Therapeutic exercise is one of the many interventions in physical therapy. Exercise as
a therapy is based on the belief that the body adapts to the physical stresses to which it is
subjected.” (Chino, Davis). There is a process to find out if therapeutic exercise is right for the patient. A
physical therapist begins by conducting a thorough evaluation of an individual’s physical capabilities
through medical history and a physical assessment. The first objective of therapeutic exercise is to help
the body reduce pain and inflammation. Once this is achieved, the exercise program focuses on regain
range of motion and rebuilding muscle strength and endurance. Therapeutic exercise will help a patient
reach their goals to reduce functional limitations.
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The three therapeutic exercises that are covered throughout this essay contribute to improving a patient’s ADL’S. Physical therapy offers numerous options for treating balance, strength, and endurance issues. Strength is very important for mobility and overall well being. A physical therapist can test for strength and use those results to establish a plan of care. A manual muscle test can express a patient’s strength and function of a muscle. Resistance is applied to muscles to determine the strength. For documentation, the test results fall under the objective portion of SOAP notes. The test is helpful to determine if the patient has made improvements. It is always important to keep in mind that if there is no improvement, then the plan of care needs to be revised. The muscle strength manual test is graded on a scale of zero to five. A five is normal, meaning tat the patient can complete the whole range of motion against gravity with maximum resistance. When a patient scores a four, it is clear that the patient is still good, but can only perform the full range of motion with moderate resistance. Grade three is broken down into two parts. A patient whom scores a three is not able to complete range of motion when force is applied by the physical therapist. A patient that scores a three plus means can complete the test with minimal resistance. The score two is always broken down into separate degrees. A patient that scores a two cannot complete range of motion against gravity. A patient with a two minus means that the patient cannot complete full range of motion at all, only expressing partial movement. Grade one demonstrates that the patient cannot move the joint at all, yet still has slight muscle contraction through palpation.
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patient with a score of zero shows no contractions at all. A manual muscle test is widely used, but is not
always dependable. Sometimes, the examiner might not handle the patient correctly. A test result may be
skewed if the examiner lacks the knowledge and skills that are necessary to conduct the test. Therefore,
the test is not always accurate. There are many therapeutic exercises that are aimed to stop muscle
atrophy. While there is a wide range of muscle strengthening exercises, here are just a few. Hamstring
curls are excellent for a patient who needs strengthening of the semitendinosus, semimembranosus, and
biceps femoris. This exercise requires no equipment. The patients will need to be in prone position, then
bend the knee, bringing the heel towards the hip. Squats are a great exercise, as they strengthen the entire
lower body. However, the physical therapist must be careful to instruct the patient to keep their back
straight and to never allow the knees to be ventral to the toes. A secure surface should be gripped with
both hands. Feet should be shoulder width apart. The knees will be bent and the patient will act as if
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they are going to sit in a chair. If performed correctly, squats can be very beneficial for the quadriceps, hamstrings, glutes, and the calves. A great shoulder muscle strengthening therapeutic exercise is adduction isometrics. This activity requires a ball with will need to be placed between the patients rib cage and elbow. The elbow must be on the patient’s side at a 90 degree angle. The patient will try to squeeze the ball. If a patient is struggling with core strength, then the physical therapist might include bridges into the plan of care. This exercise begins in supine position with the knees bent and the feet flat on the matt. The abdomen should be contracted. Next, the glutes should lift off the mat towards the ceiling. The patient should attempt to hold this position for five seconds. Then the patient will slowly lower the glutes back to the matt, and relax the stomach muscles. Although this muscle is used to strengthen the core, it can also improve posture, as well as reduce knee and back pain.Strength training is a safe way to practice therapeutic exercise without aggravating existing injuries or risking new ones. Balance exercises are a type of therapeutic exercise practiced in a physical therapy clinic. Balance issues make it difficult to maintain stable and upright positions.
Abnormal balance is more commonly
seen in geriatrics. Women are at a slightly higher risk of having balance issues. Balance problems can be
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a result of muscle weakness, again, and joint stiffness. Some medical conditions such as Parkinson’s and
arthritis may lead to abnormal balance. It is common for patients who suffered from a stroke to have
accompanying problems with balance. Abnormality of vision, the inner ear, the muscular system, and
proprioception can all increase the risk of having balance issues. Physical therapist separate balance into
two general categories; static and dynamic. Static balance is the ability to maintain the body in a fixed
position. The functional reach test is designed specifically for static balance. “Dynamic balance is the
ability to maintain postural stability and orientation with centre of mass over the base of support while the
body parts are in motion.” (Sullivan, Portnry). A patient may have dynamic balance issues with no signs
of static balance issues. The berg balance test is designed to test for both static and dynamic balance. The
test requires a chair with arms, a chair without arms, a step stool, a shoe (or any small object), and a
ruler taped to the wall. Using the chair with no arms, the patient will try to stand without using the arms for support. A perfect score for this test is a four, meaning that the patient is not at a risk of falling due to balance issues. The next test in this series is to stand still for two minutes, which will test static balance. Next, the patient will scoot forward in the chair, fold their arms, and sit still for another two minutes. The next test requires the patient to sit down in the chair without using arms. The fifth test allows the patient to use their arms to transfer from one chair to another. The sixth test requires the patient to stand with their eyes closed for ten second. The ruler should be taped horizontally on the wall. The patient will stand with their side against the wall and raise the arm closest to the wall towards the ruler. With the arm still elevated, the patient will reach forward as far as they can. It is not good if a patient reaches less than 6 inches. A patient with a reach of 10 inches may not need to perform balance exercises. In the next step of the bergs test, the patient will reach down to pick up a show from the floor. Then, the patient will turn in a full circle. The goal is for the patient to complete a full circle in four seconds. The patient will then use the step stool to alternate placing each foot on and off the stool. The physical therapist will then instruct the patient to stand on one leg without touching the extended leg with the stationary leg. It is always necessary to have a patient with balance issues to wear a belt. Once these series of tests are complete, the 5 physical therapist will evaluate the scores and determine which balance exercises that the patient will need to perform in order to achieve progress. Endurance training is a therapeutic exercise that many physical therapists use as interventions. Endurance training will increase breathing and heart rate, improve health of lungs and heart, and increase overall fitness. There are many different types of physical therapy techniques used to specifically help increase endurance. These exercises include activities that increase the heart rate and the respiratory rate. Endurance training engage large muscles over a long period of time. It is up the physical therapist to teach the patient the correct breathing techniques to use during physical therapy. A patient that isn’t breathing properly can become dizzy and have chest pain. Examples of endurance training are running, dancing, and biking. Even a short walk can increase the heart rate. Some clinics use wii games to engage patients in endurance training. The patients that are unable to do high level endurance therapy might find hydrotherapy to be beneficial. Hydrotherapy is the use of water in a pool to exercise. Hydrotherapy is easy on the joints, while still providing resistance. Hydrotherapy isn’t only used for endurance. “The manipulation of your blood's circulation by using hydrotherapy can help many ailments, such as fevers, bronchitis, headaches, sinusitis, colds, insomnia, and various other conditions. Although a gentle treatment, hydrotherapy can have profound health benefits. In addition, hydrotherapy is an effective way to stimulate the immune system, optimize circulation, and promote detoxification.” (Blach, Therapeutic exercises help a patient return to previous functional abilities, or prevent issues from worsening. These exercises help the patient gain confidence back by helping them feel they are becoming more independent. The goals of physical therapy interventions are to preserve or improve physical capacity. Physical therapy intervention can help a patient conquer the fear to move because of the risk of falling. It is important that the physical therapy adjust the plan of care to accurately fit into the patient’s needs. The objective data can help a physical therapist decide on specific muscle strength, balance, and 6 endurance exercise. It is very important that the physical therapist or physical therapist assistant teach the patient the exercises correctly before sending them to do home exercises. Performing an exercise wrong may cause more damage. Physical therapy interventions, such as therapeutic exercises, can be important because they help educate the patient, restore the patient’s functional ability, and reduce the patient’s overall pain.
When performing manual muscle testing for shoulder flexion and abduction, PTA’s typically place their hand at the wrist verses the mid-extremity because placing their hands at the wrist increases the length of the lever thus testing the muscles ability to resist externally applied force overtime and across the bone-joint lever arm system. Shorter lever arms will provide higher testing scores when compared to using longer lever arms, thus changing the point of force application affects the length of the lever arm and therefore the muscle torque.
Therapeutic stretches of the gastrocnemius and soleus muscles. If the ligament are weakened, cross fiber friction them to try to regain some of the integrity of the ankle back.
Anderson, D. I., & Sidaway, B. (2013) Kicking biomechanics: Importance of balance. Lower Extremity Review Magazine.
Strengthening the muscles that surround the Glenohumoral (shoulder) joint will keep the joint stable. This will also help prevent further injury to the joint and/or the muscles surrounding it.
Kinesiology is a complimentary therapy used to identify and correct internal issues to relieve stress, allergies, and pain. Being described as a complimentary therapy, kinesiology is not meant to be a cure-all for the patient, but a secondary method of increasing positive results of the original therapy; this method however can be used as a primary or secondary form of therapy depending on the results for the patient and satisfaction with said results. During treatment the doctor tests 14 different areas of muscles balance, these major muscles and how they react are believed to uncover problems that need correction which cannot be found with any other testing (Rude Health).
In our everyday lives, we almost take for granted this idea of balance or equilibrium that is maintained within our bodies. In general, no real thought processes are required. It is only when something is disturbed within our balance system that one is able to take notice of changes in the equilibrium. There may be several different factors that cause a disturbance to our bodies. One major area pertains to dizziness. Dizziness is found to be "the chief complaint in 8 million physician visits a year" (1). Vertigo is one type of dizziness, causing illusions of movement, that is being researched more and more today because of its widespread symptoms.
• If you have trouble walking or keeping your balance, try using a cane for stability. Sit down right away if you feel dizzy or unstable.
Athletes must accomplish amazing feats of balance and coordination of the body. As scientist, Mikhail Tsaytin discovered in the 1970s, acrobats can successfully make a two person human tower in the dark, but after adding a third acrobat, not even the most talented can maintain the balance required to keep the tower intact while in the dark (1). What does darkness have to do with it? The point is that balance relies on at least three signals coming from the body, and one of those is sight. Once you eliminate one of these signals, the body cannot accomplish the required task. In addition to sight, signals coming from muscles and joints, called proprioceptors are sensitive to changes in position. The third contributor to the human tower and the topic of discussion of this paper is the vestibular system. A three-person human tower in the dark must not have enough information coming from the vestibular and proprioceptive systems to function without vision, whereas the two-person tower did have enough information.
“An ounce of prevention is worth a pound of cure”.1 The profession of physical therapy has been defined its ability to treat injuries, however, the American Physical Therapy Association aims to redefine the profession by offering “creative and proactive solutions to enhance health services delivery and to increase the value of physical therapy to society”.2 One aspect through which this vision may be achieved is the prevention of workplace injuries. In 2013, nearly 2.9 million nonfatal workplace injuries were reported, eighty percent of which occurred in private industries. Physical therapists have an opening to target a new population and to implement preventative measures in the workplace which will benefit companies and workers alike. Such
As you grow older, your muscles start to deteriorate and your joints begin to ache and weaken. This is inevitable; so don't try to avoid it. Even if you are extremely active and exercise daily, it will occur. Getting old may not be the cause, you might simply have had a car accident, or a tragic accident of any kind. So, what do you do? You go see an occupational therapist.
radiation for cancer can take a huge hit on bone strength. Other medications such as
Physical therapy is a fun and exciting healthcare profession that helps people. It is all about helping other people who have problems with their body, muscles, joints and other parts of their body. Patients includes accident victims and individuals with disabling conditions such as low back pain, arthritis, heart disease, fractures, head injuries, and cerebral palsy. Physical therapy will perform an evaluation of your problem or difficulty. They evaluate your problem by performing tests and measures to assess the problem. These tests includes muscle strength, joint motion, sensory and neurological, coordination, balance, observation, palpation, flexibility, postural screening, movement analysis, and special tests are designed for a particular problem. Next, they develop a treatment plan and goals and then manage the appropriate treatment to aid in recovery of a problem or dysfunction. Physical therapists are able to treat their patients by using many different treatments depending on the type of injury. Some of the treatments are electrical stimulation, hot and cold packs, infrared and ultrasound to reduce swelling or relieve pain. These treatments are used to help decrease pain and increase movement and function. Therapeutic exercises instructions will help restore strength, movement, balance, or skill as a guide towards full functional recovery. Physical therapy provides "hands on techniques" like massage or joint mobilizations skills to restore joint motion or increase soft tissue flexibility. They will focus on basic skills such as getting out of bed, walking safely with crutches or a walker, moving specific joints and muscles of the body. Physical therapists treatment includes patient education to teach them how to deal with a current problem and how to prevent the problem in the future. Such documentation is used to track the patient's progress, and identify areas requiring more or less attention. They encourage patients to use their own muscles. Their main goal is to improve how an individual functions at work and home.
The human body contains numerous bones, muscles, and ligaments that allows us to withstand vast amounts of physical activity and movement without getting injured. Although, depending on the activity and the individual, there is a point where the bodies mechanics break down or sprain, causing the individual to experience pain or lack of mobility. The best treatment or rehabilitation in this situation is physical therapy, as opposed to medical drugs or surgical procedures. The technical definition for physical therapy is, “The specialized branch of rehabilitative health that uses specially designed exercises and equipment to help patients regain or improve their physical abilities.” With the advancements of work-out technology in the modern
Physical therapists are health care professionals that provide therapeutic services to their patients who have temporary or chronic physical conditions that were caused from injury or disease. Physical therapist also provided therapeutic services to patients after they have gone through surgery to help them gain back mobility and manage their pain. They can also work in preventive care by promoting healthy life styles and instructing individual patients or groups on preventing injury by using exercises that stretch and strengthen muscles. To help their patients try to recover they use massage techniques, wellness plans, and different types of equipment. When a physical therapist sees a patient for the very first time they must do an examination, evaluation, diagnosis, and then put together a physical intervention to start the rehabilitation process. They also work as a team with other health care professionals to help with their patients needs. Physical therapist can really make a difference in their patient’s lives by not only providing therapeutic services but also encouraging and motivating them so they can get better. The main goals of physical therapist are to help their patients retain or gain back lost physical mobility, eliminate or reduce pain, increase productivity and help promote a healthy life style so patients can have a better quality of life and become more independent.
Lower the package/object by placing your feet steady as when lifting. Tighten stomach muscles then bend hips and knees.