Therapeutic exercises

Out lines

Introduction Approach to patient evaluation and

program development (SOAP) Posture

Introduction to therapeutic exercises

The ultimate goal of any therapeutic exercise program is the achievement of symptom-free movement and function.

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Goals of therapeutic exercisesprevention of dysfunction the development, improvement , restoration, or maintenances of normal:

1.Strength2.Endurance and cardiovascular fitness3.Mobility and flexibility4.Relaxation5.Coordination and skill

In order to effectively administer therapeutic exercise to patient the therapist must:

1. know the basic principles and effects of the treatment

2. Be able to do a functional evaluation of the patient

3. Know the interrelationships between the anatomy and kinesiology

4. Have an understanding of the state of disability and its potential rate of recovery, complications, precautions, and contraindications

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Structure governs function› Anatomy is the structure› Biomechanics/physiology are the

function

Approach to patient evaluation and program development

Patient care is a problem-solving process.

it is feed bake loop Asses

s needs

Develop plan

Implement plan

Evaluate plan

Approach to patient evaluation and program development. Cont.,

A. Assess needs1) Subjective information (the case

history) Name , age, sex………. Ask questions to get the patient to:1. Describe how he perceives his symptoms. e.g.

location, type, and nature of pain or symptom2. Describe the behavior of the symptoms through a

24-hour period. e.g. motions or positions cause and influence the symptom

3. Briefly describe his general health, medications being taken……………..

4. Describe the previous history of the condition.5. Describe related history, such as any medical or

surgical intervention.

Approach to patient evaluation and program development. Cont.,

A. Assess needs2) Objective data (clinical evaluation)

a) Inspection (observation)1. The ADL such as gait- patient ability to

stand, sit, or dress himself2. Use of any assistive aids3. Posture 4. Shape of body parts such as contour

changes, swelling, atrophy, hypertrophy, and asymmetry

5. Appearance of the skin

Approach to patient evaluation and program development. Cont.,

b) function Functional tests include:

1. Active range of motion (AROM)2. Passive range of motion (PROM)3. Describe the end feel (normal –abnormal)4. Manual muscle testing5. Joint integrity tests

Approach to patient evaluation and program development. Cont.,c) Palpation 1. Skin and subcutaneous tissue, temperature, 2. Edema3. Muscles, tendons, trigger point……4. Joint (effusion, tenderness, changes in position

or shape)5. Nerve and blood supply

d) Neurological testse) Additional testsf) Cardiovascular status

Approach to patient evaluation and program development. Cont.,

3) AssessmentOnce the subjective and objective data

about patient are gathered: List the problem area Determine major versus minor

problems

B. Develop Plane

Goals or objectives of the treatment

Each goal should be optimized to include:

1. A measurable outcome2. Specific conditions or tests3. The time expected to accomplish the

goal

Long term-goals:1. Are a final measurable outcome

expected at the end of the treatment2. Are often described in functional terms

Short term goals: 1. Reflect the component skills needed to

obtain the long term goals2. Are helpful in directing the decision-

making process

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