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Therapeutic Exercise for Physical Therapist Assistants 2Nd Ed

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Therapeutic Exercise for Physical Therapist Assistants 2Nd Ed LWBK942-FM.qxd 6/25/11 8:45 AM Page x 91537_FM.2 11/30/06 8:30 AM Page i THERAPEUTIC EXERCISE for Physical Therapist Assistants SECOND EDITION 91537_FM.2 11/15/06 4:05 PM Page ii 91537_FM.2 11/30/06 8:38 AM Page iii THERAPEUTIC EXERCISE for Physical Therapist Assistants SECOND EDITION WILLIAM D. BANDY, PT, PhD, SCS, ATC Professor Department of Physical Therapy University of Central Arkansas Conway, Arkansas BARBARA SANDERS, PT, PhD, SCS Professor and Chair Department of Physical Therapy Texas State University—San Marcos Associate Dean College of Health Professions San Marcos, Texas Photography by MICHAEL A. MORRIS, FBCA University of Arkansas for Medical Sciences 91537_FM.2 11/15/06 4:05 PM Page iv Acquisitions Editor: Peter Sabatini Managing Editor: Andrea M. Klingler Marketing Manager: Allison M. Noplock Associate Production Manager: Kevin P. Johnson Creative Director: Doug Smock Compositor: Maryland Composition Printer: Quebecor Dubuque Copyright © 2008 Lippincott Williams & Wilkins 351 West Camden Street Baltimore, MD 21201 530 Walnut Street Philadelphia, PA 19106 All rights reserved. This book is protected by copyright. No part of this book may be reproduced in any form or by any means, including photocopying, or utilized by any information storage and retrieval system without written permis- sion from the copyright owner. The publisher is not responsible (as a matter of product liability, negligence, or otherwise) for any injury resulting from any material contained herein. This publication contains information relating to general principles of medical care that should not be construed as specific instructions for individual patients. Manufacturers’ product information and package inserts should be reviewed for current information, including contraindications, dosages, and precautions. Printed in the United States of America First Edition, 2001, Lippincott Williams & Wilkins Library of Congress Cataloging-in-Publication Data Therapeutic exercise for physical therapist assistants / [edited by] William Bandy, Barbara Sanders ; photography by Michael A. Morris. — 2nd ed. p. ; cm. Rev. ed. of: Therapeutic exercise. c2001. Includes bibliographical references and index. ISBN-13: 978-0-7817-9080-2 ISBN-10: 0-7817-9080-8 1. Musculoskeletal system—Diseases—Exercise therapy. I. Bandy, William D. II. Sanders, Barbara. III. Therapeutic exercise. [DNLM: 1. Exercise Therapy—methods. WB 541 T39804 2007] RC925.5.T48 2007 616.7'062--dc22 2006023960 The publishers have made every effort to trace the copyright holders for borrowed material. If they have inadvertently overlooked any, they will be pleased to make the necessary arrange- ments at the first opportunity. To purchase additional copies of this book, call our customer service department at (800) 638-3030 or fax orders to (301) 223-2320. International customers should call (301) 223-2300. Visit Lippincott Williams & Wilkins on the Internet: http://www.LWW.com. Lippincott Williams & Wilkins customer service representatives are available from 8:30 am to 6:00 pm, EST. 06 07 08 09 10 12345678910 91537_FM.2 11/15/06 4:05 PM Page v To Beth, Melissa, and Jamie for providing constant love, patience, and inspiration. WDB To Mike and Whitney, whose love and support allow me to do the things I enjoy. BS 91537_FM.2 11/15/06 4:05 PM Page vi 91537_FM.2 11/15/06 4:05 PM Page vii Chapter 3 • Range of Motion PREFACE he first two physical therapist assistant (PTA) educa- Ttion programs, at Miami Dade Community College in ORGANIZATION Florida and St Mary’s Campus of the College of St. Catherine in Minnesota, opened their doors in 1967. In A look at the Table of Contents shows that the book is 1969 the first 15 PTAS graduated from these two schools. divided into seven sections. Section I lays the foundation Since that time the number of these very important tech- for the next six sections of the book. A history of thera- nical assistants to the physical therapist (PT) has grown peutic exercise is provided and an understanding of where to include an estimated 50,000 PTAs currently licensed therapeutic exercise fits into the realm of all interventions in the United States. To date a plethora of textbooks exist is explained. Using current policies held by the American defining therapeutic exercises and describing the role of Physical Therapy Association, important terms related to therapeutic exercise in the treatment of patients and the management of the patient are defined and the role of clients. But no textbook exists on the topic of therapeutic the PTA within the healthcare team is clarified. Additional exercise written specifically for the PTA. The purpose of information presented in to these first two chapters Therapeutic Exercise for the Physical Therapist Assistant is to includes the reaction of the various tissues to exercise, the provide descriptions and rationale for the use of a variety use of complementary modalities, and effective use of com- of therapeutic exercise techniques that are frequently del- munication with patients. egated to the PTA by the PT for the rehabilitation of an Section II presents information for increasing mobility individual with impairment or for the prevention of by performing range of motion techniques (passive, active- potential problems. assistive, and active) and stretching activities. Information We are excited to write the first textbook devoted on increasing strength and power, ranging from frequently totally to the use of therapeutic exercise for the PTA. used therapeutic exercise techniques (open-chain and Instead of using a therapeutic exercise book written for the closed-chain exercises) to more sophisticated and aggres- PT and making changes to make the content appropriate sive exercises (PNF and plyometrics), is presented in to the PTA, it is our goal that Therapeutic Exercise for the Section III. Physical Therapist Assistant will meet the needs of educators Important information needed for understanding the who are training the future PTAs. concept of balance and providing therapeutic exercise tech- The primary audience for this textbook is individuals in niques for treatment of balance dysfunction is presented in a PTA curriculum. Although written primarily for PTA Section IV. A unique concept, reactive neuromuscular students, this textbook can also provide experienced clini- training, is presented in Section IV as well. Section V cians with background and illustrations of specific exercise addresses the practice area of cardiopulmonary, with infor- techniques, allowing even the experienced clinician to add mation presented on aerobic conditioning for the unfit but to their repertoire of therapeutic exercises used. healthy individual, cardiac rehabilitation for the patient As indicated in the Guide to Physical Therapist Practice (pub- after a cardiac accident, and enhancement of breathing for lished by the American Physical Therapy Association), the person with respiratory dysfunction. therapeutic exercise is the most important procedural inter- Section V integrates information from the previous five vention provided in the field of physical therapy. We sections in order to treat patients with dysfunction of the believe that this textbook is an excellent choice for teaching upper and lower extremities and the spine. Finally, the this important topic to the PTA in a therapeutic exercise unique applications of aquatic therapy and a new concept, course in the curriculum or as unit in a musculoskeletal contextual fitness for the elderly, are presented in Section VI. course. The basic assumption of this textbook is that the patient has been examined by the PT, the impairment has been identified, and the plan of care has been established by the PT. This textbook focuses on the implementation of the CHAPTER STRUCTURE treatment plan using therapeutic exercise techniques that the PTA will provide under the direction and supervision Each Chapter in Sections II through VII is set up using a of the PT. consistent format (excluding Chapter 5). We believe that vii 91537_FM.2 11/15/06 4:05 PM Page viii viii Preface this consistent format allows a nice flow to the book from legally is that the PTA provides therapeutic exercise within one Chapter to the next and adds to the ease of reading the plan of care developed by the PT. To illustrate the and clarity. The standard headings are presented in the fol- appropriate relationship between the PT and PTA, each lowing order: case study has been rewritten to describe appropriate (and sometimes inappropriate) interventions performed by the Objectives have been added to the beginning of each PTA and the interaction between the PT and the PTA. In chapter to clarify the content that will be presented. addition, at the end of each case study, a “Summary—An Scientific Basis includes background information and a Effective PT-PTA Team” section has been added which brief discussion of the benefits of the intervention being provides feedback as to whether the interaction between presented—supported by evidence, when available. the PTA and PT was appropriate. Clinical Guidelines provide information such as how, why, and when to use the techniques. Techniques provide illustrations of frequently used thera- SPECIAL FEATURES peutic exercise techniques. Case Studies not only provide examples as to how to use In addition to updating all chapters for the student, new the therapeutic exercise techniques on patients, but ancillary materials have been added to assist the PTA edu- demonstrate how the treatment is advanced as the cator. The educator who adopts this textbook will be pro- patient progresses. vided with a PowerPoint presentation and sample test Summary contains a bulleted list of key concepts. questions for every chapter. These PowerPoint presenta- tions and tests can be edited to meet the specific needs of References contain the most current evidence available. the instructor; it is hoped that these supplementary mate- Geriatric and Pediatric Perspectives offer information rials provide a base with which the instructor can present specific to the pediatric and geriatric patient (using the information in the chapter.
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