How do you diagnose metabolic syndrome?
> 3 diagnostic criteria:
- Increased BP
- Fasting Blood glucose
- Waist girth
- Triglycerides
- Decreased HDL
Functional activity training - Purpose
- isolate deficits in muscle performance
- compensatory movement
- give athlete psychological reassurance
- determine the presence of pain
- do as part of pre-screening
- in rehab process
- before return to sport
Functional activity training - Things to consider
- stage of healing (not during acute)
- ROM
- strength/power/endurance
- neuromuscular control, proprioception, core control
- prophylactic taping/bracing/padding
- responsibilities of the athlete
Functional activity training - Contraindications
- persistent joint effusion
- joint instability
- poor motor control
- lack of ROM
- muscle length and appropriate muscle strength and power (at least 90%)
Functional activity training - Criteria for return to play
- abolition of acute s&s
- full AROM and PROM of joints involved
- adequate muscle strength
- power and endurance (90%)
- Correct movement mechanics
- adequate cardiorespiratory fitness
- have successful completed progressive functional tests
- psychologically ready
Functional activity training - Concepts
- load
- stability
- velocity
- direction changes
- test environment
- correct movement mechanics throughout
- energy systems
Principles of posture training
- lengthen what’s tight, strengthen what is weak
- down grade activation in muscles that aren’t supposed to be firing
- correct muscle imbalance or postural faults?
Pros and cons of a walker
increase balance and relieve WB (fully or partially), most stable device,
bad for small spaces or going up stairs, no arm swing, can get no wheel,
walker measurements
stand inside, handles to wrist crease or 20-30 degree elbow flexion holding the handles
Cane pros and cons
widen base of support, help balance
least stable type of aid,
Cane measurement
cane parallel to leg with tip in line with ankle, hand position: handles to wrist crease or 20-30 degree elbow flexion holding the handles
Quad cane pros and cons
Wider BOS
Not that good for stairs
Crutches pros and cons
help with lateral stability and improve balance (inc BOS), helps dec WB
Difficult to use or use properly, risk of axilla damage
Crutches measurements
have distal end 2 inch lateral and 6 inch in front anterior to foot, hands placed so handles to wrist crease or 20-30 degree elbow flexion holding the handles
Forearm crutches pros and cons
Which population are they normally used in?
allows for use of hands,
but need more arm strength to use,
usually used in higher functioning patients or may or may not use them for longer term use;
Forearm crutches measurements
cuff on prox 1/3 of forearm, 1-1.5 inches below elbow
Step to or step through can be done with which mobility devices
Crutches or walker
4 point gait
- Synchronous or asynchronous?
- what gait looks like?
- With what gait aids?
- Provides ____, ____ gait
- Asynchronous
- 4 full weightbearing points with 3-4 points of support on ground at all times
- 1 aid advanced, then opposite LE advanced
- BIlateral crutches, canes or walkers if FeWB
- Provides slow, stable gait
2 point gait
- Synchronous or asynchronous?
- what gait looks like?
- With what gait aids?
- Gait is …
- Synchronous
- Similar to 4 point (4 full weightbearing points) but only 2 points of contact maintained at all times
- one leg and contralateral aid advance at same time
ex. R cane and L leg together, then L cane and R leg together - done with bilateral crutches or canes - Modified when only 1 crutch or cane is used
- Gait is less stable
3 point gait
- What does it look like?
- What gait aids can it be done with?
- What weight-bearing can it be done with?
- 3 points of support on floor
- Affected leg advanced, weight transferred to floor through aid via UE’s, then unaffected leg advanced and weight returned to unaffected leg
- Can be done with crutches or a standard walker
- NWB, FeWB or PWB (<80% can’t use CANE)
Step to can be progressed to ____
step-through
