Foundation Handout For Physical Therapy Students in OLFU

COLLEGE OF PHYSICAL THERAPY
OLFU
Subject: Therapeutic Exercises 101

Semester: 2nd
SY: 2015- 2016
Therapeutic Exercise: is the systematic, planned
performance of bodily movements, postures, or physical

activities intended to provide a patient/client with the
means to:
Remediate or prevent impairments
Improve, restore, or enhance physical function
Prevent or reduce health-related risk factors
Optimize overall health status, fitness, or sense

of
well-being
Muscle performance exercises: strength, power,

and endurance training
Stretching techniques including musclelengthening procedures and joint mobilization
techniques
Neuromuscular control, inhibition, and
facilitation techniques and posture awareness
training
Balance exercises and agility training
Relaxation exercises
Breathing exercises and ventilatory muscle
training
Task-specific functional training
Exercise Safety
Consider the following.
Patient vs. Client
Health Status
Environment
limitations
Equipment
Client: Individual without diagnosed dysfunction who
Execution
engages in physical therapy services to promote health
Education on fatigue
Therapist safety.
Patient: An individual with impairments and functional
and wellness and to prevent dysfunction.
PROCESS AND MODELS OF DISABLEMENT
Aspects of Physical Function

The ability to align body segments
against gravity to maintain or move the
Balance.
body (center of mass) within the

available base of support without
falling
Cardiopulmonary
fitness/Cardiopulmonary
endurance
The ability to perform low intensity,

repetitive, total body movements
(walking, jogging, cycling, swimming)
over an extended period of time.
The ability of structures or segments of
the body to move or be moved in order
Flexibility/Mobility
to allow the occurrence of range of

motion (ROM) for functional activities
(functional ROM).
The ability of the neuromuscular
system
Stability
through
synergistic
muscle
actions to hold a proximal or distal
superimposed movement
The correct timing and sequencing of
muscle firing combined with the
control/coordination
appropriate intensity of muscular

contraction leading to the effective
1.
Biological Factor
2.
Behavioral/Psychological/Social factors
3.
Physical Environmental Factors
4.
Socioeconomic factors
Patient Management:
Clinical Decision Making
Refers to a dynamic, complex process of reasoning and
analytical
(critical)
thinking
that
involves
making
judgments and determinations in the context of patient

care.
initiation, guiding, and grading of

movement. It is the basis of smooth,
accurate, efficient movement and
occurs at a conscious or automatic
Muscle performance
Disablement risk factors
body segment in a stationary position

or to control a stable base during
Neuromuscular
Disablement:
A term that refers to the impact(s) and
functional consequences of acute or chronic
conditions, such as disease, injury, and
congenital or developmental abnormalities, on
specific body systems that compromise basic
human performance and an individuals ability to
meet necessary, customary, expected, and
desired societal functions and roles.
The capacity of muscle to produce

tension and do physical work.
Includes: Strength, Power and
Endurance
Evidence-Based Practice
The conscientious, explicit, and judicious use of
current best evidence in making decisions about the care
of an individual patient.
The process of patient management has five basic
components.
Types of Therapeutic Exercise Intervention
1.
A comprehensive examination: The patients

health history A relevant systems review,
Specific tests and measures.
Aerobic conditioning and reconditioning
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2.
Evaluation of data collected: a process

characterized by the interpretation of collected
data.
3.
Determination of a Diagnosis based on

impairments, functional limitations, and
disability
4.
Establishment of a prognosis and plan of care

based on patient-oriented goals : ; A prognosis
is a prediction of a patients optimal level of
Conditions and Progression of Motor Tasks

1. The environment in which the task is performed;
2. The inter-trial variability of the environment thatis
imposed on a task
3. The need for persons body to remain stationary or to
move during the task;
4. The presence or absence of manipulation of objects
during the task.
STAGES OF MOTOR LEARNING

Stage
Description
treatment and the anticipated length of time

needed to reach specified functional outcomes.
Cognitive
stage
The plan of care, an integral component of the

prognosis, delineates the following anticipated
goals
5.
Implementation of appropriate
interventions:
Intervention, a component of
patient management, refers to any
purposeful interaction a therapist has that
directly relates to a patients care
Associative
stage
OUTCOMES
This is stated as the result
Monitored all throughout the course of PT
Outcomes are measured through:
The patient needs to think about

each component or sequence of the skilled
movement.
The patient tries to get the feel of

the exercise.
Distraction may hinder learning.
Errors are common.
The patient makes infrequent

errors and concentrates on fine-tuning the
motor task.
The patient explores slight variations

and modifications of movement strategies
while doing the task under different
environmental conditions (inter-trial
variability)
The patient requires infrequent feedback from the therapist and, instead,
begins to anticipate necessary
adjustments and make corrections even
before errors occur.
function expected as the result of a course of
Autonomou
s stage
Movements are automatic.
The patient does not have to pay

attention to the movements in the
task, thus making it possible to do
other tasks simultaneously.
(+) Variations
1. Physical Function
2. Prevention of risk
3. Level of health and wellness

4. Patients satisfaction
STRATEGIES FOR EFFECTIVE EXERCISE

INSTRUCTION
MOTOR LEARNING:
A complex set of internal processes that involves the
relatively permanent acquisition and retention of a skilled
movement or task through practice.
Motor Learning
Performance
(+) Acquisition
(+) Retention
Vs.
Motor
(+) Acquisition
(-) Retention
MOTOR TASK
Types of Motor task

A discrete task involves a movement
with a recognizable beginning and end.
Discrete
up, or locking a wheelchair are examples
movements that are combined in a particular

sequence
Continuous task involves repetitive,

uninterrupted movements that have no
Continuous
distinct beginning and ending.
task.
PRE- PRACTICE CONSIDERATION
Attention
Demonstration
Pre-practice verbal instructions

PRACTICE
Partial practice VS. Whole practice
BLOCKED VS. RANDOM VS. RANDOMBLOCKED
Physical practice VS. Mental practice
FEEDBACK
-Knowledge of performance (KP) : immediate,
post-task, augmented feedback (usually verbal) about
the nature or quality of the performance of a
motor task
Grasping an object, doing a push-
of discrete motor tasks.

Serial task is composed of a series of discrete
Serial task
VARIABLES THAT INFLUENCE MOTOR LEARNING
Examples include walking,

ascending and descending stairs, and
cycling.
-Knowledge of results (KR): Immediate, post-task,

augmented feedback about the outcome of a motor
task
Intrinsic :
Augmented
Concurrent
Post response
Immediate
Delayed
Summary
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Intermittent
Continous
ADHERENCE:
Factors
affecting adherence
Patient characteristics
Health condition/impairment
Program related variables
END
Suggestion:
Read the Therapeutic Exercise 6th edition by Kisner and
Colby for a more detailed discussions
Page 3 of 3
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COLLEGE OF PHYSICAL THERAPY

Subject: Therapeutic Exercises 101

Therapeutic Exercise: is the systematic, planned

performance of bodily movements, postures, or physical

Remediate or prevent impairments

Improve, restore, or enhance physical function

Prevent or reduce health-related risk factors

Optimize overall health status, fitness, or sense

Muscle performance exercises: strength, power,

Patient vs. Client

Client: Individual without diagnosed dysfunction who

engages in physical therapy services to promote health

Patient: An individual with impairments and functional

and wellness and to prevent dysfunction.

PROCESS AND MODELS OF DISABLEMENT

Aspects of Physical Function

body (center of mass) within the

The ability to perform low intensity,

to allow the occurrence of range of

actions to hold a proximal or distal

appropriate intensity of muscular

Physical Environmental Factors

judgments and determinations in the context of patient

initiation, guiding, and grading of

Disablement risk factors

body segment in a stationary position

The capacity of muscle to produce

Types of Therapeutic Exercise Intervention

A comprehensive examination: The patients

Aerobic conditioning and reconditioning

Evaluation of data collected: a process

Determination of a Diagnosis based on

Establishment of a prognosis and plan of care

Conditions and Progression of Motor Tasks

STAGES OF MOTOR LEARNING

treatment and the anticipated length of time

The plan of care, an integral component of the

This is stated as the result

Monitored all throughout the course of PT

Outcomes are measured through:

The patient needs to think about

The patient tries to get the feel of

Distraction may hinder learning.

Errors are common.

The patient makes infrequent

The patient explores slight variations

function expected as the result of a course of

Movements are automatic.

The patient does not have to pay

3. Level of health and wellness

STRATEGIES FOR EFFECTIVE EXERCISE

Types of Motor task

up, or locking a wheelchair are examples

movements that are combined in a particular

Continuous task involves repetitive,

distinct beginning and ending.

PRE- PRACTICE CONSIDERATION

Pre-practice verbal instructions