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Rehabilitation Exercise Lecture 2
FDSc FISM year 1 Janis Leach Baseline Measures for fitness testing FLEXIBILITY, STRENGTH, ROM, CARDIOVASCULAR, AGILITY,
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Brain warm up/ recap Write down which are physical and which are motor
Strength Balance Body Composition Agility Endurance Speed Coordination Power Flexibility Reaction time
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Physical fitness Strength Speed Flexibility Endurance Body Composition
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Motor fitness Agility Balance Coordination Power Reaction time
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Objectives Be aware of common evidence based methods of measurement
Understand the importance of using baseline measurements in therapy settings Understand the importance of screening in injury prevention Practical session to be able to instruct a client needing crutches in the NWB phase
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Screening and Baseline Measurements
Provide measurable values for existing characteristics Can identify intrinsic risk factors in sports Documented baseline and screening measurements are vital for diagnosis and rehabilitation
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Anthropometrical Height Weight Body Composition Waist to hip ratio
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Body Mass Index Body Mass Index (BMI) is a number calculated from a person’s weight and height. BMI is a reliable indicator of body fatness for some people. BMI does not measure body fat directly, but research has shown that BMI correlates to direct measures of body fat, such as underwater weighing. What are the limitations to BMI?
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Body Mass Index Formula: Weight (Kg) ÷ Height (M)2 Example:
Height = 173 cm (1.73 m) Weight = 73 kg Calculation: 73÷ (1.73) x 2 = 24.41
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Body Mass Index Interpretation of BMI for adults
For adults 20 years old and older, BMI Weight Status Below 18.5 Underweight Normal 25 – 29.9 Overweight Above 30 Obese
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Body Composition Evaluation of amount of fat in relation to lean tissue in the body Norms are 12%-18% for men and 14%-20% for women Obesity at >25% for men and >30% for women Evaluative methods Skin calipers
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Skinfold measurements
Used to determine the ratio of fat mass to fat-free mass in the body Fat mass: adipose tissue Fat-free mass: bone, muscle, and organs Measurements are performed with a skinfold caliper
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Skin-fold measurements
The Jackson and Pollock (1985) three-site method has a relatively small margin of error for the general population a. Sites for men: chest, abdomen, and thigh b. Sites for women: triceps, suprailium, and thigh Should be repeated by the same technician during reassessment to decrease error Should be performed prior to physical activity because fluid transfer to the skin could result in overestimations
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Skin-fold measurements
The Jackson and Pollock (1978) 7 sites are more commonly used with athletes. Chest, Axilla, Abdominal, Suprailium, Subscapular, Triceps ,Mid-Thigh.
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Research Friedl et al (2001)
Body weight not suitable for assessing results in training programmes for females Why? Study found that there was greater reliability female fat deposit on waist and hips instead of upper arm or thigh.
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Waist to hip ratio Waist / hip measurement
Found to test the risk of heart disease Research? Task for this week Find a journal article on either WHR or BMI
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Somatotype Classification of body type (Physique).
There are 3 somatotypes. Endomorph Mesomorph Ectomorph Each of us is likely to be predominant in one of these categories.
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Somatotypes Various body measurements are needed in order to work out your somatotype and together with your age and gender, these scores are read from a chart. Height Weight Bone size Muscle girth Fat
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Ideal Posture
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Lordosis
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Kyphosis
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Scoliosis
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Musculoskeletal Examination
Basic exam consists of observation for symmetry, ROM, strength tests for major muscles and specific tests for previously injured areas Questions asked regarding Focus on history of previous injuries, time frame, evaluation, treatment and rehabilitation. Use of protective devices
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Musculoskeletal Examination
Leg Length (True or Apparent) Foot Shape (Planus, cavus pronation/supination) Muscle Girth (Various sites) Posture Evaluation Laxity ROM Bilateral Comparison
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Pronation - Supination
Over-pronation Over-supination
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Bilateral Comparisons
All information obtained from screening can be assessed against population norms. Bilateral comparisons of joint laxity, ROM and tissue abnormalities are vital for accurate diagnosis of subsequent injuries.
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Fitness Testing Procedures
Muscular function Strength, power and endurance Cardiovascular function Speed and agility Flexibility
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Measuring exercise intensity
Repetition maximum (RM): "maximal number of times a load can be lifted before fatigue using correct technique (ACSM, 1998). " A "1RM" signifies the maximum resistance a person can move in ONE repetition of an exercise. " A "10RM" signifies the maximum resistance a person can move in TEN repetitions of an exercise.
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Cardiovascular function
Multistage fitness test (Bleep Test) Some factors to consider Motor skills Turning technique Running surfaces Cooper 12 Minute Run Flat running track Stop watch and recording sheets Suitable for most populations Can be set on treadmill
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Hexagonal Obstacle Test
66 cm sided hexagon marked out on the floor. Athlete is always facing A. Athlete jumps in and out of hexagon in alphabetical order. Usually performed 3 times, measured by stopwatch
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Flexibility: Sit and Reach
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KEY POINT Tests requiring high-skill movements, such as reaction and coordination tests, should be administered before tests that are likely to produce fatigue and confound the results of subsequent tests.
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Baseline Testing Vital to have baseline measures during treatment and rehabilitation programs in order to objectively assess outcomes and restore full functional fitness.
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Methods Manual Muscle Testing Joint ROM (Goniometer)
Girth Measurements (Tape Measure) Pain Scale
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Goniometry Measurement of joint mobility/motion Principles
Stationary arm aligned with stationary segment proximal to joint evaluated Moveable arm aligned with moveable segment distal to joint evaluated Recording scale 0 – 180º (all joints in 0º position in anatomic position) Generally accepted +/- 5-10º error with goniometric measurements
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Goniometry Reliability To increase reliability:
Intra-tester: same person getting same results Inter-tester: different people getting same results To increase reliability: All staff use same goniometer
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Pain Scales Visual Analogue Scale ASSESSMENT SCALES
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Prehab Involves: Full medical history and associated testing.
Functional physiological tests. Special tests, ( Core stability, Proprioception).
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Prehab Purpose: Injury prevention
Detailed evaluation test data may identify weaknesses or markers that indicate predisposition to injury. Once identified, specific interventions can be put in place in order to help prevent injury.
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Summary Recognise all available screening and baseline measurement tools Appreciate the need for objective measurement in musculoskeletal screening Recognise the value of Prehab regarding the possible prediction and prevention of injury
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