MASTERS IN PHYSIO 5. Movement interventions and Therapeutic Exercise: Immobility. Implications, Evaluation, and Interventions a. Physiological effects of bed rest and immobility: b. Therapeutic strategies to prevent immobility and its sequel; c. Clinical strategies to redress the effects of immobility, d. Therapeutic exercise in the context of the client's environment (e.g. home) and a range of therapeutic environments (e.g. home, gymnasium, pool/hydrotherapy, outpatient clinic, hospital ward/corridor etc.); ¢. Best practice guidelines for therapeutic exercise prescription (e.g. ACSM Guidelines): Prevention and health promotion Special populations, and f. Best practice for skills training: a. Physiological effects of bed rest and immobility: © Musculoskeletal Effects: * Atrophy: Decrease in muscle mass due to lack of use. © Joint Contractures: Limited range of motion leading to joint stiffness. * Bone Density Loss: Reduced weight-bearing results in decreased bone density. © Cardiovascular Effects: © Decreased Cardiac Output: Inactivity may lead to reduced efficiency of the heart. © Increased Thrombosis Risk: Immobility can contribute to blood clot formation. © Respiratory Effects: Reduced Lung Capacity: Limited movement can impact respiratory function, © Increased Pneumonia Risk: Difficulty clearing secretions due to immobility. © Metabolic Effects ® Altered Glucose Metabolism: Reduced physical activity can impact insulin sensitivity. * Muscle Mass Loss: Contributes to changes in metabolic rate. b. Therapeutic strategies to prevent immobility and its sequel: © Early Mobilization:* Bedside Exercises: Encourage simple movements for patients in bed. * Progressive Ambulation: Gradual increase in walking activity as tolerated. © Range of Motion Exercises © Active and Passive Movements: Preserve joint flexibility through active or assisted exercises, * Regular Assessment: Evaluate and adjust the range of motion interventions based on patient progress. © Weight-Bearing Activities: © Standing and Transfers: Promote weight-bearing to maintain bone density. © Adaptations for Safety: Use assistive devices as needed. © Assistive Devices: * Walkers, Canes, Crutches: Provide support for those with mobility challenges. ©. Training and Education: Ensure proper use and safety. ¢. Clinical strategies to redress the effects of immobility: © Progressive Mobility Programs: © Individualized Plans: Tailor programs based on patient needs and abilities © Supervised Sessions: professionals. © Strength Training: © Targeted Muscle Groups: Address weakened muscles. © Gradual Progression: Increase resistance gradually to avoid overexertion. * Cardiovascular Conditioning: * Aerobic Exercises: Incorporate activities to improve cardiovascular fitness. * Monitoring Vital Signs: Ensure safety during cardiovascular interventions. © Pulmonary Rehabilitation: © Breathing Exercises: Address respiratory issues. Education on Lung Health: Provide information on maintaining respiratory function. Implement under the guidance of healthcare d. Therapeutic exercise in the context of the client's environment: © Home Environment: © Tailored Programs: Design exercises suitable for home settings.© Patient Education: Provide guidance on performing exercises safely at home. © Other Therapeutic Environments: © Gymnasium: Utilize equipment for targeted exercises. © Pool/Hydrotherapy: Incorporate aquatic exercises for buoyancy. © Outpatient Clinic: Supervised sessions with specialized equipment. * Hospital Ward/Corridor: Adjust exercises to confined spaces within a hospital. e. Best practice guidelines for therapeutic exercise prescription: © Prevention and Health Promotion: © Individualized Plans: Tailor exercise programs based on individual health status. * Education: Provide information on the importance of regular physical activity for health. © Special Populations: ©. Geriatric Exercise: Address the unique needs of the elderly. © Pediatric Exercise: Tailor exercises for children considering developmental stages. * ACSM Guidelines (American College of Sports Medicine) Aerobic Exercise: Recommendations for cardiovascular fitness. Resistance Training: Guidelines for strength training, Flexibility Exercises: Prescriptions for joint flexibility. Safety Considerations: Emphasize safety during exercise prescription. f. Best practice for skills training: © Patient Education: © Instruction: Provide clear and understandable instructions for exercises Demonstration: Visually demonstrate correct techniques. © Feedback and Monitoring: © Regular Assessment: Continuously evaluate patient progress. * Adjustment of Programs: Modify exercises based on individual responses. In summary, the syllabus covers a comprehensive range of topics related to movement interventions and therapeutic exercise, particularly in the context of immobility. The emphasis on physiological effects, preventive and clinical strategies, environmental considerations, and evidence-based guidelines ensures that physiotherapists are equipped to address immobility challenges and provide effective and tailored interventions for their clients.