Therapeutic Interventions chapter 1 PDF

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Therapeutic Intervention Textbook questions...

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THERAPEUTIC INTERVENTIONS Chapter 1 – Therapeutic Modalities: What they are and why they are used. 1. Explain the concept of knobologist. Knobology is the study of application without theory. Knobologists is for students and clinicians who want to know only which knobs on a therapeutic modality to turn but are uninterested in why they are doing so. 2. Define therapeutic modality, physical agent, and therapeutic purpose. Therapeutic modality is a device or application that delivers a physical agent to the body for therapeutic purposes. The most common physical agents used in treating orthopedic injuries are heat, cold, light, electricity, and exercise. The therapeutic purpose of these agents is to promote or improve wound healing, pain relief, flexibility and rom, muscular strength, muscular endurance, muscular speed, muscular coordination or skill, agility, muscular power, and cardiorespiratory endurance. 3. Describe the relationship between the theory and the application of therapeutic modalities. The ideal is that all application is based on scientifically derived evidence and theory. Yet this is not possible, because application almost always precedes theory, and there is a lack of valid research. In time, scientists test the theory with research. The research either strengthens or alters the theory and often results in adjustments to the application. Thus, application, theory, and research are intertwined, each stimulating the other. 4. Identify the various therapeutic modalities classification systems. They can be classified according to the physical agent used, such as hydrotherapy, thermotherapy, and electrotherapy. They can be classified according to tissue responses, such as deep heating, superficial heating, and cooling. However, these categories are not exclusive, and many therapeutic modalities fit into different categories. Classification

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Examples

Cryotherapy

Use of cold

Ice massage, ice pack, immersion, cold whirlpool, vapocoolant sprays.

Thermotherapy

Use of superficial or deep heat

Moist hot pack, warm whirlpool, paraffin wax baths, ultrasound, diathermy.

Hydrotherapy

Application of water

Whirlpool and aquatic therapy pools, ice immersion

Electrotherapy

Use of electricity

EMS, iontophoresis, TENS, and diathermy.

Light therapy

Use of electromagnetic radiation

Laser, infrared, photo biomodulation

Mechanotherapy

Use of motion, force or pressure

Massage, mobilizations, compression, continuous passive motion, traction

Exercise

Activities the patient performs to bring about a desired response

Various

5.

Discuss the roles of physicians and clinicians in determining which therapeutic modality is used, and the selection criteria. The decision depends on your specific state practice act, which usually stipulates that Ats apply therapeutic modalities under the direction of a physician. Selection criteria: - Have a correct diagnosis, which results from analysis of the subjective and objective data obtained during a thorough evaluation of the patient and the specific injury or condition. - Have a definite concept of the pathologic and physiological changes associated with the injury. - Outline an overall treatment plan that includes long-range, medium-range, and short-range therapeutic goals. - Understand the modality’s effects, indications, and contraindications, including the type and strength of evidence supporting this information. - Match your therapeutic goal with a modality that will help you achieve that goal.

6. Define rehabilitation, and the relationship between therapeutic modalities and rehabilitation. Rehabilitation means restoring to a former capacity by providing training or therapy. The entire process of returning an injured patient to his/her/their preinjury status, including the use of therapeutic modalities, is rehabilitation. 7. Discuss each of the four erroneous concepts of rehabilitation. What effect do these misconceptions have on one therapeutic modality user? Misconception 1: treating injuries, then rehabilitating them - People may think that treating injuries is separate from rehabilitation. Treatment with modalities is part of rehabilitation, not something that precedes it. Misconception 2: rehabilitation is reconditioning - The two processes do share some common principles, but there are also some fundamental differences. Rehabilitation includes conditioning, but it also involves the promotion of healing and pain relief. Rehabilitation can be much more aggressive than conditioning. Misconception 3: Working with weights - Rehabilitation is not complete if the patient works only with weights, regardless of how creative and intense the work. Misconception 4: The cookbook approach - Cookbook approach to rehabilitation: clinical follows a specific recipe or protocol for treating each injury. The protocol includes phases with specific time periods and therapeutic interventions. Its limitation is that all patients with the same or similar injury are treated the same, without regard for individual differences. Variables that are disregarded in the cookbook approach include: o The patient’s genetic makeup, general health, preinjury state of conditioning, psychological profile, and work ethic o Severity of the injury and associated problems o Rate of progress o Difference in demands placed on the injured body part during sport participation. o Time of the season - Every patient and every injury are different, so rehabilitation programs must be individualized. 8. Describe the 12 principles of rehabilitation. The SAID principle (specific adaptation to imposed demands) - Body responds to a given demand with a specific and predictable adaptation. For a specific adaptation to occur, a specific demand must be imposed. Therapeutic Goals - Establish aim or desired result. Continual evaluation - Reevaluation is necessarily almost daily to determine the patient’s response to the therapeutic regimen and progress toward his/her/their goals. Overload and progression - Overload is a concept of challenging the body to greater function by pushing it beyond its comfort zone to near its limits. The body likes to have a reserve, so when you demand near-total functioning by a system, the body attempts to develop a reserve. Functional progression - Functional progression, also known as progressive reorientation, is accomplished by graded exercise, or the performance of functional activities in an ordered sequence, beginning with simple, easy activity and progressing to full sport or work activity. It is based on the concept of progressive resistive exercise (PRE) to regain strength during rehabilitation. Functional progression facilitates the acquisition or reacquisition of skills required for safe and effective performance of complex skills. - Usual progression: o Unloaded activities o Loaded activities o Overloaded activities o Single-plane activities o Multiple plane activities o Slow speed o Normal speed o High speed

o Slow transition o Normal transition o Very quick transition The absence of pain - All exercise should be relatively pain free. - “No pain no gain” does not apply to rehabilitation, but “ignore the pain equals no brain” does. Biofeedback - Process of measuring a biological mechanism using some objective means and then telling the patient his/her/their scores. Stimulates more rapid patient progress. Early exercise - Early exercise is essential to rehabilitation. Not only does the proper use of exercise speed the healing process, but a lack of exercise during the early stages of rehabilitation can result in permanent disability. The optimal conditions for healing depend on a fine balance between protection form too much stress and a return to normal functioning at the earliest possible time. Relatively rapid rate of reconditioning Timelines Prioritizing - Return to full performance is the priority, and the motivating force, of early rehabilitation. No matter how valuable an athlete is to the team, the interests of neither the team nor the coach should take precedence over the health of the patient. Maintain conditioning 9. What are the 10 core goals of rehabilitation? Goal 1: Structural integrity Goal 2: Pain-free joints and muscles Goal 3: Joint flexibility Goal 4: Muscular strength Goal 5: Muscular endurance Goal 6: Muscular speed Goal 7: Motor skill Goal 8: Muscular power Goal 9: Agility Goal 10: Cardiorespiratory endurance...