2.  Introduction  Approach to patient evaluation and program development (SOAP)  Posture

3. The ultimate goal of any therapeutic exercise program is the achievement of symptom-free movement and function.

4. 4 prevention of dysfunction the development, improvement, restoration, or maintenances of normal: 1. Strength 2. Endurance and cardiovascular fitness 3. Mobility and flexibility 4. Relaxation 5. Coordination and skill

5. In order to effectively administer therapeutic exercise to patient the therapist must: 1.know the basic principles and effects of the treatment 2.Be able to do a functional evaluation of the patient 3.Know the interrelationships between the anatomy and kinesiology 4.Have an understanding of the state of disability and its potential rate of recovery, complications, precautions, and contraindications

6. 6  Structure governs function › Anatomy is the structure › Biomechanics/physiology are the function

7.  Patient care is a problem-solving process. it is feed bake loop Assess needs Develop plan Implement plan Evaluate plan

8. A. Assess needs 1) Subjective information (the case history)  Name, age, sex……….  Ask questions to get the patient to: 1.Describe how he perceives his symptoms. e.g. location, type, and nature of pain or symptom 2.Describe the behavior of the symptoms through a 24-hour period. e.g. motions or positions cause and influence the symptom 3.Briefly describe his general health, medications being taken…………….. 4.Describe the previous history of the condition. 5.Describe related history, such as any medical or surgical intervention.

9. A. Assess needs 2) Objective data (clinical evaluation) a) Inspection (observation) 1. The ADL such as gait- patient ability to stand, sit, or dress himself 2. Use of any assistive aids 3. Posture 4. Shape of body parts such as contour changes, swelling, atrophy, hypertrophy, and asymmetry 5. Appearance of the skin

10. b) function Functional tests include: 1. Active range of motion (AROM) 2. Passive range of motion (PROM) 3. Describe the end feel (normal –abnormal) 4. Manual muscle testing 5. Joint integrity tests

11. c) Palpation 1.Skin and subcutaneous tissue, temperature, 2.Edema 3.Muscles, tendons, trigger point…… 4.Joint (effusion, tenderness, changes in position or shape) 5.Nerve and blood supply d) Neurological tests e) Additional tests f) Cardiovascular status

12. 3) Assessment Once the subjective and objective data about patient are gathered:  List the problem area  Determine major versus minor problems

13. B. Develop Plane Goals or objectives of the treatment Each goal should be optimized to include: 1.A measurable outcome 2.Specific conditions or tests 3.The time expected to accomplish the goal

14. Long term-goals: 1.Are a final measurable outcome expected at the end of the treatment 2.Are often described in functional terms Short term goals: 1.Reflect the component skills needed to obtain the long term goals 2.Are helpful in directing the decision- making process

15.  C. Implement plan  D. Evaluate plan  E. Home care program