Therapeutic exercise aims to treat diseases and injuries. There are two main types - passive and active movements. Passive movements are externally assisted and aim to maintain range of motion. Active movements involve patient effort and can be assisted, free, or resisted. The document outlines guidelines for applying range of motion exercises safely and effectively based on a patient's condition and goals. Progressive resistance training is also discussed as a method to gradually increase muscle strength over time.
Active and Passive movements in joints.pptxreeshmapk93
Active and passive movements in human joints with examples and how it can be utilized with modern exercise principles with resistance to increase strength and flexibility of human joints
Mobility and Flexibility of soft tissues (muscles, tendons, fascia, joint capsule, and skins) surrounding the joint along with adequate joint mobility, are necessary for normal ROM.
Mobility: is the ability of segments of the body to move through range of motion for functional activities.
Flexibility: is the ability to move a single joint or series of joints smoothly and easily through an unrestricted, pain –free ROM.
The manual muscle testing procedure was described in this power point, indications, contraindications, limitations of MMT was included. the MMT grading system (scale) was explained well in this PPT.
Active and Passive movements in joints.pptxreeshmapk93
Active and passive movements in human joints with examples and how it can be utilized with modern exercise principles with resistance to increase strength and flexibility of human joints
Mobility and Flexibility of soft tissues (muscles, tendons, fascia, joint capsule, and skins) surrounding the joint along with adequate joint mobility, are necessary for normal ROM.
Mobility: is the ability of segments of the body to move through range of motion for functional activities.
Flexibility: is the ability to move a single joint or series of joints smoothly and easily through an unrestricted, pain –free ROM.
The manual muscle testing procedure was described in this power point, indications, contraindications, limitations of MMT was included. the MMT grading system (scale) was explained well in this PPT.
Ozempic: Preoperative Management of Patients on GLP-1 Receptor Agonists Saeid Safari
Preoperative Management of Patients on GLP-1 Receptor Agonists like Ozempic and Semiglutide
ASA GUIDELINE
NYSORA Guideline
2 Case Reports of Gastric Ultrasound
Flu Vaccine Alert in Bangalore Karnatakaaddon Scans
As flu season approaches, health officials in Bangalore, Karnataka, are urging residents to get their flu vaccinations. The seasonal flu, while common, can lead to severe health complications, particularly for vulnerable populations such as young children, the elderly, and those with underlying health conditions.
Dr. Vidisha Kumari, a leading epidemiologist in Bangalore, emphasizes the importance of getting vaccinated. "The flu vaccine is our best defense against the influenza virus. It not only protects individuals but also helps prevent the spread of the virus in our communities," he says.
This year, the flu season is expected to coincide with a potential increase in other respiratory illnesses. The Karnataka Health Department has launched an awareness campaign highlighting the significance of flu vaccinations. They have set up multiple vaccination centers across Bangalore, making it convenient for residents to receive their shots.
To encourage widespread vaccination, the government is also collaborating with local schools, workplaces, and community centers to facilitate vaccination drives. Special attention is being given to ensuring that the vaccine is accessible to all, including marginalized communities who may have limited access to healthcare.
Residents are reminded that the flu vaccine is safe and effective. Common side effects are mild and may include soreness at the injection site, mild fever, or muscle aches. These side effects are generally short-lived and far less severe than the flu itself.
Healthcare providers are also stressing the importance of continuing COVID-19 precautions. Wearing masks, practicing good hand hygiene, and maintaining social distancing are still crucial, especially in crowded places.
Protect yourself and your loved ones by getting vaccinated. Together, we can help keep Bangalore healthy and safe this flu season. For more information on vaccination centers and schedules, residents can visit the Karnataka Health Department’s official website or follow their social media pages.
Stay informed, stay safe, and get your flu shot today!
micro teaching on communication m.sc nursing.pdfAnurag Sharma
Microteaching is a unique model of practice teaching. It is a viable instrument for the. desired change in the teaching behavior or the behavior potential which, in specified types of real. classroom situations, tends to facilitate the achievement of specified types of objectives.
Title: Sense of Taste
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the structure and function of taste buds.
Describe the relationship between the taste threshold and taste index of common substances.
Explain the chemical basis and signal transduction of taste perception for each type of primary taste sensation.
Recognize different abnormalities of taste perception and their causes.
Key Topics:
Significance of Taste Sensation:
Differentiation between pleasant and harmful food
Influence on behavior
Selection of food based on metabolic needs
Receptors of Taste:
Taste buds on the tongue
Influence of sense of smell, texture of food, and pain stimulation (e.g., by pepper)
Primary and Secondary Taste Sensations:
Primary taste sensations: Sweet, Sour, Salty, Bitter, Umami
Chemical basis and signal transduction mechanisms for each taste
Taste Threshold and Index:
Taste threshold values for Sweet (sucrose), Salty (NaCl), Sour (HCl), and Bitter (Quinine)
Taste index relationship: Inversely proportional to taste threshold
Taste Blindness:
Inability to taste certain substances, particularly thiourea compounds
Example: Phenylthiocarbamide
Structure and Function of Taste Buds:
Composition: Epithelial cells, Sustentacular/Supporting cells, Taste cells, Basal cells
Features: Taste pores, Taste hairs/microvilli, and Taste nerve fibers
Location of Taste Buds:
Found in papillae of the tongue (Fungiform, Circumvallate, Foliate)
Also present on the palate, tonsillar pillars, epiglottis, and proximal esophagus
Mechanism of Taste Stimulation:
Interaction of taste substances with receptors on microvilli
Signal transduction pathways for Umami, Sweet, Bitter, Sour, and Salty tastes
Taste Sensitivity and Adaptation:
Decrease in sensitivity with age
Rapid adaptation of taste sensation
Role of Saliva in Taste:
Dissolution of tastants to reach receptors
Washing away the stimulus
Taste Preferences and Aversions:
Mechanisms behind taste preference and aversion
Influence of receptors and neural pathways
Impact of Sensory Nerve Damage:
Degeneration of taste buds if the sensory nerve fiber is cut
Abnormalities of Taste Detection:
Conditions: Ageusia, Hypogeusia, Dysgeusia (parageusia)
Causes: Nerve damage, neurological disorders, infections, poor oral hygiene, adverse drug effects, deficiencies, aging, tobacco use, altered neurotransmitter levels
Neurotransmitters and Taste Threshold:
Effects of serotonin (5-HT) and norepinephrine (NE) on taste sensitivity
Supertasters:
25% of the population with heightened sensitivity to taste, especially bitterness
Increased number of fungiform papillae
New Directions in Targeted Therapeutic Approaches for Older Adults With Mantl...i3 Health
i3 Health is pleased to make the speaker slides from this activity available for use as a non-accredited self-study or teaching resource.
This slide deck presented by Dr. Kami Maddocks, Professor-Clinical in the Division of Hematology and
Associate Division Director for Ambulatory Operations
The Ohio State University Comprehensive Cancer Center, will provide insight into new directions in targeted therapeutic approaches for older adults with mantle cell lymphoma.
STATEMENT OF NEED
Mantle cell lymphoma (MCL) is a rare, aggressive B-cell non-Hodgkin lymphoma (NHL) accounting for 5% to 7% of all lymphomas. Its prognosis ranges from indolent disease that does not require treatment for years to very aggressive disease, which is associated with poor survival (Silkenstedt et al, 2021). Typically, MCL is diagnosed at advanced stage and in older patients who cannot tolerate intensive therapy (NCCN, 2022). Although recent advances have slightly increased remission rates, recurrence and relapse remain very common, leading to a median overall survival between 3 and 6 years (LLS, 2021). Though there are several effective options, progress is still needed towards establishing an accepted frontline approach for MCL (Castellino et al, 2022). Treatment selection and management of MCL are complicated by the heterogeneity of prognosis, advanced age and comorbidities of patients, and lack of an established standard approach for treatment, making it vital that clinicians be familiar with the latest research and advances in this area. In this activity chaired by Michael Wang, MD, Professor in the Department of Lymphoma & Myeloma at MD Anderson Cancer Center, expert faculty will discuss prognostic factors informing treatment, the promising results of recent trials in new therapeutic approaches, and the implications of treatment resistance in therapeutic selection for MCL.
Target Audience
Hematology/oncology fellows, attending faculty, and other health care professionals involved in the treatment of patients with mantle cell lymphoma (MCL).
Learning Objectives
1.) Identify clinical and biological prognostic factors that can guide treatment decision making for older adults with MCL
2.) Evaluate emerging data on targeted therapeutic approaches for treatment-naive and relapsed/refractory MCL and their applicability to older adults
3.) Assess mechanisms of resistance to targeted therapies for MCL and their implications for treatment selection
These lecture slides, by Dr Sidra Arshad, offer a quick overview of physiological basis of a normal electrocardiogram.
Learning objectives:
1. Define an electrocardiogram (ECG) and electrocardiography
2. Describe how dipoles generated by the heart produce the waveforms of the ECG
3. Describe the components of a normal electrocardiogram of a typical bipolar leads (limb II)
4. Differentiate between intervals and segments
5. Enlist some common indications for obtaining an ECG
Study Resources:
1. Chapter 11, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 9, Human Physiology - From Cells to Systems, Lauralee Sherwood, 9th edition
3. Chapter 29, Ganong’s Review of Medical Physiology, 26th edition
4. Electrocardiogram, StatPearls - https://www.ncbi.nlm.nih.gov/books/NBK549803/
5. ECG in Medical Practice by ABM Abdullah, 4th edition
6. ECG Basics, http://www.nataliescasebook.com/tag/e-c-g-basics
Report Back from SGO 2024: What’s the Latest in Cervical Cancer?bkling
Are you curious about what’s new in cervical cancer research or unsure what the findings mean? Join Dr. Emily Ko, a gynecologic oncologist at Penn Medicine, to learn about the latest updates from the Society of Gynecologic Oncology (SGO) 2024 Annual Meeting on Women’s Cancer. Dr. Ko will discuss what the research presented at the conference means for you and answer your questions about the new developments.
2. Therapeutic Exercise
The exercise, which is needed for the treatment purpose, is called as
therapeutic exercise.
Which are performed to come out from ones ailment or disease.
The main goal of the therapeutic exercise is preparing or making the patient
independent or symptom-free movements.
3. TYPES OF MOVEMENTS
1. Active movement
i. Assisted
ii. Free
iii. Assisted and resisted
iv.Resisted.
4. TYPES OF MOVEMENTS
2. Passive movement
i. Relaxed passive movement
ii. Passive manual mobilization techniques
iii. Mobilization
iv.Manipulation
v.Stretching.
6. Passive ROM
Indications for PROM
In the region where there is acute, inflamed tissue,
passive motion isbeneficial.
Inflammation after injury or surgery usually lasts 2 to 6
days.
When a patient is not able to or not supposed to actively
move a segment or segments of the body, as when
comatose, paralyzed, or on complete bed rest, movement
is provided by an external source.
7. Passive ROM
Goals for PROM
Maintain joint and connective tissue mobility
Minimize the effects of the formation of contractures
Maintain mechanical elasticity of muscle
Assist circulation and vascular dynamics
Enhance synovial movement for cartilage nutrition and
diffusion of materials in the joint
Decrease or inhibitpain
Assist with the healing process after injury or surgery
To maintain the patient’s awareness of movement
8. Other Uses for PROM
When a therapist is examining inert structures, PROM is
used to determine limitations of motion, to determine joint
stability, and to determine muscle and other soft tissue
elasticity.
When a therapist is teaching an active exercise program,
PROM is used to demonstrate the desired motion.
When a therapist is preparing a patient for stretching,
PROM is often used preceding the passive stretching
techniques.
9. Active ROM
Indications forAROM
If a patient is able to contract the muscles actively and move a
segment with or without assistance,AROM is used.
If a patient has weak musculature and is unable to move a
joint through the desired range (usually against gravity), A-
AROM is used.
AROM can be used for aerobic conditioning programs
During immobilization, AROM is used on the regions above
and below the immobilized segment to maintain the areas in
as normal a condition as possible and to prepare for new
activities, such as walking with crutches.
10. Active ROM
Goals forAROM
Maintain physiological elasticity and
contractility of the participatingmuscles
Provide sensory feedback from the contracting
muscles
Provide a stimulus for bone and joint tissue
integrity
Increase circulation and prevent thrombus
formation
Develop coordination and motor skills for functional
activities
12. Limitations of PassiveMotion
True passive, relaxed ROM may be difficult to obtain when muscle is
innervated and the patient is conscious.
Passive motion doesnot:
Prevent muscleatrophy
Increase strength orendurance
Assist circulation to the extent that active, voluntary muscle
contraction
does
Limitations ofActive ROM
For strong muscles,active ROM does not maintain or
increase strength.
It also does not develop skill or coordination except in the movement
15. Examination, Evaluation, and
Treatment Planning
1. Examine and evaluate the patient’s impairments and
level of function, determine any precautions and
prognosis, and plan the intervention.
2. Determine the ability of the patient to participate in the
ROM activity and whether PROM, A-AROM, or AROM
can meet the immediate goals.
3. Determine the amount of motion that can be safely
applied for
the condition of the tissues and health of the
individual.
16. 4. Decide what patterns can best meet the goals. ROM
techniques may be performed in the
a. Anatomic planes of motion: frontal, sagittal, transverse
b.Muscle range of elongation:antagonistic to the line of pull of
the muscle
c. Combined patterns:diagonal motions or movements
that incorporate several planes of motion
d.Functional patterns:motions used in activities of daily living
(ADL)
5. Monitor the patient’s general condition and responses during and
after the examination and intervention; note any change in vital
signs, any change in the warmth and color of the segment, and
any change in the ROM, pain, or quality of movement.
6. Document and communicate findings and intervention.
17. Patient Preparation
1. Communicate with the patient. Describe the plan and
method of intervention to meet the goals.
2. Free the region from restrictive clothing, linen, splints, and
dressings.
Drape the patient as necessary.
3. Position the patient in a comfortable position with
proper body alignment and stabilization but that also
allows you to move the segment through the
available ROM.
4. Position yourself so proper body mechanics can be used.
18. Application of Techniques
1. T
ocontrol movement, grasp the extremity around the joints. If
the joints are painful, modify the grip, still providing support
necessary forcontrol.
2. Support areas of poor structural integrity, such as a
hypermobile joint,
recent fracture site, or paralyzed limb segment.
3.Move the segment through its complete pain-free range to the
point of tissue resistance. Do not force beyond the available
range. If you force motion, it becomes a stretching technique.
4.Perform the motions smoothly and rhythmically, with 5 to 10
repetitions.The number of repetitions depends on the
objectives of the program and the patient’s conditionand
19. 1. During PROM the force for movement is external, being
provided by a therapist or mechanical device.When
appropriate, a patient may provide the force and be
taught to move the part with a normal extremity.
2. No active resistance or assistance is given by the
patient’s muscles that
cross the joint. If the muscles contract, it becomes an
active exercise.
The motion is carried out within the free ROM, that
is, the range that is available without forced motion
or pain.
Application of PROM
20. Application of AROM
1. Demonstrate the motion desired using PROM; then ask
the patient to perform the motion. Have your hands in
position to assist or guide the patient if needed.
2. Provide assistance only as needed for smooth
motion.When there is weakness, assistance may be
required only at the beginning or the end of the ROM, or
when the effect of gravity has the greatest moment arm
(torque).
3. The motion is performed within the available ROM.
21. ACTIVE MOVEMENTS
(ACTIVE—BY HIS /HER OWN)
Assisted Exercise:
• If the strength or the coordination of the muscle is insufficient to perform
an activity, the external force is utilized to compensate the lack.
• The muscle has the strength or endurance but is not sufficient to perform an
activity or control an action.
23. Active assistance
• The patient himself can assist with his opposite extremity to perform the
assisted exercise.
For example,
a. The opposite leg is used by the patient to increase the flexion movement of
the knee in high sitting.
• The main advantage is the patient, he himself only knows the pain limit and
availability of range of movement.
• So, that he can perform the exercise conveniently within the pain limit.
24. Passive assistance
It is classified into:
1. Manual assisted exercise
2. Mechanical assisted exercise.
26. Uses
• Increase the ROM of thejoint.
• Increase the strength, power and the endurance of themuscles.
• It breaks the adhesion formation around the joint.
• It reduces the spasm of themuscles.
• It stretches the tightened soft tissue.
• It reminds the coordinated movement of the joint or amuscle.
• Increase the blood circulation and venous return to the joint and muscle.
28. Characteristics of the Free Exercises
• Subjective
• Objective
• Example: Bending and touching the great toe with the middle finger. Here the
goal is set to touch the toe.
29. Uses
• Increases the joint range.
• Increases the muscle strength, power and endurance.
• Increases the neuromuscular coordination.
• Increases the circulation and venous drainage.
• Increases the relaxation of the muscle by the swinging movements and the pendular movements.
• Repeated active movement breaks the adhesion formation and elongates the shortened soft
tissues.
• Regulating the cardiorespiratory function, and the active exercise increases the respiratory and
venous return so that the O2 supply to muscles and blood circulation to the muscle increases.
30. Resisted Exercises
• Performed by opposing the mechanical or manual resistance is called as
resisted exercises.
• Types of Resisted Exercises
1. Manual
2. Mechanical
31. Manual Resisted
• These exercises can be operated by:
1. The therapist
2. Patient himself
3. Relatives and friends
33. Mechanical Resisted
• These resisted exercises can be stated when the muscle power is 2., i.e. from
gravity eliminated position.
• We can increase the resistance;
• By altering the leverage
• By increasing the weight
• By altering the speed
• By changing the duration.
34. Uses of Resisted Exercises
• Resisted exercises increase the strength of the muscle earlier.
• The weak muscle can be strengthened much earlier than the any other exercise
regimen.
• Can be started from the muscle power 2 onwards.
• Strength of the muscle is directly proportional to the tension created inside the
muscle.
• The resisted exercise can create the more amount of intramuscular tension.
Strength α Tension
35. Uses of Resisted Exercises
• Increases the endurance of themuscle.
• Powerful muscle contraction increases the blood flow of the muscle fiber
and it gets nutrition and the O2.
• Resisted exercise increases the muscular power.
• Power is related to the strength of the muscle and the speed.
Power = Force × Distance / Time
36. Progressive Resisted Exercise
• Repetition Maximum :
The maximum amount of the weight a person can lift throughout the range
of motion exactly 10times.
3 types of progressive resisted exercise regimens areavailable.
1. DeLorme and Watkins
2. MacQueen
3. Zinovieff (Oxfordtechnique).
37. De Lorme and Watkins
• 10 times with 1/2 10 RM.
• 10 times with 3/4 10 RM.
• 10 times with 10 RM.
Progression
i. 30 times weekly 4 sessions
ii. Every week 10 RM progression.
38. De Lorme and Watkins
• a. For example:
Consider 10RM—1 kg
First week.
1/2 of 10 RM—1/2 kg.
3/4 of 10 RM—3/4 kg
Full of 10 RM—1kg
Exercise regimen is 10 times with 1/2 kg, 10 times with 3/4 kg, 10 times with 1 kg
39. De Lorme and Watkins
•Second week
Progression 10 RM
= 10 RM + 10 RM
= 1 kg +1 kg
= 2 kg
Exercise Regimen is
10 times with 1 kg
10 times with 11/2 kg
10 times with 2 kg
40. De Lorme and Watkins
• In this exercise regimen, the weight is increased, i.e. first with 1/2 kg
followed by 3/4 kg and 1 kg.
• Each and every session the patient has to lift the above said three types of
weights 10 times each.
• So, that daily 30 times lifting been done.
41. De Lorme and Watkins
• In each and every session 30 times the exercise should be done with 2
breaks by the patient. i.e. 10 times 1/2 10 RM (1/2 kg) → Break → 10 times
with 3/4 10 RM (3/4 kg) → Break→ 10 times 10 RM (1 kg)
•Weekly 4 sessions the exercise has to be practiced.
For example:
Monday, Wednesday, Friday, Sunday (i.e. every alternative day’s) exercise has to
be practiced and remaining days, i.e. Tuesday, Thursday, Saturday given rest.