Introduction to Therapeutic Exercises Mazyad Alotaibi

Introduction Physical therapy “ is the art and science of treatment by means of heat, cold, light, water, manual manipulation, electricity, therapeutic exercise and other physical agents”. Physical therapy or physiotherapy is the provision of services to people and population to develop, maintain and restore maximum movement and functional ability throughout the lifespan. It includes the provision of services in circumstances where movement and function are threatened by the process of ageing or that of injury or disease.

Therapeutic exercise is an essential and important part of the practice of physical therapy. One of the most difficult tasks for any physical therapists is to design and apply an exercise program. Exercise presents both benefits and risks. This balance can be easily achieved towards the benefit side of the equation with the optimal exercise prescription.

Therapeutic exercise as the prescription of bodily movement to correct an impairment, improve musculoskeletal function, or maintain a state of well-being. It may vary from highly selected activities restricted to specific muscles or parts of the body, to general and vigorous activities that can return a convalescing patient to the peak of physical condition. Therapeutic exercise seeks to accomplish the following goals: Enable ambulation Release contracted muscles, tendons, and fascia Mobilize joints Improve circulation Improve respiratory capacity Improve coordination Reduce rigidity Improve balance Promote relaxation Improve muscle strength Improve exercise performance and functional capacity (endurance)

Definition of Therapeutic exercise Therapeutic exercise is the systematic and planned performance of body movements or exercises which aims to improve and restore physical function. Exercise is defined as “activity that is performed or practiced to develop or improve a specific function or skill to develop and maintain physical fitness”

Aims of Therapeutic Exercise 1. The ultimate goal of a therapeutic exercise program is the achievement of an optimal level of symptoms free movement during basic to complex physical activities. 2. To improve and restore physical function. 3. To prevent loss of function. 4. To enhance a patient’s functional capabilities. 5. To prevent and decrease impairment and disability 6. To improve overall health status, fitness and sense of well-being

Prerequisites For Designing Exercise Program For designing a successful and effective exercise program the followings should be fulfilled: The physical therapist must have knowledge of anatomy, physiology, kinesiology and pathology and can integrate and apply this knowledge to each condition. The physical therapist must understand the different forms of exercises and how these exercises affect body system. The exercise program should be individualized to the special needs of each patient.

Steps For Designing Exercise Program 1. Start with comprehensive examination of the patient. 2. Determine the patient’s problems and functional disabilities. 3. Set the aims and objectives of the treatment program. 4. Select the proper exercise program that can solve the patient’s problems and improve functional capabilities. 5. Periodic re-evaluation and examination of the patients should be carried out weekly or monthly depending on the program. 6. Modifications of the program should be made to achieve the optimal degree of improvement according to the results of the re-evaluation, 7. The purpose and goal of the exercise program should be clearly identified to the patient.

Classification of Therapeutic Exercises Therapeutic exercises are classified according to the aim and purpose of the exercises into many types: 1. Range of motion exercises which aim to maintain and increase range of motion as traditional ROM exercises (passive, active and active assisted ROM exercises) and techniques of joint mobilization and soft tissue stretching. 2. Muscle performance exercises to increase muscle strength, power and endurance as resisted exercises and endurance exercises. 3. Postural exercises to improve posture and correct faulty posture. 4. Balance and coordination exercises to improve balance and coordination. 5. Relaxation exercises to induce relaxation. 6. Area specific exercises as breathing exercises and circulatory exercises.

Examination of patient Assessment Assessment includes: 1- subjective information: - Name, age, sex, address, occupation, diagnosis. - How the patient perceive his symptoms. - Describe the behavior of the symptoms. - Related History of any previous medical or surgical history.

Examination of patient Assessment 2- Objective data: - By Inspection (observation). - By palpation. - By measurement: Muscle palpation, muscle testing, functional ability, ROM, round and long measurement, muscle tone, special tests.

Examination of patient Assessment 3- Goals of treatment: according to assessment results. - Long term goals. - Short term goals. 4- Plan of treatment.