Therapeutic Exercise for Physical Therapist Assistants 2Nd Ed
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Exercise Prescription for Osteoarthritis
CLINICAL Exercise Prescription for Osteoarthritis REVIEW Indexing Metadata/Description › Procedure: Exercise Prescription for Osteoarthritis › Synonyms: Osteoarthritis, exercise prescription; Exercise program guidelines, osteoarthritis; Guidelines for exercise, osteoarthritis › Area(s) of specialty: Orthopedic Rehabilitation, Cardiovascular Rehabilitation, Home Health, Women's Health, Geriatric Rehabilitation › Description/use: • Individualized exercise therapy is a mainstay of conservative treatment for osteoarthritis (OA). Exercise is widely promoted by the Arthritis Foundation and prescribed by healthcare professionals to reduce joint pain and improve physical functioning in persons with OA(1,2,3) • Medical guidelines and practical advice provide the basis for prescription of safe and effective therapeutic exercise training for patients with OA(4,5,6) • Persons living with OA welcome community-based exercise programs and education for self-management of their OA(1,7) • This Clinical Review focuses on general exercise prescription for patients with OA. For comprehensive treatment strategies, see theClinical Review that deals with a specific site of OA (e.g., knee, hip, spine, hand) › Indications: Joint pain, mobility impairments, functional limitations in daily life, physical inactivity, overweight/obesity › CPT code: • 97110 (therapeutic exercises to develop strength and endurance, range of motion, and flexibility) • 97530 (use of dynamic activities to improve functional performance) • 97535 (self-care/home management training) › G-codes: -
VIEW Open Access Muscle Spindle Function in Healthy and Diseased Muscle Stephan Kröger* and Bridgette Watkins
Kröger and Watkins Skeletal Muscle (2021) 11:3 https://doi.org/10.1186/s13395-020-00258-x REVIEW Open Access Muscle spindle function in healthy and diseased muscle Stephan Kröger* and Bridgette Watkins Abstract Almost every muscle contains muscle spindles. These delicate sensory receptors inform the central nervous system (CNS) about changes in the length of individual muscles and the speed of stretching. With this information, the CNS computes the position and movement of our extremities in space, which is a requirement for motor control, for maintaining posture and for a stable gait. Many neuromuscular diseases affect muscle spindle function contributing, among others, to an unstable gait, frequent falls and ataxic behavior in the affected patients. Nevertheless, muscle spindles are usually ignored during examination and analysis of muscle function and when designing therapeutic strategies for neuromuscular diseases. This review summarizes the development and function of muscle spindles and the changes observed under pathological conditions, in particular in the various forms of muscular dystrophies. Keywords: Mechanotransduction, Sensory physiology, Proprioception, Neuromuscular diseases, Intrafusal fibers, Muscular dystrophy In its original sense, the term proprioception refers to development of head control and walking, an early im- sensory information arising in our own musculoskeletal pairment of fine motor skills, sensory ataxia with un- system itself [1–4]. Proprioceptive information informs steady gait, increased stride-to-stride variability in force us about the contractile state and movement of muscles, and step length, an inability to maintain balance with about muscle force, heaviness, stiffness, viscosity and ef- eyes closed (Romberg’s sign), a severely reduced ability fort and, thus, is required for any coordinated move- to identify the direction of joint movements, and an ab- ment, normal gait and for the maintenance of a stable sence of tendon reflexes [6–12]. -
Aquatic Rehabilitation
Aquatic Rehabilitation Matt McGraw MS, ATC, PES, CES March 2, 2019 Overview • History of Aquatic Rehabilitation • Principles of Water • Aquatic Therapy Techniques • Contraindications and Precautions • Indications and Advantages • Things to think about History of Aquatic Rehab • Early Civilizations - early 20th Century • Belief that hot springs/spas provided therapeutic and medicinal value • Social activity • Hot air/water and cold plunge • Limited use of submerged exercise History of Aquatic Rehab • 1830: Vincenz Priessnitz • Combined cold water with exercise to strengthen ill patients • Dr. Winternitz • Researched varying water temps on sick patients • U.S. treatment modality during smallpox outbreak for Neurological Rehab • 1913: Dr. Charles Leroy Lowman • 1924: Hubbard Tank History of Aquatic Rehab • 1930’s Underwater PT with Physical Exercise in Warm Water • 1937: Dr. Lowman • Technique of Underwater Gymnastics: A Study in Practical Application • Dr. Rebekah Wright: Mental Diseases • 1960’s and 70’s: Space Age • 1980’s: American Physical Therapy Association • Aquatic Therapy and Rehabilitation Institute Aquatic Therapy Today • Used to Improve • Balance • Coordination • Weight Bearing • Strength • Endurance • Pain management • ROM • Motor Control • Circulatory Function Principles of Water • Buoyancy • Archimedes' principle: • Buoyant force on an object submerged in a fluid is equal to the weight of the fluid that is displaced by the object • 50% Umbilicus • 60% Xiphoid process Principles of Water • Benefits include: • Increase: • Decrease: • Supports weak muscles • Joint compressive forces • Enhance flexibility while weight bearing • ROM • Stress on connective tissue • Easier to handle patient • Fear of falling • Changes the • Blood pooling Biomechanical Stress Principles of Water • Hydrostatic Pressure (HP): Water exerts a pressure of 22.4 mm Hg/ft of water depth equally in all directions. -
Healthcare Provider Action Guide
Exercise is Medicine® Healthcare Providers’ Action Guide HEALTHCARE PROVIDERS’ ACTION GUIDE Table of Contents How to Use this Guide ..................................................................................................... 2 Promoting Physical Activity in Your Healthcare Setting ................................................... 3 Assessing the Physical Activity Levels of Your Patients.................................................. 4 Providing Your Patients with a Physical Activity Prescription .......................................... 5 Referring Your Patients to Exercise Professionals .......................................................... 8 Be an Exercise is Medicine® Champion ........................................................................ 11 Appendix A – Office Flyers ............................................................................................ 13 Appendix B – Physical Activity Vital Sign (PAVS) ......................................................... 15 Appendix C – Physical Activity Readiness Questionnaire (PAR-Q) .............................. 16 Appendix D – ACSM Risk Stratification Questionnaire .................................................. 17 Appendix E – ACSM Risk Stratification Flow Chart ....................................................... 19 Appendix F – Exercise Stages of Change Questionnaire .............................................. 20 Appendix G – Exercise is Medicine® Physical Activity Prescription Pad ....................... 21 Appendix H – EIM Disease-Specific -
The Influence of Warm Hydrotherapy on the Cardiovascular System and Muscle Relaxation
THE INFLUENCE OF WARM HYDROTHERAPY ON THE CARDIOVASCULAR SYSTEM AND MUSCLE RELAXATION By: Jerrold Petrofsky, Ph. D., J.D. Jaime Baxter, BS Jaime Bomgaars, BS Carrie Burgert, BS Sara Jacobs, BS Danielle Lyden, BS Everett B. Lohman III, DPTSc, OSC Send reprint requests to: Dr. Jerrold Scott Petrofsky Professor and Director of Research Department of Physical Therapy Loma Linda University Loma Linda, CA 92350 Telephone: (909) 558-7274 Fax: (909) 558-0481 Email: [email protected] 1 Abstract Five female and five male subjects with no known cardiovascular abnormalities nor any neuromuscular disorders were examined during exercise on a cycle ergometer or a 30 min immersion in warm water with and without exercise to determine the effects of immersion on cardiac output, heart rate, blood pressure, forearm blood flow, muscle blood flow, skin blood flow and muscle relaxation. Muscle relaxation was measured by the resistance to passively moving the leg through a 60° arc and by measurement of the Hoffman (H) reflex. The results of these experiments showed that 1) passive heating caused the greatest relaxation in muscle 2) most of the increase in blood flow to the limb during passive heating or exercise was to skeletal muscle 3) cardiac output increased modestly as did heart rate during passive exposure or light exercise in a therapeutic pool and 4) blood pressure was generally decreased during warm water immersion. Key words: hydrotherapy, muscle, H-reflex, cardiac output, circulation, exercise 2 Introduction Hydrotherapy has been used for thousands of years. Proto-Indian culture made use of hydrotherapy as far back as 2400 B.C. -
Sauna Steam and Hydrotherapy Contents
NVQ level 3 spa therapy lecturer copy 2010 PAGES WWW.BEAUTYPACKAGES.CO.UK SAMPLE Sauna, Steam & Hydrotherapy 2010 Sauna Steam 21 Sauna and Sauna, steam and hydrotherapy package Sauna Hydrotherapy A dry heat treatment Originating from then rises, Scandinavian coun- w h i c h Did you know? tries a Finnish causes the The temperature of the sauna cabin is sauna to be Finnish sauna can vary hotter on between 60-120ºC. traditionally made from pine panels the upper When water is poured with slatted benches. A on to the c oa ls i t increases the humidity wooden benches thermome- son ranging up to 14 (moisture content) of the around the walls of ter should be people. sauna. the sauna for the placed near to the Contents High tempera tures are client to sit/lie on. roof of the sauna A Laconium i s a only recommended in A thermostatically to measure the larger saunas where tiled sauna that there is a greater controlled stove temp erature inside creates an evenly amount of air. warms the coals to the sauna. A hy- distributed mild The amoun t of swea t lost produce a dry heat. grometer should be dry heat at 55ºC. through hea t can vary Water can be used to check the It creates the heat from 0.15-1.5 li tres. ladled onto the humidity of the air from under floor This is why the body loses weight af ter heat coal, w hich creates within the sauna. and seat heating treatments. However steam and ther e- Sauna cabins are rather than a i t i s only a te mpora ry loss and will be re-gained fore increases the available in various stove. -
Tissue Engineered Myelination and the Stretch Reflex Arc Sensory Circuit: Defined Medium Ormulation,F Interface Design and Microfabrication
University of Central Florida STARS Electronic Theses and Dissertations, 2004-2019 2009 Tissue Engineered Myelination And The Stretch Reflex Arc Sensory Circuit: Defined Medium ormulation,F Interface Design And Microfabrication John Rumsey University of Central Florida Part of the Biology Commons Find similar works at: https://stars.library.ucf.edu/etd University of Central Florida Libraries http://library.ucf.edu This Doctoral Dissertation (Open Access) is brought to you for free and open access by STARS. It has been accepted for inclusion in Electronic Theses and Dissertations, 2004-2019 by an authorized administrator of STARS. For more information, please contact [email protected]. STARS Citation Rumsey, John, "Tissue Engineered Myelination And The Stretch Reflex Arc Sensory Circuit: Defined Medium Formulation, Interface Design And Microfabrication" (2009). Electronic Theses and Dissertations, 2004-2019. 3826. https://stars.library.ucf.edu/etd/3826 TISSUE ENGINEERED MYELINATION AND THE STRETCH REFLEX ARC SENSORY CIRCUIT: DEFINED MEDIUM FORMULATION, INTERFACE DESIGN AND MICROFABRICATION by JOHN WAYNE RUMSEY B.S. University of Florida, 2001 M.S. University of Central Florida, 2004 A dissertation submitted in partial fulfillment of the requirements for the degree of Doctor of Philosophy in the Burnett School of Biomedical Sciences in the College of Medicine at the University of Central Florida Orlando, Florida Fall Term 2009 Major Professor: James J. Hickman ABSTRACT The overall focus of this research project was to develop an in vitro tissue- engineered system that accurately reproduced the physiology of the sensory elements of the stretch reflex arc as well as engineer the myelination of neurons in the systems. In order to achieve this goal we hypothesized that myelinating culture systems, intrafusal muscle fibers and the sensory circuit of the stretch reflex arc could be bioengineered using serum-free medium formulations, growth substrate interface design and microfabrication technology. -
Aerobics Packet # 22
AEROBICS PACKET # 22 INSTRUCTIONS This Learning Packet has two parts: (1) text to read and (2) questions to answer. The text describes a particular sport or physical activity, and relates its history, rules, playing techniques, scoring, notes and news. The Response Forms (questions and puzzles) check your understanding and appreciation of the sport or physical activity. INTRODUCTION Aerobic exercise conditions the cardiovascular system and improves performance in sports that require endurance, such as running and jogging. By conditioning the cardiovascular system, aerobics contributes to overall health and enhances the ability to use oxygen. Perhaps the best way to describe how aerobics works is to explain how exercise improves the body’s ability to perform. Depending on which exercises you do, you may develop strength, endurance, stamina or power. However, as all sports trainers know, exercise is “specific,” which means that specific exercises produce specific results. For example, exercises designed strictly to improve strength will not do much to improve your endurance. On the other hand, if you train for endurance alone (for example, by doing only long-distance running), you will not improve your strength significantly. This is why you often see runners who couldn’t bench press 200 pounds if their lives depended on it, and champion powerlifters who get out of breath just running across the street. HISTORY OF AEROBICS Aerobic activity has been around since warm-blooded animals first started running from predators. But “aerobics” as a popular type of exercise activity came into international Physical Education Learning Packets #22 Aerobics Text © 2008 The Advantage Press, Inc. -
Chapter 24 Introduction Hydrotherapy and • Throughout History and in Many Cultures, Spa Applications Water Has Been Used to Maintain Health
Chapter 24 Introduction Hydrotherapy and • Throughout history and in many cultures, Spa Applications water has been used to maintain health _________________________________________________________________________________________ and treat illness • Hydrotherapy is the internal and external Susan G. Salvo therapeutic use of water and complementary agents • Father Sebastian Kneipp (1821-1897): “father of hydrotherapy”; from Germany; published My Water Cure in 1886 Copyright © 2008 by Saunders, an imprint of Elsevier Inc. 1 Copyright © 2008 by Saunders, an imprint of Elsevier Inc. 2 All rights reserved. All rights reserved. Father Sebastian Kneipp Spa • A spa is a place where water therapies are administered • Spa therapies: body treatments (including massage) in which use of water is central • Four types of spas: – Day spa: day use only – Resort or hotel spa: located in resort or hotel – Destination spa: overnight accommodations – Medical spa: includes medical services Copyright © 2008 by Saunders, an imprint of Elsevier Inc. 3 Copyright © 2008 by Saunders, an imprint of Elsevier Inc. 4 All rights reserved. All rights reserved. Water as a Healing Agent Water as a Healing Agent • Liquid water changes to solid ice after • Body's maintenance of homeostasis being cooled to 32° F or 0° C in a changing environment is key to • Changes to steam (gas) after being hydrotherapy heated to 212° F or 100° C – When heat is applied, blood vessels dilate and perspiration is produced to cool the body – When cold is applied, blood vessels first constrict to prevent body from losing heat – After a time, blood vessels dilate so that heat can be carried to the application site Copyright © 2008 by Saunders, an imprint of Elsevier Inc. -
Managing Hip and Knee Osteoarthritis with Exercise
Therapeutic Advances in Musculoskeletal Disease Review Ther Adv Musculoskel Dis Managing hip and knee osteoarthritis with (2010) 2(5) 279290 DOI: 10.1177/ exercise: what is the best prescription? 1759720X10378374 ! The Author(s), 2010. Reprints and permissions: Maura Daly Iversen http://www.sagepub.co.uk/ journalsPermissions.nav Abstract: Hip and knee osteoarthritis are common, chronic, and disabling. Therapeutic exer- cise is a component of all major rheumatologic society guidelines, yet the frequency, dose, duration, and therapeutic threshold for exercise are not clearly delineated. This review sum- marizes current studies of exercise for hip and knee osteoarthritis, discusses issues that influence the design, interpretation, and aggregation of results and how these factors impact the translation of data into clinical practice. A review of databases to identify current ran- domized controlled trials (2000 to present) of exercise to manage the symptoms of hip and knee osteoarthritis is discussed here. One study enrolling only hip patients was identified. Six studies of outcomes for individuals with hip or knee osteoarthritis and 11 studies of persons with knee osteoarthritis were found. Limited studies focus specifically on exercise for persons with hip osteoarthritis. Exercise is provided as a complex intervention combining multiple modes and provided in various settings under a range of conditions. Regardless of the vari- ability in results and inherent biases in trials, exercise appears to reduce pain and improve function for persons with knee osteoarthritis and provide pain relief for persons with hip osteoarthritis. Given the complexity of exercise interventions and the specific issues related to study design, novel approaches to the evaluation of exercise are warranted. -
Arthritis and Exercise: the Essentials
Arthritis and Exercise THE ESSENTIALS The role, benefits and outcomes of exercise for hip and knee osteoarthritis and rheumatoid arthritis Arthritis and Exercise: The Essentials ABSTRACT Objective The paper was drafted by members of the Both in Australia and worldwide, Arthritis Australia’s Expert Advisory Panel, osteoarthritis and rheumatoid arthritis and reviewed and revised by all panel are major causes of disability and chronic members until consensus was reached. pain. Research has established exercise as Arthritis Australia’s Board, Scientific Advisory a safe and recommended treatment for Committee and Affiliate Healthy Lifestyle these arthritides. Despite evidence and Coordinators all reviewed the paper and clinical guidelines, both consumers and provided further input. health practitioners report confusion and uncertainty around the prescription of, and Results participation in, exercise. Five core components of effective exercise The purpose of this paper is to programs were identified and explored: provide clear, evidence-based practical assessment; education; exercise prescription; recommendations about the role of exercise monitoring and reporting; and behaviour in the management of osteoarthritis change strategies. Evidence for each and rheumatoid arthritis as a guide for was reviewed, summarised and practical consumers, health professionals and recommendations made. exercise & fitness professionals. These recommendations will also underpin the development of criteria that can be used Conclusions to evaluate whether current and proposed Substantial evidence supports the key role community exercise programs are suitable of exercise in the successful management of for people with these arthritides. osteoarthritis and rheumatoid arthritis. By compiling evidence-based recommendations Methods on exercise for these forms of arthritis, this Arthritis Australia established an expert document provides a national resource for advisory panel to guide the process. -
Be Able to Describe a Stretch Reflex
be able to describe a stretch reflex .(1) (2) Define muscle tone (3) be able to explain what is muscle tone (4) describe the structure , innervations and function of the muscle spindle . (5) explain what is meant by static and dynamic stretch reflex . (6) describe the spinal and supraspinal regulation of the stretch reflex . (7) describe the inverse stretch reflex and its function Stretch reflex: Whenever a muscle is stretched suddenly, excitation of the muscle spindle causes reflex contraction of the large muscle fiber (See the pictures). It is deep and monosynaptic reflex. Stretch response is produced by co-activation of alpha & gamma motor neurons. But it is maintained mainly by the tonic ( continuous) discharge of Gamma Efferent neurons. Muscle spindle: It is a sensory receptors which are distributed throughout the muscle and it sends information to nervous system about muscle length or rate of change in muscle length. - Each spindle is built around 3-12 intrafusal muscle fibers. - Muscle spindles are parallel to extrafusal muscle fibers and they are attached to them or to the tendon. Types of Intrafusal fibers Each intrafusal fiber consists of: (1) Central non-contractile area (receptor 2) Nuclear chain fibers: area). thinner and shorter 1) Nuclear bag fibers: than nuclear bag fibers (2) Peripheral contractile area. contain many nuclei in , and have one line of a dilated central area ( “ nuclei spread in a chain bag ” ) . Typically there along the receptor area are 2 nuclear bag fibers . There are 4 – 9 per spindle . nuclear chain