Transcript REHAB-2 (new window)

Rehabilitation Exercise
Lecture 2
FDSc FISM year 1
Janis Leach
Baseline Measures for fitness
testing
Brain warm up/ recap
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Write down which are physical and which are motor
Strength
Balance
Body Composition
Agility
Endurance
Speed Coordination
Power
Flexibility
Reaction time
Physical fitness
Strength
 Speed
 Flexibility
 Endurance
 Body Composition
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Motor fitness
Agility
 Balance
 Coordination
 Power
 Reaction time
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Objectives
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Be aware of common evidence based methods
of measurement
Understand the importance of using baseline
measurements in therapy settings
Understand the importance of screening in injury
prevention
Practical session to be able to instruct a client
needing crutches in the NWB phase
Screening and Baseline
Measurements
Provide measurable values for existing
characteristics
 Can identify intrinsic risk factors in sports
 Documented baseline and screening
measurements are vital for diagnosis and
rehabilitation
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Anthropometrical
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Height
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Weight
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Body Composition
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Waist to hip ratio
Body Mass Index
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Body Mass Index (BMI) is a number calculated
from a person’s weight and height.
BMI is a reliable indicator of body fatness for
some people.
BMI does not measure body fat directly, but
research has shown that BMI correlates to direct
measures of body fat, such as underwater
weighing.
What are the limitations to BMI?
Body Mass Index
Formula:
 Weight (Kg) ÷ Height (M)2
 Example:
 Height = 173 cm (1.73 m) Weight = 73 kg
Calculation: 73÷ (1.73) x 2 = 24.41
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Body Mass Index
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Interpretation of BMI
for adults
For adults 20 years
old and older,
BMI
Weight
Status
Below 18.5 Underweight
18.5 - 24.9 Normal
25 – 29.9
Overweight
Above 30
Obese
Body Composition
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Evaluation of amount of fat in relation to lean
tissue in the body
 Norms
are 12%-18% for men and 14%-20% for
women
 Obesity at >25% for men and >30% for women
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Evaluative methods
Skin calipers
Skinfold measurements
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Used to determine the ratio of fat mass to
fat-free mass in the body
Fat mass: adipose tissue
Fat-free mass: bone, muscle, and organs
Measurements are performed with a skinfold
caliper
Skin-fold measurements
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The Jackson and Pollock (1985) three-site
method has a relatively small margin of error for
the general population
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a. Sites for men: chest, abdomen, and thigh
b. Sites for women: triceps, suprailium, and thigh
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Should be repeated by the same technician
during reassessment to decrease error
Should be performed prior to physical activity
because fluid transfer to the skin could result in
overestimations
Skin-fold measurements
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The Jackson and Pollock (1978) 7 sites
are more commonly used with athletes.
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Chest, Axilla, Abdominal, Suprailium,
Subscapular, Triceps ,Mid-Thigh.
Research
Friedl et al (2001)
 Body weight not suitable for assessing
results in training programmes for females
 Why?
 Study found that there was greater
reliability female fat deposit on waist and
hips instead of upper arm or thigh.
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Waist to hip ratio
Waist / hip measurement
 Found to test the risk of heart disease
 Research?
 Task for this week
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 Find
a journal article on either WHR or BMI
Somatotype
Classification of body type (Physique).
 There are 3 somatotypes.
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Endomorph
 Mesomorph
 Ectomorph
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Each of us is likely to be predominant in
one of these categories.
Somatotypes
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Various body measurements are needed in
order to work out your somatotype and
together with your age and gender, these
scores are read from a chart.
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Height
Weight
Bone size
Muscle girth
Fat
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Ideal Posture
Lordosis
Kyphosis
Scoliosis
Musculoskeletal Examination
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Basic exam consists of observation for
symmetry, ROM, strength tests for major
muscles and specific tests for previously injured
areas
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Questions asked regarding
 Focus
on history of previous injuries, time frame,
evaluation, treatment and rehabilitation.
 Use of protective devices
Musculoskeletal Examination
Leg Length (True or Apparent)
 Foot Shape (Planus, cavus
pronation/supination)
 Muscle Girth (Various sites)
 Posture Evaluation
 Laxity
 ROM
 Bilateral Comparison
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Pronation - Supination
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Over-pronation
Over-supination
Bilateral Comparisons
All information obtained from screening
can be assessed against population
norms.
 Bilateral comparisons of joint laxity, ROM
and tissue abnormalities are vital for
accurate diagnosis of subsequent injuries.
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Fitness Testing Procedures
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Muscular function
 Strength,
power and endurance
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Cardiovascular function
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Speed and agility
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Flexibility
Measuring exercise intensity
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Repetition maximum (RM): "maximal number of
times a load can be lifted before fatigue using
correct technique (ACSM, 1998).
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" A "1RM" signifies the maximum resistance a
person can move in ONE repetition of an
exercise.
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" A "10RM" signifies the maximum resistance a
person can move in TEN repetitions of an
exercise.
Cardiovascular function
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Multistage fitness test (Bleep Test)
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Some factors to consider
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Motor skills
Turning technique
Running surfaces
Cooper 12 Minute Run
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Flat running track
Stop watch and recording sheets
Suitable for most populations
Can be set on treadmill
Hexagonal Obstacle Test
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66 cm sided hexagon
marked out on the floor.
Athlete is always facing
A. Athlete jumps in and
out of hexagon in
alphabetical order.
Usually performed 3
times, measured by
stopwatch
Flexibility: Sit and Reach
KEY POINT
Tests requiring high-skill
movements, such as reaction and
coordination tests, should be
administered before tests that are
likely to produce fatigue and
confound the results of
subsequent tests.
Baseline Testing
 Vital
to have baseline measures
during treatment and rehabilitation
programs in order to objectively
assess outcomes and restore full
functional fitness.
Methods
Manual Muscle Testing
 Joint ROM (Goniometer)
 Girth Measurements (Tape Measure)
 Pain Scale
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Goniometry
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Measurement of joint mobility/motion
Principles
 Stationary arm aligned with stationary segment
proximal to joint evaluated
 Moveable arm aligned with moveable segment distal
to joint evaluated
Recording scale
 0 – 180º (all joints in 0º position in anatomic position)
 Generally accepted +/- 5-10º error with goniometric
measurements
Goniometry
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Reliability
 Intra-tester:
same person getting same
results
 Inter-tester: different people getting same
results
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To increase reliability:
 All
staff use same goniometer
Pain Scales
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Visual Analogue Scale
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ASSESSMENT SCALES
Prehab
Involves:
 Full medical history and associated
testing.
 Functional physiological tests.
 Special tests,
 ( Core stability, Proprioception).
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Prehab
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Purpose:
 Injury
prevention
 Detailed evaluation test data may identify
weaknesses or markers that indicate
predisposition to injury.
 Once identified, specific interventions can be
put in place in order to help prevent injury.
Summary
 Recognise
all available screening and
baseline measurement tools
 Appreciate
the need for objective
measurement in musculoskeletal screening
 Recognise
the value of Prehab regarding the
possible prediction and prevention of injury