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ADINA RĂDULESCU

ENGLISH IN KINETOTHERAPY
A PRACTICAL ENGLISH HANDBOOK
FOR INTERMEDIATE STUDENTS

Universitatea SPIRU HARET


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Descrierea CIP a Bibliotecii Naţionale a României


RĂDULESCU, ADINA
English in Kinetotherapy A practical English Handbook. FOR
INTERMEDIATE STUDENTS / Adina Rădulescu. – Bucureşti,
Editura Fundaţiei România de Mâine, 2004
124 p.; 20,5 cm
ISBN 973-725-165-2

811.111.’615.825

© Editura Fundaţiei România de Mâine, 2003


ISBN 973-725-165-2

Redactor: Andreea DINU


Tehnoredactor: Marcela OLARU
Coperta: Marilena Gurlui BĂLAN

Bun de tipar: 16.12.2004; Coli tipar: 7,75


Format: 16/61×86
Splaiul Independenţei, Nr. 313, Bucureşti, S. 6, O. P. 83
Tel./Fax.: 410 43 80; www.spiruharet.ro
e-mail: contact@edituraromaniademaine.ro

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UNIVERSITATEA SPIRU HARET


FACULTATEA DE EDUCAŢIE FIZICĂ ŞI SPORT

ADINA RĂDULESCU

ENGLISH IN KINETOTHERAPY
A PRACTICAL ENGLISH HANDBOOK
FOR INTERMEDIATE STUDENTS

EDITURA FUNDAŢIEI ROMÂNIA DE MÂINE


Bucureşti, 2004
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CONTENTS

Cuvânt înainte ……………………………………………… 7


UNIT 1
THE MAIN PARTS OF THE BODY
Imperative sentences used in relaxation training techniques ... 9
Prepositions …………………………………………………. 13
UNIT 2
THE SKELETAL SYSTEM
Interrogative pronouns and adverbs used before the verb to be 17
Asking questions ……………………………………………. 21
UNIT 3
THE MUSCULAR SYSTEM
Adjectives – basic knowledge ……………………………… 29
Describing a certain muscle ………………………………... 33
UNIT 4
EXAMINING THE PACIENT
Polysemantic words ……………………………………….. 38
Therapist-patient discourse – greetings, identification and
introductory dialogues ……………………………………… 42
UNIT 5
TYPES OF INJURIES
Passive modal constructions ……………………………….. 48
Therapist-patient discourse – patient’s symptoms and complaints 51
Formal and informal medical terms ………………………… 51
Present Tense Simple and Present Perfect ………………….. 53
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UNIT 6
THERAPEUTIC EXERCISES
Word formation – derivation ………………………………. 59
Therapist-patient discourse – recommending different
therapeutic exercises ……………………………………….. 63
UNIT 7
THERAPEUTIC PROCEDURES IN HANDLING THE
PATIENT
Passive verbal constructions ……………………………….. 69
Therapist-patient discourse – positioning and handling the
patient ………………………………………………………. 72
UNIT 8
MUSCULOSKELETAL AND CONNECTIVE TISSUE
DISORDERS
Pronouncing tongue-twisters ……………………………….. 78
Therapist-patient discourse - describing symptoms and
recommending therapeutic exercises ……………………….. 79
UNIT 9
POSTURAL PROBLEMS
Conditional clauses …………………………………………. 89
Therapist-patient discourse – improving communication …... 94
UNIT 10
REVISION EXERCISES ………………………………… 99
Glossary …………………………………………………….. 113
Bibliography ………………………………………………. 123

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CUVÂNT ÎNAINTE

Specificul studierii limbilor străine în cadru universitar este


reprezentat de trecerea de la studierea limbii străine la modul general
la aprofundarea ei pe diverse domenii de specialitate. În funcţie de
specializarea pentru care studenţii optează, ei vor studia, în cazul
nostru, engleza economică, juridică, tehnică, medicală etc. Studiul
limbilor străine aplicate pe un anumit domeniu de specialitate – în
cazul nostru fiind vorba de engleza în kinetoterapie, o ramură a
englezei medicale – presupune din partea studenţilor un nivel mediu
de cunoştinţe de limba engleză, stăpânirea unor tehnici de muncă
individuală şi, de asemenea, a unui nivel mediu de cunoştiinţe
generale pe domeniul respectiv de specialitate.
Manualul de faţă se adresează studenţilor secţiei de
Kinetoterapie, din cadrul Facultăţii de Educaţie Fizică şi Sport a
Universităţii Spiru Haret Bucureşti, atât anului I cât şi anului II de
studiu. El răspunde unei nevoi reale – aceea de a avea un instrument
practic de lucru pentru desfăşurarea activităţii de seminar.
Conştientizarea avantajelor pe care le presupune stăpânirea
unui limbaj de specialitate într-o limbă străină, dintre care amintim:
posibilitatea consultării unei bibliografii de specialitate în limba
respectivă, participarea studenţilor la conferinţe internaţionale,
publicarea unor materiale în revistele de specialitate şi, poate cel mai
important, posibilitatea de a lucra într-o clinică sau cabinet de profil
cu personal şi clienţi străini fie în România fie peste hotare – a
constituit motivaţia principală pentru menţinerea interesului
studenţilor faţă de această disciplină de studiu şi pentru obţinerea
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unui certificat de competenţă lingvistică pe specialitatea engleză


medicală, eliberat în cadrul Centrului de Limbi Străine al
Universităţii Spiru Haret.
Manualul este structurat pe 10 capitole (Units), axându-se pe
trei componente principale: 1) un corpus de texte de specialitate,
care-şi asociază diverse exerciţii de vocabular, traduceri de text şi
exerciţii de redare selectivă a informaţiei prezentate; 2) o selecţie a
unor probleme de gramatică a limbii engleze, efectuată în funcţie de
criteriul frecvenţei anumitor structuri gramaticale în limbajul medical
şi 3) un set de ,,discursuri” kinetoterapeut-pacient, axate pe tematica
fiecărui capitol, având ca scop familiarizarea studenţilor cu utilizarea
unui limbaj oral, informal, care completează limbajul formal în care
sunt redate textele de specialitate. Selectarea acestor texte din diverse
materiale – atlase de anatomie, cursuri de kinetoterapie etc. a avut ca
intenţie creearea unui cadru ,,profesionist” de lucru, precum şi
stimularea interesului studenţilor pentru consultarea unor materiale
de specialitate în limba engleză. Şi, nu în ultimul rând, exerciţiile de
la fiecare sfârşit de Unit – “create your own dialogues”, “consider
yourself as a kinetotherapist” etc. testează capacitatea studenţilor de
a se exprima liber şi firesc în limbajul de specialitate asimilat, într-un
context socio-profesional artificial creat în sala de seminar, prin ceea
ce în metodica limbii engleze se numeşte “Role playing”.
Cu dorinţa şi speranţa că acest manual va răspunde nevoii
practice a studenţilor de a aprofunda limba engleză pentru o viitoare
practică kinetoterapeutică, constituind în acelaşi timp un stimulent
pentru o perfecţionare permanentă, prin consultarea unei bibliografii
actualizate în limba engleză, închei prin a le mulţumi studenţilor din
primele generaţii cu care am lucrat pentru ajutorul pe care mi l-au
acordat în vederea conturării suportului teoretic şi practic al acestui
manual, prin simpla lor participare activă la seminariile de limba
engleză.
Autoarea

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English in Kinetotherapy. A practical English handbook 9

UNIT I

THE MAIN PARTS OF THE BODY


▪ Imperative sentences used in relaxation training techniques
▪ Prepositions

1. Read the following texts containing relaxation techniques and


write down the new words:

“Trainer’s introduction: ’This relaxation procedure is one that has


been practised for many years now. It has been studied by researchers
and found to be effective. You will feel very relaxed and calm as a
result. It is not the same as hypnosis and you will not lose
consciousness at any point.’
The procedures: ’Make yourself as comfortable as you can… become
aware of the surface underneath you… let your body settle into it…
notice how it supports you… notice the points of contact between you
and the floor: your head… shoulders… spine… ribs… hips… heels…
elbows… forearms and hands… feel your body sinking into the
surface you are lying on… feel your body getting heavier as the
tension ebbs away… feel at peace…. Take one good breath and as you
let it out, feel it carrying all your tensions away… then let your
breathing settle into a gentle rhythm…’
’As you lie or sit, reflect on the idea that you are going to give the next
half-hour to yourself. No telephone can ring for you; no doorbell
disturb you; no one will call your name. You may hear sounds around
you: voices, horns, sirens, bangs and revs… think of them as being
outside your world. With these thoughts in mind, draw an imaginary
circle around yourself, about three feet from the centre. Create an
imaginary bubble… think of the interior as your space… your own
private space. Feel how safe it is… safe to get in touch with yourself.
Turn your thoughts inward.’
Trainer’s termination of the procedure: ’I am going to bring this
relaxation session to an end… I’d like you gradually to become aware

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of the room… feel the floor/chair underneath you … open your eyes…
give your limbs a few gentle stretches… have the feeling that you are
alert and ready to carry on with your life…’
’With your eyes open, raise your eyebrows… feel the tension… and
release the tension… frown… feel the tension… and release it… shut
your eyes tightly… feel the tension… and let it go… with your eyes
still closed, spend a few minutes releasing tension in this part of your
face…
Close the jaws firmly, noticing the sensations you get from the
action… hold it… and… discontinue… let your jaw drop… feel the
tension leaving you… and continuing to leave you… then repeat the
action…. Next, bare your teeth… feel the tension in the cheeks… hold
it for a few seconds… and release the tension…. Make a tight ’O’
with your lips… hold it, while you register tension in the lips… and
cancel the action….
Press your tongue against your teeth… feel the pressure and release
it… Now pull the tongue back towards the throat. Feel the muscles
drawing it back and note the sensations you get from this action…
and… release it… ”
(R. A. Payne – Relaxation Techniques)

2. Read the text again, select the words that designate: a) parts of
the body, b) verbal constructions expressing commands and
c) prepositions or other words indicating direction and place them
in three different columns.

3. Using the vocabulary practice below write the Romanian


equivalents for the terms indicating parts of the body.

♣ VOCABULARY PRACTICE
4. Pronounce and learn the names of the main parts of the human
body. For some notions two alternative terms have been provided:

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English in Kinetotherapy. A practical English handbook 11

The head:
- eyes, eyelids (pleoape), eyelashes (gene), eyebrows (sprâncene);
- nose, nostrils (nări);
- ears, ear lobe;
- mouth, lips (buze), gum (gingie), tooth - teeth, tongue (limbă), jaw
(falcă), upper jaw /maxilla (maxilar), under jaw (mandibulă);
- forehead (frunte), cheek (obraz), cheek bone (os maxilar), chin
(bărbie), dimple (gropiţă în obraz), dimple in the chin /fossette
(gropiţă în bărbie).

The neck:
- throat;
- Adam’s apple/thyroid cartilage;
- hollow of the throat (scobitura gâtului);
- nape of the neck (ceafa).

The body:
- shoulder, shoulder blade/scapula (omoplat);
- limb (membru), arm/upper limb (braţ), armpit/axilla (axilă), forearm
(antebraţ), hand, elbow (cot), crook of the arm (îndoitura braţului),
palm, wrist/carpus (încheietura mâinii), fist (pumn), fingers – thumb
(degetul mare), forefinger (deget arătător), middle finger, ring finger
(deget inelar), little finger, finger tip (vârful degetului), finger pad
(perniţa degetului), fingernail (unghie), knuckle (articulaţia degetului);
- biceps, thorax/chest (torace), breast (piept), nipple (mamelon),
abdomen, stomach, waist (talie), navel/umbilicus (buric), bottom
(şezut), buttocks (fese);
- hip (şold), leg, thigh (coapsă), calf (gambă), shin/cannon bone
(tibia, fluierul piciorului), knee (genunchi), patella/knee cap (rotulă),
ankle (gleznă), instep (scobitura gleznei), sole (talpă), heel/calcaneus
(călcâi), toes (degete de la picioare).

5. Choose the right word that best completes the sentence:


1. I can’t move my left hand; I have problems with my ………...
a) fingers b) armpit c) wrist d) fists

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2. It is not polite to talk to somebody when you have your


………. in your pockets.
a) fingers b) hands c) palms d) arms
3. He has had this nasty habit of biting his ………. ever since he
was a kid.
a) tongue b) toes c) fingers d) nails
4. This old lady can’t hear you very well; she has got an ………
infection.
a) ear b) throat c) tooth d) eye
5. He fell and hurt his ……… really bad, as he was not wearing
his knee-pads when roller skating.
a) ankles b) legs c) knees d) toes
6. The underside both of a foot and a shoe is called a …………..
a) heel b) sole c) shin d) toe
7. I ate an icecream yesterday and now I have a sore
…………….
a) neck b) eye c) jaw d) throat
8. You should not drink so much coffee on an empty
……………..
a) stomach b) waist c) abdomen d) throat
9. Nobody is perfect and carelessness is his Achilles’………...
a) toe b) arm c) heel d) head
10. He is walking on the tips of his ………… so as not to awake
the baby.
a) feet b) toes c) fingers d) sole

6. Match up the following words with their definitions:

1. wrist a. the thick, fleshy part of the back of the


leg, between the ankle and the knee
2. forehead b. large muscle at the front of the upper
arm, which bends the elbow
3. hip c. the small depression beneath the arm
where it joins the shoulder

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English in Kinetotherapy. A practical English handbook 13

4. tongue d. a thin, horny, translucent plate covering


part of the dorsal surface of the end joint of
each finger
5. calf e. the part of the face between the natural
hairline and the eyes; formed skeletally by
the frontal bone of the skull
6. armpit f. part on either side of the body below the
waist where the bone of a person’s leg is
joined to the trunk
7. nostril g. the joint between the forearm and the
hand
8. thigh h. the back part of the human foot from the
instep to the lower part of the ankle
9. fingernail i. part of the body below the chest and the
diaphragm, containing the stomach, the
bowels and the digestive organs
10. heel j. organ of taste that aids the mastication
and swallowing of food
11. abdomen k. either of the two external openings of the
nose
12. biceps l. part of the human leg between the knee
and the hip

♣ VOCABULARY PRACTICE
Prepositions
Here is a list of the most commonly used prepositions of place and
position:

above = deasupra, de deasupra, mai sus de


across/along = de-a lungul, transversal
around/round = de jur împrejurul
below = dedesubt, sub (fără a indica contact cu suprafaţa superioară)
beneath/underneath = dedesubt, sub (indicând existenţa unei
suprafeţe superioare de protecţie, separare)

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between = între (două obiecte)


behind = în spatele, înapoia
in front of = în faţa
in = în, în interiorul
into = în, înspre interior (indicând pătrunderea, străbaterea spaţiului)
on = pe, deasupra
onto = pe, deasupra (indicând mişcare pentru atingerea poziţiei)
over = peste, deasupra
through = prin, printre
under = dedesubt, sub (indicând contact cu suprafaţa superioară)

Other words indicating movement and direction:


-WARDS class (wards = spre, către, indicând direcţia)
Backward (s) = înapoi, invers, pe spate
Downward (s) = descendent, spre partea inferioară
Forward (s) = înainte, în faţă
Inward (s) = înăuntru, către interior
Leftward (s) = către stânga, dinspre stânga
Outward (s) = către/spre exterior, în afară
Towards = spre, către, în direcţia
Upright = drept, vertical
Upward (s) = ascendent, spre partea superioară
Sideways = lateral, oblic, într-o parte

►◄Pair work
7. Read the following commands to your deskmate and ask
him/her to follow your indications and practise the exercises.
Then, change activities:

• Place your hands around your ankles.


• Rest your elbows on your thighs.
• Place your fingertips on your shoulder.
• Bend your body sideways and give it a good stretch.
• Lift your arms above your head.
• Spread your arms sideways and lower them to your sides.

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English in Kinetotherapy. A practical English handbook 15

• Clasp both hands behind your head.


• Arch your body backwards.
• Stretch your arms upwards.
• Bend your knees forwards.
• Hold your head forward and up.
• Raise your arms above your head and turn the palms towards the
ceiling.
• Lean your forearms vertically on the wall. With your heels on the
ground and your knees straight, let your hips sink forwards.

8. Read the following sentences and translate them into


Romanian:

• Without moving your head, turn your eyes upwards behind your
closed lids.
• Roll your eyes in a clockwise circle… Now notice the sensations of
tension…. Pause… Roll them now in an anticlockwise direction.
• Place your palm downwards on a surface (table, chair arm or thigh);
press your fingertips into the surface, drawing them towards your
palm so that your hand gradually takes on the shape of a spider…
Hold the position, feel the tension in the hand and then let the tension
go and relax the muscles.
• Keeping your toes firmly in contact with the floor, raise your heels
up in the air… Now feel the tension in your calf muscles… Relax…
drop your heels to the ground and notice the relief, the comfort, the
warm tingling sensation in your calves.

9. Create your own relaxation techniques; write down five


examples of such exercises and then read them to your deskmates.

10. Translate into English, using the new words:


1. Plasaţi-vă ambele mâini pe umeri. Rotiţi-vă trunchiul alternativ la
stânga apoi la dreapta.
2. Staţi în poziţie depărtată, cu mâinile pe lângă corp. Ridicaţi mâna
dreaptă şi îndoiţi corpul spre stânga. Reveniţi în poziţia iniţială. Apoi

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ridicaţi mâna stângă şi îndoiţi corpul spre dreapta. Repetaţi mişcarea


de cinci ori.
3. Îndoiţi-vă uşor trunchiul în faţă. Atingeţi-vă genunchii, apoi
gambele, apoi gleznele şi dacă puteţi chiar şi degetele de la picioare.
4.Stând pe un scaun, plasaţi-vă ambele coate pe coapse, întindeţi-vă
antebraţele şi mişcaţi-vă degetele.
5. Închideţi ochii, ridicaţi mâinile deasupra capului şi arcuiţi-vă uşor
trunchiul pe spate. Staţi în poziţie 10 secunde şi apoi reveniţi în poziţia
iniţială.
6. Plasaţi-vă ambele mâini pe şolduri. Îndoiţi-vă uşor genunchii şi apoi
rotiţi-vă corpul la stânga şi la dreapta. Observaţi ce simţiţi la
articulaţiile şoldului.
7. Întindeţi-vă braţele lateral. Apoi îndoiţi-le din coate spre în faţă, la
nivelul umărului. Repetaţi mişcarea de câte ori doriţi.
8. Staţi ghemuiţi pe vârfurile picioarelor, cu capul aplecat şi cu
mâinile atârnând pe genunchi. Simţiţi cum vi se relaxează muşchii
gâtului. Menţineţi poziţia cât doriţi.
9. Staţi cu picioarele depărtate şi cu mâinile pe şold. Înclinaţi-vă spre
dreapta, ridicând piciorul stâng. Menţineţi poziţia pentru 5 secunde.
Apoi repetaţi în direcţia opusă.
10. Staţi cu picioarele depărtate şi cu mâinile întinse lateral şi cu
pumnii strânşi. Rotiţi-vă simultan braţele, trasând un cerc mic în aer.
Încercaţi rotirea braţelor în ambele direcţii. Observaţi ce se întâmplă
cu muşchii braţelor şi pieptului.

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English in Kinetotherapy. A practical English handbook 17

UNIT 2

THE SKELETAL SYSTEM


▪ Interrogative pronouns and adverbs used before the verb to be
▪ Asking questions

1. Read the following texts and write down the new words:

“The function of the bones is to form a hard skeleton for the softer
materials of the body, to enclose and protect some of the most
important vital organs. Bone development takes place at a very early
period. In embryonic life, the parts destined to become bones consist
of a congeries of cells which constitutes the simplest form of cartilage.
This temporary cartilage is an exact miniature of the bone which in
due course is to take its place. The process of ossification is slow and
not completed until adult life. The next step is the ossification of the
intercellular substance and of the cells composing the cartilage. The
period of ossification varies much in different bones. It commences
first in the clavicle, in which the primitive point appears during the
fifth week; next in the lower jaw. The ribs also, and the long bones of
the limbs, appear soon after. For a long period after birth, a thin layer
of unossified cartilage remains between the diaphysis and epiphyses,
until their growth is finally completed.”
(Henry Gray – Gray’s Anatomy. Descriptive and Surgical)

*
“Almost all the elements of the joints of adults are also present in the
joints of the newborn. The most active factor determining the
formation of a joint after birth are the muscles which exert an action
on the given joint, i.e. the work of a joint.
The development of bone articulations is directly dependent on the
formation of the bony and connective-tissue structures and muscular

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18 ADINA RĂDULESCU

tissue. All the elements encountered in the joints of the newborn


continue their formation and acquire the geometrical shapes of the
articular surfaces characteristic of each joint of an adult. ”
(R.D. Sinelnikov – Atlas of Human Anatomy)

♣ VOCABULARY PRACTICE

2. Pronounce and learn the names of the main parts of the skeletal
system. Add more terms to the list:

The skeletal system:


- skull = craniu
- spine/spinal column/backbone = coloana vertebrală
- vertebra, -ae/bony ring = vertebră
- spinal cord/marrow = măduva spinării
- the cervical, dorsal, lumbar, sacral and coccygeal sections of the
spine = secţiunile cervicale, dorsale, lombare şi coccigiene ale
coloanei vertebrale
- rib = coastă
- cartilage = cartilaj
- sternum/breastbone = stern
- clavicle/collarbone = claviculă
- thoracic cage = cuşcă toracică
- shoulder girdle = centură scapulară
- scapula/shoulder blade = omoplat, scapulă
- pelvis = pelvis
- pubis = pubis
- sacrum = os sacral
- coccyx = coccis
- articulation/joint = articulaţie
- fibrous joint = articulaţie fibroasă
- synovial joint = articulaţie sinovială
- ossification = osificare
- ligament = ligament
- hip joint = articulaţia şoldului

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English in Kinetotherapy. A practical English handbook 19

- knee joint = articulaţia genunchiului


- ankle joint = articulaţia gleznei

3. Complete the following sentences using the nouns in the box.


The first one has been done for you as an example:

sternum coccyx carpus calcaneus


scapula phalanges cranium joint
tibia metacarpus femur vertebrae

1. The spine is a flexuous column, formed of a series of bones called


vertebrae.
2. The ____________ is composed of eight bones: the occipital, two
parietal, frontal, two temporal, sphenoid and ethmoid.
3. The ____________ is a long, flat vertical bone, situated in front of
the thorax to which are attached the collarbone and the first seven
parts of ribs.
4. The ____________ is the longest, thickest and heaviest bone in the
skeleton, articulating with the pelvis above and the knee below.
5. The ____________ is the inner and thicker of the two bones of the
human leg, between the knee and ankle.
6. The ____________ is a small triangular bone at the end of the
spinal column, articulating by its base with the apex of the sacrum.
7. The ____________ is a large, flat bone, triangular in shape which
forms the back part of each shoulder.
8. The hand is subdivided into three segments: the __________ or
wrist, the ____________ or palm and the ____________ or fingers.
9. The ______________ or heel bone is the largest tarsal bone,
irregularly cuboidal in form and situated at the lower back part of the
foot.
10. The structures which enter the formation of a ___________ are:
bone, cartilage, fibro-cartilage, ligament and synovial membrane.

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20 ADINA RĂDULESCU

4. Match up the following words with their definitions:


1. breastbone a. Rings placed one above the other which
form a single column, the spinal column
2. ligament b. Triangular bone that forms the back of
the pelvis
3. skull c. Twelve pairs of curved bones extending
from the backbone round the chest
4. vertebrae d. Narrow, bony and curved column – as a
cable for the spinal cord
5. clavicle e. Basin-shaped framework of bones at the
lower end of the body
6. spine f. Tough white flexible tissue attached to
bones and joints
7. pelvis g. Tough, flexible tissue that connects bones
and holds organs in position
8. sacrum h. Thin, flat, vertical bone in the chest,
between the ribs
9. cartilage i. Bone joining the breastbone and the
shoulder blade
10. ribs j. Bony framework of the head under the
skin
■ GRAMMAR
Interrogative pronouns and adverbs used before the verb to be

When forming interrogative sentences with the verb TO BE the rule


to be remembered is to place the words in the following order:
WHAT
WHICH
WHERE + is (sg.) / are (pl.) – present + object
WHY + was (sg.) / were (pl.) – past + object
HOW
HOW MANY

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English in Kinetotherapy. A practical English handbook 21

WHAT – is used to ask somebody to specify one or more things,


places, people, etc from an indefinite number:
What are the main causes of muscular weakness?
What is the shape of the spinal column?
WHICH – is used to ask somebody to specify one or more things,
people, etc from a limited number:
Which is the best treatment in this situation?
Which is the shortest and the most curved of all the ribs?
WHY – means for what reason or purpose:
Why is physical therapy better than surgery in my case?
WHERE – means in or to what place or position:
Where is the sternum situated?
HOW – means in what way or manner:
How is the sternum described in terms of shape, position,
structure and development?
HOW MANY – is used to inquire about the number of things:
How many phalanges are for each finger, except the thumb?

5. Ask questions for the underlined phrases using the


interrogative words what, which, where, why, how, how many and
the verb to be. The first two have been done for you as examples:

1. There are twelve ribs on each side of the thoracic part of the spinal
column.
How many ribs are on each side of the thoracic part of the spinal
column?
2. The foot consists of three divisions: the tarsus, metatarsus and
phalanges.
Which are the three divisions of the foot?
3. The leg consists of three bones: the patella (knee cap), placed in
front of the knee, the tibia and fibula.

_______________________________________________________?

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4. The patella is a small, flat, triangular bone situated at the anterior


part of the knee joint.

_______________________________________________________?

5. The scapula is situated between the first and seventh ribs.

_______________________________________________________?

6. The sternum has the shape of an ancient sword, consisting of three


parts.

_______________________________________________________?
7. That form of cartilage which enters into the formation of the joints
is called articular cartilage.

_______________________________________________________?

8. The ligament is pliant and flexible, so as to allow perfect


freedom of movement but strong, tough and inextensible, so as not
to yield under a severely applied force. (ask three questions)

_______________________________________________________?

9. There are 206 distinct bones in the entire skeleton of an adult.

_______________________________________________________?

10. The superior extremity is the largest part of the humerus.

_______________________________________________________?

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English in Kinetotherapy. A practical English handbook 23

6. Read the following extracts and translate them into Romanian:


“Most bones of a human adult consist of a bony and cartilaginous
framework, as a result of which a bony part and a cartilaginous part
are distinguished in the skeletal system. The bony part makes up most
of the bone. The articular cartilages, the epiphyseal cartilages and the
costal cartilages form the cartilaginous part of the skeletal system.

The long bones (humerus, clavicle, femur, phalanges, etc.) have a


middle part, the diaphysis, and two end parts, the epiphyses. The
epiphysis located closer to the axial skeleton is called the proximal
epiphysis, while the epiphysis of the same bone but situated further
from the axial skeleton is called the distal epiphysis. The wider parts
of long bones between the diaphysis and the epiphysis are known as
metaphysis. Their boundaries are visible only in the bones of children
and adolescents when a cartilaginous layer, the epiphyseal cartilage
still remains between the diaphysis and epiphyses.

The red marrow possesses high functional activity and is capable of


forming blood cells of the myeloid series. With the development and
growth of the organism, the red marrow is gradually replaced by the
yellow marrow. The yellow marrow is less active and plays a reserve
role, but under certain conditions it may be activated.”
(R.D. Sinelnikov – Atlas of Human Anatomy)

7. Translate the following questions into English, using the new


vocabulary. Providing an answer to these questions will also test
your anatomy knowledge:
1. Care este ştiinţa care se ocupă cu studiul oaselor?
2. Care sunt principalele tipuri de oase?
3. Care sunt părţile constituente ale unei articulaţii?
4. Care sunt cauzele care determină traumatismele şi fracturile
coloanei vertebrale?
5. Din câte oase este format craniul şi care sunt acestea?
6. Care articulaţie este cel mai frecvent afectată în fracturi?

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7. Câte vertebre are coloana lombară? Dar coloana toracală?


8. Unde este plasat acromionul?
9. Cum este descris sternul în atlasul de anatomie?
10. De ce este intervenţia chirurgicală mai potrivită în acest caz decât
fiziokinetoterapia sau balneoterapia?

►◄ Pair work
8. Question-answer exercise: Using your anatomy courses notes, ask
your deskmate questions about the skeletal system.

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UNIT 3
THE MUSCULAR SYSTEM
▪ Adjectives – basic knowledge
▪ Describing a certain muscle

1. Read the following texts about the muscular system and write
down the new words:

“There are more than 600 skeletal muscles in the human body and
their total mass accounts for up to 28-35 per cent of the body mass in
females, up to 40-45 per cent in males, and up to 45-55 per cent in
athlets. Up to 50 per cent of the total weight of the skeletal muscles
fall to the share of the muscles of the lower limbs, up to 30 per cent to
those of the upper limbs, and up to 20 per cent to the share of the
muscles of the head and trunk.
Each muscle has a developed network of blood vessels. The
contraction of a muscle promotes rapid flow of blood, i.e. the muscle
is a peculiar ‘pump’ which forces the blood forward. Under conditions
of reduced motor activity (hypokinesia) in an active mode of life or
when prolongued bed-rest is necessary, this function of the skeletal
muscles is excluded as a result of which the blood flows slower,
metabolic processes are reduced and stasis occurs. In contrast, under
conditions of motor activity the reserve capillaries open, new
capillaries form, and nutrition of the skeletal muscles improves.”
(R. D. Sinelnikov – Atlas of Human Anatomy)

“All elements of the musculoskeletal system are in dynamic


equilibrum, continually changing shape, structure and function, in
response to loading and mechanical demands. The system is
vulnerable to trauma, peculiarly susceptible to local and systemic
inflamatory disorders.
Acute inflammation or tissue damage often becomes chronic, perhaps
because of continuous movement and mechanical stresses.

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Musculoskeletal disorders are major worldwide causes of chronic pain


and severe physical handicap, particularly as population becomes
older, generally fitter, and more health conscious.”
(The Merk Manual of Diagnosis and Therapy)

“Muscles vary considerably in their form. In the limbs, they are of


considerable length, especially the more superficial ones, the deep
ones being generally broad; they surround the bones and form an
important protection to the various joints. In the trunk, they are broad,
flattened and expanded, forming the parietes of the cavities which they
enclose.”
(Henry Gray – Gray’s Anatomy. Descriptive and Surgical)

♣ VOCABULARY PRACTICE

2. Pronounce and learn the main terms and collocations related to


the muscular system. Add more terms to the list:
- muscle = muşchi
- skeletal muscle = muşchi scheletic
- tendon = tendon
- muscular tissue = ţesut muscular
- blood vessels = vase sanguine
- nerves = nervi
- fibers = fibre
- fascia = fascie
- diaphragm = diafragmă
- musculature = musculatură
- muscle bulk = masă musculară
- muscular contraction/cramp = contracţie musculară
- muscular endurance = rezistenţă musculară
- muscle fatigue = oboseală/extenuare musculară
- muscular hypertrophy = hipertrofie musculară
- muscle tone = tonus muscular
- hypotonic muscles = muşchi hipotonici
- hypertonic muscles = muşchi hipertonici

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English in Kinetotherapy. A practical English handbook 27

- muscle rigidity = rigiditate musculară


- muscle spasm = spasm muscular
- spasticity = spasticitate
- muscle sprain = luxaţie
- muscle strain = întindere musculară
- muscle strength = forţă musculară
- muscular tension = tensiune musculară
- muscular weakness = slăbire musculară

3. Match the half-sentences in column A with their corresponding


half-sentences in column B to form correct and complete
sentences:

A B
1. Muscle bulk…. a. … a progressive loss of
muscle strength in a variety of
muscle groups.
2. Muscle-setting exercise…. b. …very firm, may be spastic or
rigid and resists sideways
movements.
3. Muscular dystrophy is a c. … a muscle sprain or strain,
degenerative muscle disorder arthritis, a tumor or a ruptured
characterized by …. cartilage disk between vertebrae.
4. Electromyography (EMG) is a d. … very soft, weak and flabby
techique… and is easily moved laterally.
5. A hypertonic muscle feels … e. … gives an indication of the
state of the musculature.
6. If you have observed muscle f…. an evaluation of the
weakness, … condition and functioning of the
muscles, joints and bones of the
body.
7. Involuntary movements and g. … is a method of contracting
tremors … and relaxing a skeletal muscle
without moving that part of the
body.

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8. Low back pain at the base of h. … that records changes in the


the spine can be caused by … electrical potential during
muscle contractions.
9. Musculoskeletal system i. … are signs of some
assessment is … neurological disorders.
10. A hypotonic muscle feels … j. …then a detailed test will be
necessary for each muscle.

4. Match up the following words with their definitions:

1. tendon a. Fibre or bundle of fibres carrying


impulses of sensation or of movement
between the brain and all parts of the body
2. fasciae b. Large muscle at the front of the upper
arm, which bends the elbow
3. blood vessels c.Wall of muscle, between the chest and
the abdomen, that helps to control
breathing
4. fibres d. Very narrow blood vessels connecting
arteries and veins in the body
5. nerve e. Fibrous membranes which form linings
for body cavities and cover muscles and
organs
6. capillaries f. Strong band or cord of tissue that joins
muscle to bone
7. muscular dystrophy g. Slender threads of which many human,
animal or plant tissues are formed
8. diaphragm h. Tubes (arteries, veins or capillaries)
through which blood flows in the body

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English in Kinetotherapy. A practical English handbook 29

9. biceps i. Broad, thick, triangular muscle, situated


at the upper and anterior part of the chest
that draws the arm towards the body
10. pectoral muscle j. Long-lasting illness in which the
muscles become gradually weaker

■ GRAMMAR
Adjectives – basic knowledge
Participial and qualificative adjectives
Degrees of comparison
Constructions with comparisons

Considering the frequency of certain types of adjectives in medical


language we shall deal only with participial and qualificative
adjectives.
Participial adjectives are participial forms used as adjectives:
- Present Participle forms: short infinitive + -ING: increasing,
relaxing, growing
- Past Participle forms: short infinitive + -ED (for regular verbs):
reduced, flattened, expanded or the third form of irregular verbs: cut,
hidden, frozen.
Example:
This relaxing atmosphere and these stimulating exercises will have a
pronounced effect on your back muscles.

Qualificative adjectives include all types of adjectives denoting


quality, size, shape, colour, origin, age and general descriptions of
objects (parts of the body, diseases, symptoms etc) and people:

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Example:
The first piece of the sternum has a triangular form, broad and thick
above and narrowed below.
Both participial and qualificative adjectives can either precede the
noun, having the same form for all genders, both singular and plural
(attributive position) or follow the noun, having the function of
predicatives for copulative verbs such as: be, become, look, seem, turn
etc:
Example:
Moderate exercises have a therapeutic effect on muscles.(attributive
position)
The muscles become resistant to fatigue and the patients no longer
look exhausted at the end of the session.(predicative position)
Degrees of comparison
According to the way they form their degrees of comparison
adjectives fall into three categories:
1) monosyllabic (or short) adjectives and bisyllabic adjectives
ending in -er, -y and –ly which form their corresponding degrees of
comparison by adding –er and –est (synthetic comparison):
thick – thicker – the thickest
thin –thinner – the thinnest
2) long adjectives – bisyllabic (ending in -ful and -re),
trisyllabic or plurisyllabic which form their degrees of comparison
by periphrastic means: more and (the) most (analytic comparison):
extensive – more extensive – the most extensive
3) adjectives with irregular degrees of comparison:
good – better – the best
bad – worse – the worst
little – less – the least
many/much – more – the most
old – older – the oldest (of people and objects)
old – elder – the eldest (of people)
far – farther – the farthest (of space)
far – further – the furtest (of time)

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Constructions with comparisons:


The use of adjectives at different degrees of comparison requires the
use of certain patterns. For instance, adjectives at superlative will be
associated with perfect tenses:
This is the most distressing pain I have ever had.
The comparative requires the specification of the second term of
comparison, which can be either a word or a sentence:
I am not as useless as my blind brother /as you think I am.
The injury was more severe than we thought.
Gradual increase or decrease is expressed by two comparatives joined
by and:
As your breathing becomes slower and slower you are feeling
more and more relaxed.
Sometimes the comparatives are placed at the beginning of the
sentences:
The sooner you practise the exercise, the better you will feel.
The larger the muscle, the greater its strength.

5. Reread the texts about the muscular system and extract all the
adjectives. Group them according to their attributive or
predicative position. For derivational adjectives indicate the noun
that they derive from and their suffix or prefix as in the following
examples:

systemic = system (noun) + -ic (suffix)


skeletal = skelet (noun) + -al (suffix)

6. Form derivational adjectives from the following nouns and


verbs, choosing the appropriate suffixes in the box. Sometimes
more than one suffix can be attached to part of the words:

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-al -ic -ous -less


-ish -ive -ful -able
-ible -ed -ing -y

Example:
Stern + -al = sternal

thorax comfort
sphere to identify
muscle to contract
abdomen access
stomach memory
anomaly to connect
fibre to digest
fever health
cure infection
help pain

7. Translate the following sentences into English, using the new


vocabulary and grammar notes of this unit:
1. Ce cauzează hipertrofia musculară?
2. Cu cât rezistenţa musculară este mai mare cu atât va fi mai mare
numărul de contracţii musculare.
3. Tensiunea musculară prelungită poate produce durere, care poate
duce la spasm muscular şi prin urmare la mai multă durere.
4. Tensiunea musculară are strânsă legătură cu modul nostru de a
gândi; astfel, cu cât suntem mai stresaţi, cu atât mai mare va fi şi
tensiunea noastră musculară.
5. Activitatea fizică prelungită cum ar fi mersul sau pasul alergător
poate duce la oboseală musculară.
6. Care sunt cauzele principale ale extenuării musculare?
7. Muşchiul gastrocnemian este cel mai superficial muşchi situat în
partea din spate a piciorului, care formează cea mai mare parte a
gambei.

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8. Tendonul lui Ahile este cel mai gros şi mai puternic tendon din
corpul uman.
9. Muşchiul deltoid este un muşchi lat, gros, triunghiular, situat pe
partea laterală şi posterioară a umărului.
10. Muşchiul abductor al policelui este un muşchi subţire, plat,
îngust, plasat imediat dedesubtul tegumentului (integument).

►◄ Pair work:
8. Using your anatomy courses notes, choose a certain muscle and
ask your deskmate to describe it.

9. Guessing game: Think of a certain muscle. Your deskmate will


ask you as many questions as necessary to guess the muscle. Here
are some examples of possible questions:

• Is it a muscle of the trunk/head/upper limb/lower limb?→ for


general location
(It is a muscle of the upper limb)
• Is it a muscle of the shoulder girdle or of the free upper limb?→ for
specific location
(It is a muscle of the shoulder girdle)
• Where is it situated?
(It arises from the clavicle and scapula.)
• What is its function?
(It helps the upper arm move forward, backward and horizontally.)
• Can you describe it?
(It is a thick, triangular muscle with the base facing upwards and the
apex downwards)
• Is it the deltoid muscle?
(Yes, it is indeed.)

The following classification of muscles may prove useful for this


exercise:

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A. The muscles of the trunk:

• the muscles of the back


• the muscles of the neck
• the muscles of the chest
• the muscles of the abdomen

B. The muscles of the head:


→ the muscles of facial expression:
• the muscles of the scalp
• the muscles surrounding the eyes
• the muscles surrounding the mouth
• the muscles surrounding the nose
→ the muscles of mastication

C. The muscles of the upper limb:


→ the muscles of the shoulder girdle
→ the muscles of the free upper limb:
• the muscles of the upper arm
• the muscles of the forearm
• the muscles of the hand

D. The muscles of the lower limb:


→ the muscles of the hip joint
→ the muscles of the free lower limb:
• the muscles of the thigh
• the muscles of the leg
• the muscles of the foot

10. Complete the classifications above with all categories of


muscles you have studied so far.

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UNIT 4
EXAMINING THE PACIENT
▪ Polysemantic words
▪ Therapist-patient discourse – greetings, identification and
introductory dialogues

1. Read the following text and check the glossary below to


translate the unknown words. Write down other unknown words
and try to approximate their meaning:

“Examination of a pacient is a continuous process that starts with


your first meeting and continues until treatment ceases prior to
discharge. The initial examination leads to an assessment of the
pacients` needs and a decision on the early treatment.
If the pacient has been previously examined by a diagnostician who
provides full notes, some useful and time-saving information may be
obtained by their careful perusal. To use such notes to the maximum,
divide your perusal into:
▪ Obtaining basic information about the pacient as a social entity:
names, sex, marital status, age, current work, former job and/or
retirement status, cultural background and family circumstances.
▪ Reading, in date order, the medical events that are former medical
history and the events that have marked the development of the
current illness/disability and its progress.
▪ Noting, if available, the clinical examination findings and the results
of tests, including X-rays. Any abnormalities indicated by the medical
examination sheet need to be checked by the present examiner, as
different variables such as the subjective assessment of the previous
examiner or the change in patient’s condition from the last
examination may influence the course of the treatment.Knowledge of
normal parameters should be used to decide whether any of the test
records show a need for care in examination and treatment.

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▪ Obtaining a record of immediate past and current treatment and


medication. It is important that current medications are noted for these
may have some effect on selection of or precautions in administrating
your treatments.
When examining the pacient some things need to be provided: a clean,
well ventilated, adequately warmed area, suitable coverings for the
pacient, the position of the examination couch or table in relation to
the lighting and, quite important, verbal confidentiality.There are
some small testing devices that the examiner needs: a tape measure, a
pin, a goniometer, a reflex hammer, some cotton wool, test tubes
containing hot and cold water.
Escorting the patient to the examination area can be an opportunity to
observe his/her ability to walk unaided, the type of gait abnormalities
if any, the general mien and posture.
Successful questioning produces maximum information with the
minimum of questions and is a skill that improves with practice.
Listening to the patient`s answers requires patience, instant awareness
and interpretation, and listening to the silences is equally
important.What the patient fails to say may have great relevance.
Palpation is a skill that is acquired by practice. It requires that your
hands should be relaxed, in firm comfortable contact, and aware of
what is under them.The following procedures are to be used when
palpating for specific anatomical features: place more of your hand
than you need in contact with the area to be examined, lift your palm a
little to reduce the contact, so that only the finger pads are touching
firmly enough.Your fingers should be straight so that your nails are
unlikely to be in contact. Remember that too hard a pressure will feel
like a drill digging in and too light a pressure will feel like a butterfly
coming to rest. In neither case will you feel or find anything.
Always allocate sufficient time for an initial examination of the
patient, and if the examination turns out to be more time-consuming
than your original estimate, complete only part of the tasks and
conclude the examination at a further session.”
(Adapted from M.Hollis, P.Yung – Patient examination and
assessment for therapists)

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English in Kinetotherapy. A practical English handbook 37

GLOSSARY
to cease = a înceta, a se opri
prior to = înainte de
discharge = externare
assessment = evaluare, estimare
previously = mai înainte, în prealabil
perusal = citire, lectură atentă
former job = slujbă anterioară
retirement = pensionare
cultural background = formaţie culturală
medical history = anamneză
disability = incapacitate, invaliditate
clinical examination findings = constatările examinării clinice
medical examination sheet = foaie de observaţie clinică
testing devices = instrumente de testare
tape measure = ruletă, panglică de măsurat
pin = ac cu gămălie
goniometer = goniometru
reflex hammer = ciocănel pentru testarea reflexelor
cotton wool = vată
test tube = eprubetă
gait = umblet, mers
mien = ţinută, comportament
posture = postură corporală
instant awareness = înţelegere rapidă
palpation = palpare
finger pad = buricul degetului
drill = burghiu
to dig in = a înfige

2. Scan the text above so as to answer the following questions:


1. Why is the patient’s initial examination important?
2. What should basic information about the patient include?

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3. Why does the present examiner need to check the patient`s prior
medical examination sheet?
4. Why does the examiner need to note the patient`s current
medication?
5. What things need to be provided when examining the patient?
6. What testing devices does the examiner use?
7. What should the examiner observe while escorting the patient to
the examination area?
8. When can we say that questioning the patient has been
successful?
9. What procedures are to be used when palpating the patient?
10. What should be done if the first examination takes longer than
expected?

3. Create your own examiner – patient dialogues, including


questions and answers regarding the patient`s basic information,
former medical history, clinical examination findings, past and
current medication, etc.

♣ VOCABULARY PRACTICE
Polysemantic words

Many words that are pronounced and spelt in the same way can be
used in different contexts with different meanings. They are
polysemantic words. Polysemy is closely related to homonymy and it
is sometimes difficult to distinguish between words that are
homonyms and words that are polysemantic. There is still a criterion
that can help us distinguish one notion from the other: while with
homonymy the words that have the same form do not share any
semantic resemblance in their meanings, with polysemantic words we
can easily notice a semantic feature common to all the elements of a
class. Here are two examples for each notion:

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Heart, as a polysemantic word, has a semantic feature associated –


that of being the central part of a body, of one’s life or of something
else – that is carried over from one example to the next:
Even if his heart stopped beating for several seconds, he did not die.
I think you should get to the heart of the matter.
He is my heart, my reason of living.
Calf as a young of cattle (viţel) or of certain other mammals such as
the buffalo, elephant, giraffe and whale and calf as the thick fleshy
part of the back of the leg between the ankle and the knee are two
homonyms that have nothing in common, semantically speaking.
Moreover, by looking words up in a dictionary, one can also
distinguish between polysemantic words and homonyms as the former
are listed with different numbers under the same lexical entry, while
the latter are listed and treated as separate words: calf1 and calf 2.

4. Choose from among the meanings of the following polysemantic


words the one that has been used in the text Examining the
pacient:

1. examination means:
a) written exercises, oral questions or practical tasks, set to test a
candidate’s knowledge and skill;
b) physical inspection of a patient or parts of his body, in order to
verify health or diagnose disease;
c) the formal interrogation of a person on oath (an accused or a
witness) by a lawyer in a lawcourt.

2. discharge means:
a) an official permission for (sb) to leave, after he has carried out a
duty (discharge a soldier, a patient, release a prisoner from custody);
b) unloading (cargo) from a ship;
c) firing (a gun), launching flying weapons (arrows).

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3. background means:
a) part of a view, scene or description that forms a setting for the
chief objects, people;
b) information that is needed to understand a problem;
c) a person’s social class, education, training or experience;
d) a low level of sound, lighting whose purpose is to be an
unobtrusive or appropriate accompaniment to something else, such as
a social activity, conversation or the action of a film.

4. device means:
a) a machine or tool adapted for a special purpose (time-saving
device, safety device, an explosive device etc);
b) a particular pattern of words, figures of speech used in literature
to produce a certain effect on the reader;
c) a written, printed or painted design or figure, used as a heraldic
sign, emblem, trademark by a noble family;
d) a plan or plot, esp. a clever or evil one; a scheme, trick.

5. Write your own contexts in which the polysemantic words


above, except for the version of your choice, are used with other
meanings. You can use the following expressions:

• examination paper
• background music
• entrance examination
• working-class background
• to take an examination
• background on the company’s financial
position
• pass/fail an examination
• time-saving device = aparat de uz casnic
• medical examination
• labour-saving device = dispozitiv mecanic

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English in Kinetotherapy. A practical English handbook 41

• to be under examination
• an explosive device = dispozitiv explozibil
• to stay/keep in the background
• stylistic device = figură de stil

6. Match each of the meanings below to one of the seven


polysemantic words in the box:

a. patient b. tongue c. head


d. foot e. bottom f. spine g. nerve

1. a movable organ in the mouth, used in tasting, licking,


swallowing and speaking;
2. foam on the top of a poured beer;
3. a person who is receiving medical care in hospital;
4. part of the body on which one sits, buttocks;
5. a measure of length equal to 12 inches;
6. row of bones along the back of humans and some animals,
backbone;
7. boldness, courage;
8. a person capable of accepting delay that can still remain calm;
9. part of the body, containing the eyes, nose, mouth and brain;
10. a language, dialect or idiom;
11. the lowest part of the leg, below the ankle, on which a person or
animal sits;
12. ground under the sea, lake or river;
13. any of the bundle of fibres carrying sensory or motor impulses
between the brain and all parts of the body;
14. any of the sharp needle-like parts on some plants (cactuses) and
animals (hedgehogs);
15. chief person of a group or organization;
16. a flap of leather on a shoe, under the laces or buckles to protect
the instep;

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42 ADINA RĂDULESCU

17. the lowest, deepest or farthest removed part of a thing;


18. the back part of a book that is visible when it is in a row on a shelf;
19. rib or vein in a leaf or any of the veins of an insect`s wing;
20. mental ability or natural talent for something.

7. Write your own contexts for the different meanings of the


polysemantic words above. You can make use of the following
syntagms and expressions:

• to be patient with sb. = a avea răbdare cu cineva


• mother tongue = limbă maternă
• to have lost/find one`s tongue = a-şi pierde/redobândi graiul
• the head of the family = capul familiei
• head office = sediu central
• to have a good head for business, figures = a avea cap de
afaceri, cifre
• at the foot/bottom of the stairs/hill/ mountain/list/page = în
partea de jos a …
• a 7-foot high wall = un zid înalt de 7 picioare
• to fall on one`s bottom = a cădea în fund
• the bottom of the sea/lake/river = fundul mării/lacului/râului
• to go to the bottom = a se scufunda
• to lose/regain one`s nerve = a-şi pierde/redobândi curajul
• to have the nerve to do smth.= a avea curajul/tupeul de a face
ceva
• to strain every nerve = a-şi încorda toate puterile

☼ THERAPIST-PATIENT DISCOURSE – greetings,


identification and introductory dialogues

Here are some examples of initial greetings and introductory dialogues


used before the examination takes place:

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English in Kinetotherapy. A practical English handbook 43

The therapist:
• Good morning, Mrs. Johnson. Let me introduce myself. I am
your therapist, Dr. Green.
• Please come in and take a seat.
• Make yourself comfortable. I will be with you in a second.
• My name is Dr.Green. I think we talked on the phone, didn`t
we?
• I remember you. You were my patient last year. How is your
back?
• You are Dr. Thomson`s sister, aren`t you? He told me all
about you.
Inquiring about the patient`s problem:
• Well, Mrs. Johnson, what can I do for you?
• Tell me, Mr. Baum, what`s troubling you?
• Well, Mrs. Redcliff, what`s brought you here?
• Well, let`s see… what seems to be the problem?
• Your brother, Dr. Thomson tells me that you have been having
low back pains…
• I couldn`t help noticing your slight limp. Can you tell me
more about it?
• I can`t tell you how sorry I am about your terrible accident.
How is your recovery going on?
• I understand that you have seen several therapists before.
How can I help you?
Programming further sessions:
• Considering your diagnosis, I will have to see you twice a
week, for six weeks.
• For the first two weeks we shall meet every day till your pain
goes away.
• Bring me the X-rays and then I will schedule a meeting for
you for next week.
• I am sorry, but you should have seen an orthopaedist before
coming here.

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44 ADINA RĂDULESCU

• I will meet you for our sessions three times a week, for at least
three weeks.
• We shall start on Monday and see how it is going.
• I think we can have good results if you come to all your
sessions.

►◄ Pair work
8. Practise therapist-patient dialogues using the examples above.
You can as well come up with your own examples.

9. Translate into English, using the new vocabulary:


1. Recomandarea unui program de exerciţii terapeutice nu se
poate face fără o examinare amănunţită a pacientului.
2. Orice informaţii cu privire la datele personale ale pacientului,
la un diagnostic anterior şi medicamentaţie se pot dovedi
extrem de importante în recomandarea terapiei ulterioare.
3. Pe toată durata examinării pacientul trebuie să se simtă
relaxat, protejat, fiind asigurat de confidenţialitatea discuţiilor
sale cu terapeutul.
4. Terapeutul poate sesiza în mod indirect anumite caracteristici
motrice ale pacientului, prin simpla observare a posturii sale
corporale, a ţinutei generale şi a mersului acestuia.
5. Palparea pacientului şi testarea gradului său de mobilitate sunt
indicii clare în stabilirea afecţiunii prezente şi indicarea
tipurilor de exerciţii corespunzătoare.

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UNIT 5
TYPES OF INJURIES
▪ Passive modal constructions
▪ Present Tense Simple and Present Perfect
▪ Therapist-patient discourse – patient`s symptoms and
complaints
▪ Formal and informal medical terms

1. Read the following extracts and check the glossary below for
new words. Then translate these texts into Romanian:

Patient rehabilitation after fractures


“Patient rehabilitation should begin immediately, depending on the
type of fracture and soft tissue stability. Adjacent joints should be
mobilized as soon as possible; however, in open fractures motion of
musculotendinous units over fracture surfaces will irritate the soft
tissues and may decrease resistance to infection. Immobilization of
adjacent joints can be done by using splints, braces or foot
attachments to external fixation systems. Physical therapy should
include active exercises for joint mobilization, weight-bearing
exercises, as well as range of motion and strengthening exercises, all
practised under the close supervision of both the physician and the
kinetotherapist.”
(Adapted from Thomas A. Russell – General Principles of Fracture
Treatment)

Hip dislocation
“Hip dislocation is an orthopaedic emergency and must be reduced
immediately. It occurs primarily in conjunction with severe multiple
trauma from high-speed motor vehicle accidents. The longer the hip
remains dislocated, the more likely is the possibility of complications,
including avascular necrosis of the femoral head and posttraumatic

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46 ADINA RĂDULESCU

arthritis. Most dislocations of the hip can be reduced by close


manipulation and this treatment should take precedence over treatment
of all other skeletal injuries.”
(Adapted from David G. LaVelle – Acute Dislocations)

Sprains or ligamentous injuries


“Most sprains or ligamentous injuries can be treated by
immobilization. Even though immobilization allows the stretching of
ligaments, quickly relieves pain and may be beneficial in reducing the
swelling, many specialists report that early mobilization for these
injuries produces superior results to immobilization.”
(Adapted from S. Terry Canale – Ankle Injuries)

Rupture of muscles and tendons


“The most frequent cause of partial or complete rupture of a muscle
or tendon is eccentric overload of the muscle-tendon unit. Muscle
strains are initially treated with ice, rest and antiinflammatory
medication, followed by a gentle stretching and progressive
strengthening program as symptoms resolve. Failure to regain full
flexibility and normal strength of the muscle-tendon unit results in
increased risk of further recurrent injury.”
(Adapted from Barry B. Phillips - Rupture of muscles and tendons)

Note : the texts above as well as many other specialised texts in this
handbook are written in American English; this accounts for many
spelling differences that you may encounter for one and the same
word, spelt differently as it appears either in a British English source
or in an American English one.

GLOSSARY
rehabilitation = recuperare, reabilitare
fracture = fractură
adjacent joint = articulaţie adiacentă
to decrease = a reduce, diminua
to increase = a mări, intensifica

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English in Kinetotherapy. A practical English handbook 47

splint = atelă
brace = orteză
foot attachment = dispozitiv de fixare a piciorului
weight-bearing exercise = exerciţiu de susţinere a greutăţii corporale
range of motion = grad de mobilitate
strengthening exercises = exerciţii de întărire musculară
to occur = a se petrece, a avea loc
in conjunction with = în legătură cu
avascular necrosis = necroză avasculară
femoral head = cap femural
arthritis = artrită
to take precedence over smth = a avea loc înainte, a avea prioritate
faţă de
skeletal injury = leziune a sistemului scheletic
sprain = luxaţie, scrântire
to relieve pain = a alina durerea
swelling = umflătură
rupture = ruptură, hernie
overload = încărcare excesivă
muscle strain = întindere musculară
failure = eşec, insuficienţă
further = ulterior, adiţional

2. Scan the texts above for modal constructions (can, may, should,
must etc) and write them down. Then, underline the passive ones
as in the examples below:

Example:
Should begin
Should be mobilized

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■ GRAMMAR
Passive modal constructions

All scientific languages make use of passive constructions to express


impersonal observations, avoid mentioning unknown or indefinite
subjects and focus on action and effect rather than on the agent that
caused them.
Even though the process of converting active constructions into
passive ones seems to be artificial, it may prove to be useful and
practical in situations when passives are preferred to active
constructions. Here are some examples of passives constructions
illustrated for modal verbs:

Excessive flexion and extension of the neck should be avoided in


spinal injuries.
Clinical instability may be caused by trauma, neoplastic or
infections disorders.
Spinal alignment can be obtained by skeletal traction.

The pathologic anatomy must be carefully defined before


treatment is determined.

These pills must be taken twice a day, on an empty stomach.

With modal verbs the transformation from active voice to passive


voice is made by keeping the modal unchanged and using a passive
infinitive:

Active Voice → Passive Voice

Should avoid → should be avoided (modal + BE + past participle –


short inf.+ ED )

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Must take → must be taken (modal + BE + past participle – the 3rd


form of irregular verbs)

3. Insert the following modal constructions in their corresponding


context, choosing the active or passive form that best completes
the sentence:

must be applied should wear must be used should


first direct should be confirmed may be selected
must be covered
should not be done should not be rubbed may be

1. Open hand wounds ………………. immediately with a sterile


dressing to prevent further contamination.
2. If bleeding continues, manual or digital pressure ……………
to the wound through the dressing.
3. At times it ………… helpful to elevate the arm with the
patient lying supine.
4. Cleaning the wound …………………….. in a hurry.
5. Both the examiner and the patient ………….. masks when the
wound is examined.
6. Sterile instruments and gloves ……………………..
7. The examiner …………… his attention to the circulation and
skin and then to bones, tendons and nerves.
8. The depth of the wound ……………………… with a sponge
or a brush.
9. Suspected damage to tendons and nerves ………………….
by direct vision.
10. A regional block or general anesthetic ……………
depending on the patient`s age and the severity of the injury.

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4. Rewrite the following sentences in the passive voice, making the


words in italics the subject of the sentence and placing, when
necessary, the agent at the end of the sentence:

Example:
The surgeon should closely follow the progress of patient`s
regeneration.
The progress of patient`s regeneration should be closely followed by
the surgeon (agent).

1. The examiner should advise the patient as to the extent of his


injuries.
2. The surgeon must evaluate the extent of the skin loss from the
injury.
3. The surgeons may delay the repairs of nerve and tendons.
4. During surgical procedures the assistants should use a double
binocular microscope.
5. Surgeons can master microsurgical techniques only after
countless hours of practice.
6. The surgeon must avoid coffee just before surgery.
7. If suitable instruments are available and if the surgeon is rested
he may undertake repair of severed nerves on the day of injury.
8. During weeks after nerves repair operation the patient should pay
careful attention to avoid fixed contractures.
9. After the operation the patient should begin progressive
strengthening exercises.
10. The patients should also make monthly clinical evaluations.

5. Translate into English using passive modal constructions:


1. Pacientul suspectat de fractură a coloanei vertebrale nu trebuie
mutat până la sosirea ajutorului calificat.
2. Dacă este imperativ ca pacientul să fie mutat, capul, gâtul şi
toracele lui trebuie susţinute în poziţia lor iniţială de către mai
multe persoane.

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3. Această plagă ar trebui curăţată imediat iar fractura deschisă


ar trebui imobilizată.
4. Primul ajutor în caz de rănire trebuie să fie întotdeauna rapid,
eficient şi de preferinţă efectuat de către personal calificat.
5. Programul de recuperare motorie a pacientului ar trebui
început la câteva săptămâni după operaţie.

☼ THERAPIST-PATIENT DISCOURSE
Formal and informal medical terms
Patient`s symptoms and complaints

Formal and informal medical terms

Patients and therapists/doctors do not always use the same language,


even if they are speaking about the same things. There is a certain
difference between a formal medical language used between doctors
and medical care takers, the scientific language of all medical texts
and an informal medical language that non-specialists (patients) use
to describe their symptoms or disabilities. In therapist-patient
communications a common informal language should be used to
ensure proper communication. Here are some examples of the same
notions with different formal vs. informal medical terms:

Formal term Informal term Translation


contusion bruise contuzie, vânătaie
tenosynovitis inflamed tendons tenosinovită
arteriosclerosis hardening of the arteroscleroză
arteries
sedative sleeping pill, dope sedativ
analgesic pain killer analgezic, calmant

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6. Match the formal term in column A with its corresponding


informal term in column B:

A B
1. thyroid cartilage a. dizziness
2. halitosis b. bamboo spine
3. maxilla c. lower jaw
4. alopecia d. palpitations
5. spine e. heart attack
6. tachycardia f. Adam`s apple
7. mandible g. low blood sugar
8. myocardial infarction h. bad breath
9.ankylosing spondylitis i. womb
10. subluxation j. backbone
11. thorax k. flu
12. influenza l. chest
13. hypoglycaemia m. dislocation
14. uterus n. upper jaw
15. vertigo o. baldness

Patient’s symptoms and complaints

Without assuming to cover at least part of the symptoms and problems


that patients may have when coming to see a kinetotherapist, some
examples of common complaints are presented below:

• I have sprained my left ankle. (Mi-am răsucit/ luxat glezna


stângă)
• I have strained my deltoid muscle. (Am o întindere musculară
la deltoid.)
• I have pulled a hamstring muscle. (Mi-am întins un tendon
muscular.)
• I have torn a ligament in my right knee. (Am o ruptură
ligamentară la genunchiul drept.)

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• I have snapped a tendon in my left thigh. (Am o ruptură de


tendon la coapsa dreaptă.)
• I have got a cartilage problem in my left knee joint. (Am o
problemă la nivelul cartilajului articulaţiei genunchiului
stâng.)
• I have got chilblains in my toes. (Am suferit degerături la
degetele de la picioare.)
• I have pins and needles in my feet all the time. (Simt
furnicături în picioare tot timpul.)
• I feel a tingling sensation in my fingers. (Simt o senzaţie de
furnicături în degete.)
• I have got a severe pain in my left heel. (Am o durere
puternică în călcâiul stâng.)
• I get cramp in my calves. (Am crampe la gambe.)
• I have got swelling of my ankles. (Am gleznele umflate.)
• I have got numb fingers/legs when I wake up. (Am
degetele/picioarele amorţite când mă trezesc.)
• My fingers tremble a lot and even my hands have started
shaking.(Îmi tremură degetele şi chiar şi mâinile.)

■ GRAMMAR
Present Tense Simple and Present Perfect

Present Perfect and Present Tense Simple are the tenses normally
used to express complaints in the above sentences.

7. Identify each tense in the sentences above and say how they are
formed.
Example:
Have sprained = Present Perfect Simple; formation: the auxiliary verb
have + past participle of the regular verb sprain (short infinitive +
-ed)
Have torn = Present Perfect Simple; formation: the auxiliary verb
have + past participle of the irregular verb tear (tear, tore, torn)

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54 ADINA RĂDULESCU

Present Perfect Simple is used in the above-mentioned complaints to


express previous causes/injuries that still have a certain effect in the
present, while Present Tense Simple makes these complaints a
general fact; the symptoms presented are something felt as usual.

8. Put the verbs in brackets into the Present Tense Simple or


Present Perfect:

1. _______ you ever ________ (sprain) your ankle? It’s not so


bad but you have to stay in bed for a while.
2. _______ it _________ (hurt) if I touch your swollen ankle?
______ you _______ (feel) a burning sensation?
3. My aunt’s fingers always __________ (tremble) when she
________ (give) me my monthly allowance.
4. I am still in hospital. I ________________ (not recover) yet. I
always ______ (get) cramps in my calves in the morning.
5. I ________ already _________ (practise) this stretching
exercise three times. Yes, but you still ___________ (not do)
it right.

9. Translate into English using Present Perfect Simple and Present


Tense Simple as in the above-presented examples of patient`s
complaints; sometimes modal verbs are to be used as well:

1. Nu pot să-mi îndoi cotul drept. Cred că mi l-am luxat.


2. Mi-am fracturat şoldul şi am nevoie de exerciţii de reabilitare.
3. Mi-am dislocat umărul stâng. Aş dori să am un grad mai mare
de mobilitate.
4. Mi-am rupt trei coaste într-un accident de schi. Am fost în
spital şase săptămâni.
5. Am adesea crampe durerose în ambele gambe după
terminarea meciului de fotbal.
6. Când mă scol dimineaţa nu-mi simt picioarele de la genunchi
în jos.

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7. Am dureri de spate acute. Am fost la mulţi doctori şi m-am


horătât să încerc şi nişte exerciţii terapeutice.
8. Am o întindere musculară supărătoare la nivelul gâtului. Am
nevoie de câteva exerciţii de întindere pentru a-mi redobândi
flexibilitatea.
9. Am o ruptură de tendon în deltoid şi nu-mi pot continua
programul de antrenament pentru Olimpiadă.
10. Am contracţii musculare în gamba stângă iar forţa mea
musculară nu mai este aceeaşi.

10. Place yourself in a patient’s situation and complain about


your symptoms, asking your colleagues – future kinetotherapists
for help and advice.

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UNIT 6
THERAPEUTIC EXERCISES
▪ Word formation - derivation
▪ Therapist-patient discourse - recommending different
therapeutic exercises

1. Read the following text and write down the new words; then
translate it into Romanian, using the glossary below.

“The goals of therapeutic exercises include the prevention of


dysfunction as well as the development, improvement, restoration or
maintenance of strength, endurance and cardiovascular fitness,
mobility and flexibility, stability, relaxation, coordination, balance and
functional skills.
Strength is the ability of a muscle or muscle group to produce tension
and a resulting force during a maximal effort, either dynamically or
statically, in the relation to the demands placed upon it. To increase
strength, a load that exceeds the metabolic capacity of the muscle
must be used during exercise. To produce greater muscular tension, a
high-intensity exercise (exercise performed against heavy loads) must
also be used, but for a relatively low number of repetitions.
Muscular endurance is the ability of a muscle to contract repeatedly
or generate tension, sustain that tension and resist fatigue over a
prolonged period of time. It is necessary for performing repeated
motor tasks in daily living, such as walking or climbing stairs. Active
exercises that challenge the oxygen transport system will increase
endurance - the major goal of cardiac rehabilitation programs.
Exercises are usually directed to large muscle groups, as in walking,
running, swimming and cycling and are to be prolonged and
performed for 15 to 45 minutes or more.
Mobility of soft tissues and joints is necessary for the performance of
normal functional movements.
Flexibility is the ability to move a single joint or series of joints
through an unrestricted, pain-free range of motion. It is dependent

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upon the extensibility of muscles, which allows muscles that cross a


joint to relax, lengthen and yield to a stretch force.
Stability is usually required in more proximal structures, such as the
trunk, hips and shoulder girdle, for effective positioning and motion of
the arms and hands or legs and feet.Stabilization exercises are the
means by which a patient can learn to control proximal areas of the
body and, at the same time, maintain a stable, well-aligned position
while carrying out functional activities.
Relaxation refers to a conscious effort to relieve tension in
muscles.Exercises promoting relaxation are based on the therapeutic
use of reflexive and conscious processes. Thus, the patient should be
placed in a comfortable position, with all body parts well supported
and be taught to progressively contract and relax the musculature.This
process is often coupled with deep-breathing exercise to further
promote relaxation.
Coordination, balance and the acquisition of functional skills are all
interrelated and are complex aspects of motor control. Coordination
refers to the ability to use the right muscles at the right time with
appropriate intensity. It is the basis of smooth and efficient movement
that can occur on a voluntary or involuntary level. Balance refers to
the ability to maintain the center of gravity over the base of support,
usually while in an upright position. It is a dynamic phenomenon that
involves a combination of stability and mobility. Finally, functional
skills refer to the varied motor skills necessary to function
independently in all aspects of daily living. Learning functional motor
tasks involves constant repetition of simple to more complex motor
activities, use of sensory cues (tactile, visual) to enhance motor
performance and as the quality of movement improves, so should the
speed and timing of movements.”
(Adapted from Carolyn Kisner&Lynn Allen Colby – Therapeutic
Exercise. Foundations and Techniques)

GLOSSARY
dysfunction = disfuncţie
restoration = refacere, restabilire

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maintenance = menţinere
strength = forţă, vigoare
endurance = rezistenţă fizică
cardiovascular fitness = tonus cardiovascular
balance = echilibru
functional skills = abilităţi funcţionale
load = greutate
a high-intensity exercise = exerciţiu cu intensitate crescută
fatigue = oboseală
motor tasks = sarcini motorii
to challenge = a solicita
range of motion = grad de mobilitate
to lengthen = a se lungi, întinde
to yield to = a ceda, a nu rezista la
stretch force = forţă de întindere
stable = stabil
well-aligned position = poziţie corect adoptată
carry out = a îndeplini, a realiza
to relieve = a destinde, relaxa
deep-breathing exercise = exerciţiu de respiraţie profundă
acquisition = dobândire, obţinere
smooth movement = mişcare lină, fără întreruperi
upright position = poziţie verticală
sensory cues = indici senzoriali
to enhance = a mări, intensifica
motor performance = randament motoriu
timing = sincronizare

►◄ Pair-work
2. Question-answer exercise: Reread the text above on paragraphs.
One student will ask his/her colleague one or two questions for
each paragraph and he/she should answer it either by
reproducing fragments from the text or by freely expressing a
summary of that fragment. Here is an example for the first
paragraph:

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English in Kinetotherapy. A practical English handbook 59

Example:
What are the main goals of therapeutic exercises?
Well, if I remember corectly, the goals of therapeutic exercises
are………….

How is strength defined in the text?


Well, let my see, strength is defined as ………..
What should be done to produce greater muscular tension?
Well, it says here that a high-intensity exercise….

3. Question-answer exercise: Try to find out how much you really


know about your physical abilities. Ask your deskmate to make a
self-evaluation of his/her physical abilities (strength, muscular
endurance etc.); in your answers you can make use of the
following assessment patterns or come up with new ones:

• Well, my strength is quite bad/ is not so bad/ is actually quite


good/ is excellent….
• Muscular endurance is not my strong point, if you get my
meaning.
• As for my mobility and flexibility, it goes without saying that
all I need is a little practice, to get back into shape.
• Well, my stability depends a lot on my mental stability; a state
of nervousness will certainly be detrimental to my stability.
• I have always had problems with balance; to me, it is
sometimes that does not improve with practice; you either
have it or not.

WORD FORMATION – DERIVATION

Derivation with suffixes and prefixes is one of the means of word


formation. Generally, there are some typical noun/ adjective/ adverb/
verb – forming suffixes and prefixes, but there are cases when the

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60 ADINA RĂDULESCU

same prefix or suffix is used to form different categories. For instance


the suffix –al is used to form both nouns like in arrival, refusal,
proposal and adjectives like in functional, educational. The suffix –
ing is used to form the present participle that can be used as a verbal
category (She came walking across the field.), as a noun (Walking can
sometimes be very relaxing.) or as an adjective (He was reading a very
amusing novel.). The suffix –ly is the most common adverb-forming
suffix (rapidly, daily, usually). Still, there are some adjectives that
contain the –ly suffix: daily schedule, monthly payment. The
following exercises are meant as forms of practising the word
formation process.

4. Extract from the text above (Therapeutic exercises) all the


derivational nouns and include them into their corresponding
suffix category as shown in the example:
Example:
-ion: prevention
-ment: development
-ance: maintenance
-ness: fitness
-ity: mobility
-ing:walking

5. Find the corresponding base forms (verbs, adjectives) and the


corresponding suffixes for every derivational noun in the same
text:
Example:
prevention ← prevent (verb) + -ion (suffix)
mobility ← mobil (adjective) + -ity (suffix)

6. Extract from the text above (Therapeutic exercises) all the


derivational adjectives and include them into their corresponding
suffix category:

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Example:
-ic: therapeutic
-al: functional
-ing: resulting
-ed: prolongued
-ive: effective
-ly: daily
-(i)ous: conscious
-able: comfortable
-y: sensory

7. Find the corresponding base forms (nouns, verbs) and the


corresponding suffixes for every adjective in the text:
Example:
therapeutic ← therapeut (noun) + -ic (suffix)

8. Extract from the text above (Therapeutic exercises) all the


derivational adverbs and include them into their corresponding
suffix category:
Example:
-ly: relatively
-ally: dynamically

9. Find the corresponding base forms (adjectives) and the


corresponding suffixes for every adverb:
Example:
relatively ← relative (adjective) + -ly (suffix)
There are many nouns in English that have an identical form with their
corresponding verbs:
Verbs Nouns
to pressure pressure
to question question
to estimate estimate
to exercise exercise

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62 ADINA RĂDULESCU

Yet, sometimes there are some slight spelling differences between the
noun and its corresponding verb that can easily pass unnoticed:

Verbs Nouns
To practise practice
To respond response

10. Give other examples of nouns that have the same form as their
corresponding verbs and write contexts in which the same word
functions both as a noun and as verb.

11. Write in the second column the corresponding nouns for the
verbs listed in the first column. The first one has been done for
you as an example:

include inclusion_

1. examine ________
2. prescribe ________
3. operate ________
4. assess ________
5. decide ________
6. retire ________
7. interpret ________
8. confirm ________
9. immobilize ________
10. rehabilitate ________
11. swell ________
12. treat ________
13. dislocate ________

12. Rewrite the sentences below using the nouns in the second
column (exercise 11) instead of their corresponding verbs. Do not
change the meaning of the sentences:

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Example:
It was more than vital to include Mr. Dean in our clinical study.
Mr. Dean`s inclusion in our clinical study was more than vital.

1. I will be able to tell you more after I examine the patient.


2. You should not take these pills if the doctor did not prescribe
them.
3. The surgeons operated on the injured man immediately.
4. After the therapist assesses the patient’s needs, he will also
decide a further treatment.
5. As Mrs. Strauss retires next month, she will have more time
for her therapy.
6. After the doctor interprets the results of your X-rays, he will
probably confirm your need for surgery.
7. To immobilize the patient’s fractured leg is one of the first aid
measures to be taken.
8. Our clinic is specialized in rehabilitating patients who
suffered severe injuries.
9. What can I do if my ankle swells over night?
10. I cannot treat patients without their full consent and
cooperation.
11. If the patient`s shoulder is dislocated, an emergency
intervention is needed.

☼ THERAPIST-PATIENT DISCOURSE
Recommending different therapeutic exercises

Listening to the patients’complains and symptoms will normally be


followed by the therapist’s recommandations regarding different
therapeutic techniques and exercises. Here are some examples of such
kinetotherapy exercises that therapists may recommend to their
patients:

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Kinetotherapist’s recommendations:

• You should start with a very simple relaxation technique.


• A deep-breathing exercise will help you relax.
• Some massage sessions will be good for your local
circulation.
• Passive stretching exercises will lengthen your shortened
tissues.
• You can practise these self-stretching exercises as part of
your home exercise program.
• As a gymnast, do not forget to practise your overstretching
exercises.
• Considering your long-term immobilization, you need to
practise strengthening exercises every day.
• The best solution for you to regain your balance is to practise
weight-bearing exercises.
• I recommend you to continue with joint mobilization
techniques to treat your muscular stiffness.
• In treating your spine injury, traction techniques are a good
option.

13. Translate the above sentences into Romanian and say whether
you are familiar with these exercises; give examples of such types
of exercises.

14. Consider yourself as a kinetotherapist; choose one type of the


exercises above and explain the basic procedure to a colleague-
patient of yours.

15. Consider yourself as a patient with a certain dysfunction (you


can choose one of the symptoms presented in Unit 5) and ask your
colleague-therapist what exercises he would recommend you.

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16. Translate into English using the new vocabulary:


1. Este foarte important să-ţi alegi un program de exerciţii care
să-ţi fie cu adevărat de ajutor.
2. Exerciţiile de menţinere a greutăţii corporale ar trebui să
înceapă cu reînvăţarea schimbării greutăţii corporale.
3. Dacă vrei să-ţi corectezi postura corporală defectuoasă ar
trebui să începi cu exerciţii de întărire a musculaturii slăbite.
4. Exerciţiile de întindere sunt recomandate persoanelor în
vârstă, indivizilor sedentari şi persoanelor care se refac după
operaţii sau o imobilizare prelungită.
5. Creşterea rezistenţei musculare va duce implicit la
îmbunătăţirea tonusului cardiovascular.
6. Tehnicile de mobilizare a articulaţiilor sunt folosite în tratarea
atrofiei cartilajului articular, a slăbirii ligamentoase, a
hipomobilităţii articulare ş.a.m.d.
7. Tehnicile de tracţiune sunt practicate pentru a se redobândi
flexibilitatea, forţa, rezistenţa şi stabilitatea coloanei
vertebrale.
8. Poţi să-ţi menţii echilibrul timp îndelungat pe o suprafaţă
îngustă şi fiind legat la ochi?
9. Rezistenţa musculară nu este întotdeauna rezultatul
antrenamentelor susţinute. Urcatul şi coborâtul scărilor într-un
bloc fără lift, alergatul după autobuz sau mersul pe jos ne ţin
în formă în fiecare zi.
10. Toate capacităţile noastre fizice pot fi perturbate atunci când
suntem nevoiţi să fim imobilizaţi la pat pentru o perioadă
prelungită de timp.

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UNIT 7
THERAPEUTIC PROCEDURES IN HANDLING THE
PATIENT
▪ Passive verbal constructions
▪ Therapist-patient discourse – positioning and handling the patient

1. Read the following extracts and then solve the tasks that follow
them:

“Movements at a joint are determined by the shape of the articular


surfaces. For instances, the following movements are possible at the
shoulder joint: flexion and extention about the transverse axis with
the movements occurring in the saggital plane; abduction and
adduction about the anteroposterior axis, in which case the movement
is made in the frontal plane; and finally, rotation about the vertical
axis including pronation (medial rotation) and supination (lateral
rotation), with the movement occurring in the horizontal plane.”
(R. D. Sinelnikov – Atlas of Human Anatomy)

Weight-bearing control and stability


“Develop ability to shift the body weight. If the patient cannot bear
full weight, begin in the parallel bars with part of the weight borne on
the hands. The patient shifts anteriorly, side to side, and obliquely.
Manual resistance to the motion is added with pressure against the
patient`s pelvis.”
To increase flexion of the hip with the knee extended
Hand placement:
“With the patient’s knee fully extended, support the patient’s lower
leg with your arm or shoulder.
Stabilize the opposite extremity along the anterior aspect of the thigh
with your other hand or a belt or with the assistance of another person.
With the knee in maximum extension, flex the hip as far as possible.
Alternate position.

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Kneel on the mat and place the patient`s heel against your shoulder.
Place both of your hands along the anterior aspect of the distal femur
to keep the knee extended.
The opposite extremity is stabilized in extension by a belt or towel and
held in place by the therapist’s knee.”

To increase dorsiflexion of the ankle with the knee extended


Hand placement
“Grasp the patient’s heel (calcaneus) with one hand.
Stabilize the anterior aspect of the tibia with your other hand.
Pull the calcaneus downward with your thumb and fingers and gently
push upward on the heads of the metatarsals.”

To increase wrist extension


Hand placement
“Pronate the forearm and grasp the patient at the palmar aspect of the
hand. Stabilize the forearm. To lengthen the wrist flexors, extend the
patient`s wrist, allowing the fingers to passively flex.
Alternate position:
Support the patient’s forearm on the table but allow the hand to drop
over the edge of the table. Then passively extend the wrist. This may
be more comfortable for the therapist or necessary if the patient has a
severe wrist flexion contracture.”
(Carolyn Kisner&Lynn Allen Colby – Therapeutic Exercise.
Foundations and Techniques)

TASKS
1. Enumerate the movements that are possible at the shoulder
joint.
2. Name the type of therapeutic exercise that deals with
controlling body weight.
3. What is hand placement?
4. Which parts needs to be stabilized in: hip flexion, ankle
dorsiflexion and wrist extension?
5. What should the therapist do to lengthen the wrist flexors?

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6. What is recommended if the patient has a severe wrist flexion


contracture?
7. What objects does the therapist use in handling the patient?
8. Pair work: Choose one of the last three therapeutic procedures
and illustrate them, respecting the indications offered in the
texts.
9. Pair work: Repeat the task at point 8, this time with the
therapist describing the procedure (in his /her own words)
while illustrating it in front of the class.
10. Invent one type of exercise for a certain purpose, first practise
it with your deskmate and then, describe it to your audience.

2. Complete the missing correspondent in the following verb-noun


pairs:

VERBS NOUNS
flexion
extension
abduction
adduction
rotation
to pronate
to supinate
resistance
pressure
to stabilize
to lengthen
to support

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3. Complete the missing correspondent in the following adjective-


adverb pairs:

ADJECTIVE ADVERB
possible
manual
anteriorly
obliquely
comfortable
necessary
gently
passively
fully
horizontal
severe

■ GRAMMAR
Passive verbal constructions
In Unit 5 we have already introduced the issue of Passive Voice and
exemplified its use in dealing with passive modal constructions.
Learning how to use the passive forms of the most frequently used
verbal tenses is the objective of this unit.
As a general rule, the passive voice is formed by putting the verb to be
into the same tense as the verb in the active voice and adding the past
participle of the active verb. The direct object of the active verb
becomes the subject of the passive verb, while the subject of the active
verb becomes the agent of the passive verb.

Example:

Therapists sometimes hypnotize their patients.


↓ ↓
subject direct object

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The patients are sometimes hypnotized by their therapists.


↓ ↓
subject agent

Read the chart below to see how the active to passive


transformation works for the main verbal tenses:

TENSES ACTIVE PASSIVE VOICE


VOICE
Present treat am/is/are treated
Tense
Simple
Present is/are is/are being examined
Tense examining
Continuous
Past Tense injured was/were injured
Simple
Past Tense was/were was/were being
Continuous transporting transported
Present has/have has/have been found
Perfect found
Past Perfect had had been discharged
discharged
Future Tense will/shall will/shall be included
Simple include
Future will/shall will/shall have been
Perfect have healed healed
Conditional would would be recovered
recover
Perfect would have would have been saved
Conditional saved
Gerund practising being practised

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4. Put the verbs in brackets into the passive voice of the tense
indicated:

Example:
The range of motion of the ankle is restored (restore – Present Tense
Simple) by performing stretching exercises.

1. The ankle ___________________ (immobilize – Present


Tense Simple) in a short cast for 3 to 4 weeks.
2. The patient`s lower leg ___________________ (elevate –
Present Tense Continuous) now.
3. Successive weight-bearing stresses ________________
(impose – Past Tense Simple) on the feet.
4. These faulty foot postures __________________ (cause –
Present Perfect) by the excessive adduction of the forefoot.
5. The rehabilitation program ________________ (start – Future
Tense Simple) as soon as possible.
6. Little effort _______________ (require – Present Tense
Simple) to maintain this position for extended periods.
7. Ankle and foot motions ________ previously ____________
(perform – Past Perfect) by the patient.
8. The same motion ____ now ____________ (repeat – Present
Tense Continuous) with the patient in alternate position.
9. Many balance activities _________________ (practise – Past
Tense Simple) but without any result.
10. Muscular endurance _________________ (increase – Present
Perfect) by performing the same exercises for a repeated
number of times.

5. Change the following sentences from Active Voice into Passive


Voice; the underlined direct objects will become the subjects of
the passive sentences:

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Example:
The patient sometimes describes pain from muscle spasm as a
headache.
Pain from muscle spasm is sometimes described as a headache.

1. If the patient is experiencing acute inflammation, he should


be placed in a less irritating position.
2. If a disk lesion is the cause of the acute back pain, the
therapist will first take measures to alleviate the pain.
3. Injury or degeneration of the disk affects spinal mechanics in
general.
4. The patient with acute disk lesions has avoided sitting with
the hips and knees flexed or leaning forward.
5. The patient needs bed rest during the first 2 days when
symptoms are highly irritable.
6. The therapist will instruct the patient to avoid flexion
activities that increase intradiskal pressure.
7. In one of my patients with spondylosis, traction exercises
temporarily relieved the pressure.
8. Many patients have often expressed emotional stresses as
increased tension in their lumbar region.
9. The patient performs elongation exercises only within
tolerance during the early healing phase.
10. Imbalances in the shoulder girdle will perpetuate faulty
postures.

☼ THERAPIST-PATIENT DISCOURSE
Positioning and handling the patient

►◄ Pair work

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6. Read the following positioning indications to your colleague-


patient who will then illustrate them in front of the class:

• The patient is supine, with arms in resting position.


• The patient is side-lying, with the affected hip up.
• The patient is hook-lying.
• The patient is cross-sitting.
• The patient is heel-sitting.
• The patient is on hands and knees.
• The patient is prone, with hands placed under the shoulders.
• The patient is supine, with the foot pointing upright to keep
the hip neutral to rotation.
• The patient is sitting, with the forearm supported on the
treatment table, wrist over the edge of the table.
• The patient is standing, with the hands placed in the low-back
area.
☺Team work
7. Read the following hand placement and stabilization procedure
indications to a therapist-patient pair who will then illustrate
them in front of the class.
• Grasp the patient’s wrist with your lower hand.
• Place your thumb on the anterior surface of the proximal end
of the clavicle.
• Place a belt around your shoulder and under the patient’s
thigh to help hold the weight of the lower extremity.
• Support the patient’s leg with the fingers of the top hand
under the patient’s knee and the lower hand under the heel.
• Stabilize the patient’s pelvis with the top hand or arm.
• Stabilize the patient’s pelvis by flexing the opposite hip and
holding the thigh with the hands. The hip to be mobilized is in
resting position.
• Sitting on a low stool, stabilize the leg between your knees
and place one hand on the anterior aspect of the tibia.

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☺Team work
8. Read the following therapeutic techniques to a therapist-patient
pair who will then illustrate them in front of the class:

• Perform elbow flexion and extension with the forearm


pronated as well as supinated.
• Flex the patient’s hip and knee to 90 degrees; support the
knee with the top hand.
• Pull the foot away from the long axis of the leg in a distal
direction by leaning backward.
• Flex the elbow to 90 degrees and abduct the shoulder to 90
degrees.
• Rotate the humerus by moving the forearm like a spoke on a
wheel.
• Flex the patient`s knee until discomfort is experienced in the
anterior thigh.
• Instruct the patient to arch the back by pressing against the
floor with the back of the neck and the sacrum.

9. Translate into Romanian all the sentences from the exercises 6,


7 and 8 above.

►◄Pair work
10. One student will be given a hand out containing indications for
a therapeutic exercise. He or she will read the text and then start
illustrating the stages of the exercise. The task for the other
student is to write down the content of the exercise while watching
it. The exercise will be repeated several times. At the end the
teacher or a third student will compare the two texts and
comment on their degree of similarity. Here is an example of a
hand out:

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Example:
The patient is standing, with the hands placed on the shoulders. The
patient bends his body sideways with one hand over his head. The
movement is repeated three times for each side. Then the patient
returns to the initial position.

11. Create your own therapeutic exercises, using the examples


provided in this unit and read them to your colleagues.

12. Translate into English, using the new vocabulary of this unit:

1. Plasaţi pacientul în poziţie de supinaţie, cu mâinile întinse


lateral.
2. Prindeţi încheietura mâinii pacientului şi rotiţi-i braţul.
3. Indicaţi-i apoi pacientului să încerce să facă aceeaşi mişcare
singur.
4. Poziţie iniţială: pacientul aflat în sprijin pe mâini şi genunchi.
5. Indicaţi-i pacientului să-şi menţină greutatea corporală pe
mâini şi genunchiul stâng şi să-şi întindă uşor genunchiul
drept în spate.
6. Greutatea corporală va fi apoi mutată pe mâini şi pe
genunchiul drept, iar piciorul stâng va fi întins.
7. Poziţie iniţială: pacientul este în poziţia stând pe călcâie.
Indicaţi-i pacientului să se aplece în faţă, cu capul între braţele
întinse, până ce abdomenul se va odihni pe coapsele
anterioare.
8. Poziţie iniţială: pacientul este aşezat pe-o parte, pe masa
terapeutului, cu capul plasat la marginea mesei.
9. Indicaţi-i pacientului să-şi întindă mâna de deasupra peste cap,
lăsând-o să atârne pe lângă masă. Poziţia trebuie menţinută
pentru câteva minute.
10. Aceeaşi mişcare se va repeta pentru braţul opus, cu pacientul
aşezat în poziţie simetrică.

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UNIT 8
MUSCULOSKELETAL AND CONNECTIVE TISSUE
DISORDERS
▪ Pronouncing tongue-twisters
▪ Therapist-patient discourse – describing symptoms and
recommending therapeutic exercises

1. Read the following definitions and match the names of the


disorders listed below with their corresponding definitions:

1. Osteoarthritis
2. Rheumatoid Arthritis
3. Ankylosing Spondylitis
4. Osteoporosis
5. Low Back Pain
6. Tendinitis and Tenosynovitis
7. Amyotrophic Lateral Sclerosis

A. A systemic inflammatory disorder affecting primarily the spinal


column and the large peripheral joints and eventually resulting in
hardening and deformity of the affected skeleton.

B. A generalized, progressive reduction of bone mass as bone


resorption outstrips bone formation, causing skeletal weakness and
fractures.

C. A chronic degenerative disease process occurring primarily in the


hips and knees and characterized by deterioration of the joint cartilage,
formation of new bone in subchondral areas and joint margins, and
joint hypertrophy.

D. May be caused by a muscle sprain or strain, arthritis, a tumor, or a


ruptured cartilage disk between vertebrae. Other causes are poor

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posture, obesity, enlarged prostate gland, sagging abdominal muscles,


sitting for prolonged periods of time, or excessive physical effort
involving the back muscles.

E. A rapidly progressive, degenerative disease of the upper and lower


motor neurons characterized by atrophy of the hands, arms, legs, and,
eventually, the entire body. Seventy percent of individuals die within
5 years of diagnosis.

F. A chronic systemic degenerative disease characterized by


inflammation of the connective tissues and manifested primarily in
and around peripheral joints.

G. An inflammation of the tendon and lining of the tendon sheath


characterized by pain on movement of the associated joint.

2. Translate the definitions above into Romanian, using the words


in the glossary:

GLOSSARY
disorder = disfuncţie, afecţiune, boală
primarily = în primul rând
to harden = a întări
bone resorption = resorbţie osoasă
to outstrip = a depăşi, întrece
subcondral areas = zone subcondrale
ruptured cartilage disk = disc cartilaginos rupt
poor posture = postură defectuoasă
sagging muscles = muşchi căzuţi, lăsaţi
lining = îngroşare
tendon sheath = teacă/înveliş al tendonului

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♦ PRONOUNCING TONGUE-TWISTERS

Mastering stress-emphasis is one of the keys to pronouncing multi-


syllable medical terms. English makes use of a primarily/strong
stress ( that has this graphic symbol: ') placed before the stressed
syllable and of a secondary/weaker stress (that has this graphic
symbol¸ ) that usually precedes the primarily stress, especially in
multi-syllable words.
Example:
circulation [¸s∂: kju'leiſn ] □□■□
inflammation [¸infl∂'meiſ∂n ] □□■□
Note – for the following pronounciation exercises each student
should make use of an English dictionary that contains phonetic
transcription.
3. Place the following two-syllable words in their corresponding
stress-emphasis pattern:spinal, disease, column, weakness, fracture,
prostate, muscle, tumor, posture, rotate, treatment, ankle, discharge,
bandage, acute.

Example:
first syllable stress second syllable stress
■□ □■
spi - nal ro - tate
4. Place the following three-syllable words in their corresponding
stress-emphasis pattern: atrophy, progressive, reduction, skeleton,
excessive, cartilage, formation, disorder, arthritis, physical, systemic,
lateral, sclerosis, surgery, maximum, resistance, endurance, effective.

Example:
first syllable stress second syllable stress
■□ □ □■□
a - tro – phy sys - te - mic

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5. Place the following four-syllable words in their corresponding


stress-emphasis pattern: vaccinated, peripheral, saturated,
pulmonary, pneumonia, diagnosis, emergency, compatible, penicillin,
deformity, circulation, independent, hypertrophy, spondylitis,
tendinitis, ability, relaxation, alternative, combination, voluntary,
phenomenon, restoration.

Example:
first syllable stress second syllable stress
■□ □ □ □■□□
vac-ci-na-ted pneu-mo-ni-a

third syllable stress


□□■□
in-de-pen-dent

6. Find the corresponding stress-emphasis pattern for the


following multi-syllable words and draw their graphic
reprezentation: degenerative, deterioration, individual, osteoarthritis,
osteoporosis, tenosynovitis, amyotrophic, cardiovascular,
rehabilitation, musculoskeletal, extensibility, pathophysiologic.

Example:
De-ge-ne-ra-tive □■□□□

☼ THERAPIST-PATIENT DISCOURSE
Describing symptoms and recommending therapeutic exercises

Read about the main causes and symptoms of the musculoskeletal


and connective tissue disorders in the following chart:

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The disorder Causes Symptoms


1. Osteoarthritis The etiology is early symptoms:
unknown but is deep, aching joint pain
believed to be that is aggravated by
related in some way exercise and that
to aging and worsens as the day
genetics. Men and progresses; stiffness
women are equally following inactivity.
affected, but the midcourse symptoms:
onset in men occurs reduced joint motion,
earlier. In women, tenderness, crepitus,
the incidence grating sensation,
increases after flexion contractures,
menopause. joint enlargement
late symptoms:
tenderness on palpation,
pain with passive range
of motion, increase in
degree and duration of
pain, joint deformity
and subluxation.
2. Rheumatoid The etiology is early symptoms:
Arthritis unknown but the nonspecific symptoms
disease is often of fatigue, malaise, low-
characterized as an grade fever, anorexia,
autoimmune weight loss.
disorder, and a midcourse symptoms:
familial link is tenderness, pain, and
suspected; women stiffness in affected
are three times joints (most often the
more likely than fingers) that occurs in a
men to be affected. bilateral, symmetric
pattern and spreads to
the wrists, elbows,

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knees, and ankles;


diminished joint
function; paresthesia;
joint contractures and
deformities.
3.Ankylosing the exact cause is early symptoms:
Spondylitis unknown. A higher recurrent pain in the
than expected level lower back or large
of HLA-B27 tissue peripheral joints;
antigen is seen in morning stiffness that is
90% of individuals relieved by activity;
with the disease. It stooped posture; limited
is three to four motion of lumbar spine
times more or limited range of
common in men motion in affected
than in women, and joints; fatigue; fever;
onset typically anorexia; weight loss;
occurs between 20 diminished chest
and 40 years of age. expansion; red, painful
eyes.
late symptoms:
kyphosis, fixed flexion
of hips, vertebral
fractures, impotence,
incontinence,
diminished bladder and
rectal sensation, angina,
pericarditis, pulmonary
fibrosis (rare).
4. Osteoporosis Inadequate calcium A dull, aching, constant
intake, early pain in the bones,
menopause, particularly the back
sedentary life-style, and chest; muscle
a familial hystory spasm; the spinal
of the disease, column mass

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endocrine diminishes, dorsal


disorders, kyphosis and cervical
prolongued lordosis increase,
immobility leading to multiple
compression fractures
of the spine and a
reduction in height.
5. Low Back Muscle sprain or The pain may be
Pain strain, arthritis, a accompanied by muscle
tumor, or a weakness or spasms. It
ruptured cartilage may radiate down the
disk between back of one or both
vertebrae; poor legs, as in sciatica. It
posture, obesity, may be started or
enlarged prostate increased by coughing,
gland, sagging sneezing, rising from a
abdominal muscles, seated position, lifting,
sitting for stretching, bending, or
prolonged periods turning.
of time, or
excessive physical
effort involving the
back muscles.
6. Tendinitis and Repetitive The involved tendons
Tenosynovitis movements, strain, usually show visible
or excessive, swelling; the joint may
unaccustomed be tender and hot to the
exercise; touch; motion of the
underlying joint causes pain.
systemic disease
(rheumatoid
arthritis, gout,
sclerosis); middle-
aged and older
adults and athletes

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or individuals with
occupations
requiring repetitive
motion are at
greatest risk.
7. Amyotrophic The etiology of early symptoms:
Lateral Sclerosis amyotrophic lateral weakness, cramps in the
sclerosis (ALS) is hands and forearms.
unknown, but midcourse symptoms:
proposed fatigue; dyspnea;
explanations slurred speech;
include genetics, dysphagia; asymmetric
metabolic spread of muscle
disturbances, and weakness to the rest of
the body; spasticity;
external agents.
fasciculations;
hyperactive deep
tendon and extensor
plantar reflexes.
late symptoms:
paralysis of vocal cords;
paralysis of chest
muscles, necessitating
ventilatory support.

►◄Pair work
7. Check if your deskmate has attentively read the chart by asking
him/her questions like these:

• What are the main causes of low back pain?


• What are the early symptoms in amyotrophic lateral
sclerosis?
• What are the late symptoms in ankylosing spondylitis?
• The symptom of which disease is the visible swelling of
tendons?

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• Which parts of the body are affected by pain in ankylosing


spondylitis?
• In which diseases does stiffness affect various parts of the
body?
Take turns in asking and answering various questions.

8. Extract or create sentences using the chart above and ask your
deskmate to say if they are true or false.

Example:
Athlets or individuals with occupations requiring repetitive
movements are very likely to suffer from tendinitis and tenosynovitis.
→ True

Men are three times more likely than women to be affected by


rheumatoid arthritis. → False

9. Translate the content of the chart above using a medical


dictionary.

10. Match the disorders in the first column with their


corresponding therapeutic exercises in the second column. Check
the symptoms in the chart above so as to make the appropriate
choice of the therapeutic exercises:

The disorder Therapeutic exercises


1. Osteoarthritis a. Therapy and exercise to increase range
of motion, strength, and endurance; balance
of activity and rest; splints, canes, walkers
to aid mobility;
moist compresses, paraffin gloves to reduce
pain and edema.
2. Rheumatoid b. The patient should sleep on a firm
Arthritis mattress with the knees flexed and
supported. Pain killers, muscle relaxants,

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and tranquilizers may help, as may applying


dry or moist heat. When the pain subsides,
the patient may increase activity if fatigue
is avoided. A corset or back brace may be
required. The patient should use a straight-
backed chair and not cross or extend the
legs.
3. Ankylosing c. Moist heat compresses to joint; rest of
Spondylitis joint with controlled progressive exercise
program.
4. Osteoporosis d. Physical therapy, exercise, postural
training; traction/back brace in special
cases.
5. Low Back Pain e. Physical therapy to maintain muscle
strength; occupational therapy for activity
of daily living support; speech therapy to
aid communication; splints for neutral joint
alignment; leg braces, canes, walkers to aid
ambulation.
6. Tendinitis and f. Exercise: isometric, isotonic, isokinetic,
Tenosynovitis strengthening, stretching, range of motion,
balance exercise; rest; massage, moist heat
for pain; elastic bandages for support;
canes, walkers to aid mobility. Avoid: soft
chairs, recliners, pillows under knees; use
firm bed and hard chairs; wear sturdy,
lowheeled shoes.
7. Amyotrophic g. Consistent exercise regimen, including
Lateral Sclerosis weight-bearing hyperextension and resis-
tance exercises to slow calcium loss and
strengthen musculature; heat and massage
for muscle spasm; orthopedic supports for
back and neck to prevent stress fractures.

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►◄ Pair work
11. Consider yourself as a kinetotherapist and choose the best way
to recommend the corresponding therapeutic exercises to your
colleague – patient who may ask you many questions regarding
the duration, the difficulty and the expected results of such an
exercise programme. Use the charts with medical information,
symptoms and treatments above. Here are some examples to help
you:

Example:
Therapist’s recommandations:
• Considering your aggravated joint pain and your stiffness
following inactivity, it is to your best interest that you should
start these therapeutic exercises.
• I do not want to put any pressure on you, but I do believe that
you should consider starting your physical therapy as soon as
possible.
• Your low back pain now radiates down the back of both your
legs. And as things are not getting better, you should really
take some urgent measures and start your therapy.

Patient’s questions:
• In what way will my general condition be improved after
starting these therapeutic exercises?
• How long will this therapy be and how many sessions a week
are necessary?
• Will this therapy be painful? How difficult are the exercises?
• Do I have to make any changes in my diet or in my daily
routine?
• Will this short-term therapy prevent the disease from getting
worse?

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UNIT 9
POSTURAL PROBLEMS
▪ Conditional clauses
▪ Therapist-patient discourse – improving communication

1. Read the following text, consult the glossary below and


translate the text into Romanian:

“Posture is a position or attitude of the body, the relative arrangement


of body parts for a specific activity, or a characteristic manner of
bearing one’s body.
A postural fault is a posture that deviates from normal alignment but
has no structural limitations. The postural pain symdrome refers to
the pain that occurs from mechanical stress when a person maintains a
faulty posture for a prolongued period; the pain is usually relieved
with activity. There are no abnormalities in muscle strength or
flexibility, but if the faulty posture continues, strength and flexibility
imbalances will eventually develop.
Lordotic posture
This posture is characterized by an increase in the lumbosacral angle,
an increase in the lumbar lordosis, and an increase in the anterior
pelvic tilt and hip flexion. This is often seen with an increased thoracic
kyphosis and forward head and is called a kypholordotic posture.
Relaxed or slouched posture
This posture is also called swayback. The entire pelvic segment is
shifted anteriorly, resulting in hip extension and the thoracic segment
is shifted posteriorly, resulting in flexion of the thorax on the upper
lumbar spine. This results in an increased lordosis in the lower lumbar
region, an increased kyphosis in the lower thoracic region, and usually
a forward head. When standing for prolongued periods, the person
usually assumes an asymmetric stance in which most of the weight is
borne on one lower extremity, with periodic shifting of weight to the
opposite extremity.

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Flat low-back posture


This posture is characterized by a decreased lumbosacral angle, a
decreased lumbar lordosis, hip extension, and a posterior tilting of the
pelvis.
Flat upper back posture
This posture is characterized by a decrease in the thoracic curve,
depressed scapulae, depressed clavicle, and a flat-neck posture. It is
associated with an exaggerated military posture but is not a common
postural deviation.
It is not normal for a person to always maintain good posture.
Therefore, the patient should be instructed to use cues throughout the
day to check posture. For example, the patient can be instructed to
check the posture every time he or she walks past a mirror, waits at a
red light while driving a car, sits down for a meal, enters a room, or
begins talking with someone. If the patient becomes aware of his/her
daily routines, they can be used as reminders to practise maintaining a
good posture.”
(Carolyn Kisner&Lynn Allen Colby – Therapeutic Exercise.
Foundations and Techniques)

GLOSSARY
to bear one’s body = a-şi susţine corpul
postural fault = defect postural
mechanical stress = solicitare mecanică
imbalance = dezechilibru
eventually = în cele din urmă
pelvic tilt = înclinare/aplecare pelviană
forward head = cap împins către anterior
to slouch = a se gârbovi cocârja
swayback = înclinare spre spate
to shift = a deplasa, schimba
stance = poziţie, postură
bear, bore, borne = a purta, a duce
flat low-back posture = postură aplatizată a zonei inferioare a spatelui

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flat upper-back posture = postură aplatizată a zonei superioare a


spatelui
thoracic curve = curbură toracică
depressed scapulae = omoplaţi căzuţi, lăsaţi
flat-neck = gât întins
cues = indicii
throughout the day = pe toată durata zilei
2. Check your reading comprehension by solving the following
tasks:
1. After reading about the four faulty postures, try demonstrating
each of them in front of the classroom.
2. Define in your own words what a postural fault is.
3. When does postural pain syndrome occur?
4. What happens if a patient continues to maintain a faulty
posture?
5. What are the visible signs of kypholordotic posture?
6. What postural habit does the slouched patient manifest while
standing?
7. What are the characteristics of flat upper-back posture?
8. What methods can a patient use to correct a faulty posture?
9. What are the causes of faulty postures, in your opinion?
10. How do you correct your faulty postures when you become
aware of them?

■ GRAMMAR
Conditional clauses
Conditional clauses consist of two parts: the subordinate clause or the
if-clause and the main clause. There are three main types of
conditional clauses and various mixed types. Each type is used to
express different real/unreal, present/past conditions, using certain
pairs of tenses. There are also many exceptions from each type but
students dealing with conditionals for the first time should simply
concentrate on the basic rules that will be presented in the following
chart:

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Types If-clause Main clause Meaning


Type I Present tense Future tense
simple simple
If the faulty strength Real
posture continues, imbalances will situation,
develop. present or
Present tense Modal verbs future
simple oriented
If the pain the patient
increases, must/should see
a doctor.

Present tense Imperative


simple
If you get tired, take a break and
then start again.
Type II Past tense would
simple/continuous could + short Unreal,
should hypothetic
infinitive situation,
might present or
If I were you, I would try the future
new procedure. oriented,
If he had more he could come to unlikely to
time, his sessions. happen

If she did what the


she might have a
doctor says, chance to avoid
surgery.
Type III Past perfect would Imaginary
simple/continuous could + have + situation,
should past past
might participle oriented

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If I had known I could have (regrets,


anything about helped the unfulfilled
first help, injured cyclist. plans,
wishes to
If you had you would have change the
practised your felt better. past)
therapeutic
exercises,

3. Fill in the gaps with the verbal constructions in the box to


complete the following conditional clauses:

may simply disappear begins should get up


would not have felt knew cannot relax
had performed is check could control

1. If the patient ……………. to feel discomfort, ask him to


corret the faulty posture.
2. If you were able to notice what posture causes your low back
pain, you …………………… it.
3. If you modify your sleeping posture, your morning pains
……………………… .
4. If he ………………. his relaxation exercises, he would not
have got stiff-necked.
5. If you are experiencing any pain, …………. your posture.
6. If you have a sedentary job, you …………….. and walk every
hour.
7. If the mattress …….. too soft, the patient sags and stresses
ligaments.
8. If the mattress is too firm, some patients ……………….
9. If she had slept in a comfortable bed, she
…………………….. so tired in the morning.
10. If I ………… what my ideal sleeping posture is, I would not
hesitate to immediately adopt it.

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4. Put the verbs in brackets into the correct tense:

a) I met my wife in hospital ten years ago. I had fallen on ice and
broken my leg. She was a nurse in my orthopaedics ward. Just
imagine! If I (1)………….. (not fall) on ice and (2) …………….
(not brake) my leg, I (3) …………………. (never meet) her. So I
could say that there is nothing so bad as not to be good for
something.

b) If this desk height (4) ………… (be) adequate, I (5)


…………………. (not have to) lean over my work. My back is
killing me! Not to mention the chair! If it (6) …….. (not be) so
high, my feet (7) ……………. (rest) comfortably on the floor. I
should complain about all these to our personnel manager. If more
employees (8) ………….. (express) their complaints, some
measures (9) ……………………. (passive – take).

c) You know what they say, that it all happens for a reason… Take
my example. If (10) …………….. (passive – not be) injured in
that car accident last year, I (11) …………… (accept) that job
offer in Paris. But here I am now… working in this rehabilitation
clinic… If people (12) ……… (know) how to deal with their
disabilities, they (13) ……………. (be able) to accept them more
easily.

5. Rewrite the following sentences, using an if construction:

Example:
a) The patient suffers from osteoporosis. Then, he will need
physical therapy, exercise and postural training.
If the patient suffers from osteoporosis, then he will need
physical therapy, exercise and postural training.

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b) The patient did not sleep on a firm mattress. He had to take pain
killers and muscle relaxants for his poor back.
If the patient had slept on a firm mattres, he would not have had to
take pain killers and muscle relaxants for his poor back.

1. This injury is severe. That is why the patient may run the risk
of paralysis.
2. He got injured in a football match. He had his left leg broken.
3. I worked hard to finish my science project. I had mild low
back pain for a week after.
4. My mother has a low resistance. She catches diseases very
easily.
5. The old man got panic-striken. His heart started beating more
rapidly.
6. He has the surgery right now. The chances of success may
increase to about 20%.
7. The infection spread. That is why he needed that urgent
treatment.
8. The diagnosis is correct. The family will have to evaluate their
options.
9. You do not spend enough time relaxing. That is why you are
always complaining about being tired.
10. These therapeutic exercises are to be practised every day.
They prevent the patient`s condition from getting worse.

6. Translate the following conditional sentences into English:

1. Dacă practici aceste exerciţii regulat, vei dobândi flexibilitatea


şi rezistenţa necesare pentru menţinerea stabilităţii spinale.
2. Dacă vrei să-ţi uşurezi acestă durere acută, trebuie în primul
rând să-ţi modifici obiceiurile posturale.
3. Nu poţi obţine stabilitate posturală dacă nu înveţi să-ţi
controlezi greutatea corporală.
4. Dacă aş fi ştiut că oboseala musculară măreşte riscul de
accidentare, nu m-aş mai fi antrenat atât de mult.

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5. Dacă eşti obosit şi te simţi mult mai relaxat într-o poziţie


gârbovită, corectează-ţi imediat această tendinţă nesănătoasă.
6. Dacă persistaţi în a vă menţine defectele posturale pentru mult
timp, aceasta va duce la slăbire musculară şi la rezistenţă
musculară redusă.
7. Dacă meseria vă solicită să staţi aplecaţi pentru perioade
îndelungate de timp, nu uitaţi să faceţi o pauză scurtă din
oră-n oră şi să vă faceţi exerciţiile de întindere.
8. Dacă pacienţii ar fi mai conştienţi de programul lor de mişcări
sigure, nu le-ar mai fi teamă de o nouă accidentare.
9. Dacă un pacient cu handicap fizic vrea să fie independent, el
va trebui să înveţe cum să-şi modifice mediul înconjurător:
patul, scaunele, scaunul din maşină, locul de muncă etc.
10. Dacă pacienţii doresc ca programul lor de exerciţii să fie
eficient, ar trebui să cunoască mai întâi foarte bine tehnicile
posturale şi numai apoi să le şi execute.

☼ THERAPIST-PATIENT DISCOURSE
Improving communication

7. Insert the sentences below in their corresponding semantic


class:

A. THERAPIST’S INSTRUCTIONS
B. CHECKING IF THE PATIENT GOT THE MESSAGE
C. OFFERING ASSISTANCE FOR THE PATIENT
D. ENCOURAGING THE PATIENT
E. BUILDING MUTUAL TRUST
F. GETTING A POST-PRACTISE FEED-BACK FROM
THE PATIENT

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Example:
Do you see my point?→B.(CHECKING IF THE PATIENT GOT THE
MESSAGE)
1. Lean backward and hold the stretch!
2. Did you get it right?
3. Is this too difficult for you?
4. I’m right here if you need me!
5. Don’t worry! I’ll keep an eye on you!
6. You can do it! Give it another try!
7. Need I say this again?
8. You have to trust me on this!
9. Have the cramps gone away now?
10. Lean forward, resting your abdomen on the anterior thighs.
11. Does this make any sense to you?
12. Don’t hesitate to ask for my help!
13. You had to deal with worse than this before!
14. Can you manage practising this exercise by yourself now?
15. You have to take my word for it!
16. Are you with me on this?
17. Don’t give up! One more try!
18. Have you experienced any muscle spasms during this
exercise?
19. Bend your trunk laterally and hold the position.
20. Did you take my hint?
21. If you need a helping hand… I’m not going anywhere!
22. Do your best! It’s worth trying!
23. Does it still hurt when you flex your knee?
24. You will have to learn to trust me.
25. Tuck in your chin and lift your head.
26. Did you get my message?
27. Do you still feel pins and needles in your feet?
28. I give you my word on this! Don’t you doubt it!
29. Lift both arms simultaneously.
30. Are your fingers still numb now?

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8. Create your own therapist-patient dialogues using the semantic


classes above and the examples provided for each class. Follow the
logical order of asking questions (first the instructions, then the
checking part and so on so forth).
9. Read the following types of dialogues and match them with
their corresponding titles:
1. Fixing an appointment
2. Changing an apointment
3. Returning a call
4. Taking a family history
5. Taking a social history
6. Examining a patient
A.
Dr. Thomson: Well, are you married?
Mr. Stiff: Yes, of course, who isn’t ?
Dr. Thomson: Do you have any children?
Mr.Stiff: Yes, but they are no longer living with us.
Dr. Thomson: What about your parents? Are they in good health?
Mr. Stiff: My mother died last year. Bone cancer. And my father
suffers from osteoarthritis.
Dr. Thomson: I`m sorry to hear that.
B.
Secretary: Wilkinson Rehabilitation Centre. Hello, may I help you?
Mr. Jones: Yes, hello. I am calling to fix an appointment, to see
Dr. Wilkinson.
Secretary: Right. Let me check his schedule. Er… how about 25th of
September?
Mr. Jones: Oh, I’m afraid it is a bit late. I have an urgent matter, you
see…
Secretary: Well, what about 21st of September, at 11 a.m.?
Mr. Jones: Oh, that’s better, thank you.
Secretary: Call us, please, in case you can’t make it.
Mr. Jones: Thank you, it would not be the case.

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C.
Dr. Richards: Could you just take off your clothes so that I can
examine you?
Mr. Spike: Okay, I have done this many times…
Dr. Richards: Would you, please, lie flat on the couch for a few
minutes? Can you now show me where it hurts?
Mr. Spike: Right here, in my left thigh.
Dr. Richards: Can you raise your left leg for me? And hold it for a
second? Does it hurt when you rotate it?
Mr. Spike: A little bit, when I return to the initial position.

D.
Mrs. Slender: Hello, Dr. Walsh?
Dr. Walsh: Speaking.
Mrs. Slender: Ah, Mrs. Slender here.
Dr. Walsh: Yes, hello, Mrs. Slender. It is good that you returned my
call.
Mrs. Slender: Is there anything wrong, doctor?
Dr. Walsh: No, nothing to worry about. I have just received your
X-rays and it looks that your ankle is not broken, but just sprained.
Mrs. Slender: Oh, what a relief!
Dr. Walsh: Please, come to see me tomorrow and we’ll discuss more
about it.

E.
Secretary: Wilkinson Rehabilitation Centre. Hello, may I help you?
Mr. Jones: Yes, hello. I’m Jones, I called you a couple of days ago…
Secretary: Yes, Mr. Jones. What can I do for you?
Mr. Jones: It is about my appointment. I won’t be able to make it. I
wonder if we could possibly move it to the 25th of September?
Secretary: First of all, Mr. Jones, you change your appointment at
short notice and then you want to fix the day for your future
appointment?

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Mr. Jones: I’m very sorry if I have caused you any inconvenience.
Shall I call back another time?
Secretary: We have your phone number and if someone cancels an
appointment we’ll let you know.
Mr. Jones: Thank you for your trouble.

F.
Dr. Thomson: Yes, you are still working, isn’t it?
Mr. Stiff: Yes, two more years till my retirement.
Dr. Thomson: Have you pushed yourself too hard lately?
Mr. Stiff: You know how things are. I am no longer young and keeping
up with the newly hired ……
Dr. Thomson: What about your working hours? Have you considered
working part-time?
Mr. Stiff: I’m afraid this is not an option in my field.
Dr. Thomson: Then, I hate to bring you the bad news, but you should
consider retiring…. Otherwise…..

►◄ Pair work
10. Create your own dialogues, starting from the following titles:
Introductory dialogues, The first examination, Programming the
first session, Recommending a better treatment, Proposing a new
experimental programme, Explaining how the devices work, How to
focus your effort, Dealing with home exercises programme, etc.

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UNIT 10
REVISION EXERCISES

1. Complete the following sentences using the nouns in the box:

dislocation muscular dystrophy fracture


cartilage spinal column joints
balance cardiovascular disease
postural fault range of motion exercise

1. The ……………….. is made up of 33 vertebrae that are


separated by spongy disks and protects the spinal cord that
runs inside of it among other things.
2. The connections between bones are called ………… each
being classified according to structure and movability as
fibrous, cartilaginous, or synovial.
3. The ……………….. is a tissue made of cells and fibers, that
connects and supports. It is found mostly in the joints, the
chest, and stiff tubes of all sorts, as the voicebox (larynx),
windpipe (trachea), nose, and ear.
4. In all forms of …………………… there is a slow loss of
strength with increasing disability and deformity.
5. ……………… is the displacement of any part of the body
from its normal position; this applies most often to a bone
moved from its normal position with a joint.
6. A ……………… is an injury to a bone in which the tissue of
the bone is broken.
7. A ………………………….. may cause problems with the
heart and blood vessels.

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8. ……………….. refers to the ability to maintain the center of


gravity over the base of support, usually while in an upright
position.
9. ……………………….. any body action involving the
muscles, joints, and movements in natural directions of arms
and legs.
10. A …………………… is a posture that deviates from normal
alignment but has no structural limitations.

2. Choose the right version that best completes the sentence:

1. Being placed in a supine position means:


a) lying flat or face downwards;
b) lying or resting on the back, with the face, palm, etc
upwards;
c) sitting cross-legged;
d) side-lying, with one arm up.
2. To adduct the arm means:
a) to draw or pull the arm towards the median axis of the
body;
b) to flex and elongate the arm successively;
c) to pull away the arm from the median axis of the
body;
d) to turn the arm around its own axis.
3. ………………….. is a generalized, progressive reduction of
bone mass as bone resorption outstrips bone formation,
causing skeletal weakness and fractures.
a) Osteomyelitis;
b) Osteoarthritis;
c) Rheumatoid Arthritis;
d) Osteoporosis.
4. Inadequate calcium intake, early menopause, sedentary life-
style, endocrine disorders, prolongued immobility are some of
the causes of ……………..

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a) Osteoarthritis;
b) Ankylosing Spondylitis;
c) Osteoporosis;
d) Amyotrophic Lateral Sclerosis.
5. An abnormal, increased degree of forward curvature of any
part of the spine is the characteristic of …………….
a) kypholordotic posture;
b) lordotic posture;
c) slouched posture;
d) flat low-back posture.
6. …………………………. are necessary to treat joint
dysfunctions such as stiffness, reversible joint hypomobility,
or pain.
a) strenghtening exercises;
b) stretching exercises;
c) weight-bearing exercises;
d) joint mobilization exercises.
7. ……………………………… is the ability of a muscle to
contract repeatedly or generate tension, sustain that tension
and resist fatigue over a prolonged period of time.
a) muscle strength ;
b) muscular endurance ;
c) muscular contraction ;
d) muscular extensibility.

3. Find the root-verbs that the following nouns are derived from:
examination, treatment, assessment, decision, diagnostician,
information, retirement, development, selection, questioning,
interpretation, palpation

Example:
examination ← examine (the root-verb)

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4. Derive the corresponding nouns, adjectives and adverbs from


the following verbs:
affect, aggravate, compress, contract, diminish, disturb, explain,
expect, function, immobilize, include, increase, limit, paralyse,
propose, radiate, reduce, repeat, suspect, swell.

Example:
verb noun adjective adverb
repeat repetition, repeatable, repeatedly
repeater, repeated,
repeating,
repetitional

5. Find the corresponding stress-emphasis pattern for the


following two/three/four/multi-syllable words and pronounce
them accordingly: affected, aggravated, alignment, compression,
contracture, deformity, disease, duration, fasciculation,
hyperextension, inactivity, kypolordotic, lumbosacral, pericarditis,
recliner, strengthening, stiffness, subluxation, tranquilizer.
6. Complete each space with a word formed from the words in
capitals.
A. Warming up soft tissues prior to
stretching will increase the
(1)…………… of the shortened tissue. EXTEND
Warm muscles relax and (2)……………. LENGTH
more easily, making stretching more
(3) ………………….. for the patient. As COMFORT
the temperature of muscle increases, the
amount of force required to elongate
noncontractile and contractile tissues and
the time the stretch force must be
(4) ………………. decrease. Although APPLY
stretching is often thought of as a warm-

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up activity and performed prior to


(5) …………… exercise, the clinician VIGOUR
and patient must always remember that
an appropriate warm-up must also occur
in the (6) ………………….. for PREPARE
stretching. It is (7) ………………… DEBATE
whether heating should occur prior to or
during the stretching procedure.

B. Some anger may serve a


(1) ………… purpose; much anger USE
however, is purely (2)……………….. DESTRUCT
The energy that goes into its arousal
could often be more (3) ……………….. PROFIT
spent in solving the problem. Here are
some ways in which anger can be
controlled:
• reinterpreting the stimulus in a more
positive light; many situations contain
ambiguities which allow
(4) ……………….. to be made; REINTERPRET
• being realistic in our (5)………………. EXPECT
of other people;
• giving oneself (6)……………… to PERMIT
make a mistake, as it is part of being
human to make mistakes (7)…………….. OCCASION
• distancing oneself; if circumstances
seem to be overwhelming, one can try
stepping back mentally to get a more
(8) …………………. view; OBJECT
• introducing humour at (9)………….. SUIT
moments; when a person smiles and
laughs the (10) ……………. response RELAX
takes over.

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7. Read the text below and choose the version that best completes
the empty spaces:

Pain is often the reason why the patient has come for attention in the
first place. Always remember that pain is a/an (1) …………….. to the
patient who may find that it is making his or her life (2)…………… .
Pain is a/an (3)………….. experience and any measurement must
incorporate a degree of (4) ………………. .
Reactions to pain vary widely (5) …………. different people and
depend (6) ……. many different physical and mental factors. Specific
diseases and injuries and the health, pain (7) …………., fear and
anxiety, and ethnic background all affect reactions to pain.
Patients will describe pain (8) ……….. in terms of its sensory
qualities, for example shooting, sharp, burning or in terms of its
affective qualities, for example vicious, cruel, sickening, or in terms of
its evaluative qualities, for example intense, unbearable, annoying.
Severe pain causes pale skin, cold sweat, ”(9)…….. bumps,” wide
pupils, and higher levels of pulse, breathing rate, blood (10) ………..,
and muscle (11)………… . When brief, strong pain starts to go away,
the pulse may be slower and the blood pressure lower than before the
pain began. If pain occurs often or is long term, the pulse (12) …….
and blood pressure may not go up much. If pain lasts for many days,
the (13) ………… to fight infections may be lost. The patient's tone of
voice, speed of speech, cries, groans, or other sounds, face and body
movements, or attempts to withdraw are noted by the physician.
It is hard to (14) ………… strong or long-term pain, but a patient can
learn to live almost (15) ………….. even with some pain.

1. a) illusion b) reality c) dream d) perception


2. a) intolerable b) impossible c) easier d) irritating
3. a) individual b) objective c) personal d) subjective
4. a) objectivity b) doubt c) subjectivity d) error
5. a) to b) among c) with d) from
6. a) on b) of c) in d) with

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7. a) point b)limit c) degree d) level


8. a) or b)either c) neither d) nor
9. a) hen b)road c) goose d) heat
10. a) group b)relation c) test d) pressure
11. a) bulk b) tension c) spasm d) strain
12. a) rate b)rhythm c) beat d) tempo
13. a) talent b)volition c) ability d) capacity
14. a) relieve b)cure c) release d) solace
15. a) usually b) patiently c) regularly d) normally

8. Turn the following sentences from active voice into passive


voice. Begin the passive sentences with the underlined words:

1. Total body streching, such as toe touches, may maintain or


overstretch a mobile area.
2. Strengthening programs tend to overemphasize flexion
exercises.
3. When performing this kind of stretch, you must keep your
shoes on.
4. Patients should perform flexibility exercises prior to and after
a strengthening program.
5. An effective stretching or flexibility routine should not cause
pain or excessive stress to tissues.
6. Patients should slightly bend their knees when performing
forward-bending exercises.
7. You will warm up the tissues with gentle rhythmic activities.
8. Increase the pace of activity so that you can maintain the
target heart rate for 10 to 20 minutes.
9. To avoid injuries from stress, you should use appropriate
equipment, such as correct footware.
10. People often use inappropriately the phrase “No pain, no
gain” as the guideline for intensity of stretch.

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9. Identify the type of the following conditional sentences and fill


in the missing tenses or modal constructions to complete them:

1. If pain begins while exercising, you …………………


(decrease) effort and rest between sessions.
2. You would have avoided overuse symdromes if you
………………… (perform) proper warm-up.
3. If she really wanted to protect vulnerable joints, she
…………………... (not stress) joints and ligaments at the end
of the range.
4. If he wanted to increase his muscular endurance, he
……………………. (perform) the exercises with many
repetitions and minimal resistance to the point of muscle
fatigue.
5. If you ………….. (keep) your knee straight, the
gastrocnemius is stretched.
6. If you do not want to be injured during your aerobic program,
you …………… (avoid) running, jogging or aerobic dancing
on hard surfaces such as asphalt and concrete.
7. If your sister had practised aerobic activity 3 to 5 times per
week, she …………………. (feel) much better.
8. If you bend your knee, the soleus ………. (be) stretched.
9. Concentrate on stretching the tight muscles, if there …… (be)
decreased flexibility between antagonistic muscle groups.
10. If your patient were excessively mobile in a segment of his
body, it ………………… (be) safer to selectively stretch tight
structures than the total body.

10. Translate intoRomanian, without using a dictionary:

a) Inability to reverse the normal lumbar lordosis on flexion occurs in


degenerative arthritis. Limited lumbar flexion is characteristic of
ankylosing spondylitis. Localized bone pain suggests such disorders

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such as osteomyelitis, leukemia, primary or metastatic cancer,


compression fracture or herniated disk.

b) Normally, when a patient had limited range of motion, the


therapeutic approach was to stretch the region with passive stretching
techniques. Over the past 30 years, therapists have identified and
learned techniques that deal more directly with stretching the source
of limitation, and thus they are managing dysfunctions better and with
less trauma. Muscle elongation or active inhibition techniques are
used to counteract the loss of flexibility in the contractile elements of
muscles; cross-fiber massage techniques are used to increase mobility
in selected ligaments and tendons; and joint mobilization and
manipulation techniques are used to safely stretch or snap structures to
restore normal joint mechanics with less trauma than passive
stretching.

c) It could be argued that smoking has more to do with relaxation than


smoking abstinence has, and many people become smokers because
they perceive cigarettes as being a source of mental calm. However,
many such people then wish to quit smoking. Quitting is associated
with stress, which means that the same people may be seeking
relaxation training. Health care professional increasingly find
themselves faced with groups of people who are struggling to give up
cigarettes and for whom relaxation training hes been prescribed.

d) The main symptoms of muscular distrophy are: delays in gross


motor development; difficulty walking, running, climbing stairs, and
riding a tricycle appears about 3 to 5 years of age; progressive
weakness with waddling gait, lordosis, difficulty rising from a sitting
or supine position; calf muscle hypertrophy; scoliosis; contractures
and joint deformities; inability to ambulate by about age 12; mild
mental retardation; respiratory and accessory muscles involved in end
stage with cardiomegaly.
The general treatment includes: long-term rehabilitation (occupational
and physical therapy) to maintain activities of daily living and help

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adapt to progressive loss of function, prevent disuse syndrome, and


promote bowel and bladder control; assistive devices (canes, walkers,
bracing, casting, wheelchairs); counseling and psychologic support of
individual and family; respite home care; ventilatory assistance and
communication devices in end-stage; family genetic counseling,
identification of carriers.

e) Inverted bicycle
This popular exercise is performed by the subject starting supine, then
rolling up onto the shoulders so that the feet are up in the air. The
weight of the inverted body is borne on the upper thoracic and cervical
spine. Once in this position, the person attempts to balance while
flexing and extending the lower extremities in a reciprocal manner.
Problems with this exercise include the position itself, which places
the head in a forward-head posture. The body weight becomes a
strong stretch force into flexion on the upper thoracic region, a region
that frequently tends to be flexed from a faulty posture. The flexed and
inverted position compresses the lungs and heart, decreasing their
potential effectiveness. It is questionable whether the benefits of this
exercise outweigh the combined negative effects on the neck and
upper back posture, circulation and respiration.

f) Scissors
This activity is performed with the person lying supine and legs held
extended several inches above the exercise mat. The person then
abducts and adducts the legs, mimicking a scissors motion. The
mechanics of the activity are similar to straight-leg raising in that it
requires a strong abdominal muscle contraction to stabilize the pelvis
against the pull of the hip flexor muscles, which, in this case, must
contract strongly to hold the legs off the ground. There is no resistance
to the abductor and adductor muscles, because the legs move parallel
to the ground. To stabilize the pelvis, the person is often instructed to
place the hands under the pelvis. This defeats the intent of
strengthening the abdominals, because they then do not have to work.

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g) Many types of joint surgeries are available to treat chronic joint


disease of the hip and some fractures of the hip that compromise the
vascular supply to the head of the femur. The procedures include
osteotomy (which is actually an extra-articular procedure), arthrodesis,
and several variations of arthroplasty of the hip, such as resurfacing,
hemireplacement, and total joint replacement procedures. The goals of
joint surgery and postoperative management are to provide a patient
with: a pain-free hip, a stable joint for lower extremity weight bearing
and functional ambulation, and adequate range of motion and strength
of the lower extremity for functional activities.
It is important for the therapist to have a basic understanding of the
more common surgical procedures for management of joint disease
and deformity and a thorough knowledge of appropriate therapeutic
exercise procedures and their progression for an effective and safe
postoperative rehabilitation program.

11. Translate into English:

a) Staţi întinşi sau aşezaţi într-o poziţie pe care o simţiţi comodă.


Închideţi ochii. Simţiţi cum începeţi să vă relaxaţi. Pe măsură ce trupul
şi mintea se calmează, permiteţi-i locului dumneavoastră special să ia
contur în imaginaţia dumneavoastră. Observaţi priveliştea, sunetele şi
mirosurile acestui loc. Apoi, încercaţi să simţiţi cum muşchii se
relaxează, eliminând tensiunea de peste zi.

b) Staţi aşezaţi, cu tălpile unite către interior şi cu genunchii îndreptaţi


lateral către exterior. Plasaţi-vă mâinile în jurul gleznelor şi odihniţi-
vă coatele pe coapse. Apăsaţi uşor cu coatele asupra coapselor. Apoi
odihniţi-vă. Apăsaţi apoi din nou. Ar trebui să simţiţi o întindere
plăcută în zona şoldului.

c) Pentru a învăţa să conduceţi relaxaţi, în primul rând identificaţi


grupele musculare de care aveţi nevoie pentru condus. Dacă observaţi
că aceste grupe sunt tensionate, relaxaţi-le. Verificaţi dacă şi muşchii
pe care nu-i solicitaţi când conduceţi, cum ar fi muşchii feţei, sunt

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relaxaţi. Nu uitaţi zona umerilor. Menţineţi-vă relaxaţi şi atunci când


viraţi sau schimbaţi viteza.

d) Exerciţiile de întindere sunt atât de utile pentru că ajută la


menţinerea elasticităţii. Elasticitatea este una dintre proprietăţile
ţesutului muscular care nu numai că permite muşchilor să funcţioneze
mai bine, dar îi şi protejează faţă de o posibliă accidentare. De multe
ori, obişnuim la modul inconştient să ne întindem, după ce am stat
mult timp în aceeaşi poziţie. Se pare că trupul nostru ne-o cere. Ne
întindem după ce dormim, după ce stăm cu orele la birou, după ce
lucrăm aplecaţi în grădină…

e) Cum ne dăm seama, fără a fi specialişti, de existenţa unei luxaţii sau


fracturi? Diagnosticul prezumtiv este relativ simplu: în cazul
luxaţiilor, articulaţia respectivă are o formă anormală, nu mai poate fi
mişcată din cauza durerilor, iar pacientul îşi înclină corpul sau îşi
modifică poziţia membrului în poziţia cea mai comodă pentru el. În
această poziţie îl vom imobiliza sau îl vom susţine până la cel mai
apropiat punct medical. Fracturile se recunosc uşor prin deformarea
segmentului pe membrul respectiv (se angulează în locuri unde nu
sunt articulaţii), mobilitatea anormală şi dureroasă, în aceleaşi locuri şi
crepitaţiile (pârâituri) care se aud în locurile respective când
accidentatul încearcă să mişte membrul.

f) Tratamentul recuperator în cazul fracturilor este deosebit de


important, asigurând reluarea cât mai rapidă a funcţiei membrului.
Kinetoterapia începe din primele momente după imobilizarea fracturii
şi constă în contracţii izometrice musculare sub gips şi mişcare activă
precedată de masaje a segmentelor libere. Activitatea cu membrele
sănătoase (mersul cu cârje) sunt o gimnastică ideală, simetria
impulsurilor care se transmit la ambele membre având rol trofic foarte
important pentru membrul lezat.

g) Hidrokinetoterapia este o formă specială de kinetoterapie care se


practică în secţii de recuperare bine dotate. Ea se practică în bazine de

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forme şi dimensiuni variate în care pacientul execută mişcări sau


programe complexe pasive şi active, în imersiune totală (doar capul
rămâne afară) sau parţială ( membrul superior sau segmentele sale).
Imersiunea are un dublu rol: eliberează mişcările de acţiunea gravităţii
şi opune rezistenţă mişcărilor.

h) Ergoterapia reprezintă etapa cea mai complexă a kinetoterapiei. Ea


constituie o etapă prelungită de tratament, care stă la baza reeducării
profesionale şi reintegrării deficientului în circuitul economico-social.
Ergoterapia orientativă are ca scop educarea profesională şi
îndrumarea deficienţilor către anumite profesiuni pentru care au
aptitudini. Ergoterapia retributivă poate fi utilizată pentru bolnavii
care recuperează spontan o paralizie sau care au suferit un tratament
paliativ al sechelelor şi şi-au recâştigat mişcările principale.

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GLOSSARY

acute muscle soreness = durere musculară acută


admission (to hospital) = internare
aerobic exercise = exerciţiu aerobic
aid = ajutor
ailment = indispoziţie, durere uşoară
amputation = amputare
amyotrophic lateral sclerosis = scleroză laterală amiotrofică
anaerobic exercise = exerciţiu anaerobic
analgesic/pain killer = analgezic. calmant
anemia = anemie
anesthesia = anestezie
anesthetic = anestezic
angina = angină
ankle joint = articulaţia gleznei
ankylosing spondylitis/bamboo spine = spondilită anchilozantă
anorexia = anorexie
antiseptic dressing = pansament antiseptic
aortic aneurysm = anevrism aortic
apnea = apnee
arrythmia = aritmie
arterial insufficiency = insuficienţă arterială
arterial pressure = tensiune arterială
arteriosclerosis/hardening of the arteries = arterioscleroză

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arteritis = arterită
arthritis = artrită
arthrokinematic = artrocinematic
arthropathy = artropatie
arthroplasty = artroplastie
arthroscopy = artroscopie
articular cartilage = cartilaj articular
articulation/joint = articulaţie
atrophy = atrofie
avascular necrosis = necroză avasculară
axilla/armpit = axilă, subsuoară
balance = echilibru
bandage = bandaj
bladder = vezică urinară
blood vessels = vase sanguine
bowels = intestine
brace = orteză
bradypnea = bradipnee
calcaneus/heel = călcâi
calcification = calcifiere
cardiovascular fitness = tonus cardiovascular
carpus/wrist = încheietura mâinii
cartilage disk = disc cartilaginos
cerebrovascular accident/stroke = accident cerebrovascular
cervical lordosis = lordoză cervicală
chilblain/frostbite = degerătură
clavicle/collarbone = claviculă
coccyx = coccis
compression dressing = pansament compresiv

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connective tissue = ţesut conjunctiv


contusion/bruise = contuzie, vânătaie
convalescence = convalescenţă
coronary artery disease = boală coronariană
cotton wool = vată
cranium/skull = craniu
crepitus = crepitaţii
crutch = cârjă
cyanosis = cianoză
dermatitis = dermatită
diaphysis = diafiză
dislocation = dislocare
dorsiflexion = dorsiflexie
double up with pain = a se îndoi, chirci de durere
dynamometer = dinamometru
dyspnea = dispnee
dyspnea = dispnee
edema = edem
edema/swelling = edem, umflătură
electromyography = electromiografie
encephalitis = encefalită
epidemiology = epidemiologie
epiphyseal cartilage = cartilaj epifizar
epiphysis = epifiză
ergometer = ergometru
etiology = etiologie
exercise bouts = număr optim de repetări ale unui exerciţiu
expiratory flow rate = frecvenţă respiratorie
fibrous joint = articulaţie fibroasă
flat low-back posture = postură aplatizată a zonei inferioare a

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spatelui
forward head posture = postură cu capul împins către înainte
gait = umblet, mers
gall bladder = vezică biliară
gangrene = cangrenă
go on crutches = a merge în cârje
goniometer = goniometru
halitosis/bad breath = halitoză
hemarthrosis = hemartroză
hemiparesis = hemipareză
hereditary = ereditar
herniated disk = disc herniat
herniation = herniere
high-protein diet = dietă bogată în proteine
hip = şold
hip joint = articulaţia şoldului
hydrotherapy = hidroterapie
hyperglycaemia/high blood sugar = hiperglicemie
hyperkinesia = hiperkinezie
hyperplastia = hiperplastie
hyperreflexia = hiperreflexie
hyperthermia = hipertermie
hypertonic muscles = muşchi hipertonici
hyperventilation = hiperventilaţie
hypokinesia = hipokinezie
hypotonic muscles = muşchi hipotonici
hypoxia = hipoxie
idiopathic = idiopatic
immobility = imobilitate

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impairment = afectare
in-patient = pacient spitalizat/internat
inspiratory capacity = capacitate inspiratorie
instep = scobitura gleznei
isokinetic exercise = exerciţiu izokinetic
isometric (static) exercise = exerciţiu izometric
isotonic (dynamic) exercise = exerciţiu izotonic
joint hypertrophy = hipertrofie articulară
joint mobilization = mobilizare articulară
knee joint = articulaţia genunchiului
knuckle = articulaţia degetului
kypholordotic posture = postură cifolordotică
kyphoscoliosis = cifoscolioză
kyphosis = cifoză
kyphotic posture = postură cifotică
lethargy = letargie
limb = membru
lordosis = lordoză
lordotic posture = postură lordotică
low back pain = durere joasă de spate
low-grade fever = febră uşoară; subfebrilitate
lupus erythematosus = lupus eritematos
lymphedema = limfedem
malaise = indispoziţie
medical examination sheet = foaie de observaţie clinică
medical history = anamneză
meningitis = meningită
mien = ţinută, comportament
motility = motilitate

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multiple sclerosis = scleroză multiplă


muscle bulk = masă musculară
muscle fatigue = oboseală/extenuare musculară
muscle rigidity = rigiditate musculară
muscle spasm = spasm muscular
muscle sprain = luxaţie
muscle strain = întindere musculară
muscle strength = forţă musculară
muscle tone = tonus muscular
muscular contraction /cramp = contracţie musculară
muscular dystrophy = distrofie musculară
muscular endurance = rezistenţă musculară
muscular hypertrophy = hipertrofie musculară
muscular tension = tensiune musculară
muscular weakness = slăbire musculară
myocardial infarction/heart attack = infarct miocardic
nape (of the neck) = ceafă
nausea = greaţă
necrosis = necroză
neurasthenic = neurastenic
neuromuscular tension = tensiune neuromusculară
nostril = nară
numbness = amorţeală
obesity = obezitate
occupational therapy = terapie ocupaţională
ointment = unguent
onset = debut (al afecţiunii, bolii)
orthopedic support = suport ortopedic
orthopedics = ortopedie

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orthopnea = ortopnee
osteoarthritis/degenerative joint disease (DJD) = osteoartrită
osteomyelitis = osteomielită
osteoporosis/bone atrophy = osteoporoză
osteotomy = osteotomie
out-patient = pacient extern
overstrain = supraîncordare
overstretch = supraîntindere
palliative = paliativ
paralysis = paralizie
paraplegia = paraplegie
parasthesia = parestezie
paresis = pareză
paresthesia = parestezie
patella, -ae/knee cap = rotulă
pathology = patologie
pelvic tilt = înclinare/aplecare pelviană
pericarditis = pericardită
pharmacology = farmacologie
phlebitis = flebită
physician = medic
physiology = fiziologie
physiotherapy = fizioterapie
plantarflexion = flexie plantară
plaster bandage = pansament gipsat
plaster cast = aparat gipsat
poliomyelitis/infantile paralysis = poliomielită
postoperative = postoperator
postural fault = defect postural

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prescription = prescripţie, reţetă


progressive muscular atrophy = atrofie musculară progresivă
progressive muscular dystrophy = distrofie musculară progresivă
psoriasis = psoriazis
pull one’s hamstring muscle = a-şi întinde un tendon muscular
quadriplegia = cvadriplegie
range of motion = grad de mobilitate
recreational therapy = terapie recreaţională
reflex hammer = ciocănel pentru testarea reflexelor
rehabilitation = recuperare (a pacientului)
remedy = remediu
remission = remisie
rheumatism = reumatism
rheumatoid arthritis = artrită reumatoidă
rib = coastă
round-back posture = postură rotunjită a spatelui
rupture = ruptură, hernie
sacrum = os sacral
scapula/shoulder blade = omoplat, scapulă
sciatica = sciatică
scoliosis = scolioză
sedative/sleeping pill/dope = sedativ
seizure = atac de apoplexie
sequela, -ae = sechelă, -e
shin/cannon bone = tibia, fluierul piciorului
shoulder girdle = centură scapulară
skeletal injury = leziune a sistemului scheletic
skin lesion = leziune a epidermei
snap a tendon = a suferi o ruptură de tendon

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sole = talpă
spasticity = spasticitate
speech theraphy = logopedie
spinal cord injury = leziune a coloanei vertebrale
spinal cord/marrow = măduva spinării
spine/spinal column/backbone = coloana vertebrală
splint = atelă
spondylitis = spondilită
spondylosis = spondiloză
sprain one’s ankle/wrist = a-şi luxa glezna/încheietura mâinii
stance = poziţie, postură
stasis = stază
sterile dressing = pansament steril
sternum/breastbone = stern
sticking plaster = leucoplast
stiffness = rigiditate
stitches = copci
stooped posture = postură aplecată, înclinată
strain one’s muscle = a suferi o întindere musculară
strengthening exercises = exerciţii de întărire musculară
stretcher = targă
stupor/apathy = indiferenţă, apatie
sway back posture/relaxed (slouched) posture = postură aplecată,
gârbovită
symptomatic = simptomatic
synovectomy = sinovectomie
synovial joint = articulaţie sinovială
synovitis = sinovită
tachycardia/palpitations = tahicardie
tape measure = ruletă, panglică de măsurat

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tear/pull a ligament = a suferi o ruptură ligamentară


tenderness = consistenţă redusă
tendinitis = tendinită
tendinosis = tendinoză
tenosynovitis/inflamed tendons = tenosinovită
test tube = eprubetă
testing devices = instrumente de testare
thigh = coapsă
thoracic cage = cuşcă toracică
thrombophlebitis = tromboflebită
thrombosis = tromboză
thyroid cartilage/Adam’s apple = cartilaj tiroidian
tissue = ţesut
tomography = tomografie
twitch = tic nervos
vertebra, -ae/bony ring = vertebră
ward = secţie/salon de spital
weight loss = scădere în greutate
weight-bearing exercise = exerciţiu de susţinere
a greutăţii corporale
wheel stretcher = targă prevăzută cu roţi

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124 ADINA RĂDULESCU

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Universitatea SPIRU HARET

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