Introduction to therapeutic activities

Therapeutic activities- therapeutic exercise, purposeful activity, terminologies, MMT, ROM.

1. Introduction to Therapeutic A ctivities M s. Ambreen Department of H ealth P rofessional Technologies Faculty of Allied Health Sciences University of Lahore 1

2. Learning objects: Occupational Therapy Purposeful activity Therapeutic exercise Therapeutic activity Range of Motion Concentric contraction Eccentric contraction Isometric contraction 2

3. Occupational Therapy Occupational therapy is the only profession that helps people across the lifespan to do the things they want and need to do through the therapeutic use of daily activities (occupations). 3

4. Occupational Therapy Practitioners Occupational therapy practitioners enable people of all ages to live life to its fullest by helping them promote health, and prevent or live better with injury , illness, or disability.  4

5. Continued.. Occupational therapy practitioners have a holistic perspective, in which the focus is on adapting the environment and/or task to fit the person, and the person is an integral part of the therapy team. It is an evidence-based practice deeply rooted in science.  5

6. Occupational Therapy I nterventions Common occupational therapy interventions include helping children with disabilities to participate fully in school and social situations, helping people recovering from injury to regain skills, and providing supports for older adults experiencing physical and cognitive changes. 6

7. Continued.. Occupational therapy services typically include: A n individualized evaluation, during which the client/family and occupational therapist determine the person’s goals, C ustomized intervention to improve the person’s ability to perform daily activities and reach the goals, and A n outcomes evaluation to ensure that the goals are being met and/or make changes to the intervention plan.  7

8. Purposeful Activity It is a task in which individuals actively participate with their focus on the task itself rather than the exercise within it. For example, an individual participating in sanding. 8

9. Continued.. A piece of wood may focus on the task of smoothing the wood rather than achieving the required movements of shoulder and elbow. 9

10. Therapeutic E xercise It directs the individuals attention to increasing a specific function such as strength or range of motion. There is no inherent goal within the activity itself. For example, a weight program designed for strengthening muscles would be considered a T herapeutic exercise. 10

11. Therapeutic Activity A term “ T herapeutic Activity” covers both therapeutic exercise and purposeful activity and refers to any activity adapted by the therapist to achieve a “Therapeutic Goal”. 11

12. Manual muscle testing  ( MMT ) Manual muscle testing  ( MMT ) is a very common practice of orthopedic examination specifically designed to assess function and strength of various  muscles , usually when rehabilitating sports injuries or recovering from an illness. 12

13. MMT scale 13

14. Range of Motion Range of motion(ROM) is described in terms of a portion of the normal range of the joint movement. 14

15. Types of ROM There are three primary types of exercises specific to range of motion.  Passive range of motion   Active-assistive range of motion   Active range of motion   15

16. Passive range of motion It  is typically practiced on a joint that is inactive. The physical therapist may use this exercise on a client who is paralyzed or unable to mobilize a specific joint. This type of exercise can help prevent stiffness from occurring. During this exercise the patient does not perform any movement, while the therapist stretches the patient's soft tissues . 16

17. Active-assistive range of motion The exercises are more progressive, intended for the client to perform movement around the joint with some manual assistance from the physical therapist or from a strap or band. These exercises can often feel painful, and the muscles can feel weak. Increasing range of motion with these exercises should be a gradual advancement . 17

18. Active range of motion The exercises are highly independent, performed solely by the client. The physical therapist's role may be simply to provide verbal cues. 18

19. Testing Your Range of Motion To measure range of motion, physical therapists most commonly use a  goniometer , which is an instrument that measures angle at a joint. Goniometers show degrees of an angle from zero to 180 or 360 degrees and are available in different shapes and sizes for the unique joints in the human body . 19

20. Continued.. As an example, when using a goniometer to measure knee flexion, the center of the tool will be at the side view of the knee joint, and the arms of the goniometer are aligned in the center of the long bones above and below the knee. As the knee is bent or flexed the movable arms provide a measure of the degree of movement. 20

21. Goniometer 21

22. Muscle strength Categorization Light: Any activity requiring minimal resistance of grade 3+ or less. Moderate: Any activity requiring minimal resistance of more than Grade 3 +. 22

23. Concentric (isotonic) contraction During a concentric contraction there is a joint motion and the muscle shortens. This is done with or without resistance. Concentric contractions may be performed in positions with gravity assisting or gravity eliminated or against gravity, according to the clients muscle grade and goal of the exercise. 23

24. Continued.. An example of a concentric contraction the biceps is lifting a bucket of sand up from the ground. 24

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26. Eccentric Contraction When muscles contraction eccentrically, the tension in the muscle increases or remains constant while the muscle lengthens. This may be done with or without resistance. 26

27. Continued.. An example of an eccentric contraction performed against no resistance is the slow lowering of the arm on the table. The biceps are contracting eccentrically in this instance. 27

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29. Isometric Contraction During an isometric contraction there is no joint motion, and the muscle length remains the same. A muscle and its antagonist may be contracted at any point in the ROM to stabilize a joint. This may be without resistance or against some outside resistance, such as the therapist’s hand or a table top. 29

30. Continued.. An example of isometric exercise of biceps against resistance is pressing up underneath a table with the forearm in supination. 30

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32. Concentric/Eccentric (vice versa) When a movement is in one direction, one set of muscles may be using a concentric contraction and the opposite group of muscles may be using an eccentric contraction. 32

33. C ontinued… However, when the movement is done in the opposite direction the opposition contractions may be used, in such cases, this has been indicated b concentric /eccentric (vise versa). 33

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35. Fine Motor Fine motor activities involves any hand function, either for stabilization or active control. 35

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37. Gross Motor Gross motor activities includes any activity, either stabilization or active movement in the upper limb except the hand. 37

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39. Difference between TE & PA Therapeutic Exercise Any activity in which the only goal is the rehabilitation goal, it has no inherent goal within the activity itself. Purposeful Activity Any activity which has an inherent goal other than the rehabilitation value. 39

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