Overview of Therapeutic Exercise

Therapeutic exercise is basically movements doctors or therapists recommend to help repair bodily function, mend muscle and bone issues, or simply keep you feeling good. Exercise is known to have countless benefits for our well-being – especially when it’s used as a treatment method. It has a range of benefits, including improving function, improving quality of life, and boosting overall health.

Some people may be struggling with basic physical abilities in their daily life. Even a minor sickness could impact their ability to function significantly. Using exercise as a treatment method involves engaging in regular physical activities of different types. This helps improve a person’s ability to resist sickness and recover faster when they do fall ill.

Rehabilitation exercise aims to restore your normal function. Ideally, it’s designed so that once you recover, you’re unlikely to worsen again. But even when further deterioration is expected, like terminal illnesses, exercise still has beneficial effects. There are three main types of rehabilitation – physical therapy, occupational therapy, and speech and swallowing therapy. These are all conducted by experts trained in those specific fields.

Anatomy and Physiology of Therapeutic Exercise

The exact structure of each joint will not be covered here, but it’s important to understand that exercise can potentially involve all joints. Basically, exercise can significantly benefit several body systems such as the muscles and bones, metabolism, heart and blood vessels, and breathing.

For those recovering from illness or injury, exercise can be especially helpful. It can help make movement easier, improve heart and lung function, and aid in managing chronic diseases like diabetes by helping the body use insulin more effectively. Two key indicators of exercise capacity are the lactake threshold and maximal oxygen uptake, also called VO2 max.

VO2 max reflects a person’s ability to consume, transport and use oxygen, defining their overall fitness capacity. It is widely regarded as one of the best measures of cardiovascular fitness and endurance capacity. Below is the equation for VO2 max:

VO2 max (ml/kg/min) = 79.9 – (0.39 x age) – (13.7 x sex (0=male, 1=female) – (0.127 x height)

Moving on to how muscles work during exercise: the contraction and relaxation of muscles mainly depend on the breakdown of ATP, a form of chemical energy. This energy allows proteins called myosin and actin in muscle cells to interact and cause the muscle to contract.

Specifically for those with osteoarthritis, exercise has proven to be an effective treatment. The benefits of exercise can last anywhere from 2 to 6 months after ending formal physical training. Exercise seems to reduce inflammation and helps nourish the joints by promoting the movement of joint fluid.

Why do People Need Therapeutic Exercise

Therapeutic exercise, which is basically a targeted workout routine, is often recommended for treating a variety of health conditions, mainly those affecting your muscles, bones, and joints (musculoskeletal disorders) and the heart and lungs (cardiopulmonary disorders). Whether it’s appropriate for someone depends on many factors, including the person’s health condition and overall fitness.

For most adults and children who are not currently very sick, therapeutic exercise can be a good option, as it can be tailored to their ability level. This form of exercise is not just about improving fitness. It’s widely accepted that guided physical activity can provide numerous health benefits and can help manage certain specific conditions.

For instance, it can provide targeted relief for musculoskeletal conditions like osteoarthritis, a condition that causes joint pain and stiffness, or patellofemoral disorder, which affects the knee. Therapeutic exercise can also help to reduce the risk of falls, particularly among older adults. Moreover, it has been shown to be a valuable part of recovery from illnesses in general.

When a Person Should Avoid Therapeutic Exercise

There are various reasons why someone may be advised not to exercise, such as if they are currently unwell or have an injury. In these instances, it’s often best to wait until you’ve fully recovered before starting to exercise again. Chronic diseases that aren’t well controlled can also interfere with your ability to exercise. If you have an ongoing health condition, generally you are advised to have it under control before you start exercising.

However, there are alternative ways to stay physically active. For instance, if you’re going through a severe arthritis flare-up, you might find low-impact exercises done in a pool helpful. Certain heart conditions, like problems with heart valves, thickening of the heart muscle, serious irregular heart rhythms, and very high blood pressure, can keep you from exercising. Yet, in most cases, the benefits of regular physical activity far outweigh the small risks that come with increased activity.

Equipment used for Therapeutic Exercise

The type of equipment you’ll need for your exercise routine will vary based on the particular exercises you’ll be doing. Here’s a breakdown:

1. Aerobic exercise: This type of exercise, such as running, often doesn’t require any equipment if you’re doing it outdoors. However, you can also choose to use exercise machines like elliptical trainers if you prefer.

2. Strength exercise: This exercise type usually calls for weights. Alternatively, if you’re doing calisthenics, which are exercises using your own body weight, you might need to use some gymnastic equipment.

3. Mobility: This involves static and dynamic stretching. It’s important to note, though, that time spent stretching doesn’t contribute to the suggested 150 minutes of weekly exercise. If you’re regularly using all your major joints during your workouts, you probably won’t need to add specific mobility exercises to your routine.

Who is needed to perform Therapeutic Exercise?

The team involved in your healthcare treatment can vary based on the type of therapy you are going through. If you are taking part in therapy for heart or lung-related issues, your treatment team might include physical therapists, occupational therapists, and other health professionals. This is because these conditions can be quite serious, and it’s important to have various experts involved in your care.

If you’re attending therapy for a sports injury, you might only need a physical therapist. They can help you with certain exercises that are specifically tailored to your injury and recovery needs.

Additionally, they might suggest exercises that you can safely do on your own at home. This means you can continue your therapy between sessions, while also reducing any potential risks. They’ll keep an eye on your progress to make sure everything is going well.

Preparing for Therapeutic Exercise

If you’re starting a new exercise routine or regimen, it’s crucial to get a complete check-up from your healthcare provider. They would focus on examining any particular health risks you might have. This check-up is in-depth and takes into account factors such as how severe your current health conditions might be, the specific type of diseases you have, and any other health issues that might coexist.

How is Therapeutic Exercise performed

Therapeutic exercise can be separated into three main types:

1. Endurance training: This type of exercise involves using large muscle groups to boost heart health. People usually work out at around 50 to 60% of their maximum capacity.

2. Resistance training: This form of exercise helps to increase overall strength. It can be split into three types:
– Isotonic: This involves dynamic movements with a constant weight.
– Isokinetic: Involves moving at a constant speed with varying weights.
– Isometric: Involves static muscle contractions where the muscle length doesn’t change.
All of these exercises can help with conditions like diabetes, osteoporosis, and cancer by improving bone density, speeding up digestion, increasing the intake of glucose in muscles, and easing back pain.

3. Flexibility training: These are slow, controlled exercises that help in improving the range of movement in joints. They are typically done for fifteen to thirty seconds at a time. They can be static (held positions), dynamic (repetitive bouncing movements), or PNF (alternating contraction and relaxation of certain muscles), which typically results in the largest increase in flexibility.

These different types of exercises can be combined to make a program that suits all sorts of patients. Sometimes, a particular form of exercise can be adapted to suit people with specific requirements. For example, doing exercises in water can be helpful for patients recovering from a stroke who are having difficulty with balance.

When deciding on an exercise program, healthcare professionals can use the FITT method:
– F- Frequency: How many days per week
– I – Intensity: Low, moderate, or vigorous
– T – Time: How many minutes each session should last
– T – Type: Whether the exercises will focus more on endurance, strength, flexibility, or a combination.

It’s essential to adapt the exercise program to the patient’s age, the severity of the disease, and any other illnesses they might have. There are specific therapies that target muscle strength around certain joints – for instance, for hip pain, exercises might focus on the hip abductors, adductors, flexors, and extensors. In knee pain, the focus might be on strengthening the muscles in the thigh, calf, and hip.

For certain conditions, exercise can have particularly positive effects:

Diabetes: Regular exercise can help prevent and manage diabetes by having positive effects on how the body processes glucose and decreasing insulin resistance, a tell-tale sign of Type 2 Diabetes. Exercise can help with increasing the body’s sensitivity to insulin, and also increase glucose transport mechanisms, thus helping to regulate blood sugar levels. Exercise can also assist in reducing obesity, which can lead to diabetes, by reducing free fatty acid levels in the blood. Adding resistance training to the regime can increase muscle mass, which also helps with glucose uptake. Regular exercise can also slow down the development of peripheral neuropathy – nerve damage that commonly affects those who have diabetes – by improving blood flow to nerves.

Osteoarthritis: In people with osteoarthritis. regularly doing therapeutic exercises can help to reduce pain and improve strength, balance, and range of movement. It’s particularly beneficial for people with osteoarthritis in large joints like the knee, helping to reduce pain and improve balance. The most recognized form of exercise for knee osteoarthritis is isokinetic.

Possible Complications of Therapeutic Exercise

The problems that could arise from therapeutic exercise, or exercise prescribed to aid in healing, are primarily due to incorrect techniques which can lead to sudden injuries or a decrease in physical function. But when done properly, it’s very uncommon to face any negative effects from therapeutic exercise.

What Else Should I Know About Therapeutic Exercise?

A person’s ability to exercise normally for their age can typically rule out heart and lung problems related to most diseases. When it comes to specific muscle and bone injuries, therapeutic exercises can help build strength and work towards returning to normal function. For conditions concerning the heart and lungs, these types of exercises can aid in recovery and sustain essential functions that improve the quality of life.

The U.S. Department of Health and Human Services advises physical activity for maintaining health and well-being. According to their guidelines released in November 2018:

-Children aged 3 to 5 should be physically active throughout the day.
-Youngsters aged 6 to 17 should undertake at least 60 minutes of moderate to intense physical activity daily.
-Adults aged 18 to 65 should aim for 150 to 300 minutes of moderate aerobic exercise per week or 75 to 150 minutes of vigorous aerobic exercise, or a mixture of both.
-For individuals aged 65 and older, the recommendation is a combination of balance training, aerobic activities, and exercises that strengthen muscles.

Frequently asked questions

1. What specific exercises should I be doing for my condition? 2. How often should I be doing these exercises? 3. What intensity level should I aim for during my exercises? 4. How long should each exercise session last? 5. Are there any precautions or modifications I should be aware of when performing these exercises?

Therapeutic exercise can have several benefits for individuals. It can make movement easier, improve heart and lung function, and aid in managing chronic diseases like diabetes. Additionally, exercise can be an effective treatment for those with osteoarthritis, reducing inflammation and promoting the movement of joint fluid.

You may need therapeutic exercise if you are currently unwell or have an injury and are advised not to engage in regular exercise. Therapeutic exercise can also be beneficial if you have a chronic disease that is not well controlled, as it can help improve your overall health and manage your condition. Additionally, if you have certain heart conditions or high blood pressure, therapeutic exercise can be a safe and effective way to stay physically active.

Someone should not get therapeutic exercise if they are currently unwell, have an injury, or have a chronic disease that is not well controlled. It is important to wait until fully recovered or have the health condition under control before starting to exercise.

The recovery time for Therapeutic Exercise can vary depending on the individual and their specific condition. However, the benefits of exercise can last anywhere from 2 to 6 months after ending formal physical training. Additionally, exercise can help improve movement, heart and lung function, and aid in managing chronic diseases, such as diabetes, by helping the body use insulin more effectively.

To prepare for therapeutic exercise, it is important to first consult with a healthcare provider to assess any health risks or specific conditions that need to be taken into account. The exercise program should be tailored to the individual's age, severity of the disease, and any other illnesses they may have. Following the FITT method (Frequency, Intensity, Time, Type) can help determine the appropriate frequency, intensity, duration, and type of exercises for the individual.

The complications of Therapeutic Exercise are primarily due to incorrect techniques, which can lead to sudden injuries or a decrease in physical function. However, when done properly, it is very uncommon to face any negative effects from therapeutic exercise.

Symptoms that may require therapeutic exercise include musculoskeletal conditions such as joint pain and stiffness, as well as conditions like osteoarthritis and patellofemoral disorder that affect the knee. Therapeutic exercise can also be beneficial for reducing the risk of falls, particularly among older adults, and can aid in recovery from illnesses in general.

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