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Rehabilitation Concepts
Concepts: Technical Knowledge
• Pain Physiology
• Vestibular Rehabilitation
• Sarcopenia & Aging
• Injury Care & Prevention
• Strength-Based Rehab
• Other
Application: Technical Skills
• Clinical Reasoning
• Manual Therapy
• Movement Therapy
• Exercise Prescription - Strength
• Exercise Prescription - Mobility
• Activity Modification
Pain Physiology
• All pain is neurogenic.
• The nervous system is sensitive to thermal, mechanical,
and chemical inputs.
• Pain is not simply a sensation. It is an experience
comprised of input, processing, and output.
Vestibular Rehabilitation
• Vestibular input is extremely important for balance and
orientation.
• The vestibular apparatus can be disrupted and corrected
by mechanical means and trained through various
exercises.
• Must distinguish red flags!
Sarcopenia & Aging
• Unless something is done to counteract it, we all lose
muscle mass as we age.
• Loss of muscle mass is the #1 biomarker of aging and
has major impact on function and health.
• Activity alone does not slow this process; stimulation of
strength is essential.
Injury Care & Prevention
• Injury involves the disruption of tissue and requires
healing and/ or surgical correction.
• We can determine the degree of injury and support the
healing process.
• Healing is facilitated by appropriately graded early
mobilization.
Strength-Based Rehab
• Loss of strength is correlated with almost all chronic
conditions.
• Strength is an essential component of functionality.
• Although there are some contraindications, most people
will respond to safe training that induces positive tissue
adaptations.
Other
• We are open to high quality clinical interventions that
reduce pain, increase mobility, and improve strength.
• Eg. Dry needling fits well into the neuromatrix theory and
appears to be a powerful neuromodulatory tool.
Clinical Reasoning
• Expert clinical reasoning is about pattern recognition.
• With Pain as the symptom, there are 3 potential issues:
(1) Injury (2) Persistent Pain (3) Pathology.
• Think about mechanisms and origins NOT structures and
causes.
Manual Therapy
• The effects of manual therapy are primarily related to
neurophysiology rather than biomechanics.
• Premise is that hands-on sensory stimulation and
movement is helpful for mechanical stimulation.
• Be careful with what you are communicating.
Movement Therapy
• Movement is the consummatory act for mechanical pain.
• Movement can be graded in various ways, but works best
when it introduces novel experiences that limit
nociceptiion and overcomes fear-avoidance.
• Voluntary and Involuntary Motor Patterns
Exercise Prescription - Strength
• Strength is an essential component of function.
• Exercise prescription is based on frequency, intensity, and
duration to produce the desired adaptations with the
minimum dose required.
• Intensity is the most important variable for efficiency and
effectiveness.
Exercise Prescription - Mobility
• Recognize habitual patterns of restriction
• Increase awareness and freedom of movement
• Restore mobility through full range where possible
Activity Modification
• Pacing and Graded Exposure
• Baseline, Protection-by-Pain, Tissue Tolerance
• Flare-up line: somewhat subjectively determined
threshold for tolerating challenges to adaptive potential
The One to One Approach

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The One to One Approach

  • 2. Concepts: Technical Knowledge • Pain Physiology • Vestibular Rehabilitation • Sarcopenia & Aging • Injury Care & Prevention • Strength-Based Rehab • Other
  • 3. Application: Technical Skills • Clinical Reasoning • Manual Therapy • Movement Therapy • Exercise Prescription - Strength • Exercise Prescription - Mobility • Activity Modification
  • 4. Pain Physiology • All pain is neurogenic. • The nervous system is sensitive to thermal, mechanical, and chemical inputs. • Pain is not simply a sensation. It is an experience comprised of input, processing, and output.
  • 5.
  • 6. Vestibular Rehabilitation • Vestibular input is extremely important for balance and orientation. • The vestibular apparatus can be disrupted and corrected by mechanical means and trained through various exercises. • Must distinguish red flags!
  • 7. Sarcopenia & Aging • Unless something is done to counteract it, we all lose muscle mass as we age. • Loss of muscle mass is the #1 biomarker of aging and has major impact on function and health. • Activity alone does not slow this process; stimulation of strength is essential.
  • 8. Injury Care & Prevention • Injury involves the disruption of tissue and requires healing and/ or surgical correction. • We can determine the degree of injury and support the healing process. • Healing is facilitated by appropriately graded early mobilization.
  • 9. Strength-Based Rehab • Loss of strength is correlated with almost all chronic conditions. • Strength is an essential component of functionality. • Although there are some contraindications, most people will respond to safe training that induces positive tissue adaptations.
  • 10. Other • We are open to high quality clinical interventions that reduce pain, increase mobility, and improve strength. • Eg. Dry needling fits well into the neuromatrix theory and appears to be a powerful neuromodulatory tool.
  • 11. Clinical Reasoning • Expert clinical reasoning is about pattern recognition. • With Pain as the symptom, there are 3 potential issues: (1) Injury (2) Persistent Pain (3) Pathology. • Think about mechanisms and origins NOT structures and causes.
  • 12. Manual Therapy • The effects of manual therapy are primarily related to neurophysiology rather than biomechanics. • Premise is that hands-on sensory stimulation and movement is helpful for mechanical stimulation. • Be careful with what you are communicating.
  • 13. Movement Therapy • Movement is the consummatory act for mechanical pain. • Movement can be graded in various ways, but works best when it introduces novel experiences that limit nociceptiion and overcomes fear-avoidance. • Voluntary and Involuntary Motor Patterns
  • 14. Exercise Prescription - Strength • Strength is an essential component of function. • Exercise prescription is based on frequency, intensity, and duration to produce the desired adaptations with the minimum dose required. • Intensity is the most important variable for efficiency and effectiveness.
  • 15. Exercise Prescription - Mobility • Recognize habitual patterns of restriction • Increase awareness and freedom of movement • Restore mobility through full range where possible
  • 16. Activity Modification • Pacing and Graded Exposure • Baseline, Protection-by-Pain, Tissue Tolerance • Flare-up line: somewhat subjectively determined threshold for tolerating challenges to adaptive potential