INTRO

通報

問題一覧

is the systematic, planned performance of physical movements, postures, or activities

Therapeutic exercise

Therapeutic exercise are individualized to each patient’s unique needs.

True

Therapeutic exercise requires passive participation by the patient/client.

False

ability to align body segments against gravity to maintain or move the body (COM) w/in the available BOS without falling

Balance

in equilibrium w/ gravity via sensory & motor systems

Balance

The ability to perform moderate-intensity, repetitive, total body movements (walking, jogging, cycling, swimming, etc.) over an extended period of time.

Cardiopulmonary endurance

The correct timing and sequencing of muscle firing combined with the appropriate intensity leading to the effective initiation, guiding, and grading of movement

Coordination

The ability to move freely, without restriction; used interchangeably with mobility

Flexibility

to move or be moved in order to allow range of motion (ROM) for functional activities (functional ROM)

Mobility

ACTIVE or PASSIVE

Mobility

Used interchangeably with static or dynamic balance

Postural control/stability

The capacity of muscle to produce tension and do physical work.

Muscle performance

encompasses strength, power, and muscular endurance

Muscle performance

The ability of the neuromuscular system through synergistic muscle actions to hold a proximal or distal body to control a stable base during superimposed movement

Stability

ABILITY OF MUSCLES to anticipate or respond to proprioceptive and kinesthetic information and, subsequently, to work in correct sequence to create coordinated movement.

Neuromuscular control

Problems associated with the physiology of the body systems (including psychological functions).

Impairments in body function

Problems with the anatomical features of the body.

Impairments in body structure

Difficulties an individual may have in executing actions, tasks, and activities.

Activity limitation

Problems an individual may experience with involvement in life situations

Participation restriction

refers to the impact and functional consequence of acute or chronic conditions

Disablement

is more than a consequence of a medical condition; rather, it is part of the human condition that is experienced by everyone either temporarily or permanently.

Disability

ICF framework

2001

NCMRR model

1993

ICIDH model

1980

Nagi model

1977

Executing tasks in a standard environment

Capacity

Executing tasks in the current environment

Performance

The entire background of an individual's life and living situation

Contextual factors

Prevention: Activities such as health promotion designed to prevent disease in an at-risk population.

Primary

Prevention: Early diagnosis and reduction of the severity or duration of existing disease and sequelae.

Secondary

Prevention: Use of rehabilitation to reduce the degree or limit the progression of existing disability and improve multiple aspects of function in persons with chronic, irreversible health conditions

Tertiary

refers to a dynamic, complex process of reasoning and analytical (critical) thinking that involves making judgments and determinations in the context of patient care.

Clinical decision making

One of the many areas of clinical decision-making in which a therapist is involved is the (3) of therapeutic exercise interventions based on the unique needs of each patient or client.

Selection, Implementation, Modification

To make effective decisions, merging clarification and understanding with critical and creative thinking is unnecessary

False

Sharing responsibilities

Comanagement

Providing or seeking professional expertise/judgement

Consultation

Delegation of some portion of treatment while remaining responsible for the care provided.

Supervision

Includes both referring to another provider and receiving referrals from another provider

Referral

the conscientious, explicit, and judicious use of current best evidence in making decisions about the care of an individual patient.

Evidence based practice

also involves combining knowledge of evidence from well-designed research studies with the expertise of the clinician and the values, goals, and circumstances of the patient.

Evidence-based practice

are required of the physical therapist throughout the entire episode of patient management.

Coordination, Communication, Documentation

Examination

Health history, Systems review, Test and measures

Shortness of breath, pressure or pain in the chest, pulsating pain, history of heart or lung disease

Cardiovascular/pulmonary

History of thyroid or other hormonal conditions, medications

Endocrine

History of surgery or use of adaptive equipment

Eyes, ears, nose and throat

Heartburn, reflux, diarrhea, constipation, vomiting, severe abdominal pain, swallowing problems

Gastrointestinal

Bowel or bladder function, burning with urination, sexual function, unusual menstrual cycles, pregnancy

Genitourinary/reproductive

Results of recent bloodwork or treatment, bleeding or lymphedema

Hematological or lymphatic

History of skin cancer, dermatological conditions (eczema, psoriasis, etc.), lumps or growths

Integumentary

History of CNS or peripheral nerve symptoms, muscular cramping, spasms, atrophy, weakness

Neurological/musculoskeletal

Persistent fatigue, malaise, fever, chills, sweats, unexplained weight change, depression, mood swings, suicidal thoughts

Overall physical and emotional well-being

Heart rate and rhythm, respiratory rate, blood pressure, and edema

Cardiovascular/pulmonary

Skin temperature, color, texture, integrity, scar formation, wound or incision healing

Integumentary

Symmetry, gross ROM and strength, height and weight

Musculoskeletal

General assessment of gross coordinated movement (e.g., balance, gait, locomotion, transfers, transitions) and motor function (motor control, motor learning)

Neuromuscular

Ability to make needs known, consciousness, orientation (person, place, time), expected emotional/behavioral responses, learning preferences (e.g., learning barriers, educational needs)

Communication ability, affect, cognition, language, learning style

a process characterized by the interpretation of collected data.

Evaluation

This process involves analysis and integration of information to establish the diagnosis, prognosis, and plan of care using a series of sound clinical decisions.

Evaluation

can be used in two ways—it refers to either a process or a category (label) within a classification system.

Diagnosis

Physical therapists use this systematic process to identify an appropriate diagnostic category amenable to physical therapy intervention.

Differential diagnosis

essential and required element of patient management whose primary purpose is to guide the physical therapy prognosis, plan of care, and interventions

Diagnosis

a prediction of a patient’s optimal level of function expected as the result of a plan for treatment during an episode of care and the anticipated length of time needed to reach specified functional outcomes

Prognosis

an integral component of the prognosis, is established in coordination with the patient and, if indicated, others involved in the care of the patient.

Plan of care

type of intervention that physical therapists use with every individual they see.

Patient client instruction

means by which a therapist helps a patient learn how to reduce his or her impairments and how to participate fully in the plan of care to achieve goals.

Patient-related instructions

the degree to which individuals have the capacity to obtain, process, and understand basic health information and services needed to make appropriate health decisions.

Health literacy

involves an action or movement with a recognizable beginning and end.

Discrete

composed of a series of discrete movements that are combined in a particular sequence.

Serial

involves repetitive, uninterrupted movements that have no distinct beginning and ending.

Continuous

Wheelchair transfers

Serial

Isolating and contracting a specific muscle group

Discrete

lifting and lowering a weight or performing a self-stretching maneuver

Discrete

Kicking a ball

Discrete

Locking a wheelchair

Discrete

Doing a push up

Discrete

Grasping an object

Discrete

ascending and descending stairs

Continuous

Walking

Continuous

Cycling

Continuous

What to do

Cognitive

must learn the goal or purpose and the requirements of the exercise or functional task.

Cognitive

learn how to do the motor task safely and correctly.

Cognitive

the patient needs to think about each component or the sequencing of the skilled movement

Cognitive

FOCUSED

Cognitive

needs a CLOSED environment

Cognitive

tries to avoid mistakes but errors are common

Cognitive

need constant feedback

Cognitive

makes infrequent errors and concentrates on fine-tuning

Associative

focuses on producing the most consistent and efficient movements

Associative

Refinement

Associative

explores slight variations and modifications under different environmental conditions (intertrial variability)

Associative

problem-solving to self-correct errors

Associative

requires infrequent feedback from the therapist and begins to make corrections even before errors occur

Associative

Movements are automatic

Autonomous

does not have to pay attention to the movements in the task, thus making it possible to do other tasks simultaneously

Autonomous

easily adapts to variations in task demands and environmental conditions

Autonomous

Little to no instruction unless the patient encounters a recurrence of symptoms

Autonomous

most patients are discharged before reaching this stage of learning.

Autonomous

Open environment w less Feedback

Autonomous

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