Functional Performance And Rehabilitation Expert Guide

Functional Performance And Rehabilitation

Fpr is a membership site where Function is the basis for Performance and Rehabilitation. Fpr takes the approach to performance and rehabilitation where sound clinical and evidence based rationale is used for corrective exercise to negate movement impairments and dysfunctions. Fpr looks through a functional pair of lenses at other parts of the body and how those body parts contribute to movement dysfunction. All this is brought to the members through articles, videos, and presentations. Fpr has a mission to collect the newest research articles on performance and rehabilitation topics that members perhaps dont have time to read on their own. Fpr will not only read articles but will develop an application to the learned concepts for allied health professions, coaches, and athletes to utilize. The end result is members training and rehabilitation programs become more functional and efficient. The key to designing any functional rehabilitation or performance program is to first assess what the functional deficits are. With this exercise you get the benefits of core stabilization, glute activation, and lower trap stabilization. You achieve core stabilization by having your patient/client maintain a neutral spine positioning through a flexionextension dynamic movement but you also obtain neutral spine from the glute max activation.

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Psychosocial Influences On Painrelated Limitations In Cancer Survivors

As can be seen from the list of strategies included in cognitive-behavioral pain management programs, some are clearly linked to facilitating resumptions of life role activities (e.g., goal setting) while others are primarily palliative in nature (e.g., relaxation, imagery). In a related fashion, many cognitive-behavioral interventions have as their primary focus the reduction of emotional distress or the reduction of pain. While emotional distress and pain no doubt contribute to functional limitations, the reduction of emotional distress and pain are typically not sufficient to contribute in a meaningful manner to resumption of life role activities.159 There are grounds to caution the use of overly palliative or passive psychological intervention strategies in the treatment of individuals with persistent pain when functional restoration is also a major goal. In other domains of practice, palliative or passive intervention strategies have been shown to accentuate as opposed to...

Preventive and Therapeutic Treatment of Injuries in Selected Sports

If an injury occurs, the same dry needling acupuncture treatment as was used for prevention can be used, in conjunction with other modalities, to accelerate recovery from the injury and heal the musculo-skeletal dysfunction. The process of treating injuries has three phases the acute phase, the rehabilitation phase, and the functional restoration phase. conventional interventions include anti-inflammatory and analgesic medications, thermal modalities, and protection and relative rest of the injured body part. During the rehabilitation phase of care, the athlete's injured tissue continues to heal. Biomechanical alterations and consequent tissue overloads should be identified and treated with a program of progressive strengthening and conditioning, including flexibility and proprioceptive neuromuscular training throughout the kinetic chain. At the conclusion of the rehabilitation phase, the athlete is ready to progress to sport-specific functional exercises, culminating in a return to...

Scientific evaluation of the Intermed

Predictive validity, as required for an instrument that should provide clinically meaningful information (clinimetric approach), was studied by selecting relevant outcome variables in several specific patient populations (for a summary, see Table 2). In patients admitted to a general medical ward, those classified by the INTERMED as having a high degree of case complexity were found to have a doubled length of hospital stay and increased use of medications, nurse interventions, and specialist consultations 43 . The findings were replicated later 44 in addition, poorer quality of life at discharge was documented for the complex patients. In patients who had diabetes, INTERMED scores correlated with HbA1c values assessed 6 months before and 3 and 9 months after the INTERMED interview 45 . In a sample of patients who had low back pain who had participated in a 3-week functional rehabilitation program or who had applied for disability compensation, INTERMED scores were significantly...

A model of the relationship between capacity and performance

Figure 13.1 presents the hypothesized relationships between fatigue as a symptom experience, capacity for action, and functional performance. The symptom experience of fatigue refers to the intensity, severity, and duration of fatigue. Capacity for action includes, but is not limited to, the motor and cognitive components necessary for functional performance. Motor components include range of motion, muscle strength, and endurance. Cognitive components include attention, concentration, and memory. As such, motor and cognitive components provide the person with the potential to engage in everyday activities. Functional performance refers to a person's actual ability to do everyday tasks and activities, and is, in part, the result of the coordination of various motor and cognitive components within the context of a particular environment, in order to meet the demands of a particular task or activity (Kielhofner 1995). These two people illustrate that knowing the intensity severity of...

Why distinguish between capacity and performance

This distinction between capacity and functional performance provides several important advantages. First, it makes clear the difference between the potential for action and the realization of that potential in the performance of everyday activities. Second, it highlights the indirect relationship between capacity and performance and, in doing so, may account for research findings where capacity explains only a small portion of the variance in functional performance (Roth et al. 1998). Third, it demonstrates that the study of the impact of fatigue on daily life must take into account the notion that capacity alone is insufficient to explain understand functional performance.

The observation of skilled performance

Both conceptually in the work of Leidy (1994) and Glass (1998) and empirically in the work of Trombly and others (Ma et al. 1999 Murphy et al. 1999) it is apparent that capacity is not sufficient to understand functional performance. However, observable functional performance has rarely been assessed in the nursing literature. In general, clinicians have evaluated functional status using coarse observer rating scales, such as the Zubrod Performance Status Rating Scale (Zubrod et al. 1960) or the Karnofsky Performance Status Rating Scale (Karnofsky et al. 1948). These seldom capture the more subtle impact of fatigue on functional performance, such as decreased speed and endurance. However, if, as Leidy argues, the field is to 'have a better understanding of the functional status of clients in order to design interventions and evaluate outcomes appropriately' (Leidy 1994, p. 202) some observable evaluation of functional performance within a task context will be needed. A concept now...

Quality and effectiveness of performance

While components such as range of motion, muscle strength, endurance, memory, and attention describe the capacity for performance, they do not say anything about 'how effective an action is in accomplishing a functional purpose' (Fisher and Kielhofner 1995, p. 114). This is because there are many ways in which underlying capacities can be 'assembled' in order to complete an everyday activity. As such, underlying capacity is related to, but does not predict, successful functional performance since 'one cannot know ahead of time how one will use one's capacities in a given task and context' (Fisher and Kielhofner 1995, p. 115). There is a growing appreciation that motor control (the production of movement) is not under the executive control of the central nervous system, but rather it 'emerges' from the coalescence of the person (including their past motor learning), the demands of the particular task, and the supports (affor-dances) within the environment. For example, Ma et al. (1999)...

Implications for the evaluationmeasurement of fatigue and function

Historically, studies in oncology examining functional status or the impact of fatigue in patients with cancer have relied on self-report (Cella et al. 1993 Yellen et al. 1997 Mendoza et al. 1999). Consequently, little is known about how similar or divergent are patients' reports of functional impairment and therapists' observations of patients' functional performance. For example, a study of injured workers suggests that the more disabled a patient is, the more divergent patient and therapist ratings may be. As the functional status of a patient improved, so patient and therapist ratings became increasingly similar (Gerardi and Eckberg 1995). Patient self-reports of functional status are convenient and often-used methods of capturing change in functional status due to fatigue. While such approaches offer valuable insights into patient perceptions of performance, clinical observation provides an alternative 'outsider' view of performance, i.e. performance as it is observed by others....

Confounding fatigue symptoms with outcomes

Winningham et al. (1994) criticised some instruments used to evaluate CRF for combining the symptoms of fatigue (physical, emotional, and cognitive manifestations of fatigue) with the consequences of fatigue (for example impairment of functional performance and quality of life) in a single composite score to indicate fatigue status. This problem persists in more recent instruments. As a result, various combinations of high low symptom scores and impairment scores can yield similar composite scores but very different fatigue experience. Measures of symptoms of fatigue should be distinguished from measures of consequences of fatigue, at least through the use of separate subscale scores or separate instruments.

The Challenges

The approaches that have evolved in the long-term clinics appear promising. With some creativity and persistence there is no reason why these approaches originally developed in the academic medical center cannot be expanded to primary care and the community clinic This has occurred to some degree but needs to increase. I have been involved in multidisciplinary care since the early 1980s when developing the Pain Treatment Center and the Center for Occupational Rehabilitation at The University of Rochester Medical Center. I saw that even after many years of this approach being used for many complex medical problems there continued to be many challenges. Learning which specialists to involve, the specific roles of these specialists, team collaboration and insurance reimbursement or generation of other sources of revenue for clinical services are some of the challenges that continue to present realistic barriers. While it seems unrealistic to think such operations can be widely...