therapy and sports medicine chapter

Therapy and Sports Medicine Chapter

Apply therapeutic skills for rehabilitation and injury

prevention

Demonstrate Assistive and Therapeutic Techniques Range of motion When patients have

limited movement range of motion exercise help keep muscles and joints functioning

An example of a psychological benefit of massage therapy is relaxation

Range of Motion ROM Ordering by physician, Administered by

physical therapist, nurse assistant or other authorized person

Done during daily bath or at other times.

Using massage on strained muscle can help increase circulation

ROM is done to avoid Contractures

(tightening/shortening of muscle causing permanent flexing of joint, for example foot drop)

ROM exercise are done to prevent contractures

Muscle atrophy or stiff joints Circulatory impairment

(leading to blood clots or decubitius ulcers

Mineral loss Other problems, poor appetite,

constipation, urinary infections, respiratory problems, and hypostatic pneumonia.

Active ROM Active ROM-Performed by patients who are able to move each joint

without assistance.

The term that describes the ROM movement when a straight leg is bent at the knee is flexion.

Passive ROM Another person moves

each joint for a patient who is not able to exercise.

If a person has a cast on their wrist, the motion that can still be done to the wrist and hand is rotation.

Resistive ROM Performed by a

therapist against resistance provided by the therapistThe training a certified athletic trainer must have a bachelor’s degree.

The medical practice that would use a massage therapist as an associate is an orthopedics office.

Movements Abduction Adduction Flexion Extension Hyperextension Rotation Pronation Supination

Inversion Eversion Dorsiflexion Plantar Flexion

Principles for Performing ROM Movements should be done slow, smooth,

and gentle to prevent injury Support should be provided to the parts

above and below the joint being exercised Never force joint beyond range or to the point

of pain If patient complains of pain, stop exercise

and report it to the supervisor

Repeat three times or as ordered Encourage patient to assist as much as

possible Prevent unnecessary exposure of patient Close door, provide privacy Use correct body mechanics at all times

Principles of Ambulatory Assistance Crutches-Usually

prescribed by physician Therapist or authorized person fits crutches

Appropriate gait must be taught

Must be properly fit (axillary pressure can cause damage to radial nerve).

When ambulating a pt. with crutches, be sure: the pat supports his/her weight on the hand bars and not the axillary support.

When fitting crutches: Patient should wear good fitting walking shoes with

low, broad heels If possible, position patient against wall for support

(use chair for additional support) Position crutches 4-6” in front and 4-6” to the side of

patient’s foot Allow 2” space between armpit and axillary bar. Adjust hand pieces so that each elbow is flexed at

25-300 angle.

Crutches Gait taught depends

upon condition Patients must be taught

to support weight on hand bars, NOT axillary supports

Cane Provides balance and

support Some have 3 or 4 legs

for additional support Used on unaffected

(good) side

Walker 4 legged device Often used for weak

patients without leg injuries

Must be properly fitted to the pt.

Patient must lift walker, place it in front of the body, and walk into it

Patients must NOT slide walker

When helping a client’s who is recovering from a stroke the nurse aide should assist on the clients weak side.

Gait Belt Band of fabric or leather around patient’s waist During transfers or ambulation, health care workers

can hold gait belt to provide additional support Gait belt must be the proper size-secure fit around

waist but not too tight Belt may have loop to hold, or use an underhand

grasp to hold below Grasp belt at the back during ambulation Grasp the belt on both sides while facing the patient Apply gait belt over the patient's clothing at the

waist

Safety Checks Remain alert when ambulating patient Walk on weak side and slightly behind patient If the patient starts to fall, use your body to brace the

patient Ease the patient to the floor as slowly as possible Protect the patient’s head and neck Stay with the patient and call for help If a patient falls, an incident report must be filled out

in most agencies

Massage A traditional backrub uses

primarily friction. The massage technique

involving making fine, tremulous movement with the fingers or the use of a mechanical device is vibration.

During childbirth the massage technique that is used when light, circular strokes over the lower abdomen done during controlled breathing is called Effleurage.

During a massage you should encourage the pt. to understand the potential source of healing in his/her own consciousness.

Taping an ankle… When taping an ankle under

wrap is used to protect the skin.

When taping an ankle, the first piece of tape to go on is a single strip of tape around the ankle, approximately 5 or 6 inches above the malleous. The strip of tape is called an anchor.

Test Your Gray MatterWhen you are ambulating a pt. with a gait belt, how should you hold the gait belt?

When ambulating pt. with crutches, be sure:

You go into a pt.’s room and note that the humidifier attached to the oxygen is empty. What should you do?

What statement about the walker is true?

Sheena has a cast on her wrist. What motion can she still do with her lower arm, wrist and hand?

A physician wishes to treat a pts. Hemorrhoids with moist heat. Which of the following applications might be ordered?

What term describes the ROM movement when a straight leg is bent at the knee?

A pt. has shallow respirations, rapid pulse, restlessness, and cyanosis. The physician will likely order?

Hold the back of the belt using an underhand grasp.

The pt. supports his/her weight on the hand bars and not the axillary support Notify your

supervisor immediately

The walker should be properly fitted to the pt.

Sitz bath FlexionOxygen