Transcript Patient Assessment and Treatment Methods

Patient Assessment and
Treatment Methods
Always A Fire
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http://vimeo.com/48857883
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Patient Assessment is done through
evaluation of the injury and recording the
accident
◦ SOAP Notes
Phases of Treatment
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IMPRESS
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Initial Injury
Mobility Restoration
Proprioception
Resistance Training
Endurance Training
Sports-Specific
Initial Injury
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Primary goal: control inflammation
◦ Preventing further damage
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Inflammation is characterized by warmth,
redness, swelling, and pain
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Pain-spasm-pain cycle
◦ Can cause muscle spasm, which causes pain,
which causes muscle spasm
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PRICES/RICE
Mobility Restoration Phase
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3 phases
◦ Passive ROM
 Used to keep soft tissue from becoming tight
 Stop if it causes pain
◦ Active-Assisted ROM
 Athlete is strong enough to produce contraction of
muscle, but not produce ROM
◦ Active ROM
 Necessary before strengthening can begin
Mobility Restoration Phase
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Establishing Flexibility
◦ Flexibility and ROM are NOT the same
 Flexibility: Ability for joint to move through full
ROM without restriction
 Achieved through stretching
Proprioception
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Body’s ability sense position in time and
space
◦ Addressed early in the rehab program and
continued till the end
 Diving Fails
 https://www.youtube.com/watch?v=7EEpIeXhO54
Resistance Training
Used to improve strength around joint
 Significant phase in Rehabilitation
 Accomplished through manual resistance,
resistant tubing, machines, and free weight
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Endurance
In addition to establishing and maintaining
cardiorespiratory endurance, muscular
endurance must be addressed
 Athlete should not RTP until muscles have
the ability to perform movement over
time
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◦ Performed with weights – high reps, low
poundage
Sports-Specific
Activities that mimic those that the
athlete will perform on the field
 Progresses from light-functional to heavyfunctional, and then to limited practice.
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◦ Athlete cannot begin Sport-specific until they
have achieved full ROM, Normal Strength,
Normal Flexibility, Normal Coordination, and
Normal Cardiorespiratory
Progressive Resistive Exercise
Goal: Develop Strength
 Progressively increasing the load both
during the training session and over a
period of time
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Overload Principle
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In order to gain strength or endurance,
the muscle group must be stressed
beyond the demands of the previous
activity
◦ Ex: benching 50lb daily for 3 wks vs. benching
50 lbs day 1, 55lbs day 3, 60lbs day 5 etc.
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Many variable beyond lb can be adjusted
to achieve overload (i.e. frequency of
workout, intensity of exercise, length of
workout, type of ex performed.
Types of Muscles Actions
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3 types of Actions:
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Isotonic
Isometric
Isokinetic
https://www.youtube.com/watch?v=4q19ChKpD
Dc
2 types of contractions
◦ Concentric Contraction – Muscle shortens
against resistance
◦ Eccentric Contraction – Muscle lengthens against
resistance
Isotonic – moving joint through ROM
with fixed amount of resistance.
 Isometric – NO JOINT MOVEMENT.
Maximum muscular contraction with no
ROM (i.e. pushing against a wall)
 Isokinetic – movement at pre-determined
speed no matter how much force is
applied
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Rehab techniques for foot/ankle,
lower leg
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Reestablishing AROM
◦ Ankle pumps
◦ ABC’s
◦ Calf Stretch
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Reestablishing Proprioception
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Single-leg ball catches
Hop-scotch
Single-leg cup pick up
https://www.youtube.com/watch?v=8mTBsx0
TVNY
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Reestablishing strength
◦ Ankle 4-ways
◦ Lunges
◦ Calf raises
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Reestablishing Endurance
◦ Jump rope
◦ Jogging
◦ Stairs
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Sports specific
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Often, rehab techniques over lap
◦ hop scotch works proprioception & strength;
◦ jump rope works endurance (both muscular
and cardiorespiratory) & Proprioception &
Muscular Strength
Progression
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Proprioception progress
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Flat ground double leg
Flat ground single leg
Unstable surface double leg
Unstable surface single leg
Moving through ROM in Sports Specific
patterns
Progression
Over-load theory
 Muscular Strength Progression
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◦ Heavy weight – low reps
 Methods
 3x5
 5x5
 Pyramid
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Muscular Endurance Progression
◦ Light weight – high reps
 8-15 reps per set
Lab Time!
ROM
 Proprioception
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◦ Hop Scotch
◦ Cup Pick-up
◦ Single-Leg Ball Tops
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Muscular Strength
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Muscular Endurance
◦ Pull-up hang