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Trombly - ch 5

ROM, strength & endurance

Limits of motion the beginning & ending postion of movement @ a joint. Is determined by sturcture & integrity of surrounding tissue
Passive range of Motion (PROM) The amount of movement possible @ a joint when an outside force moves the limb
Active range of motion (AROM) The amount of movement possible @ a joint when the patient voluntarily moves the limb by muscle contraction
What is the problem it active range of motion is less than passive range of motion There is a problem of muscle weakness
If the limitations are observed the therapist attempts to move the joint through full range of motion
If the joint is free to move the end range, the problem is Active motion
If the end range can not be attained when the therapist moves the limb, the problem is Passive motion sensor
The goniometer is used to measure Joint motion
Every goniometer has protractor, axis and two arms
Shoulder flexion is in what plane Sagittal plane
Shoulder abduction is in what plane Frontal plane
Shoulder horizontal abduction & adduction is in what plane Horizontal plane
Which range of motion is more reliable Active motion measurements
A significant limitation is one that Decreases occupational functioning or maybe two deformity
Limit of motion can be compared to involved extremity
It is important to compare an initial evaluation scores to Mid in post treatment scores to assess the outcome
One cause of limited range of motion is quantified using circumferntial or volumetric measurements edema
Volumetric measures Changes in mass of the body part by using water displacement
The figure eight technique To measure edema
Pain is another possible cause of range of motion limitations. True or false True pain built up that willingness to move
visual analog scale, faces test, color scale, adjective test: measure Intensity of pain (VAS is the most frequent)
0 to 10 scale Zero no pain, 10 the worst pain
Muscle strength Demonstrating the degree of muscle power when movement is resisted as with objects or gravity
Weakness is Lack for reduction of power of the muscle or muscle group
Maximum voluntary contraction The maximum amount of tension that can be produced under voluntary control is commonly used to measure strength
Break test The muscle to be tested is positioned at its greatest mechanical advantage
Make test the joint is placed in a gravity eliminated position in the handheld dynamometer is placed perpendicular to the limb segment
Mechanical advantage Refers to the link tension relationship of the muscle
Prior to Manual muscle testing The passive range of motion scan should be done to determine what range of motion is available at each joint
Most important too score reliability Repeated tests
Manual muscle testing is valid and reliable for Measuring muscle strength
name Pinch tests Tip pinch, lateral pinch, palmer pinch
Ability to sustained effort and to resist the fatigue endurance
Cardiopulmonary endurance Ability of the whole body to sustain prolong rhythmical activity
Endurance of a muscle or muscles group is the ability to Sustain intense activity
Endurance may be decreased because of Local trauma or reduction of innervation
Endurance can be measured by Dynamically or statically
Dynamic assessments include Number of repetitions per unit of time for the maximal heart rate generate but aerobic activity or exercise or metabolic equivalent level
Frequency duration and intensity of the activity are considerations of Evaluation of endurance
Intensity is related to both Speed and resistance
Basal metabolic rate is amount of oxygen consumption to maintain the metabolic processes (ex respiration, circulation, peristalsis, temperature regulation, glandular function) of the body @ rest & is quantified as 3.5ml of oxygen per kilogram of body weight per minute
1-2 MET Eating, dressing, washing hands and face, sweeping four, desk work, riding in a car, standing, walking 1 miles per hour, playing cards, painting
2.5 - 3.5 MET Showering, food prep, make bed, iron, clean windows, well-being, parts assembly, buying a musical instrument, walking 2 miles per hour, cycling 5.5 miles per hour, horseback riding, billiards, bowling, golf,
4-5 MET Raking leaves, walking downstairs, heavy assembly work, like carpentry, walking 3 miles per hour, cycling 9 miles per hour, golf carrying clubs,
5.5 - 6.5 MET Walking with braces & crutches, mowing the lawn by hand mower, carpentry, chopping wood, walking 4 miles/hr, tennis, horseback riding (trot), ice or roller skating
7-8 MET Shoveling 22 pounds for 10 minutes, baking, jogging 5 miles/hr, Sking (vigours), horseback riding (gallop)
8.5 - 9.5 MET Shoveling 31 pounds for 10 minutes, running 7.5 miles/hr, fencing, football, basketball
One MET equals Basal Metabolic rate
Heart rate is measured by Placing the index finger lightly but firmly over the radial artery at the wrist and counting the number of beats per minute
Whether to measure it dynamically or statically depends on The functional goal of the patient and his or her cardiopulmonary status
If patient expects to return to work for a hobby that requires maintain grasp for holding loads, they should be tested Static endurance
If patient activity is mostly isotonic they should be evaluated Dynamically
isometric holding increases Blood pressure and stresses the cardiopulmonary system
When performing isometric testing the patient should be able to Talk, count or sing to prevent holding breath
The difference between resting and peak exercise heart rates: measured in beats per minute Maximum heart rate reserve
The mechanical effect caused by the length of extrinsic finger flexors and extensors. When the rest is flexed in the fingers tend to extend because the extensors are too short to allow full finger flexion and wrist flexion at the same time Tenodesis
Created by: jen4zoe
Popular Occupational Therapy sets




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