complete rupture with immense immediate pain.

Tissue Engineering and Advances in Investigation

Tissue Engineering is an interdisciplinary and multidisciplinary field that aims to develop biological substitutes to restore, maintain or improve tissue function.
Substances used in tissue engineering include the body's cells, plastic, polymers, and proteins.
Polymers can be synthetic, inorganic materials or biopolymers from plants, animals, and smaller animal and plant forms.
Biopolymers are used to build scaffolds that create an environment conducive to new tissue formation.
Cells from the body are inserted into these scaffolds, which produce interactions with other cells and ultimately form new tissue.

Role of Therapeutic Exercise in Healing

Exercise can enhance recovery, but only if applied appropriately at each specific stage of healing.
Signs of too much stress include increased pain, increased oedema, and decreased function.
You need to consider the healing phases and timing for each injury.

Examination and Assessment

Subjective examination involves a systematic, yet flexible approach to information gathering, establishing a level of comfort and trust with the client.
Information to gather includes general demographics, occupation, history of injury, client's report of pain, onset and pattern of symptoms, past medical history, and previous and current rehab/treatment.
Objective examination involves assessing the extent of the injury, how it affects the patient's function and quality of life, and determining the objective examination process.

End-Feel of Movement, ROM, and Muscle Strength

End-Feel is the nature of the resistance felt at end-ROM, which can be capsular, bony, or soft.
ROM can be normal, hypermobile, or hypomobile, and may vary in athletes.
Muscle strength is tested using manual muscle testing, which assesses contractile tissue, including muscle, tendon, and nerve.

Special Tests, Neurological Tests, Touch/Palpation, and Functional Testing

Special tests help distinguish muscle, ligament, tendon, joint surface, and nerve injuries.
Neurological testing includes examination of sensory, motor, and reflex parameters.
Touch/palpation is used to assess skin temperature, tone, and oedema, as well as fascia, muscles, ligaments, and tendons for tenderness, trigger points, and crepitus.
Functional testing determines painful activities, the injured part's ability to perform an activity, and quality of movement.

Individualisation of Rehabilitation and Exercise Continuum

Each client will progress at different rates and respond differently to rehab.
Re-assess continually, including outcome measures.
Challenge the client, but do not over-stress and aggravate the injury.
Regularly discuss progression with the client in relation to their short- and long-term goals.
In situations of long-term injury and chronic pain, ideally progress to self-management.

Effects of Immobilisation on Connective Tissue

Immobilisation results in a loss of ROM in all tissues, with increased collagen cross-links, a loss of ground substance, and fibrosis
In muscles, immobilisation decreases fibre size, myofibril and capillary numbers, increases fibrous and fatty tissue within muscle, and leads to atrophy within two weeks
In articular cartilage, prolonged immobilisation can result in irreversible damage
The flexibility of ligaments, joint capsules, fascia, and tendons all reduce with immobilisation

Effects of Re-Mobilisation on Connective Tissue

Early re-mobilisation prevents cross-links and increases fluid content in the extracellular matrix
Dynamic and PNF stretching is typically used later in the rehabilitation program
PNF stretching requires some skill from both the patient and clinician

Exercise Progression and Considerations

The choice of stretch depends upon tissues involved, stage of healing, patient motivation, time, and facilities available
First week: stretching within the pain-free ROM
Re-modelling phase: light intensity prolonged stretches and short-duration active and passive stretches
3-4 months post-injury: scar tissue is stronger, and PNF stretching can begin

Indications, Contraindications, and Precautions

Indications: decreased ROM due to scar tissue adhesions, adaptive shortening of soft tissue due to immobilisation/movement restriction
Contraindications: fracture, bony block, infection, acute inflammation, sharp pain, tightened soft tissue providing joint stability
Precautions: patient education, no new swelling, stretch slowly to the point of resistance and release slowly, stretched muscle should be relaxed

Achieving Rehabilitation Outcomes - Muscle Strength and Endurance

Neuromuscular physiology: receptor input from the periphery to the CNS, response sent along efferent nerves to motor units within muscle
Motor units: nerve (motor neuron) and muscle fibres
Sarcomeres contain actin and myosin which slide over one another when a motor unit is stimulated

Muscle Structure and Function

Muscles move joints and continually maintain posture against gravity
Joint movement: one end of muscle remains stable while the other end moves

Muscle Strength, Power, Endurance, and Recovery

Strength: max force a muscle (or group) can exert
Power: strength over a distance for a specific amount of time
Endurance: continually produce force over a period of time

Types of Muscle Activity

Isometric muscle activity (no change in muscle length): advantages: low joint stress, can be used early in rehab; disadvantages: strength gains limited, becomes fatigued and loses coordination

Agility

Agility: the ability to control the direction of the body or its parts during rapid movement
Requires the development of flexibility, strength, and power, followed by balance and coordination

Therapeutic Exercise for Proprioception

Introduce balance, coordination, and agility exercises (in that order) after developing some flexibility and strength
Gradually increase the complexity and intensity of exercises, building up to movements that resemble the patient's activities

Plyometric Production

Plyometrics or “stretch-shortening activity”: the lengthening of muscle/tendon followed by rapid shortening
Faster stretch-reflex (i.e., elastic energy) = greater force produced
Performance-specific exercises: walking, jogging, running, jumping, bounding

Upper-Extremity Functional and Performance-Specific Progression

Progress from non-weight-bearing to partial-weight-bearing to full-weight-bearing positions using a combination of closed- and open-kinetic chain exercises
Check technique and control: look for scapula positioning and movement
Build up to full kinetic chain exercises – fingers, hand, wrist, elbow, and shoulder

Returning The Patient To Full Participation

1. No acute signs or symptoms of the injury are present and no pain or oedema
1. Can demonstrate full ROM, normal strength, endurance, and CR fitness
1. Can perform the skills at least as well as they could before the injury
1. Has confidence in their ability to return to full activities without hesitation

Posture and Body Mechanics

Posture is defined as the relative arrangement of the body's parts, with good posture being the state of muscular and skeletal balance that protects the body's supporting structures against injury or progressive deformity.
Good posture allows for efficient muscle function, optimal positions for thoracic and abdominal organs, and involves perception of balance, space, gravity, self-image, and kinaesthetic awareness.
The Alexander Technique aims to reduce muscle tension, increase awareness, and improve movement quality through self-examination, breathing, balance, and coordination.
Body awareness programs, such as Pilates, focus on relaxation, concentration, control, breathing, and postural alignment to build strength and balance the body.

Ambulation and Ambulation Aids

Normal gait cycle requires specific joint range of motion (ROM) and muscle activity.
Clinical gait analysis involves assessing areas of tightness, pain, or weakness, and observing gait patterns, including stride rate, step length, limping, and favouring one side.
Pathological gait patterns include Trendelenburg gait, quadriceps gait, restricted knee motion, ankle lurch gait, shortened step length, and antalgic gait.
Ambulation aids provide external support for mobility and can affect pain perception.

Chronic Pain

Chronic pain is the brain's interpretation of nociceptive input and is characterized as maladaptive, dominated by cognitive and emotional dimensions, and not correlated with structural or anatomical damage.
Chronic pain involves peripheral sensitization, where nerve endings become more sensitive, and central sensitization, where the brain dedicates a greater area to nociceptive information.
Neurotags, including past experience, mood, attention, knowledge, and cues, can contribute to chronic pain.
Behavioural components, such as fear, anxiety, and avoidance, can also play a role in chronic pain.

Red vs. Yellow Flags

Red flags indicate potentially serious pathology, while yellow flags suggest an increased risk of progression to long-term pain and disability.

Treatment

Exercise intervention can facilitate neuroplasticity and reduce pain through the release of BDNF.
Discussing the neurophysiology of pain with patients can be more productive than discussing anatomy and structure.

Studying That Suits You

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Description

This quiz covers the concept of rehabilitation and evidence-based practice, including ethical and legal standards, personal response, and needs.

EHR 520 weeks 1 - 4

Choose a study mode

Podcast

Questions and Answers

What is an important factor to consider when designing a rehabilitation program?

It is always best to expect a patient to progress in the same manner as the last patient with the same injury.

What is the primary goal of a rehabilitation program?

The seven principles of rehabilitation include avoiding ______________ and ensuring proper timing.

Match the principles of rehabilitation with their descriptions:

What is the purpose of providing written instructions to patients?

A patient always has the last say in what is done with or to their body.

According to the World Health Organisation, what is rehabilitation?

An AEP should always have ______________ present when dealing with a patient in an isolated situation.

Match the following concepts with their definitions:

What is the ideal scenario for sensitivity and specificity ratings?

A rehabilitation program should always prioritize the most significant problems or deficiencies last.

What is the ultimate goal of therapeutic exercise?

Goals in a rehabilitation program should be ______________________ whenever possible.

Match the components of a rehabilitation program with their descriptions:

What are the three factors that AEPs consider when deciding on rehabilitation techniques and applications?

Outcomes-based practice is only concerned with clinician-based outcomes.

What is the purpose of outcomes tools in outcomes-based practice?

Outcomes tools can be categorized into ______________________ measurement tools and region-specific measurement tools.

Match the types of outcomes with their descriptions:

What happens to an individual's strength during the first week of immobilization?

Expecting a patient to progress in a program the same way as the last patient with a similar injury is a good approach.

What is the key factor in ensuring a patient is compliant with a rehabilitation program?

During the first week of immobilization, an individual's strength is lost at a rate of _______ % per day.

Match the following concepts with their descriptions:

What is the goal of tissue engineering?

Exercise can hinder recovery if applied inappropriately at each stage of healing.

What are the three main components of information to gather during a subjective examination?

Polymers used in tissue engineering can be composed of organic molecules synthesised by ______________ forms.

Match the following components of a subjective examination with their descriptions:

What happens when exercise is applied to damaged tissues during the initial healing phase?

During Phase 2 of rehabilitation, the focus is on strength training with heavy isotonic exercises.

What are the consequences of misjudging the amount of stress applied or the tissue's ability to withstand it during a rehabilitation session?

Any new bleeding during the initial healing phase will ______________________ the inflammation process.

Match the phase of rehabilitation with its characteristics:

What type of trauma can cause muscle strains?

Satellite cells can restore and replace muscle cells routinely damaged during activity.

What happens to muscle tissue when a small muscle injury occurs?

A Grade I muscle strain involves _______ fibres stretched or torn.

Match the muscle strain grade with its description:

What is the nature of the resistance you feel at end-ROM for a capsular end-feel?

Special tests should be performed if a fracture or dislocation is suspected.

What is the purpose of touch/palpation in assessment and examination?

ROM or mobility of a joint can be normal, hypermobile (excessive) or ______________________.

Match the following types of muscle strength testing with their descriptions:

What is the median time difference for return to play between early intervention and delayed intervention groups?

Each patient with the same injury will progress at the same rate in a rehabilitation program.

What is the definition of self-management in the context of chronic conditions?

The early rehab group commenced rehab _______ days post-injury.

Match the following stages of rehabilitation with their descriptions:

What happens to the flexibility of connective tissues such as ligaments, joint capsules, fascia, and tendons with immobilisation?

Prolonged immobilisation can result in irreversible damage to articular cartilage.

What is agility characterized by?

What are the effects of immobilisation on muscle tissue?

Early re-mobilisation prevents the formation of ____________________ in connective tissue.

Plyometric exercises are used to improve strength and flexibility.

What should therapeutic exercises for proprioception gradually do?

Match the effects of immobilisation with the corresponding tissue:

Plyometrics or 'stretch-shortening activity' involves the lengthening of muscle/tendon followed by rapid _______________

Match the following exercises with their characteristics:

What happens to muscle tissue when a small muscle injury occurs?

Strength is the maximum force a muscle or group can exert.

What is the main difference between isometric and isotonic muscle activity?

Muscles move joints and continually maintain posture against ______________________.

Match the types of muscle strength with their descriptions:

What is a key factor to consider when selecting a stretch in a rehabilitation program?

PNF stretching can be used in the first week of rehabilitation.

What is important to consider when designing a plyometric and agility exercise program?

A patient can be considered ready to return to full participation if they demonstrate full ROM, normal strength, endurance, and CR fitness, but still have some pain or oedema.

What is the primary goal when stretching two-joint muscles?

A stretched muscle should always be in a state of ______________________.

What are the four criteria that a patient must meet to be considered ready to return to full participation?

Match the following indications for stretching with their descriptions:

When progressing upper-extremity exercises, the therapist should progress from _________ to partial-WB to full-WB positions.

Match the following upper-extremity functional exercises with their descriptions:

What is the definition of posture?