1. Components of a Rehab Program

2. Rehab principles, objectives and goals  Principles of rehab are used to achieve the goas and objectives of a therapeutic exercise program  Principles and objectives are constants in a therapeutic program  These goals are established for each individual patient  Avoid aggravation  Timing  Compliance  Individualization  Specific sequencing  Intensity  Total patient

3. Avoid aggravation  Do not make it worse  Help or at least do no harm –HIPPOCRATES  Rehabilitate in a continually progressive manner  Knowledge of how body works ---ANATOMY  Response to injury and healing process  Aptitude in determining which exercises to use when  How much to push and when to back off

4. Timing  Begin as soon as possible with out aggravating injury  Sooner get started sooner get better  Rest is good but too much can be detrimental to recovery  Appell 1990 – 3-4% of strength lost each day – takes longer to get back  This emphasizes the importance to start as soon as safe

5. Compliance  Patient must be compliant or the program will not be successful  Inform the patient of the content of the program and the expected course of rehab  Injured often feel powerless – being aware and involved in the program can help them feel more powerful and thus more compliant  Program carried out consistently, patient performs the exercises outlined for them, attends treatments regularly

6. Individualization  Each person responds differently to an injury and a rehab program  No two patients the same – will be frustrated if you treat them the same  Individual physiological and chemical differences can change a patients response to injury  Other factors – outside support, patients psychological make up, other outside stresses, general health and stresses

7. Specific Sequencing  A specific sequence of therapeutic exercises should be followed  Determined by body's ability to heal  Will discuss more later – in healing

8. Intensity  We must challenge the patient and the injured area, but not aggravate  Knowledge of progression and amount of stresses  Imagination- modification  Keep programs interesting – helps both you and patient

9. Total Patient  Cardio  Maintaining ROM  Other areas strength endurance power  There is lots more to patient than the injured area

10. Objectives  Prevent deconditioning of un injured areas  Rehabilitate injured part in a safe and efficient and effective manner

11. Goals  Goals are results one strives to achieves  Ultimate goal is to return to activity or sport  Safe, yet quick efficient and effective  Return to sports in a minimum of time that allows the healing process to occur and also provides enough time to rehab the injury – with out undue time away from sport  Fine line between too slow and too fast  Want gains but not at the cost of over stressing or reinjury  Goals should be objective and measurable – some time subjective – pain – girth \rom strength – all can be measured

12. Short and long term goals  Short term goals – establish weekly –biweekly depending on the patient  Short term goals give something for patient to achieve – may be a long road – and can be overwhelming  Short term goals reasonable, attainable yet challenging but realistic as well  Effecting short term goals is the patients dedication, personality and outside pressure  Complications will effect short team goals  Long term goals is the final desired outcome – return to sport

13. Examination and assessment  Therapists continually examine and re-examine injuries  The only way to establish goals is to assess the current condition  To create short term goals we must establish current status  Then decide on realistic goals that can be achieved in a period of time

14. Progression  Programs progress in a challenging and yet safe manner  Progressions should be accordance with the severity and type of the injury and the patients response to the treatment Exercise progression  Strength – isometrics, isotonics, isokinetics and plyometrics

15. Outcome based rehabilitation  Buzzword – outcomes  Outcome of a rehab program is often assessed using a tool that has been devised for measuring the patients responses and satisfaction following the treatment  Most often a questionnaire that is given at the start of the program, sometime during and at completion  Lower extremity Functional Scale