Shilta Rola

Name: - Shilta Rola

Date: - August 10, 2021

Plan of Care Implementation

Third Module Exam:

Answer exhaustively (10 points each)

1. What does FITT mean? Correlate with exercise intervention.

Answer:

❖ FITT is one of the foundations of exercise, a set of guidelines that help you set up a workout routine to fit

your goals and fitness level while helping you get the most out of your exercise program.

❖ The FITT equation for exercise intervention means:

● Frequency: How often will the patient receive skilled care?

This is typically defined in terms of the number of times per week treatment will be given (e.g., daily or
three times per week), or the number of visits before a specific date. E.g. A 50-year-old patient with low
back pain is prescribed a core strengthening exercise for ≥ 3 days per week.

● Intensity: What is the prescribed intensity of exercises or activity training?

For example, the POC includes sit-to-stand repetitions, 3 sets of 5 reps each, progressing from high
seat to low. E.g. A 50-year- old patient with low back pain is prescribed a core strengthening
Exercise for 8 – 12 repetitions/day.

● Time (duration): How long will the patient receive skilled care?

This is typically defined in terms of days or weeks (e.g., three times per week for 6 weeks). The duration
of an anticipated individual treatment session should also be defined (e.g., 30- or 60-minute sessions).

● Type of intervention: What are the specific exercise strategies or procedural interventions used?
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For example: In case of treatment of low back pain a heating pad may be applied to warm up the muscles
prior to doing exercising and stretching and an ice pack may be used afterward to sooth the muscles and
soft tissues.

2. Define the necessary components that should be identified in the implementation of Plan of Care.
Answer:

❖ The therapist must take into account a number of factors in structuring an effective treatment session.

The patient’s comfort and optimal performance should be a priority. The environment should be
structured appropriately to reduce distractions and focus the patient’s attention on the task. Patient
privacy should be respected, with adequate draping and positioning. The therapist should consider good
body mechanics, effective use of gravity and position, and correct application of techniques and
modalities. Any equipment should be gathered prior to treatment and be in good working order. All safety
precautions must be observed.

❖ Necessary components that should be identified include the following:

A description of the specific posture and activity the

Posture and patient must perform (e.g., sitting, weight shifting or
activity standing, modified plant grade, reaching).

Mode of therapist action or intervention used

Techniques (e.g., guided, active-assisted, or resisted
used movement), or specific technique (e.g., rhythmic
stabilization, dynamic reversals).
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Strategies specific to type of feedback (e.g.,

Motor knowledge of results, knowledge of performance)
learning and scheduling of feedback (e.g., constant or
strategies variable), practice schedule (e.g., blocked, serial, or
used random order), and environment (e.g.,
closed/structured or open/variable).

Those elements necessary to assist the patient in the

Additional exercise or activity (e.g., verbal cues, manual
required contacts) or equipment (e.g., elastic band resistance,
elements: therapy ball, body weight support system with
motorized treadmill).

3. Cite examples of what to do under Home Exercise Plan.

Answer:

❖ Instruction in a home exercise plan (HEP): patient/caregiver instruction regarding the following:

● Home exercises, activity training, ADL training

● Use of adaptive equipment (e.g., assistive devices, orthoses, wheelchairs)

❖ Below is the example of a 52 –year-old female was prescribed the following home exercise plan:

Make sure the chair you sit in has proper support for your
lower back. You can add a lumbar support to hold the
Use a Correct natural inward curve in your lower back. Tape a rolled –up
Sitting Posture towel to the back of your chair or car seat for a simple
lumbar support. Make sure your knees are even with your
hips. If they are lower than your hip level. Put a thick book or
small stool when you can. This will keep you from bending
forward.
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Change Position Most important, stand up and change your position every 30
Often to 60 minutes. Doing a standing back bend will help take
stress off the muscles and ligaments that support your back
when you sit. Put your hands just below your waist. Gently
push your pelvis forward and lean back. Repeat 3 to 5 times
every 30 to 60 minutes.

Bending at your Bending often or for a long time causes back pain. You may feel
knees and hips this pain when gardening or cleaning. Be sure to bend at your
knees and hips and keep your back straight. This takes the load
off your back. (Over)

Start Moving Walking is a simple and effective way to reduce or prevent back
pain. Walking is increases blood flow to the muscles, ligaments
and disc in your back. Start with five minutes a day and work up
to 20 to 30 minutes each day.

Chair stand - for resistance training each major muscle group

Functional should be exercised 2-3 days a week. This exercise is benefits to
Exercises improve strength for older patient. Wall sits to improve
strengthen and increase endurance in thighs. This is important at
any age.

Perform this exercises slowly without forcing movement. Be sure

to breath throughout the exercises.Perform the exercises 2-3
times daily.

Lumbar rotation Exercise : Slowly rock knees from side to side in

a pain free range of motion. Allow back to rotate slightly. Repeat
10-15 times.

Cat and Camel Exercise : On all fours, assume a “hump” back

position by arching the back up.Hold briefly and then slowly
lower the back into a sagging position. Repeat 10 – 15 times.
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Low Back
Exercises

Balance Exercises: To improve and maintain physical function and

Balance exercises reduce falls. It should be performed for at least 20 – 30 minutes
and Aerobic or more 2 – 3 days per week. For example heel walking, Toe
exercises walking, and one leg standing exercises.

Aerobic Exercises: aerobic exercises like walking, running can also

be done at home and help in reducing obesity, diabetes and
hypertension and heart disease.

4. Cite examples of what to do under Evaluation of Home Environment.

Answer:

❖ Evaluation/modification of the home environment:

▪ Planning regarding the home environment and modifications needed to assist the patient in the

home (e.g., installation of ramps and rails, bathroom equipment such as tub seats, raised toilet seats,
bathroom rails, furniture rearrangement or removal to ease functional mobility).

▪ All essential equipment and renovations should be in place before discharge.

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❖ The other examples of evaluation/ modification of the home environment include:

▪ Housing Conditions: Housing conditions too many individuals live in housing that may adversely

affect their health and the delivery of care. For example, over 6 million households (about 5 percent
of the total) live in housing that has moderate or severe physical problems related to heating,
plumbing, and electrical deficiencies( U.S. Department of Housing and Urban Development, 2009,
p.389). Such problems are more prevalent in homes of low – income persons who are also at risk of
exposure to lead paint, vermin and pest infections, water leakage, and lack of air conditioning. Hence
a careful examination and modification of the house is required to prevent further damage to the
patient’s health.

▪ Housing Barriers: The physical layout of homes can put individuals at greater risk of accidents, make

daily living activities more difficult to perform, and even necessitate moving to a different home,
assisted living, or nursing home. For example, an older adult with mobility difficulties living in a three
– story home may begin to experience difficulty navigating its stairs. Hence it is important to modify
the home by adding a lift to help the elderly patient navigate safely.