Therapeutic exercise - Physiotherapy
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Transcript of Therapeutic exercise - Physiotherapy
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K.SUNDARAGANESH
LECTERER IN PHYSIOTHERAPY DIVISION OF PM&R
RMMCHANNAMALAI UNIVERSITY
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THERAPEUTIC EXERCISE
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REHABILITATIONRE – againHABILIATION – behavior & skills
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PHYSIOTHERAPIST1. Examination 2. Intervention3. Prevention4. Consultation , education & research
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THERAPEUTIC EXERCISEIs the systematic , planned performance of
bodily movements , postures or physical activities intended to provide a patient / client to optimize overall health , status , fitness or sense of well being
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FUNCTION
FUNCTION
STRENGHT , POWER &
ENDURANCE
MOBILITY EX’S
BALANCE &FLEXIBI
LITY
NEURO MUSCULAR CONTROL &
COORDINATION
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STRENGTH , ENDURANCE , POWER & BALANCE
Ability to generate maximal forceAbility to sustainRate of work [ speed ]COG over body’s BASE OF SUPPORTFlexibility [ elongation ]
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COMMON PHYSICAL IMPAIRMENTSPainMuscular weaknessDecreased muscle enduranceLimitation of ROMJoint hypermobilityFaulty postureMuscle tightnessBalanceIncoordinationDelayed motor developmentAbnormal toneDecreased aerobic capacityImpaired circulation
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STARTING POSITIONSStandingKneelingLyingSittingHanging
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MUSCLE WORKISOTONICISOMETRICISOKINETIC
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ISOTONICCONCENTRICECCENTRIC
EVALUVATIONBy calculating RM
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MUSCLE STRENGTH TESTING Gold standard is 1RMProtocol for 1RM testingSTEP 1 – warm up (5-10 rep of 40% to 60%)STEP 2 – brief rest (1-min)STEP 3 – 3-5 rep @ 60% - 80% of 1RMSTEP 4 – determine 1RM - 3 to 5 trails - 3 to 5 min rest between trailsWIDELY USED – bench press - leg press
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MODIFICATION OF RM TESTINGE.G : 6 – RM strength test5-10 rep at 50% of estimated 6 – RM1 min rest6 rep 70 % of estimated 6 – RM2 min rest6 rep at 100 % of 6 RM (adjust wg )1 RM predictionMEN : 1 RM = wg (lb)/(1.0278 – rep x 0.0278)WOMEN : 1 RM = (0.92xwg (kg))+(0.58xrep)-3.41OLDER WOMEN : 1 RM = (0.92xwg kg)
+(0.79xrep)-3.73
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ISOMETRICMuscle setting exercise Stabilization exerciseMultiple – angle isometrics ( resisted )
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MUSCLE STRENGTH – ISOMETRIC DYNAMOMETRYDevices used :-Hand grip dynamometry : grip strengthLeg & back dynamometry : lower extremity
strength
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MUSCLE STRENGTH – ISOKINETIC DYNAMOMETRYAssesses strength development at constant
speedProtocol :Speed set at 30 – 60*/sec2-3 submaximal trails , followed by 3-5 maximal trails (till drop in performance
noted ) , best of maximum trails
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ASSESSMENT OF POWER
VERTICAL JUMP TESTSTAIR SPRINT TESTSPRINT TEST
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ASSESSMENT OF MUSCLE ENDURANCE
Suggested techniques :1. Maximal # of lifts at 70% of 1-RM weight2. Bench press at fixed weight Cadence of 30 reps/min Test ends when cadence cannot be maintained Men : 80 – lb bar Women : 35 – lb bar3. Push – up test Measures # of push-ups completed without
rest
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12-MIN RUN FITNESS TEST FOR ENDURANCE
Calculate your estimated vo2 maxIn miles : vo2 max = (35.97xmiles)-11.29In Km : vo2 max = (22.351xkilometers)-
11.288
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MOVEMENTPASSIVE MOVEMENTACTIVE MOVEMENT
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PASSIVE MOVEMENTRelaxed passive movement & accessory
movementPassive manual mobilization techniquea. Mobilizationb. Manipulationc. Passive stretching
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ACTIVE MOVEMENTFree exerciseAssisted exerciseAssisted – resisted exerciseResisted exercise
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STRETCHINGStatic stretchingBallistic stretchingProprioceptic neuromuscular fascilitation
stretching
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RESISTED EXERCISEManual Mechanical
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PROGRESSIVE RESISTED EXERCISE
1.DE LORME & WATKINS2.ZINOVIEFF ( OXFORD TECHNIQUE )3.MAC QUEEN
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1.DE LORME & WATKINS10 lifts with ½ 1o R.M.10 lifts with ¾ 1o R.M.10 lifts with 1o R.M.
30 lifts 4 times weeklyProgress 10 R.M once weekly
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2.Zinovieff (oxford technique)10 lifts with 10 R.M. minus lb
10 lifts with 10 R.M. minus 1 lb10 lifts with 10 R.M. minus 2 lb10 lifts with 10 R.M. minus 3 lb10 lifts with 10 R.M. minus 4 lb10 lifts with 10 R.M. minus 5 lb10 lifts with 10 R.M. minus 6 lb10 lifts with 10 R.M. minus 7 lb10 lifts with 10 R.M. minus 8 lb10 lifts with 10 R.M. minus 9 lb100 lifts 5 times weeklyProgress 10 R.M. daily
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3.Mac queen
10 lifts with 1o R.M.10 lifts with 1o R.M.10 lifts with 1o R.M.10 lifts with 1o R.M.
40 lifts 3 times weeklyProgress 10 R.M. every 1-2 weeks
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CO-ORDINATION Smooth , accurate and purposeful , is brought
about by the integrated action of many muscles
Principle of re-educationFrenkel’s exercise :-I. Concentration II. PrecisionIII. Repetition
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RE-EDUCATION OF MUSCLEMRC GRADING0-no contraction1-flicker of contraction2-full range of motion eliminating gravity3-full range of motion against gravity4-full range of motion against gravity with
minimal resistance5-full range of motion against gravity with
maximal resistance
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Gait training-walking aidsGait parametersCructhes , sticks , tripod , quadripod , framesPreparation for cructh walkingCrutch walking
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OTHER TECHNIQUESPNFSensory motor integrationNeuro developmental therapy
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THANK YOU