1. Therapeutic Exercise for Rehabilitation
Chapter 18
Therapeutic Exercise for Rehabilitation

2. Rehabilitation
The process of recovering from an injury through treatment and education
Designed to help injured patients regain maximum function, a sense of well-being, and the highest level of independence possible

3. The Rehabilitation Team
Physician
Physical therapist
Athletic trainer
Strength and conditioning specialist
Physical therapy assistant
Physical therapy aide

4. The Rehabilitation Team
Patient’s family
Teammates and coach
The patient

5. The Rehabilitation Environment
Successful physical rehabilitation
Requires more than medical care
Requires belief in a positive outcome
Rehabilitative environment should reflect a sense of competence and optimism

6. The Rehabilitation Environment
To create an optimal environment for healing, address these considerations:
Patient safety
Patient environment
Patient comfort
Staff conduct and professionalism

7. The First Session Patient History
Consists of age, past illnesses, inherited conditions, previous therapies, and information about prescribed medications
Lists any precautions associated with the patient’s condition
Contains facts important to rehabilitation process

8. The First Session Motivating the Patient
Greet the patient with a smile.
Dress professionally to suit the work environment.
Use the patient’s name frequently throughout the treatment session.
Express understanding of the nature of the patient’s injury.

9. The First Session Motivating the Patient
Make sure the patient understands what is causing the condition.
Convey confidence about the physical therapy procedure to the patient.
Explain the objectives of the physical therapy to the patient.

10. The First Session Motivating the Patient
Point out improvements the patient can watch for while going through the physical therapy sessions.
Suggest and/or organize group activities for the patient.
Always provide clear and simple directions.
Maintain a positive attitude about the techniques used.

11. The First Session Motivating the Patient
Provide a clean, organized, and pleasant rehabilitative environment.
Always give the patient full attention.
Present a professional attitude.
Stay in good health in order to display a positive example to the patient and co-workers.

12. Posture and Joint Assessment
Proper body alignment is vital to the functioning of the body’s muscles and joints.
Patients with poor body alignment
Limited in normal movements
Joints and tissues surrounding them become stressed

13. Posture and Joint Assessment
Active participants in the rehabilitative process must be able to assess a patient’s ability to move and the ways in which body alignment may be affecting that movement.

14. SOAP Notes in Documentation
SOAP acronym
Subjective findings
Objective findings
Assessment
Plan

15. SOAP Notes in Documentation
A concise, easy-to-read method of documenting the patient’s health status
Efficient means of recording the patient’s progress as well as difficulties encountered along the way
Organized method of communication to other team members

16. Subjective Findings “S” in SOAP is for subjective findings
Information about patient and treatment
Examples:
A family member mentions that the patient is unmotivated at home
Patient complains of nausea
Patient mentions feeling depressed
Patient thinks the coach is pushing too hard for the patient to return to playing

17. Objective Findings “O” in SOAP is for objective findings
Documents things that are observable and measurable
Examples:
Patient ambulates with walker 150 feet
Patient refuses treatment for past three days
Patient becomes tired when walking, requiring frequent rest

18. Assessment Notes “A” in SOAP is for assessment notes
Licensed professional’s opinions of the patient’s condition, progress or obstacles to rehabilitation
Examples:
Patient seems depressed
Patient seems anxious to go home
Patient has soreness from custom brace
Patient’s balance is now fair

19. Plan “P” in SOAP is for plan
States what the rehabilitation team wants to accomplish with the patient in terms of long- and short-term goals
Examples:
Advance the patient to the use of a cane this week (as able)
Make arrangements to go to a local gym
Continue to encourage patient’s participation in exercises

20. The Phases of Physical Rehabilitation
Successful rehabilitation
Complex process that can vary in length of time to complete; depends on severity of the injury and degree of function that must be regained
Other variables such as type of health insurance, access to care, etc., also impact success of the program.

21. The Phases of Physical Rehabilitation
Three phases of healing must take place in order for the patient to resume pre-injury activities.
Phase I: Control inflammation
Phase II: Repair
Phase III: Remodel

22. Patient Education Patients must be educated about their rehabilitation
How they can speed recovery
How they can protect the injury
What kind of progress they can expect

23. Patient Education Ongoing communication is vital.
Patient must be informed of many aspects of rehabilitation
Activities of daily living
Specific activities to mobilize patients and to help them regain the ability to function in their daily lives using their own capabilities

24. Patient Education Proper body mechanics
Nutritional needs to help healing
Use of such aids as crutches