1. Therapy and Sports Medicine Chapter
Apply therapeutic skills for rehabilitation and injury prevention

2. Demonstrate Assistive and Therapeutic Techniques
Range of motion
When patients have limited movement range of motion exercise help keep muscles and joints functioning
An example of a psychological benefit of massage therapy is relaxation

3. Range of Motion ROM Ordering by physician,
Administered by physical therapist, nurse assistant or other authorized person
Done during daily bath or at other times.
Using massage on strained muscle can help increase circulation

4. ROM is done to avoid
Contractures (tightening/shortening of muscle causing permanent flexing of joint, for example foot drop)
ROM exercise are done to prevent contractures
Muscle atrophy or stiff joints
Circulatory impairment (leading to blood clots or decubitius ulcers
Mineral loss
Other problems, poor appetite, constipation, urinary infections, respiratory problems, and hypostatic pneumonia.

5. Active ROM
Active ROM-
Performed by patients who are able to move each joint without assistance.
The term that describes the ROM movement when a straight leg is bent at the knee is flexion.

6. Passive ROM
Another person moves each joint for a patient who is not able to exercise.
If a person has a cast on their wrist, the motion that can still be done to the wrist and hand is rotation.

7. Resistive ROM
Performed by a therapist against resistance provided by the therapist
The training a certified athletic trainer must have a bachelor’s degree.
The medical practice that would use a massage therapist as an associate is an orthopedics office.

8. Movements Abduction Adduction Flexion Extension Hyperextension
Rotation
Pronation
Supination
Inversion
Eversion
Dorsiflexion
Plantar Flexion

9. Principles for Performing ROM
Movements should be done slow, smooth, and gentle to prevent injury
Support should be provided to the parts above and below the joint being exercised
Never force joint beyond range or to the point of pain
If patient complains of pain, stop exercise and report it to the supervisor

10. Repeat three times or as ordered
Encourage patient to assist as much as possible
Prevent unnecessary exposure of patient
Close door, provide privacy
Use correct body mechanics at all times

11. Principles of Ambulatory Assistance
Crutches-Usually prescribed by physician Therapist or authorized person fits crutches
Appropriate gait must be taught
Must be properly fit (axillary pressure can cause damage to radial nerve).
When ambulating a pt. with crutches, be sure: the pat supports his/her weight on the hand bars and not the axillary support.

12. When fitting crutches:
Patient should wear good fitting walking shoes with low, broad heels
If possible, position patient against wall for support (use chair for additional support)
Position crutches 4-6” in front and 4-6” to the side of patient’s foot
Allow 2” space between armpit and axillary bar.
Adjust hand pieces so that each elbow is flexed at angle.

13. Crutches Gait taught depends upon condition
Patients must be taught to support weight on hand bars, NOT axillary supports

14. Cane Provides balance and support
Some have 3 or 4 legs for additional support
Used on unaffected (good) side

15. Walker
When helping a client’s who is recovering from a stroke the nurse aide should assist on the clients weak side.
4 legged device
Often used for weak patients without leg injuries
Must be properly fitted to the pt.
Patient must lift walker, place it in front of the body, and walk into it
Patients must NOT slide walker

16. Gait Belt Band of fabric or leather around patient’s waist
During transfers or ambulation, health care workers can hold gait belt to provide additional support
Gait belt must be the proper size-secure fit around waist but not too tight
Belt may have loop to hold, or use an underhand grasp to hold below
Grasp belt at the back during ambulation
Grasp the belt on both sides while facing the patient
Apply gait belt over the patient's clothing at the waist

17. Safety Checks Remain alert when ambulating patient
Walk on weak side and slightly behind patient
If the patient starts to fall, use your body to brace the patient
Ease the patient to the floor as slowly as possible
Protect the patient’s head and neck
Stay with the patient and call for help
If a patient falls, an incident report must be filled out in most agencies

18. Massage A traditional backrub uses primarily friction.
The massage technique involving making fine, tremulous movement with the fingers or the use of a mechanical device is vibration.
During childbirth the massage technique that is used when light, circular strokes over the lower abdomen done during controlled breathing is called Effleurage.
During a massage you should encourage the pt. to understand the potential source of healing in his/her own consciousness.

19. Taping an ankle…
When taping an ankle under wrap is used to protect the skin.
When taping an ankle, the first piece of tape to go on is a single strip of tape around the ankle, approximately 5 or 6 inches above the malleous. The strip of tape is called an anchor.

20. Test Your Gray Matter
When you are ambulating a pt. with a gait belt, how should you hold the gait belt?
When ambulating pt. with crutches, be sure:
You go into a pt.’s room and note that the humidifier attached to the oxygen is empty. What should you do?
What statement about the walker is true?
Sheena has a cast on her wrist. What motion can she still do with her lower arm, wrist and hand?
A physician wishes to treat a pts. Hemorrhoids with moist heat. Which of the following applications might be ordered?
What term describes the ROM movement when a straight leg is bent at the knee?
A pt. has shallow respirations, rapid pulse, restlessness, and cyanosis. The physician will likely order?
The pt. supports his/her weight on the hand bars and not the axillary support
The walker should be properly fitted to the pt.
Hold the back of the belt using an underhand grasp.
Notify your supervisor immediately
Flexion
Sitz bath
Oxygen