Posts Tagged ‘rehabilitation’
Psychosocial Flags
As one on the frontlines for 20 years the concept of “flags” was useful to provide a strategy for integrating multiple elements into patient management strategies. Unfortunately , much like pain management programs recognition has driven a hands off strategy of patient management on the basis that “manual therapy” is either ineffective or creates dependance in this patient group.
The converse view is that manual therapy and functionally specific rehabilitation can be used directly as a cognitive-behavioural strategy to address specific patient complaints / functional impairments. As physiotherapists we need to recognise that any interactions we have with patients have cognitive / emotive connotations and there is no practical reason why physical means cannot be used to facilitate this approach as an adjunct or an alternative to psychotherapy techniques
Those who attended the “Decade of the Flags” conference in Keel university at the end of 2007 will know that primary care clinicians can now no longer hide behind professional boundaries as an excuse not to challenge patients distorted beliefs or facilitate rehabilitation programs which are tailored to their needs.
This obviously poses clinical challenges but the facts won’t go away by passing the buck.
What do you find the most challenging aspects of of this situation?
Planning Rehabilitation Programs
Key points to consider planning a rehabilitation program
1. How do we determine the relative amount of resistance for an individual?.
2. How many repetitions should be done?.
3. How much rest period is necessary?.
4. How do we determine the factors limiting exercise performance clinically?.
5.How do we determine which components of rehabilitation are appropriate targets?.
6. Where is the transition between rehabilitation and conditioning?.
7. What is the difference between physiotherapy prescribed exercise and sport rehabilation / fitness instructor?.
8. How do the principals of strength and conditioning apply to rehabilitation?.
9. What do we need to know about the structures we are rehabilitating?.
10. How do we improve exercise compliance?
Manipulating Exercise Variables
Selecting variables to modify in a rehabilitation program can prove challenging. Most therapists are familiar with the obvious variables of LOAD & REPETITION but there are numerous other factors that can be manipulated.
Speed
Range of Motion
Base of Support
Plane of Motion
Combining different elements of these components allows progression or regression as required. It is essential that therapists are competent in applying these principals in a clinical setting
[hidepost=1]
Click exercise variables to hear the lecture.
[/hidepost]
