Exercise Therapy

 

Exercise Therapy

Definition

Exercises is physical activity that is planned, structured and repetitive for the purpose of conditioning any part of the body. Exercise is utilized to improve health, maintain fitness and is important as a means of physical rehabilitation.

There has been a gradually growing awareness among policy makers and health care professionals about the great importance of appropriate exercise habits to major public health outcomes. It has been known for decades that physical activity prevents heart disease, rejuvenate our cells and aid in relaxation in most part but data now suggest that, on average, physically active people outlive those who are inactive and that regular physical activity helps to maintain the functional independence of everyone especially older adults and to enhance the quality of life for people of all ages. The basic elements of an exercise prescription for all ages especially working adults are presented below.

 

 

 

The 7-minutes exercise as illustrated above can be perform regularly every other day, daily or twice a day depending on how often the best results can be achieve. If these exercises are recommended by a physical therapy, then the resulting aptitude can only be determined by follow up discussions.

 

 

Examples of balance enhancing activities include T’ai chi movements, standing yoga or ballet postures, tandem standing and walking, standing on one leg, stepping over objects, climbing up and down steps slowly, turning, and standing on heels and toes.

 

Intensity is increased by decreasing the base of support (e.g., progressing from standing on two feet while holding onto the back of a chair to standing on one foot with no hand support); by decreasing other sensory input (e.g., closing eyes or standing on a foam pillow); or by perturbing the center of mass (e.g., holding a heavy object out to one side while maintaining balance, standing on one leg while lifting the other leg out behind the body, or leaning forward as far as possible without falling or moving the feet).

The rationale for the integration of a physical activity prescription into health care for older adults is based on four essential concepts. First, there is a great similarity between the physiologic changes that are attributable to disuse and those which have been typically observed in aging populations, leading to the speculation that the way in which people age may in fact be greatly affected by activity levels. Second, chronic diseases increase with age, and exercise has now been shown to be an independent risk factor and/or potential treatment for most of the major causes of morbidity and mortality in Western societies, a potential that currently is vastly underutilized. Third, traditional medical interventions do not typically address disuse syndromes accompanying chronic disease, which may be responsible for much of their associated disability. Exercise is particularly good at targeting syndromes of disuse. Finally, many pathophysiological aberrations that are central to a disease or its treatment are specifically addressed only by exercise, which therefore deserves a place in the mainstream of medical care, not as an optional adjunct. Therefore, understanding the effects of aging on exercise capacity and how habitual physical activity can modify this relationship in the older adult, including its specific utility in treating medical diseases, is critical for health care practitioners of all disciplines.

 

Purpose

Exercise is useful in preventing or treating coronary heart disease, osteoporosis, weakness, diabetes, obesity, and depression. Range of motion is one aspect of exercise important for increasing or maintaining joint function. Strengthening exercises provide appropriate resistance to the muscles to increase endurance and strength. Cardiac rehabilitation exercises are developed and individualized to improve the cardiovascular system for prevention and rehabilitation of cardiac disorders and diseases. A well-balanced exercise program can improve general health, build endurance, and slow many of the effects of aging. The benefits of exercise not only improve physical health, but also enhance emotional well-being.
Studies have shown that a consistent, guided exercise program benefits almost everyone from Gulf War veterans coping with fatigue, distress, cognitive problems, and mental health functioning to patients awaiting heart transplants. Exercise in combination with a reduced-calorie diet is the safest and most effective method of weight loss. The United States Department of Agriculture (USDA) food pyramid, called MyPyramid, makes exercise as well as food recommendations to emphasize the interconnectedness between exercise, diet, and health.

 

 

Precautions

Before beginning any exercise program, an evaluation by a physician is recommended to rule out potential health risks. Once health and fitness level are determined and any physical restrictions identified, the individual’s exercise program should begin under the supervision of a health care or other trained professional. This is particularly true when exercise is used as a form of rehabilitation. If symptoms of dizziness, nausea, excessive shortness of breath, or chest pain are present during exercise, the individual should stop the activity and inform a physician about these symptoms before resuming activity. Exercise equipment must be checked to determine if it can bear the weight of people of all sizes and shapes. Individuals must be instructed in the proper use of exercise equipment in order to prevent injury.

Description

Range of motion exercise

Range of motion exercise refers to activity aimed at improving movement of a specific joint. This motion is influenced by several structures: configuration of bone surfaces within the joint, joint capsule, ligaments, tendons, and muscles acting on the joint. There are three types of range of motion exercises: passive, active, and active assists. Passive range of motion is movement applied to a joint solely by another person or persons or a passive motion machine. When passive range of motion is applied, the joint of an individual receiving exercise is completely relaxed while the outside force moves the body part, such as a leg or arm, throughout the available range. Injury, surgery, or immobilization of a joint may affect the normal joint range of motion. Active range of motion is movement of a joint provided entirely by the individual performing the exercise. In this case, there is no outside force aiding in the movement. Active assist range of motion is described as a joint receiving partial assistance from an outside force. This range of motion may result from the majority of motion applied by an exerciser or by the person or persons assisting the individual. It also may be a half-and-half effort on the joint from each source.

There are common muscle stretches’ occurrences which result with individuals who perform continuous exercises for 3 to 5 days per week; and do experience relaxation and flexiblity shoulders mobilities.”

If a patient comes with compliant related to these motions, they may be numerous possibilities of strenuous pulls which may have gone wrong.
Most of the time, some of these exercises requires physical examinations and warm up exercises before they can be performed.

Comments:

 Range-of-motion and strengthening exercise are recommended to my patients and a scan for prolong pains to actually examine the bone/muscles located at point-of-discomfort. Pain relieve drugs and continuous exercises are necessary for these patients while they maintain their regular duties.

Date: 2016-06-23

Complaints/What brought the patient into the Doctor office: Follow-up with left shoulder pains. Patient insist it’s a disturbing, annoying, lingering pains.

Patient is not able to perform full stretches and extension with her left arm. As described, the patient may have had twiggling and tingling feeling on scapula and humerus bones.

She exhibits muscles pains on the left trapezius muscles descending to the deltoid and levator scapulae.

Patient should continue calcium and quinolone prescribed to be taken by mouth for 4 days.

2016-06-06
Follow-up on left shoulder abnormal pains.

Patient may exhibit minor arthritis pain on left shoulder.

Patient is able to perform range-of-motion to strengthen the motion and movement of that part of the body. She has experience progressive improvement by performing range-of-motion and using that hand to do other duties.

Medical Recommendations/Notes: Patient is not able to perform full stretches and extension with her left arm. As described, the patient may have had twiggling and tingling feeling on scapula and humerus bones.

She exhibits muscles pains on the left trapezius muscles descending to the deltoid and levator scapulae.

Any bone infection may certainly occur in the clavicle spine of scapula.

X-ray were ordered to detaily examine the left shoulder joint.

Strengthening exercise

Strengthening exercise increases muscle strength and mass, bone strength, and the body’s metabolism. It can help attain and maintain proper weight and improve body image and self-esteem. A certain level of muscle strength is needed to perform daily activities such as walking, running, and climbing stairs. Strengthening exercises increase muscle strength by putting more strain on a muscle than it is normally accustomed to receiving. This increased load stimulates the growth of proteins inside each muscle cell that allow the muscle as a whole to contract. There is evidence indicating that strength training may be better than aerobic exercise alone for improving self-esteem and body image. Weight training allows one immediate feedback, through observation of progress in muscle growth and improved muscle tone. Strengthening exercise can take the form of isometric, isotonic and isokinetic strengthening.

Isometric exercise

During isometric exercises, muscles contract. However, there is no motion in the affected joints. The muscle fibers maintain a constant length throughout the entire contraction. The exercises usually are performed against an immovable surface or object such as pressing one’s hand against a wall. The muscles of the arm are contracting but the wall is not reacting or moving in response to the physical effort. Isometric training is effective for developing total strength of a particular muscle or group of muscles. It often is used for rehabilitation since the exact area of muscle weakness can be isolated and strengthening can be administered at the proper joint angle. This kind of training can provide a relatively quick and convenient method for overloading and strengthening muscles without any special equipment and with little chance of injury.

Isotonic exercise

Isotonic exercise differs from isometric exercise in that there is movement of a joint during the muscle contraction. A classic example of an isotonic exercise is weight training with dumbbells and barbells. As the weight is lifted throughout the range of motion, the muscle shortens and lengthens. Calisthenics are also an example of isotonic exercise. These would include chin-ups, push-ups, and sit-ups, all of which use body weight as the resistance force.

Isokinetic exercise

Isokinetic exercise utilizes machines that control the speed of contraction within the range of motion. Isokinetic exercise attempts to combine the best features of both isometrics and weight training. It provides muscular overload at a constant preset speed while a muscle mobilizes its force through the full range of motion. For example, an isokinetic stationary bicycle set at 90 revolutions per minute means that no matter how hard and fast the exerciser works, the isokinetic properties of the bicycle will allow the exerciser to pedal only as fast as 90 revolutions per minute. Machines known as Cybex and Biodex provide isokinetic results; they generally are used by physical therapists.

 

Cardiac rehabilitation

Exercise can be very helpful in prevention and rehabilitation of cardiac disorders and disease. With an exercise program designed at a level considered safe for the individual, people with symptoms of heart failure can substantially improve their fitness levels. The greatest benefit occurs as muscles improve the efficiency of their oxygen use, which reduces the need for the heart to pump as much blood. While such exercise does not necessarily improve the condition of the heart itself, the increased fitness level reduces the total workload of the heart. The related increase in endurance also should translate into a generally more active lifestyle. Endurance or aerobic routines, such as running, brisk walking, cycling, or swimming, increase the strength and efficiency of the muscles of the heart.

Preparation

A physical examination by a physician is important to determine if strenuous exercise is appropriate or detrimental for an individual, especially when the exercise program is designed for rehabilitation. Before exercising, proper stretching is important to prevent the possibility of soft tissue injury resulting from tight muscles, tendons, ligaments, and other joint-related structures.

Aftercare

Proper cool down after exercise is important in reducing the occurrence of painful muscle spasms. Proper cool down stretching also may decrease frequency and intensity of muscle stiffness the day following any exercise program.

Risks

Improper warm up can lead to muscle strains. Overexertion without enough time between exercise sessions to recuperate also can lead to muscle strains, resulting in inactivity due to pain. Stress fractures also are a possibility if activities are strenuous over long periods without proper rest. Although exercise is safe for the majority of children and adults, there is still a need for further studies to identify potential risks.

Normal results

Significant health benefits are obtained by including a moderate amount of physical exercise in the form of an exercise prescription. This is much like a drug prescription in that it also helps enhance the health of those who take it in the proper dosage. Physical activity plays a positive role in preventing disease and improving overall health status. People of all ages, both male and female, benefit from regular physical activity. Regular exercise also provides significant psychological benefits and improves quality of life.

Abnormal results

Exercise burnout may occur if an exercise program is not varied and adequate rest periods are not taken between exercise sessions. Muscle, joint, and cardiac disorders have been noted among people who exercise. However, they often have had preexisting or underlying illnesses.

 

 

Key Terms

 

Aerobic

Exercise training that is geared to provide a sufficient cardiovascular overload to stimulate increases in cardiac output.

Calisthenics

Exercise involving free movement without the aid of equipment.

Endurance

The time limit of a person’s ability to maintain either a specific force or power involving muscular contractions.

Osteoporosis

A disorder characterized by loss of calcium in the bone, leading to thinning of the bones. It occurs frequently in postmenopausal women.

 

Bibliography

Websites

• “Exercise Therapy”Masco Corporation March 10, 2012 [cited March 10, 2012].
  https://masoblogdotcom.wordpress.com/exercise-therapy/.
• “ExerciseandPhysical”MedlinePlus. February 25, 2009 [cited February 26, 2009]. http://www.nlm.nih.gov/medlineplus/exerciseandphysicalfitness.html.
• “Exercisefor”MedlinePlus. February 23, 2009 [cited February 26, 2009]. http://www.nlm.nih.gov/medlineplus/exerciseforchildren.html.
• “Exercisefor”MedlinePlus. February 18, 2009 [cited February 26, 2009]. http://www.nlm.nih.gov/medlineplus/exerciseforseniors.html.

 

Organizations

• AmericanCollege of Sports P. O. Box1440,Indianapolis, IN 46206-1440.Telephone:(317)637-9200.Fax:(317)634-7817.http://www.acsm.org.
• AmericanMedical515 N. StateStreet,Chicago, IL 60610.(800)621-8335.http://www.ama-assn.org.
• AmericanPhysicalTherapy1111NorthFairfaxStreet,Alexandria, VA 22314-1488.(800)999-APTA(2782) or (703)684-APTA(2782).TDD:(703)683-6748.http://www.apta.org.
• NationalAthleticTrainers’2952StemmonsFreeway,Dallas, TX 75247-6916.(800)879-6282 or (214)637-6282.Fax:(214)637-2206.http://www.nata.org.