Functional Fitness And Rehabilitation: A Comprehensive Guide

Key Steps in Developing a Functional Fitness Program

1. What are some of the key steps in developing a functional fitness program?

2. Describe the differences between the traditional model of medicine and a more contemporary model of medicine.

3. Which model is more conducive to the fitness therapy approach and why?

4. Explain the difference between dysfunction, disability and handicap.

5. What is the role of fitness therapy?

6. Explain "functional fitness".

7. What are the steps in designing a comprehensive therapeutic exercise program?

8. Explain what a congenital disability is.

9. Describe those conditions that are best served by a pre-habilitation exercise program and those conditions that are best served by a post-rehabilitation program.

10. Which conditions are best served by proper breathing exercises?

11. List some of the signs of hypoglycemia.

12. List some of the physiological, psychological and social benefits derived from a therapeutic exercise program.

13. Explain what ADL's are.

14. List some of the cardio-respiratory conditions that you might interact with as a Specialist in Exercise Therapy.

15. Identify some of characteristics of a diabetic coma.

16. Describe what is an acquired disability is.

17. Evaluate which learning style best describes your personal learning approach.

18. List what things a Specialist in Exercise Therapy should do if a client is having a seizure.

19. Describe the differences between diaphragm breathing and inter-costal (chest) breathing.

20. Name the muscles that make the up rotator cuff.

21. List some of the health conditions that result from being over-fat.

22. Describe what causes 'spasticity' in CVA/ABI clients.

23. Explain why clients with arthritis prefer a warm exercise climate whereas a client with MS would prefer a cooler exercise climate.

24. Describe the differences between 'gross motor skills' and 'fine motor skills' and then explain when it is appropriate to participate in either.

25. List some of the minor types of arthritis.

26. What does HIV stand for?

27. Explain when it is not appropriate for someone who is HIV positive to exercise.

28. List those chronic conditions that are best served in an aquatic experience.

29. What PNF exercises would you include in an exercise program and how would you properly perform them?

30. Describe the specific advantages and benefits of including PNF exercises in a rehabilitation/exercise program.

31. Explain which level of intensity is best for HIV clients and why.

32. List those conditions which an aquatic experience would be contraindicated.

33. What does AIDS stand for?

34. Design a balance progression program using static and dynamic exercises.

35. Explain the differences between muscular strength and muscular endurance and when it is best to engage in either.

Differences between Traditional and Contemporary Medicine

1. A few key steps can be followed for developing fitness program. Firstly, one needs to assess their fitness level. The baseline scores must be measured according to which a fitness program can be designed considering goals. A balanced routine must be created for aerobic activity. The equipments such as shoes and machines must be assembled. After beginning exercises, the personal fitness assessment shall be undertaken. New goals can be created as and when required (Hoeger & Hoeger, 2016).
2. Traditional medicine is different from conventional medicine as it has been developed over generations. The main difference between the two models is the way of observance for health and disease. The traditional medicine is accepted through tradition in a culture due to which it varies in different cultures. Modern medicine is scientifically verified but ignores the spiritual or psychological aspects affected in a person (Tait et al., 2013).
3. The traditional medicine model is more conducive to fitness therapy approach as it reduces risk of side effects. The medicines are more responsive to chronic health conditions. Another advantage is the low cost and widespread availability. However, it is argued that a combination of traditional and modern medicines would be better as modern medicines affect quicker. Modern medicine treats symptoms in addition to the presenting illness in order to alleviate patient discomfort and speed the healing process (Knopf, 2016).
4. Dysfunction is any impairment, abnormality or loss in a specified organ or system. T is simply a problem related with an organ or structure of the body. Disability is any lack or restriction in the body that acts as limitation to perform a particular activity. Handicap is any disadvantage possessed by an individual that limits or prevents them from fulfilling a normal role (Anastasiou & Kauffman, 2013).
5. The key role of fitness therapy is to improve self-efficacy, fitness and mobility. The therapeutic exercises help in improving performance by physical exertion. The fitness therapy corrects any physical deformity and improves overall health. The fitness programs help in achieving muscular endurance and strength. The fitness therapy considers all the important factors such as diet, recovery, exercise programs and the benefits availed (Knopf, 2016).
6. Functional fitness can be described as the exercises for preparing or training muscles by stimulating common movements to be done at work, home or sports. The functional fitness training uses various muscles in the lower and upper body at the same time that emphasizes core stability. Functional fitness training can be beneficial for all age groups as it makes everyday activities easier, reduces the risk of injury and improves quality of life (Santos et al., 2012).
7. For designing therapeutic exercises, a few steps can be followed. A comprehensive examination of the patient shall be started with. The problems and functional disabilities shall be determined. The aims and objectives of the treatment program shall be listed. Next, a proper exercise program that would serve the aims and objectives is designed. Periodic examination and re-evaluation of the patients shall be carried out weekly or monthly. Modifications must be made as and when required for improving results (Kisner & Colby, 2012).
8. A congenital disability is an anomaly or medical condition that is present at or before birth. Such conditions are also known as birth defects as it can be gained during foetal development stage. There are several causes of congenital disabilities such as consumption of alcohol during pregnancy, toxic substances, improper medications, infections or genetic causes. The defects vary in causes and symptoms. Some diseases can be identified prenatally, at birth or at a later stage (Bogart, 2014).
9. The Pre-habilitation exercise involves strengthening and conditioning specific muscles. It is beneficial as the exercises help in reducing injury risks before an injury actually happens. The program helps in analyzing the uninjured player’s movement patterns, risks involved with the sport and the player’s position. It is beneficial for knee replacement, shoulder tendinitis, tennis/golfer’s elbow, ankle sprain and various others. The Post-rehabilitation helps the patients who have finished their physical therapy. This program helps in bridging the gap between health care and fitness. The program shall help the patients in recovering to achieve physical fitness (Knopf, 2016).
10. The lung conditions are mainly served by proper breathing exercises. A proper breathing exercises program can help the patients suffering from chronic obstructive pulmonary disease (COPD). The exercises help in cleansing lung. Not only the lungs, proper breathing exercises also help in reducing or managing stress. It helps in improving health and quality of living. Breathing exercises are a natural way to eliminate depression and chronic pain (Marshall et al., 2014).
11. Hypoglycemia is a condition of low blood glucose usually less than 70 mg/dl. It is also called as insulin shock. The conditions or symptoms can occur suddenly that includes unexplained fatigue, blurry vision, hunger, difficulty in sleeping, loss of consciousness, skin tingling, pale skin, sudden nervousness, sudden mood changes, shaking, trouble in concentrating, and headache. It also involves dizziness or light headedness, irritability or impatience, anger, sadness, stubbornness, seizures, chills or clamminess (American Diabetes Association, 2016).
12. A therapeutic exercise program helps in gaining physiological, psychological and social benefits. The physiological benefits involve mobilising joints, improving balance, improving blood circulation, releasing contracted muscles, promoting relaxation, improving endurance, functional capacity and various others. The psychological effects involve the immediate release of hormones. The training and exercise releases endorphins leaving the individual calm, energised and optimistic. It also helps in improving overall intelligence quotient and cognitive functions. The social benefits involve reduction in anxiety and depression, and improving self-esteem. The program helps in increasing self-confidence and establishes new network for the individual (Healthguidance.org, 2016).
13. ADLs refer to activities of daily living that we perform daily for self-care such as bathing, eating, work, grooming, leisure and homemaking. The non-performance of ADLs can be considered as a form of disorder as it is a basic measure of the abilities. The people with disability, elderly, or post-injury, may not be able to perform daily activities. The physical therapists use exercises to assist patients and help them in gaining independence in ADLs (Fong et al., 2015).
14. As a specialist in exercise therapy, I shall assess a few cardio-respiratory conditions such as Cystic fibrosis and respiratory muscle weakness, disordered breathing syndrome or hyperventilation syndrome. As a specialist, the causes of the cardio-respiratory conditions such as asthma or chronic obstructive pulmonary disease (COPD) must be looked into (Gosh.nhs.uk, 2016).
15. A diabetic coma is a medical emergency condition when the blood sugar level is too high or low. Before developing a diabetic coma, the high blood sugar or hyperglycemia patients may experience fatigue, rapid heartbeat, excessively dry mouth, fruity breath odour, stomach pain, nausea and vomiting, shortness of breath and frequent urination. The low blood sugar or hypoglycaemia patients may show signs of anxiety, fatigue, shakiness, dizziness, confusion, hunger and sweating. When the person feels he may pass out due to extreme conditions of low or high blood sugar signs, he must call for emergency (Mayoclinic.org, 2016).
16. Acquired disabilities are physical conditions that interfere with daily life of individual resulting from a disease or accident. The disabilities may be visible or invisible and may be related to health, illness or accident. A few examples of acquired disabilities are loss of hearing, vision, spinal injuries, loss of limbs, head trauma, arthritis, post-traumatic stress, muscle sclerosis, and mental illness (Higgins et al., 2012).
17. Out of the seven learning styles, my dominant learning style for personal understanding is solitary or intrapersonal. The frontal and parietal lobes, and the limbic system, are also active with this style. However, I have a mix of visual or spatial learning style un which I use pictures or images for better understanding (Pritchard, 2012).
18. A seizure or convulsion is change in behaviour after an episode of abnormal electric activity in the brain. The individual experiences muscle contraction and relaxation repeatedly. As a specialist in exercise therapy, a few considerations shall be made regarding eye movements, drooling, brief blackout, teeth clenching, shaking of body, temporary halt of breathing, grunting or snorting, sudden falling, loss of bladder control and jerking limbs. The individual may also experience nausea, anxiety, vertigo or visual symptoms (Nytimes.com, 2016).
19. Diaphragmatic breathing involves utilization of diaphragm for promoting maximum lung expansion. It is also known as deep breathing technique where the expansion happens in abdomen rather than the chest when a person inspires. It is also considered as a remedy for certain ailments such as stress, headaches, high blood pressure and various other discomforts. Inter-costal or chest or shallow breathing refers to expansion of chest during inspiration rather than belly. The main difference between the two breathing techniques is that deep breathing is more beneficial and optimal for one’s body (Yamaguti et al., 2012).
20. The rotator cuff is a group of muscles and tendons in the shoulder that connects upper arm and shoulder blade. It helps in providing stability to the shoulder and allows it to rotate. There are four muscles that make up the rotator cuff namely, Teres minor, Infraspinatus, Supraspinatus and Subscapularis (WebMD, 2016).
21. The over-fat or obese people are prone to several health conditions such as high blood pressure, gout, diabetes, heart disease, stroke, breathing problems such as asthma, Osteoarthritis, some cancers, Obesity Hypoventilation Syndrome, and Gallstones. Being excessively fat also increases abnormal blood fats, cholesterol, and other health problems (Brochu, Bouchard, & Haddad, 2013).
22. Spasticity is a muscle control disorder characterized by inability to control or having stiff muscles. The spasticity is caused by an imbalance in the brain and spinal cord to the muscles. The condition may e caused due to traumatic brain injury, stroke, cerebral palsy, spinal cord injury and multiple sclerosis. It may also be caused by Krabbe disease and hereditary spastic paraplegias as it damages nerve pathways (Brashear & Elovic, 2011).
23. The clients with arthritis prefer warm climates because warmth makes their joint feel less stiff. Cool climate can worsen the stiffening or arthritis. However, for MS patients, cooler climate is preferred as heat affects neurons thereby slowing the signal rate. Additionally, exercising in hot weather makes them perspire profusely and adding up to the tiredness (Clarke-Jenssen et al., 2014).
24. Gross motor skills refer to the larger movements made such as crawling, jumping or running using arms, feet, legs and entire body. However, fine motor skills refer to the small movements such as holding or picking up things. The main difference between the two sills are that gross motor skills uses large muscles of the body while fine motor skills uses smaller muscles. The gross motor skills can be improved by activities leading to muscular strength, endurance, balance, muscle tone, coordination and postural control. The fine motor skills are appropriate when there is difficulty in performing tasks such as tying shoelace, doing up buttons, quick fatigue, resistance in hand and finger strength (Cameron et al., 2012).
25. Arthritis forms are over 100 in number. However, the most common one is osteoarthritis which is a result of trauma or infection to the joint. Another common one is Rheumatoid Arthritis which is caused due to inflammation of joint. The third common form is Psoriatic Arthritis which is caused due to inflammation of skin and joints.
26. HIV stands for human immunodeficiency virus. It is a subgroup of retrovirus causing HIV infection and acquired immunodeficiency syndrome (AIDS) (Deeks, Lewin & Havlir, 2013).
27. There is no harm in exercising and living a normal routine for people diagnosed with HIV. It can help the patients in strengthening bones, increasing lung capacity, lower depression and various other benefits. However, it is not appropriate to exercise if the person is exerting himself with chest pain or pressure. If the patient is performing resistance training, any pain caused while exercising must be noted. If the pain is still felt after two or three days of being sore, it must not be continued. If the individual is sick or has a cold, he must take a break. No exercise must be performed if the body is not hydrated well or the person had sufficient sleep as it may lead to fatigue (Garcia et al., 2013).
28. The aquatic therapy helps in serving various chronic conditions such as chronic back pain, spinal cord injuries, Parkinson’s disease, osteoarthritis, stroke heart diseases, diabetes, or brain injury. The aquatic exercises can help in strengthening patient muscles and improving cardiovascular performance. It also helps in improving circulation and strengthens injured tissue (Baena-Beato et al., 2013).
29. PNF or Proprioceptive neuromuscular facilitation that can be added in the exercise program is for stretching and flexibility. Various techniques such as hold-relax, contract-relax, hold-relax-contract can be added in the exercise program. For improving general flexibility, a few exercises involving hamstrings, fascia, glutes, hip flexors and back can be stretched. The exercise can be performed by stretching the muscle group for 5-6 seconds while an immovable object or person offers resistance. The contracted muscle must then be relaxed and controlled for about 20 to 30 seconds. The muscle must then recover for 30 seconds and process must be repeated for about 2-4 times (Stretchcoach.com, 2016).
30. The main objective of including PNF exercises in a fitness routine is to hasten or promote the neuromuscular mechanism’s response by stimulating the proprioceptors. The PNF exercises help in increasing flexibility, enhancing motion, rehabilitation of injuries, reduces injury risk and improving overall range of motion. The overall performance of the individuals can be enhanced by introducing PNF exercises in the regular routine (Hindle et al., 2012).
31. The HIV clients can exercise up to a moderate intensity and allow about 8-10 repetitions for every exercise. The HIV clients are recommended to exercises at least 30-60 minutes per session and aim for a moderate intensity. The resistance training must be performed 2-3 days a week for recruiting major muscle groups. The low-moderate level is suitable for HIV clients as high intensity can cause fatigue. Exercises must be performed consistently and moderate level would suit them the best (Cannon, 2011).
32. Aquatic therapists are always looking for ideas on what conditions should be contraindicated for aquatic therapy. A few conditions that are contraindications are uncontrolled seizures, uncontrolled diabetes, bowel incontinence, open wounds without internal protection, orders for nothing by mouth, tracheotomies until healed and presence of deep vein thrombosis (Gibson & Shields, 2015).
33. AIDS stands for Acquired Immunodeficiency Syndrome.
34. A program is designed for balancing using static and dynamic exercises.

Static Balance- The individual must stand with feet side by side and at least shoulder-width apart. The space must gradually be decreased between the feet until the individual feels wobbly. The individual must focus at a point on a wall and keep knees soft to find the balance. Next, the individual must stand with one foot in front of the other and try standing only on one foot. After the individual is able to balance over each foot, an unstable surface may be added such as wobble boards or foam pads (Killip, 2016).

Dynamic Balance- As the individual gets better with static poses, movement can be added such as swinging arms or free leg. The individual can transition from balancing on one leg into a forward lunge with the front foot on a balance disc. Further, the individual can step up onto the balance disc and stand on it with both feet (Killip, 2016).

35. Muscular strength can be defined as the muscle’s capacity to exert force against resistance whereas muscle endurance is a particular action for a prolonged period of time. The muscular strength can be focused upon by the bodybuilders who wish to build bigger and stronger muscles. It is the best for rugby players, power lifters, football players and other sports. However, muscle endurance is suitable for rowers, triathletes and runners (Sedano et al., 2013). 

ACL is the abbreviated form of Anterior Cruciate Ligament, which is a common graft present in the knee. It is a tendon present on the knee cap which helps in the free movement of the knee joints. Due to the injuries pertaining to the ligament especially in the athletes, there occurs instability in movement of knee in the patients leading to pain and restriction in the walking ability of the individuals.  

Rehab is a program used for recovering from injuries, addictions and other mental or physical illness. The rehab program as applied to the post ACL surgery of individuals involves the processes that aim at restoring the functional ability of the affected joint or limb.

The rehab program for the knee patients post the ACL surgery includes the following emphasis:

• Restoring the hyperextension same to as the other knee
• Allowing early healing of wound
• Regaining the leg control (Han et al., 2015)

Phase 1: Restoring the hyperextension

An integrated pneumatic pump, cryo/ cuff are to be placed on the knee of the patients for providing relief from swelling and pain. The CPM machine should be attached with the patient’s leg and is required to be remaining on until one week post surgery.

An initiation of continuous passive movement is implemented following the discharge from the recovery room. The flexion range is facilitated with the heel slides and wall slides. The leg control exercises are also required to be initiated from the first day post surgery. This main objective of the phase is to regain the full extension of the range of motion within 7 to 14 days of the surgery.

Phase 2: Speed strengthening

The functional strengthening program including squats, leg raises and step downs is started in order to regain the agility of the knee movement to normal. This phase is intuited once the patient is capable of performing a unilateral knee bend without facing any difficulty.

Program	Steps	Exercises
Warming up	20 meters	Forward jogging
Stretching	30 sec x 2 reps	Calf, inner thigh, hamstring
Strengthening	30 reps	Single toe raises
Plyometrics	20 reps	Single leg hops over cone

Table 1: Rehab program for post ACL surgery patients

Source: Created by author

Phase 3: Final phase

This is an advanced phase of the rehab session which helps the patients to get back to normal life activities. The phase is generally initiated after 4 weeks post surgery. The clinical goal of this phase is to include a full range of motion activities including the leg presses, full squat of more than 90 degrees, unilateral calf raises, step downs and lunges (Vuorenmaa et al., 2014). The progression of this phase is tested through the isometric and isokinetic strength testing. 

Role of Fitness Therapy in Rehabilitation

After 9 months of the ACL surgery, the patients start to get back to their normal life activities. Still, for full proprioception of the normal knee movements, the patients are required to perform intense walking exercises trill 15 months post the operation (Han et al., 2015).

2. Body Mechanics

2.1 Concepts and Terms

Gait

            Gait is referred to as the manner in which an individual walks including the striding, speed and lilt. It is typically associated with physical diseases including deformity and obesity. Joint pain, restriction of motion and joint deformity are the factors associated with abnormal gait.

2.2 Evaluation

Walking in water and cycling both would be good exercises as these are least impact exercises which could help in supporting the strengthening and contraction of the joints. The training program needs to be comprised of an alternate session of pool and cycling exercise such that to reduce down on the impact on the joints of the obese person.

2.3 Program

5 day program

Training	Pool exercises				Cycling exercises
	Walking in pool	Jumping jacks	Arm circles	Dog paddle	Stationary cycling	Increased tension and spin
Day 1	At shallow end 5 min x 1 rep	At shallow end 5 min x 1rep	At shallow end 5 min x 1rep	At deep end 5 min x 1rep	-	-
Day 2	-	-	-	-	15 min x 1rep	5 min x 1rep
Day 3	5 min x 1rep	5 min x 1rep	5 min x 1rep	5 min x 1rep	-	-
Day 4	-	-	-	-	15 min x 1rep	5 min x 1rep
Day 5	5 min x 1rep	5 min x 1rep	5 min x 1rep	5 min x 1rep	-	-

Table 2: 5-day program for the patient with joint pain and gait

Source: (Created by author)

2.4 Recommendation

            The exercises such as running and walking should not be included in the above training program as these causes more strain and weight on the knees and joints of the obese patient.

3. Orthopaedics

3.1 Concepts and Terms

Rotator cuff

            The rotator cuff is a group of muscles and tendons connecting the scapula (shoulder blade) with the upper arm (humerus). The rotator cuff tendons help in providing stability to the shoulder, the muscles which allows the shoulders to rotate.  

3.2 Evaluation

            The throwing athlete had a rotator cuff surgery such that he is requiring to undergo a basic strengthening program, which should be stretching over 3 months. The athlete then, needs to get back to the PT sessions. Thus, the training program should be incorporating the exercises which should be helping in the gradual strengthening of the shoulder muscles.

3.3 Program

Exercise plan for the athlete with rotator cuff surgery

Week	ROM exercises					Strength exercises
	Hand and wrist	Elbow bends	Pendulum swings	Grip strength	Lying wand exercise	Bicep curls	Shrugs	Rope pulley exercise	Throwing drills
1-3	Twice daily without moving shoulder 10 min x 1 rep	Do	Do	Do	Do	-	-	-	-
3-6	Active	Active	Active	Active	Active	Once daily	Once daily	Once daily	-
6-9	Active	Active	Active	Active	Active	Active	Active	Active	-
9- 12	Active	Active	Active	Active	Active	Active	Active	Active	Start with tennis ball

Table 2:  Exercise plan for the athlete with rotator cuff surgery

Source: (Created by author)

3.4 Example

Rotator Cuff rehab program example 1:

Week	ROM exercises				Strength exercises
1-3	Pendulum swings	Elbow bends	Grip strength	Lying wand exercise	Brace	Modalities with ice	-	-
3-9	Pendulum swings	Elbow bends	Grip strength	Lying wand exercise	Brace	Modalities with ice	Shrugs	-
9-12	Pendulum swings	Elbow bends	Grip strength	Lying wand exercise	Brace	Modalities with ice	Shrugs	Shoulder retraction

Table 3:  Rotator Cuff rehab program

Source: (Lowe, 2016)

Days	ROM exercises				Strength exercises
1-6	Passive Supine	Sling	Grip strength	Cryotherapy	Brace	-	-	-
7-10	Passive Supine	Sling	Grip strength	Cryotherapy	Brace	Sleeping brace	-	-
11- 30	Passive Supine	Sling	Grip strength	Cryotherapy	Brace	Sleeping brace	Overhead pulley	-
30-60	Passive Supine	Sling	Grip strength	Cryotherapy	Brace	Sleeping brace	Overhead pulley	Lateral raises

Table 4: Rotator Cuff rehab program

Source: (taosortho.com, 2016)

The Exercise plan for the athlete with rotator cuff surgery should be incorporating the exercises as evident from the examples evident from two literatures. This inclusion of the exercises would be helping the athlete to increase the strength in his shoulder muscles on a gradual basis.

Best Practices for Pre-habilitation and Post-rehabilitation Programs

4. Outcome management

4.1 Concepts and terms

Outcome management can be defined as the set of activities related to the realizing, planning and managing the desired outcomes from the initiatives (Mos et al., 2014). It represents the simultaneous focus on quality, costs, accountability and assessment.

4.2 Evaluation

In terms of rehab or medical fitness program, the outcome management can be regarded as the managing care system for identifying and assessing the interventions or non interventions for leading to the desired medical outcome.

4.3 Analysis

In rehab and fitness care system, the Outcome management can be applied to provide continuous quality improvement for assessing the efficiency and effectiveness of the services and products and the quality with which they are being provided (Wakabayashi & Sakuma, 2014). The outcome management helps in linking the process and structure of the fitness program to the outcome of the program. A successful outcome management helps in making the fitness program to have a better value by reducing the costs through the development of effective treatment guidelines.

As for example, in the health care system, the sources of information related to the outcome management include the medical records, databases, and patient surveys. The outcome management helps in overcoming the barriers in getting the desired outcome before realizing the full potential of the outcome.

For performing a hypertension evaluation, the resting blood pressure was recorded. The blood pressure was recorded as 112/73. Aerobic exercises were performed that stimulated heart rate and lowered blood pressure. On doing mild-moderate arm curls and bench press, the blood pressure responded equally. The moderate to vigorous exercise increased to 143/88. The mild-moderate arm curls and bench press was recorded as 140/84. After holding breath, the pressure was recorded as 137/89. Supine increased the heart pressure while performing seated press, leg press and inverted leg press. The inverted leg press increased blood pressure in comparison with seated press.

A hypertensive 50 year old male with a resting pressure of 145/92 can perform three types of exercises. A 5-10 minute warm up is necessary that would help in improving flexibility and preventing injury. The person must perform cardiovascular or aerobic exercises such as jogging, bicycling, skating, rowing, and swimming daily for 30 minutes. It would help in lowering blood pressure. The focus shall also be laid on weight training that would help in burning more fats and calories and building muscles. Other than that, the person must also reduce salt consumption (Knopf, 2016).

In the past, one of the contra-indicated exercises performed by me is frog jumps. I started this exercise to burn off extra calories and shed extra pounds. The frog jumps must go as far as possible and not as high as possible. The exercise is suitable for facilitating body toning and defining muscles. Other benefits were to strengthen my calves, quads, leg muscles and glutes. The exercise is perfectly suited for toning muscles. I began this exercise as I did not have to join a gym as frog jumps can be easily practiced at home. However, the exercise did not do any long-term harm. Mistakenly, I landed in the heels first due to which my knees and heels were harmed. The repetitive jumping has caused stress on my joints. If I stress my joint too much, it starts paining.

Benefits of Therapeutic Exercise

After visiting exercise classes at clubs and sports team, I identified an exercise at the swimming club that was bio-mechanically wrong. The swimmers were asked to stretch their arms for increasing range of motion of the arms, chest and shoulders. The move was performed in a ballistic manner, with the individual pulsing stretch upwards. The stretch could lead to shoulder instability and predisposition to long term injury. Not only this, but the exercise puts a lot of strain and stress on the lower back. Alternatively, the swimmers can perform standing doorway chest stretch. It shall help in increasing blood flow and help joints stay strong and healthy.

According to research, women are more likely to have knee problems than men. The anatomy and hormones make them more prone to knee injuries (WebMD, 2016).

There are biomechanical differences between men and women that make it more risky for women to have sports injuries.  Q angle refers to quadriceps femoris muscle angle. A high Q angle for women causes the quadriceps to disposition patella leading to poor tracking. The same issue may lead to knee pain and muscular imbalance. Women also have higher rates of ACL injuries than men as the increased Q angle causes greater stress and less stable knees (WebMD, 2016).

The Patellar tracking disorder is a problem as the kneecap shifts out of place. A few exercises can help in improving flexibility such as quad sets and Straight-leg raises to the front. Both the exercises help in tightening muscles (Knopf, 2016).

The conditions leading to COPD are long term exposure to lung irritants, inherited factors and preterm birth defects. The clients would be taking bronchodilators, anticholinergics, methylxanthines and steroids. A client with mid-moderate COPD can carry out activities at 4-5 Mets including bicycling, light effort stationary. Exercising at 3-4 METs is like above, low intensity aerobic exercise, and 4-6 METS is high impact aerobic exercise and greater includes jumping robe and running (Knopf, 2016).

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Post-Knee Surgery Rehab Program

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