Therapeutic Exercise in Rehabilitation
General Approach to Rehabilitation - answer Begins immediately after injury or surgery
Initial first aid has a substantial impact on the injury
One of ATC's primary responsibilities is to design, implement and supervise rehab plans
Easy part is designing the program based on short- and long-term goals
Progress based on healing process
Short term goals - answer Control pain and inflammation
Maintain or improve ROM
Restore and increase strength
Re-establish neuromuscular control
Maintain levels of cardiorespiratory fitnes
Long term goals - answer Return athlete to practice and competition quickly and safely
Difficult part is knowing when and how to progress relative to the injury - answer Return
to play must be based on functional outcomes
Due to competitive nature of sports, rehab must be aggressive
Rehab should be based on framework of healing process Must have broad theoretical
knowledge base of rehab techniques in order to select appropriately for each case
Therapeutic Exercise vs. Conditioning Exercise - answerBasic principles of strength
training apply to rehabilitation
Use conditioning to prevent injury and also to recover from injury
Training and conditioning limit and minimize possibility of injury just as rehab works to
return to play and prevent re- injury
Cardio-respiratory System and Immobilization - answerStroke volume, maximum
oxygen uptake and vital capacity decrease concurrently with increased HR
Effects of General Inactivity - answerHighly conditioned athlete will experience rapid
generalized loss of fitness
Loss of muscle strength, endurance and coordination
Effects of Immobilization - answerCause a number of disuse problems that impact
muscle, joints, ligaments, bones, neuromuscular efficiency and cardiorespiratory system
Muscle Immobilization - answerAtrophy and fiber conversion •Loss of muscle mass -
greatest atrophy occurring in Type I fibers •Immobilization in a lengthened or neutral
position tends to atrophy less
, Decreased neuromuscular efficiency - answerMotor nerves become less efficient in
recruiting and stimulating individual fibers w/in a given motor unit
Joints and Immobilization - answerLoss of normal compression leads to decreased
lubrication, subsequently causing degeneration
Ligaments and Bone and Immobilization - answerBoth adapt to normal stress -
becoming or maintaining their strength
Without stress ligaments and bone become weaker
Major Components of a Rehabilitation Program - answerMinimizing Initial Swelling
Swelling is caused by many factors and must be controlled immediately after injury
Minimizing swelling significantly speeds the healing process (RICE!)
Controlling Pain
Restoring Range of Motion
Physiological versus Accessory Movement
Restoring Muscular Strength, Endurance and Power Isometrics
Progressive Resistance Exercise (PRE)
Isokinetic Exercise
Testing Strength, Endurance and Power
Re-establishing Neuromuscular Control, Proprioception, Kinesthesia and Joint Position
Sense - answerFollowing injury, body forgets how to integrate information coming in
from multiple biological sources
Neuromuscular control is mind's attempt to teach the body conscious control of a
specific movement
Re-establishing neuromuscular control requires repetition of same movement, step by
step until it becomes automatic (progression from simple to difficult task
Four key elements - answerProprioception and kinesthetic awareness
Dynamic stability
Preparatory and reactive muscle characteristics
Conscious and unconscious functional and motor patterns
Joint Mechanoreceptors - answerFound in ligaments, capsules, menisci, labra, and fat
pads •Ruffini's endings
•Pacinian corpuscles
•Free nerve endings
Muscle Mechanoreceptors - answerMuscle spindles -sensitive to changes in length of
muscle
Golgi tendon organs -sensitive to changes in tissue tension
General Approach to Rehabilitation - answer Begins immediately after injury or surgery
Initial first aid has a substantial impact on the injury
One of ATC's primary responsibilities is to design, implement and supervise rehab plans
Easy part is designing the program based on short- and long-term goals
Progress based on healing process
Short term goals - answer Control pain and inflammation
Maintain or improve ROM
Restore and increase strength
Re-establish neuromuscular control
Maintain levels of cardiorespiratory fitnes
Long term goals - answer Return athlete to practice and competition quickly and safely
Difficult part is knowing when and how to progress relative to the injury - answer Return
to play must be based on functional outcomes
Due to competitive nature of sports, rehab must be aggressive
Rehab should be based on framework of healing process Must have broad theoretical
knowledge base of rehab techniques in order to select appropriately for each case
Therapeutic Exercise vs. Conditioning Exercise - answerBasic principles of strength
training apply to rehabilitation
Use conditioning to prevent injury and also to recover from injury
Training and conditioning limit and minimize possibility of injury just as rehab works to
return to play and prevent re- injury
Cardio-respiratory System and Immobilization - answerStroke volume, maximum
oxygen uptake and vital capacity decrease concurrently with increased HR
Effects of General Inactivity - answerHighly conditioned athlete will experience rapid
generalized loss of fitness
Loss of muscle strength, endurance and coordination
Effects of Immobilization - answerCause a number of disuse problems that impact
muscle, joints, ligaments, bones, neuromuscular efficiency and cardiorespiratory system
Muscle Immobilization - answerAtrophy and fiber conversion •Loss of muscle mass -
greatest atrophy occurring in Type I fibers •Immobilization in a lengthened or neutral
position tends to atrophy less
, Decreased neuromuscular efficiency - answerMotor nerves become less efficient in
recruiting and stimulating individual fibers w/in a given motor unit
Joints and Immobilization - answerLoss of normal compression leads to decreased
lubrication, subsequently causing degeneration
Ligaments and Bone and Immobilization - answerBoth adapt to normal stress -
becoming or maintaining their strength
Without stress ligaments and bone become weaker
Major Components of a Rehabilitation Program - answerMinimizing Initial Swelling
Swelling is caused by many factors and must be controlled immediately after injury
Minimizing swelling significantly speeds the healing process (RICE!)
Controlling Pain
Restoring Range of Motion
Physiological versus Accessory Movement
Restoring Muscular Strength, Endurance and Power Isometrics
Progressive Resistance Exercise (PRE)
Isokinetic Exercise
Testing Strength, Endurance and Power
Re-establishing Neuromuscular Control, Proprioception, Kinesthesia and Joint Position
Sense - answerFollowing injury, body forgets how to integrate information coming in
from multiple biological sources
Neuromuscular control is mind's attempt to teach the body conscious control of a
specific movement
Re-establishing neuromuscular control requires repetition of same movement, step by
step until it becomes automatic (progression from simple to difficult task
Four key elements - answerProprioception and kinesthetic awareness
Dynamic stability
Preparatory and reactive muscle characteristics
Conscious and unconscious functional and motor patterns
Joint Mechanoreceptors - answerFound in ligaments, capsules, menisci, labra, and fat
pads •Ruffini's endings
•Pacinian corpuscles
•Free nerve endings
Muscle Mechanoreceptors - answerMuscle spindles -sensitive to changes in length of
muscle
Golgi tendon organs -sensitive to changes in tissue tension
