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Problem-Oriented Exercise Management

Problem-Oriented Exercise Management. SOAP format 1. Collection of subjective data 2. Collection of objective data 3. Assessment and generation of a problem list 4. Formulation of a diagnostic or therapeutic plan 5. Periodic reassessment (follow-up). Subjective Data.

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Problem-Oriented Exercise Management

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  1. Problem-Oriented Exercise Management • SOAP format • 1. Collection of subjective data • 2. Collection of objective data • 3. Assessment and generation of a problem list • 4. Formulation of a diagnostic or therapeutic plan • 5. Periodic reassessment (follow-up)

  2. Subjective Data • Prior to testing a diseased individual • Characterize their problem • Why are they coming to you? • What exercises have been done in the past? • What are their limitations presently? • What injuries have occurred? • What medical problems exist presently? • Heart Gastrointestinal • Lung Circulatory • Metabolic Neurological • Musculoskeletal • Current medications? • Recent results of exercise or medical testing? • Obtaining subjective data helps you determine what tests to use!

  3. Objective Data • Physical examination data & laboratory test results • Once the client’s problems have been determined! • Select and perform tests that best fit their exercise capacity! • Exercise testing families (categories): • Aerobic tests • Oxygen consumption • Anaerobic tests • Ability to do unsustainable high intensity exercise • Endurance tests • Sustained submaximal exercise performance • Strength tests • Unsustainable exercise against a high resistance • Flexibility tests • Ability of joints to move through a range of motion • Neuromuscular tests • Activities that require coordination and skill • Functional performance tests • Ability to do specific physical activities of daily living

  4. Making the Assessment • Generate a list of specific problems • The assessment may lead to the causes of the problem! • Strategic planning of the assessment • Several different testing sessions • Classify each weakness into an exercise family! • Sequence the problems! • Use a systematic fashion to list them!

  5. Formulating a Plan • Plan of action • Can lead to diagnosis of the problem, treatment, or both! • 1. Establish the exercise prescription • Realistic long-term goals • Short-term goals • In terms of daily functions

  6. Formulating a Plan • 2. Consider unique circumstances • Prosthetics, medications, facilities, etc. • Evaluate the risks, benefits, and program cost • Risks • Activity-dependent risks • Injuries related to the activity • Disease-dependent risks • Heart attack, sudden death, related to specific disease • Benefits • Increase in physical activity, quality of life, less medicine,etc. • Costs • Time, energy, equipment, facility cost, etc.

  7. Formulating a Plan • 3. Design the exercise program • Person’s current fitness level • Select appropriate levels for the following: • Frequency • Intensity • Duration • Utilize principles of progression and overload!

  8. Formulating a Plan • 4. Set schedule for a follow-up reassessment • Too short of time • Waste of time and resources • Too long of time • Old problem can get out of control • New problem can arise! • Evaluate progress and reassess the validity of the prescription • Organize by exercise family • Track each individual strength or weakness

  9. SOAP NOTES • Be concise • Use key phrases • Avoid irrelevant information • Discuss only the current relevant problems • Categorize the problems by exercise family • Assign a number to each problem • Follow-up unresolved problems

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