2- Therapeutic Exercise

Dr. Danyal Ahmad

 Course contents
• Patient management and clinical decision
making
 Patient management model
• 1.History
• A comprehensive examination
• 2. Evaluation of data collected
• 3. Determination of a diagnosis based on impairments
of body structure and function, functional limitations
(activity limitations), and disability (participation
restrictions)
• 4. Establishment of a prognosis and plan of care based
on
• patient-oriented goals
• 5. Implementation of appropriate interventions
 Patient management model
• Ability to make good clinical judgment
• Knowledge of limitation, impairment and
association in daily life.
• Clinical reasoning
• EBP
 Patient management model
• Dynamic and complex process of reasoning
and analytical thinking
• Judgment and determination in context of
patient care.
• Creative thinking?
 Requirements of clinical decision making

• Knowledge of information about problem

• Cognitive and psychomotor skill=unfamiliar
• Information gathering style
• Prior experience
• Recall relevant information
• EBP
• Clinical patterns
• Option and reflective thinking
• Comprehensive approach
• Systemic series & STEPS
• Examination
• Evaluation of data
• Diagnosis=impairment(activity
limitation),disability (participation restriction)
• Prognosis
• Appropriate intervention.
 Examination
• Problem identification
• Reasons for coming.
• Screening
• Diagnostic testing
• Treatable or not?
• Baseline measurement=impairments,
deficits,abilities
 Examination
• Health history
• Review of system
• Specific tests and measures
Initial examination questions
 History
• Current and past conditions
• Health status
• Risk and co-existing conditions
• Medications
• Hypertension
• Pulmonary disorders.
• Interview
• Medical record
 Indoor/outdoor
• Acute care facility-compare.
• c/c
• o/e
• I have difficulty in playing tennis(look location,
intensity, description , provoking factors)
• Self reported questionnaire
• Categorize questions
• Working hypothesis
History
History
History
 ROS
• Cardio=HR,RR,BP,lightheadedness, edema
• Integumentary = temperature, color, texture.
• MSKT= ROM, strength, height, weight
• GI and GU = heartburn, diarrhea, constipation etc,
bladder, menstrual cycle.
• Cognitive, social emotional= emotional stressor,
response, orientation.
• General= Fatigue, ,malaise, weight gain loss, chills,
fever, sweat.
 Specific tests and measures
• Why?
• Accurate information?
• Target multiple level of functioning.
• Prioritize tests
 History
• Gait analysis
• Adaptive equipment