When a patient is given an exercise that addresses a specifi…

Questions

When а pаtient is given аn exercise that addresses a specific gоal in a specific stage, but it is tоо difficult or too easy, recommend an alternative exercise that addresses the same goals. Case 1: Pt. 6 weeks s/p TKA. Pt. in controlled motion. Strength around knee is 4/5. There is no pain, min. edema. Goal is to address hypomobility R knee. Pt. still lacks 10 degrees of extension. Therapist has been supine 90/90 position of hip/knee with A contraction of quadriceps to gain knee extension.(dynamic stretch). 1a. Pt. finds the 90/90 active dynamic stretch too difficult and effortful. Pt. fatigues and is unable to gain extension. Recommend a different exercise that addresses same goals but is slightly less challenging or more stable.  Answer:  1b. Pt. is able to straighten knee to 30 degrees from 0. Hamstring length is normal, but pt. still lacks 5 degrees extension. Recommend an exercise that addresses same goals but is more challenging or more unstable (can be same exercise with challenge added)  Answer:  Case 2: Pt. 4 weeks s/p moderate strain/sprain R ankle lateral ligament/muscle tendons. Controlled motion. Pain 2/10, min. swelling. Strength ankle eversion 3+/5, other motions 4/5. Goal is to address hypermobility (gain stability) of R ankle in WB. Pt. placed in tandem stand with R foot in front of left.   2a. Pt. unable to maintain position. 4 seconds. R ankle. Unstable Recommend a different exercise that addresses same goals but is slightly less challenging or more stable.  Answer:  2b. Pt. finds this too easy. Able to maintain position for 60 seconds, little effort. Recommend an exercise that addresses same goals but is more challenging or more unstable (can be same exercise with challenge added)  Answer:  Case 3: Hip 4 weeks s/p hip THA. Pt. is in controlled motion. Hip AB and Ext 4/5. Pt. has problems with neuromuscular control. Pt. has problems with eccentric control when stand to sit regular height chair 18”. Pt. working on mini squats from partial stand to sit.  3a. Pt. unable to control eccentric descent into chair. Falls into chair. Recommend a different exercise that addresses same goals but is slightly less challenging or more stable.  Answer: 3b: Pt. finds this too easy. Able to perform 10 reps with little effort, good eccentric control. Recommend an exercise that addresses same goals but is more challenging or more unstable (can be same exercise with challenge added)  Answer:     

When а pаtient is given аn exercise that addresses a specific gоal in a specific stage, but it is tоо difficult or too easy, recommend an alternative exercise that addresses the same goals. Case 1: Pt. 6 weeks s/p TKA. Pt. in controlled motion. Strength around knee is 4/5. There is no pain, min. edema. Goal is to address hypomobility R knee. Pt. still lacks 10 degrees of extension. Therapist has been supine 90/90 position of hip/knee with A contraction of quadriceps to gain knee extension.(dynamic stretch). 1a. Pt. finds the 90/90 active dynamic stretch too difficult and effortful. Pt. fatigues and is unable to gain extension. Recommend a different exercise that addresses same goals but is slightly less challenging or more stable.  Answer:  1b. Pt. is able to straighten knee to 30 degrees from 0. Hamstring length is normal, but pt. still lacks 5 degrees extension. Recommend an exercise that addresses same goals but is more challenging or more unstable (can be same exercise with challenge added)  Answer:  Case 2: Pt. 4 weeks s/p moderate strain/sprain R ankle lateral ligament/muscle tendons. Controlled motion. Pain 2/10, min. swelling. Strength ankle eversion 3+/5, other motions 4/5. Goal is to address hypermobility (gain stability) of R ankle in WB. Pt. placed in tandem stand with R foot in front of left.   2a. Pt. unable to maintain position. 4 seconds. R ankle. Unstable Recommend a different exercise that addresses same goals but is slightly less challenging or more stable.  Answer:  2b. Pt. finds this too easy. Able to maintain position for 60 seconds, little effort. Recommend an exercise that addresses same goals but is more challenging or more unstable (can be same exercise with challenge added)  Answer:  Case 3: Hip 4 weeks s/p hip THA. Pt. is in controlled motion. Hip AB and Ext 4/5. Pt. has problems with neuromuscular control. Pt. has problems with eccentric control when stand to sit regular height chair 18”. Pt. working on mini squats from partial stand to sit.  3a. Pt. unable to control eccentric descent into chair. Falls into chair. Recommend a different exercise that addresses same goals but is slightly less challenging or more stable.  Answer: 3b: Pt. finds this too easy. Able to perform 10 reps with little effort, good eccentric control. Recommend an exercise that addresses same goals but is more challenging or more unstable (can be same exercise with challenge added)  Answer:     

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