Therapeutic Exercise in Healthcare

Therapeutic Exercise

• Therapeutic Exercise is a systematic and planned performance of bodily movements, postures, or physical activities intended to balance, remediate, or prevent impairments, and improve physical function, stability, and overall health status.

Goals of Therapeutic Exercise

• To provide a patient with the means to:
  • Remediate or prevent impairments
  • Improve, restore, or enhance physical function
  • Prevent or reduce health-related risk factors
  • Optimize overall health status
  • Enhance fitness or overall well-being

Neuromuscular Control

• The ability of the neuromuscular system to control and coordinate muscle actions to hold a proximal or distal body segment in a stationary position
• Involves the interaction of sensory and motor systems
• Enables synergists, agonists, and antagonists to work together to create coordinated movement

Muscle Performance

• The ability of a muscle to produce tension and move through a range of motion (ROM)
• Encompasses strength, power, and muscular endurance
• Requires correct timing and sequencing of muscle firing

Postural Control and Stability

• The ability to maintain the center of mass within the base of support
• Involves maintaining the alignment of body segments against gravity
• Essential for balance and equilibrium

Balance and Equilibrium

• The ability to maintain the center of mass within the base of support
• Involves the interaction of sensory and motor systems
• Requires the ability to make adjustments to maintain equilibrium

Cardiopulmonary Fitness

• The ability to respond to moderate intensity, repetitive, total body movement over an extended period
• Involves the ability to work at a moderate intensity without excessive fatigue

Exercise Safety

• Taking patient's health history and current health status to determine level of exertion
• Obtaining medical clearance from a physician for exercise program
• Ensuring a safe environment with adequate space, proper support surface, and well-maintained equipment
• Ensuring proper posture, alignment of body, correct movement execution, and appropriate intensity, speed, and duration

Therapeutic Exercise Interventions

• Effective exercise instruction for unsupervised execution
• Aerobic conditioning and reconditioning
• Patient education
• Muscle performance exercises: strength, power, and endurance training
• Therapist safety: proper body mechanics, joint protection, and stretching techniques
• Neuromuscular control, inhibition, and facilitation, and posture awareness training
• Postural control, body mechanics, and stabilization
• Balance exercises and agility training
• Relaxation exercises and breathing exercises
• Task-specific functional training

Effective Exercise Instruction

• Preparation: planning and facilitating interventions prior to and during exercise
• Creating a motivating environment and establishing a good relationship with the patient
• Identifying patient's learning style and attitude towards exercise
• Ensuring patient adherence to exercise program
• Providing clear, concise, and written/verbal instructions in a non-distracting environment