The ability to function independently at home, in the workplace, within the community, or during leisure and recreational activities is contingent upon physical as well as psychological and social function. The multidimensional aspects of physical function encompass the diverse yet interrelated areas of performance

Balance. The ability to align body segments against gravity to maintain or move the body (center of mass) within the available base of support without falling; the ability to move the body in equilibrium with gravity via interaction of the sensory and motor systems.

Cardiopulmonary fitness. The ability to perform low-intensity, repetitive, total body movements (walking, jogging, cycling, swimming) over an extended period of time; a synonymous term is cardiopulmonary endurance.

Coordination. The correct timing and sequencing of muscle firing combined with the appropriate intensity of muscular contraction leading to the effective initiation, guiding, and grading of movement. It is the basis of smooth, accurate, efficient movement and occurs at a conscious or automatic level.

Flexibility. The ability to move freely, without restriction; used interchangeably with mobility.

Mobility. The ability of structures or segments of the body to move or be moved in order to allow the occurrence of range of motion (ROM) for functional activities (functional ROM).

Passive mobility is dependent on soft tissue (contractile and noncontractile) extensibility; in addition, active mobility requires neuromuscular activation.

Muscle performance. The capacity of muscle to produce tension and do physical work. Muscle performance encompasses strength, power, and muscular endurance.

Neuromuscular control. Interaction of the sensory and motor systems that enables synergists, agonists and antagonists, as well as stabilizers and neutralizers to anticipate or respond to proprioceptive and kinesthetic information and, subsequently, to work in correct sequence to create coordinated movement.

Postural control, postural stability, and equilibrium. Used interchangeably with static or dynamic balance.

Stability. The ability of the neuromuscular system through synergistic muscle actions to hold a proximal or distal body segment in a stationary position or to control a stable base during superimposed movement. Joint stability is the maintenence of proper alignment of bony partners of a joint by means of passive and dynamic components.

The systems of the body that control each of these aspects of physical function react, adapt, and develop in response to forces and physical stresses (stress = force/area) placed upon tisses that make up body systems. Gravity, for example, is a constant force that affects the musculoskeletal, neuromuscular, and circulatory systems. Additional forces, incurred during routine physical activities, help the body maintain a functional level of strength, cardiopulmonary fitness, and mobility. Imposed forces and physical stresses that are excessive can cause acute injuries, such as sprains and fractures, or chronic conditions, such as repetitive stress disorders. The absence of typical forces on the body can also cause degeneration, degradation, or deformity. For example, the absence of normal weight bearing associated with prolonged bed rest or immobilization weakens muscle and bone. Prolonged inactivity also leads to decreased efficiency of the circulatory and pulmonary systems.

Impairment of any one or more of the body systems and subsequent impairment of any aspect of physical function, separately or jointly, can result in functional limitation and disability. Therapeutic exercise interventions involve the application of carefully graded physical stresses and forces that are imposed on impaired body systems, specific tissues, or individual structures in a controlled, progressive, safely executed manner to reduce physical impairments and improve function.

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