Concepts of Rehabilitation ATHT 333

Who is on the team? The injured person Clinician Physician Parents Athletic Training Student Coach

As a clinician Interpersonal skills –Competent, energetic, interested, empathy, active listening skills Keep records Educate others –Prepares the injured, more compliance, family members, coaches

Communication AT serves as the center of communication Talk to the patient –Know when to talk, know when not to –Right time to use medical terminology –“I don’t know”…but I’ll find out –Use your filter

Communication With the physician –Treatment plan, limitations, patient response With family –At time of injury to develop rapport With coach –Extent of injury, limitations –Don’t give definitive timelines Remember HIPAA

Principles: ATC IS IT Avoid aggravation: of the injury Timing: start as soon as it is safe (won’t aggravate injury). Too much rest is detrimental Compliance: better if patient informed Individualization: no “cookbook” rehab, everyone responds differently

Specific Sequencing: determined by body’s healing response Intensity: challenge but not aggravate, need imagination to modify Total patient: cardio, uninjured limb, kinetic chain

Objectives 1. Prevent deconditioning –Keep up cardio –Use areas not effected (ie wrist and hand during shoulder immobilization) 2. Rehabilitation of injured part –Knowledge of injury, healing process, and methods to be effective and safe

Goals Ultimate goal? –Safe but quick, aggressive but guarded Objective and measurable –Girth, ROM, strength, pain Short and Long term –What is a typical long term goal? –Short term- weekly/biweekly, determined by pt’s response, reasonable and attainable Ex: reduce edema by 1 cm and increase ROM 15 degrees in 1 week

Examination and Assessment Done continually from time of inx to RTP Use to set goals

Progression Exercise progression (isometric -> isotonic-> isokinetic -> plyometric) Program progression- pt must have flexibility before performing advanced skills

Outcomes-Based Rehab Assessed using a tool devised for measuring patient’s response and satisfaction 2 categories: general health and region specific Used to modify tx, justify tx, evaluate effectiveness of protocols, judge appropriateness of tx responses, asssit in authorization of payment

Basic Components Proprioception, coordination, agility Strength and Muscle Endurance Flexibility and ROM

Flexibility & ROM Flexibility- mobility of muscle –Muscles loses flexibility when immobilized ROM- movement possible at a joint –Affected by joint capsule, ligaments, fascia, scar tissue Strength- if pt doesn’t have strength to move through ROM

Flexibility & ROM Must be first thing regained –Other parameters are based on flexibility of affected area –ROM’s impact on healing process Scar tissue

Strength and Muscular Endurance Strength- maximum force that a muscle or muscle group can exert –Amount of weight in one rep Muscular endurance- muscle’s ability to sustain a sub-maximal force in either a static or repetitive activity over time –Gymnast, marathon runner

Need both –Pitcher may have good strength, but only for 10 pitches When you improve in strength, also gains in endurance and vice versa

Proprioception, Coordination,Agility If any are impaired, increased risk of injury Proprioception- body’s ability to transmit afferent information regarding position sense, to interpret the information, and respond consciously or unconsciously to stimulation through appropriate execution of posture and movement

Coordination- ability of muscles to and muscle groups to perform complicated movements Agility- ability to control direction of the body or its parts during rapid movement

RTP Criteria Fully examine and asses the injured area, the patient’s ability to withstand demands of the sport, and patient’s readiness to return to competition. –Full readiness- no pain, swelling, atrophy; full ROM, flexibility, strength, endurance, ability to perform sport specific skills

Stages of Grief G_Z3lmidmrY