Maryland Physical Therapy & PTA Ebook Continuing Education

● Home Exercise Program Review/Instruction: practice and demonstration of new exercises, starting with ROM and progressing to strengthening exercises when indicated. ● Re-measurement of active ROM. This progression fits the concept of a one-hour visit, applying multiple and varied treatment methods. There is emphasis on therapeutic exercise, manual therapy and neuro-muscular re-education. A key point within this structure is the assessment and documentation of active ROM. The measurements should be taken first rather than after the therapy session, as it is more reflective of actual functional capacity. Reporting the initial daily visit measurement on progress reports avoids a disconnect with measurements performed by other providers in office (i.e., the orthopedist)

Time management for clinical visits is imperative and directly influences the success of any treatment program. When considering all the factors for effective individual treatment methods, a useful program structure can be incorporated as follows: ● Pain level assessment and active ROM measurements (elevation and external rotation). ● Physiologic warm-up: 5 minutes. ● Wand flexion, extension, and external rotation ROM: 1-2 sets of 10 repetitions each. ● Joint mobilization techniques: 10-15 minutes. ● Soft Tissue techniques: 5-10 minutes. ● Modality (Optional): ice massage, ice pack, heat, etc.

Figure 9

Figure 10

Figure 11

Figure 12

Figure 13

This patient is applying stretch load with assistance from the opposite hip. With early attempts at this exercise, a pillow is placed beneath the elbow.

DECISION MAKING FOR PATIENT PLATEAUS

● Patients who have made initial progress but demonstrate plateau during treatment. ● Post-surgical and post-fracture patients that require an immobilization period and develop an immediate stiffness contracture in the first month after their procedure or injury.

Despite a proven high success rate for recovery from frozen shoulder and adhesive capsulitis, studies show there are approximately 5-10% of patients who present as outliers. This group of resistant cases include three primary categories: ● Idiopathic patients who fail to achieve adequate functional recovery.

EliteLearning.com/Physical-Therapy

Page 59

Powered by