Principles of Exercise Rehabilitation: Difference between revisions
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=== The Influence of pain on movement and motor control === | === The Influence of pain on movement and motor control === | ||
Pain has a massive influence on our movement patterns. As a pain avoidance strategy, a person with injured ankle may acquire an antalgic gait. Walking with slight planter flexion and short strides may later develop to a compensatory foot pronation, knee valgus and hip adduction moment, thus affecting tissue stress. | Pain has a massive influence on our movement patterns. As a pain avoidance strategy, a person with injured ankle may acquire an antalgic gait. Walking with slight planter flexion and short strides may later develop to a compensatory [[Foot and Ankle Structure and Function|foot pronation]], knee valgus and hip adduction moment, thus affecting tissue stress. | ||
Another example is seen when a person develops a co-contraction of [[Erector spinae|Erector Spinae]] muscle due to flexion-related [[Low Back Pain|LBP]]. This rigidity results in excessive hip movement to compensate for the loss of lumbar flexion. Additionally, the excessive lumbar extension may cause increased load on [[Facet Joints|facet joint]] and posterior [[Intervertebral disc|disc]] elements. | Another example is seen when a person develops a co-contraction of [[Erector spinae|Erector Spinae]] muscle due to flexion-related [[Low Back Pain|LBP]]. This rigidity results in excessive hip movement to compensate for the loss of lumbar flexion. Additionally, the excessive lumbar extension may cause increased load on [[Facet Joints|facet joint]] and posterior [[Intervertebral disc|disc]] elements. | ||
{{#ev:youtube|UzyTvyQfXK0}} | The fear of movement could possibly develop to catastrophizing and complicate the conditions. Therefore, we need to consider the central elements of pain by implementing [[desensitization]] in the rehabilitation program. | ||
{{#ev:youtube|UzyTvyQfXK0}}<ref>Understanding Fear-Avoidance Beliefs and Chronic Pain. Available from: https://www.youtube.com/watch?v=UzyTvyQfXK0</ref> | |||
== Rehabilitation Considerations == | == Rehabilitation Considerations == | ||
=== Motor skill Learning/Rehabilitation === | |||
teaching patient the movement. work on motor skill learning. the underpinning concepts of learning starts with accusition:carrying out teh basic functions in a deconstructive way. repetin-tive. retenstion phase: that we can deliver the task away from the initial learning time. recalling. | |||
ideally we want the transference phase, in other functional task. | |||
Cognitive phase | |||
== References == | == References == | ||
Revision as of 21:09, 24 June 2018
Physical Stress Theory[edit | edit source]
According to Mueller and Maluf[1], biological tissues adapt to changes in the levels of applied stress. Maintaining tissue tolerance is essential to prevent tissue atrophy, whereas overloading result in hypertrophy. Excessively high level of stresses lead to tissue injury and a potential permanent damage. The magnitude, time, and direction of stress application determine the overall level of exposure to physical stress. Injury may occur due to a high-magnitude stress applied for a brief period, a low-magnitude stress applied for a long duration, and a moderate-magnitude stress applied to the tissue many times.
Mechanotransduction Hypothesis[edit | edit source]
Refers to the conversion of mechanical loads on the cellular level, eventually resulting in structural changes. Increased bone thickness and width in response to mechanical loading is the classical example of this hypothesis. Regardless of the type of loading, torsional, compressive or tensile, the mechanical stimulus triggers a release of various chemicals, which in turn result in building up layers of tissue and improves load tolerance[2].
This hypothesis is aligned with a sub-principle of Wolff's law that tissues adapt to the specific applied loads. Exposure to compressive loads, for instance, will qualify the tissue to tolerate the same type of applied loads exclusively[3].
Physiologically stressing the tissue, below the level of injury, with sufficient time for this adaptive response to occur causes cellular response that strengthen the tissue and improves its tolerance
Mobility and Stability[edit | edit source]
Maintaining mobility while stabilizing an injured tissue is required in successful rehabilitation. The key here is to avoid rigidity. Muscular rigidity refers to Co-contraction, occurring in response to pain and/or kinesiophbia. Appropriate level of co-contraction which allows mobility to occur once stress is minimized.
The Influence of pain on movement and motor control[edit | edit source]
Pain has a massive influence on our movement patterns. As a pain avoidance strategy, a person with injured ankle may acquire an antalgic gait. Walking with slight planter flexion and short strides may later develop to a compensatory foot pronation, knee valgus and hip adduction moment, thus affecting tissue stress.
Another example is seen when a person develops a co-contraction of Erector Spinae muscle due to flexion-related LBP. This rigidity results in excessive hip movement to compensate for the loss of lumbar flexion. Additionally, the excessive lumbar extension may cause increased load on facet joint and posterior disc elements.
The fear of movement could possibly develop to catastrophizing and complicate the conditions. Therefore, we need to consider the central elements of pain by implementing desensitization in the rehabilitation program.
Rehabilitation Considerations[edit | edit source]
Motor skill Learning/Rehabilitation[edit | edit source]
teaching patient the movement. work on motor skill learning. the underpinning concepts of learning starts with accusition:carrying out teh basic functions in a deconstructive way. repetin-tive. retenstion phase: that we can deliver the task away from the initial learning time. recalling.
ideally we want the transference phase, in other functional task.
Cognitive phase
References[edit | edit source]
- ↑ Mueller MJ, Maluf KS. Tissue adaptation to physical stress: a proposed “Physical Stress Theory” to guide physical therapist practice, education, and research. Physical therapy. 2002 Apr 1;82(4):383-403.
- ↑ Khan KM, Scott A. Mechanotherapy: how physical therapists’ prescription of exercise promotes tissue repair. British journal of sports medicine. 2009 Apr 1;43(4):247-52.
- ↑ Frost HM. Wolff's Law and bone's structural adaptations to mechanical usage: an overview for clinicians. The Angle Orthodontist. 1994 Jun;64(3):175-88.
- ↑ Understanding Fear-Avoidance Beliefs and Chronic Pain. Available from: https://www.youtube.com/watch?v=UzyTvyQfXK0
