Range of motion ( ROM / ROME ) is a basic technique used for the examination of movement and for initiating movement into a program of therapeutic intervention. Movement that is necessary to accomplish functional activities can be viewed, in its simplest form, as muscles or external forces moving bones in various patterns or ranges […]

The clavicle articulates with the manubrium of the sternum to form the sternoclavicular joint (SC joint), the only direct skeletal connection between the upper extremity and the trunk. The sternal articulating surface is larger than the sternum, causing the clavicle to rise much higher than the sternum. A fibrocartilaginous disk is interposed between the two […]

There are numerous sources from which to obtain information on training for endurance in athletes and healthy young people and for individuals with coronary heart disease. Information or emphasis on endurance training and the improvement of fitness in the individual who has other types of chronic disease or disability is beginning to emerge. Using the […]

UPPER EXTREMITY DIAGONAL PATTERNS

NOTE: All descriptions for hand placements are for the patient’s right (R) upper extremity. During each pattern tell the patient to watch the moving hand. Be sure that rotation shifts gradually from internal to external rotation (or vice versa) throughout the range. By mid-range, the arm should be in neutral rotation. Manual […]

I NTRODUCTION

Proprioceptive neuromuscular facilitation (PNF) is an approach to therapeutic exercise that combines functionally based diagonal patterns of movement with techniques of neuromuscular facilitation to evoke motor responses and improve neuromuscular control and function. This widely used approach to exercise was developed during the 1940s and 1950s by the pioneering work of Kabat, Knott, […]

The most common system of resistance training used with dynamic exercise against constant or variable resistance is progressive resistance exercise (PRE). A later section of the chapter, which covers systems of training using mechanical resistance, addresses PRE.
Dynamic constant external resistance (DCER) exercise is a form of resistance training where a limb moves through a ROM […]

A dynamic muscle contraction causes joint movement and excursion of a body segment as the muscle contracts and shortens (concentric contraction) or lengthens under tension (eccentric contraction). The term concentric exercise refers to a form of dynamic muscle loading where tension in a muscle develops and physical shortening of the muscle occurs as an external […]

Isometric exercise is a static form of exercise in which a muscle contracts and produces force without an appreciable change in the length of the muscle and without visible joint motion. Although there is no mechanical work done (force × distance), a measurable amount of tension and force output are produced by the muscle. Sources […]

As shown in , modifying risk factors through an intervention such as therapeutic exercise is an important tool for reducing or preventing the major components of the disablement process. Risk factors related to disablement are influences or characteristics that predispose a person to the process of disablement. As such, they exist prior to the onset […]

Understanding the relationships among pathology, impairments, functional limitations, and perceived disability is fundamental to the prevention or reduction of disability. The presence of functional limitations may or may not lead to loss of independence and result in disability. Take, for example, a relatively inactive person with long-standing osteoarthritis of the knees. The inability to get […]

The final category of the disablement continuum is disability. There is a growing body of knowledge suggesting that physical impairments and functional limitations directly contribute to disability.Consequently, an approach to patient management that focuses on restoring or improving function may prevent or reduce disability and may have a positive impact on quality of life.
A disability […]

Functional limitations in the physical domain deal with the performance of sensorimotor tasks, that is, total body actions that are typically components or elements of functional activities. These activities include basic activities of daily living (ADL), such as bathing, dressing, or feeding, and the more complex tasks known as instrumental activities of daily living (IADL), […]

Functional limitations, the third component of the disablement model, occur at the level of the whole person. They are the result of impairments and are characterized by the reduced ability of a person to perform actions or components of motor skills in an efficient or typically expected manner. For example, restricted range of motion (impairment) […]

Impairments are the consequences of pathological conditions; that is, they are the signs and symptoms that reflect abnormalities at the body system, organ, or tissue level. Impairments can be categorized as arising from anatomical, physiological, or psychological alterations as well as losses or abnormalities of structure or function of a body […]

This first major component of the disablement model refers to disruptions of the body’s homeostasis as the result of acute or chronic diseases, disorders, or conditions characterized by a set of abnormal findings (clusters of signs and symptoms) that are indicative of alterations or interruptions of structure or function of the […]

During the early 1990s physical therapists began to explore the potential use of disablement models and suggested that disablement schema and related terminology provided an appropriate framework for clinical decision making in practice and research. In addition, practitioners and researchers suggested that consistent use of disablement related language could be […]

Several models that depict the process of disablement have been proposed over the past 40 years. The first two schema developed were the Nagi model and the International Classification of Impairments, Disabilities, and Handicaps (ICIDH) model for the World Health Organization (WHO). The ICIDH model was revised after its original publication, with adjustments made in […]

It has been said that the physical therapy profession is defined by a body of knowledge and clinical applications that are directed toward the elimination or resolution of disability.Understanding the disabling consequences of disease, injury, and abnormalities of development and how the risk of potential disability can be reduced, therefore, must be fundamental to the […]

Therapeutic exercise procedures embody a wide variety of activities, actions, and techniques. The techniques selected for an individualized therapeutic exercise program are based on a therapist’s determination of the underlying cause or causes of a patient’s impairments, functional limitations, or disability.The types of therapeutic exercise interventions presented here are listed below. Additional […]

Almost everyone, regardless of age, values the ability to function as independently as possible during everyday life. Health-care consumers (patients and clients) typically seek out or are referred for physical therapy services because of physical impairments associated with movement disorders caused by injury, disease, or health-related conditions that interfere with […]

The disablement model is distinctly different from the classic medical model, where the emphasis is on treating the specific diagnosis with pharmacology or surgery. The disablement model emphasizes the functional and health status of individuals, with intervention based on improving these aspects of the patient’s condition. The model has four […]