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ADINA RDULESCU

ENGLISH IN KINETOTHERAPY. A PRACTICAL ENGLISH HANDBOOK

Editura Fundaiei Romnia de Mine 2004

ADINA RDULESCU

English in Kinetotherapy. A practical English handbook

CONTENTS
CUVNT NAINTE

UNIT 1
THE MAIN PARTS OF THE BODY IMPERATIVE SENTENCES USED IN RELAXATION TRAINING TECHNIQUES PREPOSITIONS

UNIT 2
THE SKELETAL SYSTEM
INTERROGATIVE PRONOUNS AND ADVERBS USED BEFORE THE VERB TO BE ASKING QUESTIONS

UNIT 3
THE MUSCULAR SYSTEM ADJECTIVES BASIC KNOWLEDGE DESCRIBING A CERTAIN MUSCLE

UNIT 4
EXAMINING THE PACIENT POLYSEMANTIC WORDS THERAPIST-PATIENT DISCOURSE GREETINGS, IDENTIFICATION AND INTRODUCTORY DIALOGUES

UNIT 5
TYPES OF INJURIES PASSIVE MODAL CONSTRUCTIONS PRESENT TENSE SIMPLE AND PRESENT PERFECT THERAPIST-PATIENT DISCOURSE PATIENT`S SYMPTOMS AND COMPLAINTS FORMAL AND INFORMAL MEDICAL TERMS

ADINA RDULESCU

UNIT 6
THERAPEUTIC EXERCISES WORD FORMATION DERIVATION THERAPIST-PATIENT DISCOURSE RECOMMENDING DIFFERENT THERAPEUTIC EXERCISES

UNIT 7
THERAPEUTIC PROCEDURES IN HANDLING THE PATIENT PASSIVE VERBAL CONSTRUCTIONS THERAPIST-PATIENT DISCOURSE POSITIONING AND HANDLING THE PATIENT

UNIT 8
MUSCULOSKELETAL AND CONNECTIVE TISSUE DISORDERS PRONOUNCING TONGUE-TWISTERS DESCRIBING SYMPTOMS AND RECOMMENDING THERAPEUTIC EXERCISES

UNIT 9
POSTURAL PROBLEMS CONDITIONAL CLAUSES THERAPIST-PATIENT DISCOURSE IMPROVING COMMUNICATION

UNIT 10
REVISION EXERCISES

BIBLIOGRAPHY

CUVNT NAINTE

English in Kinetotherapy. A practical English handbook

Specificul studierii limbilor strine n cadru universitar este reprezentat de trecerea de la studierea limbii strine la modul general la aprofundarea ei pe diverse domenii de specialitate. n funcie de specializarea pentru care studenii opteaz, ei vor studia, n cazul nostru, engleza economic, juridic, tehnic, medical etc. Studiul limbilor strine aplicate pe un anumit domeniu de specialitate n cazul nostru fiind vorba de engleza n kinetoterapie, o ramur a englezei medicale presupune din partea studenilor un nivel mediu de cunotiine de limba englez, stpnirea unor tehnici de munc individual i, de asemenea, a unui nivel mediu de cunotiine generale pe domeniul respectiv de specialitate. Manualul de fa se adreseaz studenilor seciei de Kinetoterapie, din cadrul Facultii de Educaie Fizic i Sport a Universitii Spiru Haret Bucureti, att anului I ct i anului II de studiu. El rspunde unei nevoi reale aceea de a avea un instrument practic de lucru pentru desfurarea activitii de seminar. Contientizarea avantajelor pe care le presupune stpnirea unui limbaj de specialitate ntr-o limb strin, dintre care amintim: posibilitatea consultrii unei bibliografii de specialitate n limba respectiv, participarea studenilor la conferine internaionale, publicarea unor materiale n revistele de specialitate i, poate cel mai important, posibilitatea de a lucra ntr-o clinic sau cabinet de profil cu personal i clieni strini fie n Romnia fie peste hotare a constituit motivaia principal pentru meninerea interesului studenilor fa de aceast disciplin de studiu i pentru obinerea unui certificat de competen lingvistic pe specialitatea englez medical, eliberat n cadrul Centrului de Limbi Strine al Universitii Spiru Haret.

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Manualul este structurat pe 10 capitole (Units), axndu-se pe trei componente principale: 1) un corpus de texte de specialitate, care-i asociaz diverse exerciii de vocabular, traduceri de text i exerciii de redare selectiv a informaiei prezentate; 2) o selecie a unor probleme de gramatic a limbii engleze, efectuat n funcie de criteriul frecvenei anumitor structuri gramaticale n limbajul medical i 3) un set de discursuri kinetoterapeut-pacient, axate pe tematica fiecrui capitol, avnd ca scop familiarizarea studenilor cu utilizarea unui limbaj oral, informal, care completeaz limbajul formal n care sunt redate textele de specialitate. Selectarea acestor texte din diverse materiale atlase de anatomie, cursuri de kinetoterapie, etc a avut ca intenie creearea unui cadru profesionist de lucru, precum i stimularea interesului studenilor pentru consultarea unor materiale de specialitate n limba englez. i, nu n ultimul rnd, exerciiile de la fiecare sfrit de Unit create your own dialogues, consider yourself as a kinetotherapist etc. testeaz capacitatea studenilor de a se exprima liber i firesc n limbajul de specialitate asimilat, ntr-un context socioprofesional artificial creat n sala de seminar, prin ceea ce n metodica limbii engleze se numete Role playing. Cu sperana i dorina c acest manual va rspunde nevoii practice a studenilor de a aprofunda limba englez pentru o viitoare practic kinetoterapeutic, constituind n acelai timp un stimulent pentru o perfecionare permanent, prin consultarea unei bibliografii actualizate n limba englez, nchei prin a le mulumi studenilor din primele generaii cu care am lucrat pentru ajutorul pe care mi l-au acordat, prin simpla lor participare activ la seminariile de limba englez, n conturarea suportului teoretic i practic al acestui manual.

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Autoarea

UNIT I
THE MAIN PARTS OF THE BODY IMPERATIVE SENTENCES USED TRAINING TECHNIQUES PREPOSITIONS IN RELAXATION

1. Read the following texts containing relaxation techniques and write down the new words: Trainers introduction: This relaxation procedure is one that has been practised for many years now. It has been studied by researchers and found to be effective. You will feel very relaxed and calm as a result. It is not the same as hypnosis and you will not lose consciousness at any point. The procedures: Make yourself as comfortable as you can become aware of the surface underneath you let your body settle into it notice how it supports you notice the points of contact between you and the floor: your head shoulders spine ribs hips heels elbows forearms and hands feel your body sinking into the surface you are lying on feel your body getting heavier as the tension ebbs away feel at peace. Take one good breath and as you let it out, feel it carrying all your tensions away then let your breathing settle into a gentle rhythm As you lie or sit, reflect on the idea that you are going to give the next half-hour to yourself. No telephone can ring for you; no doorbell disturb you; no one will call your name. You may hear sounds around you: voices, horns, sirens, bangs and revs think of them as being outside your world. With these thoughts in mind, draw an imaginary circle around yourself, about three feet from the centre. Create an imaginary bubble think of the interior as your space your own private space. Feel how safe it is safe to get in touch with yourself. Turn your thoughts inward.

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Trainers termination of the procedure: I am going to bring this relaxation sesssion to an end Id like you gradually to become aware of the room feel the floor/chair underneath you open your eyes give your limbs a few gentle stretches have the feeling that you are alert and ready to carry on with your life With your eyes open, raise your eyebrows feel the tension and release the tension frown feel the tension and release it shut your eyes tightly feel the tension and let it go with your eyes still closed, spend a few minutes releasing tension in this part of your face Close the jaws firmly, noticing the sensations you get from the action hold it and discontinue let your jaw drop feel the tension leaving you and continuing to leave you then repeat the action. Next, bare your teeth feel the tension in the cheeks hold it for a few seconds and release the tension. Make a tight O with your lips hold it, while you register tension in the lips and cancel the action. Press your tongue against your teeth feel the pressure and release it Now pull the tongue back towards the throat. Feel the muscles drawing it back and note the sensations you get from this action and release it (R. A. Payne Relaxation Techniques) 2. Read the text again, select the words that designate: a) parts of the body, b)verbal constructions expressing commands and c) prepositions or other words indicating direction and place them in three different columns. 3. Using the vocabulary practice below write the Romanian equivalents for the terms indicating parts of the body. VOCABULARY PRACTICE 4. Pronounce and learn the names of the main parts of the human body. For some notions two alternative terms have been provided:

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The head: - eyes, eyelids (pleoape), eyelashes (gene), eyebrows (sprncene); - nose, nostrils (nri); - ears, ear lobe; - mouth, lips (buze), gum (gingie), tooth - teeth, tongue (limb), jaw (falc), upper jaw /maxilla (maxilar), under jaw (mandibul); - forehead (frunte), cheek (obraz), cheek bone (os maxilar), chin (brbie), dimple (gropi n obraz), dimple in the chin /fossette (gropi n brbie). The neck: -

throat; Adams apple/thyroid cartilage; hollow of the throat (scobitura gtului); nape of the neck (ceafa).

The body: - shoulder, shoulder blade/scapula (omoplat); - limb (membru), arm/upper limb (bra), armpit/axilla (subsuoar), forearm (antebra), hand, elbow (cot), crook of the arm (ndoitura braului), palm, wrist/carpus (ncheietura minii), fist (pumn), fingers thumb (degetul mare), forefinger (deget arttor), middle finger, ring finger (deget inelar), little finger, finger tip (vrful degetului), finger pad (pernia degetului), fingernail (unghie), knuckle (articulaia degetului); - biceps, thorax/chest (torace), breast (piept), nipple (mamelon), abdomen, stomach, waist (talie), navel/umbilicus (buric), bottom (ezut), buttocks (fese); - hip (old), leg, thigh (coaps), calf

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(gamb), shin/cannon bone (fluierul piciorului, tibia), knee (genunchi), knee cap (rotul), ankle (glezn), instep (scobitura gleznei), sole (talp), heel/calcaneus (clci), toes (degete de la picioare). 5. Choose the right word that best completes the sentence: 1. I cant move my left hand; I have problems with my ... a) fingers b) armpit c) wrist d) fists 2. It is not polite to talk to somebody when you have your . in your pockets. a) fingers b) hands c) palms d) arms 3. He has had this nasty habit of biting his . ever since he was a kid. a) tongue b) toes c) fingers d) nails 4. This old lady cant hear you very well; she has got an infection. a) ear b) throat c) tooth d) eye 5. He fell and hurt his really bad, as he was not wearing his knee-pads when roller skating. a) ankles b) legs c) knees d) toes 6. The underside both of a foot and a shoe is called a .. a) heel b) sole c) shin d) toe 7. I ate an icecream yesterday and now I have a sore . a) neck b) eye c) jaw d) throat 8. You should not drink so much coffee on an empty .. a) stomach b) waist c) abdomen d) throat 9. Nobody is perfect and carelessness is his Achilles... a) toe b) arm c) heel d) head 10. He is walking on the tips of his so as not to awake the baby. a) feet b) toes c) fingers d) sole

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6. Match up the following words with their definitions: 1. wrist 2. forehead 3. hip 4. tongue 5. calf 6. armpit 7. nostril 8. thigh 9. fingernail 10. heel 11. abdomen 12. biceps a. the thick, fleshy part of the back of the leg, between the ankle and the knee b. large muscle at the front of the upper arm, which bends the elbow c. the small depression beneath the arm where it joins the shoulder d. a thin, horny, translucent plate covering part of the dorsal surface of the end joint of each finger e. the part of the face between the natural hairline and the eyes; formed skeletally by the frontal bone of the skull f. part on either side of the body below the waist where the bone of a persons leg is joined to the trunk g. the joint between the forearm and the hand h. the back part of the human foot from the instep to the lower part of the ankle i. part of the body below de chest and diaphragm, containing the stomach, bowels and digestive organs j. organ of taste that aids the mastication and swallowing of food. k. either of the two external openings of the nose l. part of the human leg between the knee and the hip

VOCABULARY PRACTICE

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Here is a list of the most commonly used prepositions of place and position: above = deasupra, de deasupra, mai sus de across/along = de-a lungul, transversal around/round = de jur mprejurul below = dedesubt, sub (fr a indica contact cu suprafaa superioar) beneath/underneath = dedesubt, sub (indicnd existena unei suprafee superioare de protecie, separare) between = ntre (dou obiecte) behind = n spatele, napoia in front of = n faa in = n, n interiorul into = n, nspre interior (indicnd ptrunderea, strbaterea spaiului) on = pe, deasupra onto = pe, deasupra (indicnd micare pentru atingerea poziiei) over = peste, deasupra through = prin, printre under = dedesubt, sub (indicnd contact cu suprafaa superioar) Other words indicating movement and direction: -WARDS class (wards = spre, ctre, indicnd direcia) Backward (s) = napoi, invers, pe spate Downward (s) = descendent, spre partea inferioar Forward (s) = nainte, n fa Inward (s) = nuntru, ctre interior Leftward (s) = ctre stnga, dinspre stnga Outward (s) = ctre/spre exterior, n afar Towards = spre, ctre, n direcia Upright = drept, vertical

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Upward (s) = ascendent, spre partea superioar Sideways = lateral, oblic, ntr-o parte Pair work 7. Read the following commands to your deskmate and ask him/her to follow your indications and practise the exercises. Then, change activities: Place your hands around your ankles. Rest your elbows on your thighs. Place your fingertips on your shoulder. Bend your body sideways and give it a good stretch. Lift your arms above your head. Spread your arms sideways and lower them to your sides. Clasp both hands behind your head. Arch your body backwards. Stretch your arms upwards. Bend your knees forwards. Hold your head forward and up. Raise your arms above your head and turn the palms towards the ceiling. Lean your forearms vertically on the wall. With your heels on the ground and your knees straight, let your hips sink forwards. 8. Read the following sentences and translate them into Romanian: Without moving your head, turn your eyes upwards behind your closed lids. Roll your eyes in a clockwise circle Now notice the sensations of tension. Pause Roll them now in an anticlockwise direction. Place your palm downwards on a surface (table, chair arm or thigh); press your fingertips into the surface, drawing them towards your palm so that your hand gradually takes on the shape of a spider Hold the position, feel the tension in the hand and then let the tension

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go and relax the muscles. Keeping your toes firmly in contact with the floor, raise your heels up in the air Now feel the tension in your calf muscles Relax drop your heels to the ground and notice the relief, the comfort, the warm tingling sensation in your calves. 9. Create your own relaxation techniques; write down five examples of such exercises and then read them to your deskmates. 10. Translate into English, using the new words: 1. Plasai-v ambele mini pe umeri. Rotii-v trunchiul alternativ la stnga apoi la dreapta. 2. Stai n poziie deprtat, cu minile pe lng corp. Ridicai mna dreapt i ndoii corpul spre stnga. Revenii n poziia iniial. Apoi ridicai mna stng i ndoii corpul spre dreapta. Repetai micarea de cinci ori. 3. ndoii-v uor trunchiul n fa. Atingei-v genunchii, apoi gambele, apoi gleznele i dac putei chiar i degetele de la picioare. 4.Stnd pe un scaun, plasai-v ambele coate pe coapse, ntindei-v antebraele i micai-v degetele. 5. nchidei ochii, ridicai minile deasupra capului i arcuii-v uor trunchiul pe spate. Stai n poziie 10 secunde i apoi revenii n poziia iniial. 6. Plasai-v ambele mini pe olduri. ndoii-v uor genunchii i apoi rotii-v corpul la stnga i la dreapta. Observai ce simii la articulaiile oldului. 7. ntindei-v braele lateral. Apoi ndoii-le din coate spre n fa, la nivelul umrului. Repetai micarea de cte ori dorii. 8. Stai ghemuii pe vrfurile picioarelor, cu capul aplecat i cu minile atrnnd pe genunchi. Simii cum vi se relaxeaz muchii gtului. Meninei poziia ct

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dorii. 9. Stai cu picioarele deprtate i cu minile pe old. nclinai-v spre dreapta, ridicnd piciorul stng. Meninei poziia pentru 5 secunde. Apoi repetai n direcia opus. 10. Stai cu picioarele deprtate i cu minile ntinse lateral i cu pumnii strni. Rotii-v simultan braele, trasnd un cerc mic n aer. ncercai rotirea braelor n ambele direcii. Observai ce se ntmpl cu muchii braelor i pieptului.

UNIT 2
THE SKELETAL SYSTEM INTERROGATIVE PRONOUNS BEFORE THE VERB TO BE ASKING QUESTIONS AND ADVERBS USED

1. Read the following texts and write down the new words:

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The function of the bones is to form a hard skeleton for the softer materials of the body, to enclose and protect some of the most important vital organs. Bone development takes place at a very early period. In embryonic life, the parts destined to become bones consist of a congeries of cells which constitutes the simplest form of cartilage. This temporary cartilage is an exact miniature of the bone which in due course is to take its place. The process of ossification is slow and not completed until adult life. The next step is the ossification of the intercellular substance and of the cells composing the cartilage. The period of ossification varies much in different bones. It commences first in the clavicle, in which the primitive point appears during the fifth week; next in the lower jaw. The ribs also, and the long bones of the limbs, appear soon after. For a long period after birth, a thin layer of unossified cartilage remains between the diaphysis and epiphyses, until their growth is finally completed. (Henry Gray Gray`s Anatomy. Descriptive and Surgical) Almost all the elements of the joints of adults are also present in the joints of the newborn. The most active factor determining the formation of a joint after birth are the muscles which exert an action on the given joint, i.e. the work of a joint. The development of bone articulations is directly dependent on the formation of the bony and connective-tissue structures and muscular tissue. All the elements encountered in the joints of the newborn continue their formation and acquire the geometrical shapes of the articular surfaces characteristic of each joint of an adult. (R.D. Sinelnikov Atlas of Human Anatomy)

VOCABULARY PRACTICE

2. Pronounce and learn the names of the main parts of the skeletal system. Add more terms to the list:

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The skeletal system: - skull = craniu - spine/spinal column/backbone = coloana vertebral - vertebra, -ae /bony ring = vertebr - spinal cord /marrow = mduva spinrii - the cervical, dorsal, lumbar, sacral and coccygeal sections of the spine = seciunile cervicale, dorsale, lombare i coccigiene ale coloanei vertebrale - rib = coast - cartilage = cartilaj - sternum /breastbone = stern - clavicle /collarbone = clavicul - thoracic cage = cuc toracic - shoulder girdle = centur scapular - scapula/ shoulder blade = omoplat, scapul - pelvis = pelvis - pubis = pubis - sacrum = os sacral - coccyx = coccis - articulation /joint = articulaie - fibrous joint = articulaie fibroas - synovial joint = articulaie sinovial - ossification = osificare - ligament = ligament - hip joint = articulaia oldului - knee joint = articulaia genunchiului - ankle joint = articulaia gleznei 3. Complete the following sentences using the nouns in the box. The first one has been done for you as an example:

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sternum scapula tibia

coccyx phalanges metacarpus

carpus cranium femur

calcaneus joint vertebrae

1. The spine is a flexuous column, formed of a series of bones called _vertebrae_. 2. The ____________ is composed of eight bones: the occipital, two parietal, frontal, two temporal, sphenoid, and ethmoid. 3. The ____________ is a long, flat vertical bone, situated in front of the thorax to which are attached the collarbone and the first seven parts of ribs. 4. The ____________ is the longest, thickest and heaviest bone in the skeleton, articulating with the pelvis above and the knee below. 5. The ____________ is the inner and thicker of the two bones of the human leg, between the knee and ankle. 6. The ____________ is a small triangular bone at the end of the spinal column, articulating by its base with the apex of the sacrum. 7. The ____________ is a large, flat bone, triangular in shape which forms the back part of each shoulder. 8. The hand is subdivided into three segments: the __________ or wrist, the ____________ or palm and the ____________ or fingers. 9. The ______________ or heel bone is the largest tarsal bone, irregularly cuboidal in form and situated at the lower back part of the foot. 10. The structures which enter the formation of a ___________ are: bone, cartilage, fibro-cartilage, ligament and synovial membrane. 4. Match up the following words with their definitions: 1. breastbone 2. ligament 3. skull a. Rings placed one above the other which form a single column, the spinal column b. Triangular bone that forms the back of the pelvis c. Twelve pairs of curved bones extending

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4. vertebrae 5. clavicle 6. spine 7. pelvis 8. sacrum 9. cartilage 10. ribs

from the backbone round the chest d. Narrow, bony and curved column as a cable for the spinal cord e. Basin-shaped framework of bones at the lower end of the body f. Tough white flexible tissue attached to bones and joints g. Though, flexible tissue that connects bones and holds organs in position h. Thin, flat, vertical bone in the chest, between the ribs i. Bone joining the breastbone and the shoulder blade j. Bony framework of the head under the skin AND ADVERBS USED

GRAMMAR INTERROGATIVE PRONOUNS BEFORE THE VERB TO BE

When forming interrogative sentences with the verb TO BE the rule to be remember is to place the words in the following order:
WHAT WHICH WHERE + is (sg.) / are (pl.) present + object WHY + was (sg.) / were (pl.) past + object HOW HOW MANY WHAT is used to ask somebody to specify one or more things,

places, people, etc from an indefinite number: What are the main causes of muscular weakness? What is the shape of the spinal column? WHICH - is used to ask somebody to specify one or more things, people, etc from a limited number:

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Which is the best treatment in this situation? Which is the shortest and the most curved of all the ribs? WHY - means for what reason or purpose: Why is physical therapy better than surgery in my case? WHERE means in or to what place or position: Where is the sternum situated? HOW means in what way or manner: How is the sternum described in terms of shape, position, structure and development? HOW MANY is used to inquire about the number of things: How many phalanges are for each finger, except the thumb? 5. Ask questions for the underlined phrases using the interrogative words what, which, where, why, how, how many and the verb to be. The first two have been done for you as examples: 1. There are twelve ribs on each side of the thoracic part of the spinal column. How many ribs are on each side of the thoracic part of the spinal column? 2. The foot consists of three divisions: the tarsus, metatarsus and phalanges. Which are the three divisions of the foot? 3. The leg consists of three bones: the patella (knee cap), placed in front of the knee, the tibia and fibula. ________________________________________________________ __? 4. The patella is a small, flat, triangular bone situated at the anterior part of the knee joint. ________________________________________________________ __?

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5. The scapula is situated between the first and seventh ribs. ________________________________________________________ __? 6. The sternum has the shape of an ancient sword, consisting of three parts. ________________________________________________________ __? 7. That form of cartilage which enters into the formation of the joints is called articular cartilage. ________________________________________________________ __? 8. The ligament is pliant and flexible, so as to allow perfect freedom of movement but strong, tough and inextensible, so as not to yield under a severely applied force. (ask three questions)

________________________________________________________ _? 9. There are 206 distinct bones in the entire skeleton of an adult. ________________________________________________________ _? 10. The superior extremity is the largest part of the humerus. ________________________________________________________ _?

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6. Read the following extracts and translate them into Romanian: Most bones of a human adult consist of a bony and cartilaginous framework, as a result of which a bony part and a cartilaginous part are distinguished in the skeletal system. The bony part makes up most of the bone. The articular cartilages, the epiphyseal cartilages and the costal cartilages form the cartilaginous part of the skeletal system. The long bones (humerus, clavicle, femur, phalanges, etc.) have a middle part, the diaphysis, and two end parts, the epiphyses. The epiphysis located closer to the axial skeleton is called the proximal epiphysis, while the epiphysis of the same bone but situated further from the axial skeleton is called the distal epiphysis. The wider parts of long bones between the diaphysis and the epiphysis are known as metaphysis. Their boundaries are visible only in the bones of children and adolescents when a cartilaginous layer, the epiphyseal cartilage still remains between the diaphysis and epiphyses. The red marrow possesses high functional activity and is capable of forming blood cells of the myeloid series. With the development and growth of the organism, the red marrow is gradually replaced by the yellow marrow. The yellow marrow is less active and plays a reserve role, but under certain conditions it may be activated. (R.D. Sinelnikov Atlas of Human Anatomy) 7. Translate the following questions into English, using the new vocabulary. Providing an answer to these questions will also test your anatomy knowledge: 1. Care este tiina care se ocup cu studiul oaselor? 2. Care sunt principalele tipuri de oase? 3. Care sunt prile constituente ale unei articulaii? 4. Care sunt cauzele care determin traumatismele i

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fracturile coloanei vertebrale? 5. Din cte oase este format craniul i care sunt acestea? 6. Care articulaie este cel mai frecvent afectat n fracturi? 7. Cte vertebre are coloana lombar? Dar coloana toracal? 8. Unde este plasat acromionul? 9. Cum este descris sternul n atlasul de anatomie? 10. De ce este intervenia chirurgical mai potrivit n acest caz dect fiziokinetoterapia sau balnoeterapia? Pair work 8. Question-answer exercise: Using your anatomy courses notes, ask your deskmate questions about the skeletal system.

UNIT 3
THE MUSCULAR SYSTEM

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ADJECTIVES BASIC KNOWLEDGE DESCRIBING A CERTAIN MUSCLE 1. Read the following texts about the muscular system and write down the new words: There are more than 600 skeletal muscles in the human body and their total mass accounts for up to 28-35 per cent of the body mass in females, up to 40-45 per cent in males, and up to 45-55 per cent in athlets. Up to 50 per cent of the total weight of the skeletal muscles fall to the share of the muscles of the lower limbs, up to 30 per cent to those of the upper limbs, and up to 20 per cent to the share of the muscles of the head and trunk. Each muscle has a developed network of blood vessels. The contraction of a muscle promotes rapid flow of blood, i.e. the muscle is a peculiar pump which forces the blood forward. Under conditions of reduced motor activity (hypokinesia) in an active mode of life or when prolongued bed-rest is necessary, this function of the skeletal muscles is excluded as a result of which the blood flows slower, metabolic processes are reduced and stasis occurs. In contrast, under conditions of motor activity the reserve capillaries open, new capillaries form, and nutrition of the skeletal muscles improves. (R. D. Sinelnikov Atlas of Human Anatomy) All elements of the musculoskeletal system are in dynamic equilibrum, continually changing shape, structure and function, in response to loading and mechanical demands. The system is vulnerable to trauma, peculiarly susceptible to local and systemic inflamatory disorders. Acute inflammation or tissue damage often becomes chronic, perhaps because of continuous movement and mechanical stresses. Musculoskeletal disorders are major worldwide causes of chronic pain and severe physical handicap, particularly as population becomes older, generally fitter, and more health conscious.

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(The Merk Manual of Diagnosis and Therapy) Muscles vary considerably in their form. In the limbs, they are of considerable length, especially the more superficial ones, the deep ones being generally broad; they surround the bones and form an important protection to the various joints. In the trunk, they are broad, flattened and expanded, forming the parietes of the cavities which they enclose. (Henry Gray Grays Anatomy. Descriptive and Surgical)
VOCABULARY PRACTICE

2. Pronounce and learn the main terms and collocations related to the muscular system. Add more terms to the list: - muscle = muchi - skeletal muscle = muschi scheletic - tendon = tendon - muscular tissue = esut muscular - blood vessels = vase sanguine - nerves = nervi - fibers = fibre - fascia = fascie - diaphragm = diafragm - musculature = musculatur - muscle bulk = mas muscular - muscular contraction /cramp = contracie muscular - muscular endurance = rezisten muscular - muscle fatigue = oboseal/ extenuare muscular - muscular hypertrophy = hipertrofie muscular - muscle tone = tonus muscular - hypotonic muscles = muchi hipotonici

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hypertonic muscles = muchi hipertonici muscle rigidity = rigiditate muscular muscle spasm = spasm muscular spasticity = spasticitate muscle sprain = luxaie muscle strain = ntindere muscular muscle strength = for muscular muscular tension = tensiune muscular muscular weakness = slbire muscular

3. Match the half-sentences in column A with their corresponding half-sentences in column B to form correct and complete sentences: A B 1. Muscle bulk. a. a progressive loss of muscle strength in a variety of muscle groups. 2.Muscle-setting exercise. b. very firm, may be spastic or rigid and resists sideways movements. 3. Muscular dystrophy is a c. a muscle sprain or degenerative muscle strain, arthritis, a tumor or disorder characterized by . a ruptured cartilage disk between vertebrae. 4. Electromyography (EMG) d. very soft, weak and flabby and is easily moved is a techique laterally. 5. A hypertonic muscle feels e. gives an indication of the state of the musculature. 6. If you have observed f. an evaluation of the condition and functioning muscle weakness, of the muscles, joints and bones of the body.

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7. Involuntary movements g. is a method of contracting and relaxing a and tremors skeletal muscle without moving that part of the body. 8. Low back pain at the base h. that records changes of the spine can be caused in the electrical potential during muscle by contractions. 9. Musculoskeletal sysytem i. are signs of some neurological disorders. assessment is 10. A hypotonic muscle feels j. then a detailed test will be necessary for each muscle. 4. Match up the following words with their definitions: 1. tendon a. Fibre or bundle of fibres carrying impulses of sensation or of movement between the brain and all parts of the body b. Large muscle at the front of the upper arm, which bends the elbow c.Wall of muscle, between the chest and the abdomen, that helps to control breathing d. Very narrow blood vessels connecting arteries and veins in the body e. Fibrous membranes which form linings for body cavities and cover muscles and organs f. Strong band or cord of tissue that joins muscle to bone

2. fasciae 3. blood vessels 4. fibres 5. nerve 6. capillaries

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7. muscular dystrophy 8. diaphragm 9. biceps

10. pectoral muscle

g. Slender threads of which many human, animal or plant tissues are formed h. Tubes (arteries, veins or capillaries) through which blood flows in the body i. Broad, thick, triangular muscle, situated at the upper and anterior part of the chest that draws the arm towards the body j. Long-lasting illness in which the muscles become gradually weaker

GRAMMAR ADJECTIVES BASIC KNOWLEDGE Participial and qualificative adjectives Considering the frequency of certain types of adjectives in medical language we shall deal only with participial and qualificative adjectives. Participial adjectives are participial forms used as adjectives: - Present Participle forms: short infinitive + -ING: increasing, relaxing, growing - Past Participle forms: short infinitive + -ED (for regular verbs): reduced, flattened, expanded or the third form of irregular verbs: cut, hidden, frozen. Example: This relaxing atmosphere and these stimulating exercises will have a pronounced effect on your back muscles. Qualificative adjectives include all types of adjectives denoting quality, size, shape, colour, origin, age and general descriptions of objects (parts of the body, diseases, symptoms etc) and people: Example:

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The first piece of the sternum has a triangular form, broad and thick above and narrowed below. Both participial and qualificative adjectives can either precede the noun, having the same form for all genders, both singular and plural (attributive position) or follow the noun, having the function of predicatives for copulative verbs such as: be, become, look, seem, turn etc: Example: Moderate exercises have a therapeutic effect on muscles.(attributive position) The muscles become resistant to fatigue and the patients no longer look exhausted at the end of the session.(predicative position) Degrees of comparison According to the way they form their degrees of comparison adjectives fall into three categories: 1) monosyllabic (or short) adjectives and bisyllabic adjectives ending in -er, -y and ly which form their corresponding degrees of comparison by adding er and est (synthetic comparison): thick thicker the thickest thin thinner the thinnest 2) long adjectives bisyllabic (ending in -ful and -re), trisyllabic or plurisyllabic which form their degrees of comparison by periphrastic means: more and (the) most (analytic comparison): extensive more extensive the most extensive 3) adjectives with irregular degrees of comparison: good better the best bad worse the worst little less the least many/much more the most old older the oldest (of people and objects)

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old elder the eldest (of people) far farther the farthest (of space) far further the furtest (of time) Constructions with comparisons: The use of adjectives at different degrees of comparison requires the use of certain patterns. For instance, adjectives at superlative will be associated with perfect tenses: This is the most distressing pain I have ever had. The comparative requires the specification of the second term of comparison, which can be either a word or a sentence: I am not as useless as my blind brother /as you think I am. The injury was more severe than we thought. Gradual increase or decrease is expressed by two comparatives joined by and: As your breathing becomes slower and slower you are feeling more and more relaxed. Sometimes the comparatives are placed at the beginning of the sentences: The sooner you practise the exercise, the better you will feel. The larger the muscle, the greater its strength. 5. Reread the texts about the muscular system and extract all the adjectives. Group them according to their attributive or predicative position. For derivational adjectives indicate the noun that they derive from and their suffix or prefix as in the following examples: systemic = system (noun) + -ic (suffix) skeletal = skelet (noun) + -al (suffix) 6. Form derivational adjectives from the following nouns and verbs, choosing the appropriate suffixes in the box. Sometimes more than one suffix can be attached to part of the words:

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-al -ish -ible

-ic -ive -ed

-ous -ful -ing

-less -able

Example: Stern + -al = sternal thorax sphere muscle abdomen stomach anomaly fibre fever cure help comfort to identify to contract access memory to connect to digest health infection pain

7. Translate the following sentenses into English, using the new vocabulary and grammar notes of this unit: 1. Ce cauzeaz hipertrofia muscular? 2. Cu ct rezistena muscular este mai mare cu att va fi mai mare numrul de contracii musculare. 3. Tensiunea muscular prelungit poate produce durere, care poate duce la spasm muscular i prin urmare la mai mult durere. 4. Tensiunea muscular are strns legtur cu modul nostru de a gndi; astfel, cu ct suntem mai stresai, cu att mai mare va fi i tensiunea noastr muscular. 5. Activitatea fizic prelungit cum ar fi mersul sau

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pasul alergtor poate duce la oboseal muscular. 6. Care sunt cauzele principale ale extenurii musculare? 7. Muchiul gastrocnemian este cel mai superficial muchi situat n partea din spate a piciorului, care formeaz cea mai mare parte a gambei. 8. Tendonul lui Ahile este cel mai gros i mai puternic tendon din corpul uman. 9. Muchiul deltoid este un muchi lat, gros, triunghiular, situat pe partea lateral i posterioar a umrului. 10.Muchiul abductor al policelui este un muchi subire, plat, ngust, plasat imediat dedesubtul tegumentului (integument). Pair work: 8. Using your anatomy courses notes, choose a certain muscle and ask your deskmate to describe it. 9. Guessing game: Think of a certain muscle. Your deskmate will ask you as many questions as necessary to guess the muscle. Here are some examples of possible questions: Is it a muscle of the trunk/head/upper limb/lower limb? for general location (It is a muscle of the upper limb) Is it a muscle of the shoulder girdle or of the free upper limb? for specific location (It is a muscle of the shoulder girdle) Where is it situated? (It arises from the clavicle and scapula.) What is its function? (It helps the upper arm move forward, backward and horizontally.)

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Can you describe it? (It is a thick, triangular muscle with the base facing upwards and the apex downwards) Is it the deltoid muscle? (Yes, it is indeed.) The following classification of muscles may prove useful for this exercise: A. The muscles of the trunk: the muscles of the back the muscles of the neck the muscles of the chest the muscles of the abdomen B. The muscles of the head: the muscles of facial expression: the muscles of the scalp the muscles surrounding the eyes the muscles surrounding the mouth the muscles surrounding the nose the muscles of mastication C. The muscles of the upper limb: the muscles of the shoulder girdle the muscles of the free upper limb: the muscles of the upper arm the muscles of the forearm the muscles of the hand D. The muscles of the lower limb: the muscles of the hip joint

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the muscles of the free lower limb: the muscles of the thigh the muscles of the leg the muscles of the foot 10. Complete the classifications above with all categories of muscles you have studied so far.

UNIT 4
EXAMINING THE PACIENT POLYSEMANTIC WORDS THERAPIST-PATIENT DISCOURSE GREETINGS, IDENTIFICATION AND INTRODUCTORY DIALOGUES 1. Read the following text and check the glossary below to translate the unknown words. Write down other unknown words and try to approximate their meaning:

English in Kinetotherapy. A practical English handbook EXAMINING THE PACIENT

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Examination of a pacient is a continuous process that starts with your first meeting and continues until treatment ceases prior to discharge. The initial examination leads to an assessment of the pacients` needs and a decision on the early treatment. If the pacient has been previously examined by a diagnostician who provides full notes, some useful and time-saving information may be obtained by their careful perusal. To use such notes to the maximum, divide your perusal into: Obtaining basic information about the pacient as a social entity: names, sex, marital status, age, current work, former job and/or retirement status, cultural background and family circumstances. Reading, in date order, the medical events that are former medical history and the events that have marked the development of the current illness/disability and its progress. Noting, if available, the clinical examination findings and the results of tests, including X-rays. Any abnormalities indicated by the medical examination sheet need to be checked by the present examiner, as different variables such as the subjective assessment of the previous examiner or the change in patient`s condition from the last examination may influence the course of the treatment.Knowledge of normal parameters should be used to decide whether any of the test records show a need for care in examination and treatment. Obtaining a record of immediate past and current treatment and medication. It is important that current medications are noted for these may have some effect on selection of or precautions in administrating your treatments. When examining the pacient some things need to be provided: a clean, well ventilated, adequately warmed area, suitable coverings for the pacient, the position of the examination couch or table in relation to the lighting and, quite important, verbal confidentiality.There are some small testing devices that the examiner needs: a tape measure, a pin, a goniometer, a reflex hammer, some cotton wool, test tubes containing hot and cold water.

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Escorting the patient to the examination area can be an opportunity to observe his/her ability to walk unaided, the type of gait abnormalities if any, the general mien and posture. Successful questioning produces maximum information with the minimum of questions and is a skill that improves with practice. Listening to the patient`s answers requires patience, instant awareness and interpretation, and listening to the silences is equally important.What the patient fails to say may have great relevance. Palpation is a skill that is acquired by practice. It requires that your hands should be relaxed, in firm comfortable contact, and aware of what is under them.The following procedures are to be used when palpating for specific anatomical features: place more of your hand than you need in contact with the area to be examined, lift your palm a little to reduce the contact, so that only the finger pads are touching firmly enough.Your fingers should be straight so that your nails are unlikely to be in contact. Remember that too hard a pressure will feel like a drill digging in and too light a pressure will feel like a butterfly coming to rest. In neither case will you feel or find anything. Always allocate sufficient time for an initial examination of the patient, and if the examination turns out to be more time-consuming than your original estimate, complete only part of the tasks and conclude the examination at a further session. (Adapted from M.Hollis, P.Yung Patient examination and assessment for therapists)
GLOSSARY

to cease = a nceta, a se opri prior to = nainte de discharge = externare assessment = evaluare, estimare previously = mai nainte, n prealabil perusal = citire, lectur atent former job = slujb anterioar retirement = pensionare

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cultural background = formaie cultural medical history = anamnez disability = incapacitate, invaliditate clinical examination findings = constatrile examinrii clinice medical examination sheet = foaie de observaie clinic testing devices = instrumente de testare tape measure = rulet, panglic de msurat pin = ac cu gmlie goniometer = goniometru reflex hammer = ciocnel pentru testarea reflexelor cotton wool = vat test tube = eprubet gait = umblet, mers mien = inut, comportament posture = postur corporal instant awareness = nelegere rapid palpation = palpare finger pad = buricul degetului drill = burghiu to dig in = a nfige 2. Scan the text above so as to answer the following questions: 1. Why is the patient`s initial examination important? 2. What should basic information about the patient include? 3. Why does the present examiner need to check the patient`s prior medical examination sheet? 4. Why does the examiner need to note the patient`s current medication? 5. What things need to be provided when examining the patient? 6. What testing devices does the examiner use? 7. What should the examiner observe while escorting the patient to the examination area?

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8. When can we say that questioning the patient has been successful? 9. What procedures are to be used when palpating the patient? 10. What should be done if the first examination takes longer than expected? 3. Create your own examiner patient dialogues, including questions and answers regarding the patient`s basic information, former medical history, clinical examination findings, past and current medication, etc.
VOCABULARY PRACTICE POLYSEMANTIC WORDS

Many words that are pronounced and spelt in the same way can be used in different contexts with different meanings. They are polysemantic words. Polysemy is closely related to homonymy and it is sometimes difficult to distinguish between words that are homonyms and words that are polysemantic. There is still a criterion that can help us distinguish one notion from the other: while with homonymy the words that have the same form do not share any semantic resemblance in their meanings, with polysemantic words we can easily notice a semantic feature common to all the elements of a class. Here are two examples for each notion: Heart, as a polysemantic word, has a semantic feature associated that of being the central part of a body, of one`s life or of something else - that is carried over from one example to the next: Even if his heart stopped beating for several seconds, he did not die. I think you should get to the heart of the matter. He is my heart, my reason of living. Calf as a young of cattle (viel) or of certain other mammals such as the buffalo, elephant, giraffe and whale and calf as the thick fleshy part of the back of the leg between the ankle and the knee are two homonyms that have nothing in common, semantically speaking.

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Moreover, by looking words up in a dictionary, one can also distinguish between polysemantic words and homonyms as the former are listed with different numbers under the same lexical entry, while the latter are listed and treated as separate words: calf1 and calf 2. 4. Choose from among the meanings of the following polysemantic words the one that has been used in the text Examining the pacient: 1. examination means: a) written exercises, oral questions or practical tasks, set to test a candidates knowledge and skill; b) physical inspection of a patient or parts of his body, in order to verify health or diagnose disease; c) the formal interrogation of a person on oath (an accused or a witness) by a lawyer in a lawcourt. 2. discharge means: a) an official permission for (sb) to leave, after he has carried out a duty (discharge a soldier, a patient, release a prisoner from custody); b) unloading (cargo) from a ship c) firing (a gun), launching flying weapons (arrows) 3. background means: a) part of a view, scene or description that forms a setting for the chief objects, people; b) information that is needed to understand a problem; c) a persons social class, education, training or experience; d) a low level of sound, lighting whose purpose is to be an unobtrusive or appropriate accompaniment to something else, such as a social activity, conversation or the action of a film.

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4. device means: a) a machine or tool adapted for a special purpose (timesaving device, safety device, an explosive device etc); b) a particular pattern of words, figures of speech used in literature to produce a certain effect on the reader; c) a written, printed or painted design or figure, used as a heraldic sign, emblem, trademark by a noble family; d) a plan or plot, esp. a clever or evil one; a scheme, trick. 5. Write your own contexts in which the polysemantic words above, except for the version of your choice, are used with other meanings. You can use the following expressions:

English in Kinetotherapy. A practical English handbook

examination paper background music entrance examination working-class background to take an examination background on the companys financial position pass/fail an examination time-saving device = aparat de uz caznic medical examination labour-saving device = dispozitiv mecanic to be under examination an explosive device = dispozitiv explozibil to stay/keep in the background stylistic device = figur de stil

English in Kinetotherapy. A practical English handbook

6. Match each of the meanings below to one of the seven polysemantic words in the box:

a. patient d. foot

b. tongue e. bottom

c. head f. spine

g. nerve

1. a movable organ in the mouth, used in tasting, licking, swallowing and speaking; 2. foam on the top of a poured beer; 3. a person who is receiving medical care in hospital; 4. part of the body on which one sits, buttocks; 5. a measure of length equal to 12 inches; 6. row of bones along the back of humans and some animals, backbone; 7. boldness, courage; 8. a person capable of accepting delay that can still remain calm; 9. part of the body, containing the eyes, nose, mouth and brain; 10. a language, dialect or idiom; 11. the lowest part of the leg, below the ankle, on which a person or animal sits; 12. ground under the sea, lake or river; 13. any of the bundle of fibres carrying sensory or motor impulses between the brain and all parts of the body; 14. any of the sharp needle-like parts on some plants (cactuses) and animals (hedgehogs); 15. chief person of a group or organization; 16. a flap of leather on a shoe, under the laces or buckles to protect the instep; 17. the lowest, deepest or farthest removed part of a thing; 18. the back part of a book that is visible when it is in a row on a shelf;

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19. rib or vein in a leaf or any of the veins of an insect`s wing; 20. mental ability or natural talent for something. 7. Write your own contexts for the different meanings of the polysemantic words above. You can make use of the following syntagms and expressions: to be patient with sb. = a avea rbdare cu cineva mother tongue = limb matern to have lost/find one`s tongue = a-i pierde/redobndi graiul the head of the family = capul familiei head office = sediu central to have a good head for business, figures = a avea cap de afaceri, cifre at the foot/bottom of the stairs/hill/ mountain/list/page = n partea de jos a a 7-foot high wall = un zid nalt de 7 picioare to fall on one`s bottom = a cdea n fund the bottom of the sea/lake/river = fundul mrii/lacului/rului to go to the bottom = a se scufunda to lose/regain one`s nerve = a-i pierde/redobndi curajul to have the nerve to do smth.= a avea curajul/tupeul de a face ceva to strain every nerve = a-i ncorda toate puterile

English in Kinetotherapy. A practical English handbook

THERAPIST-PATIENT DISCOURSE Greetings, identification and introductory dialogues Here are some examples of initial greetings and introductory dialogues used before the examination takes place:

The therapist: Good morning, Mrs. Johnson. Let me introduce myself. I am your therapist, Dr. Green. Please come in and take a seat. Make yourself comfortable. I will be with you in a second. My name is Dr.Green. I think we talked on the phone, didn`t we? I remember you. You were my patient last year. How is your back? You are Dr. Thomson`s sister, aren`t you? He told me all about you. Inquiring about the patient`s problem: Well, Mrs. Johnson, what can I do for you? Tell me, Mr. Baum, what`s troubling you? Well, Mrs. Redcliff, what`s brought you here? Well, let`s see what seems to be the problem? Your brother, Dr. Thomson tells me that you have been having low back pains I couldn`t help noticing your slight limp. Can you tell me more about it? I can`t tell you how sorry I am about your terrible accident. How is your recovery going on? I understand that you have seen several therapists before. How can I help you?

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Programming further sessions: Considering your diagnosis, I will have to see you twice a week, for six weeks. For the first two weeks we shall meet every day till your pain goes away. Bring me the X-rays and then I will schedule a meeting for you for next week. I am sorry, but you should have seen an orthopaedist before coming here. I will meet you for our sessions three times a week, for at least three weeks. We shall start on Monday and see how it is going. I think we can have good results if you come to all your sessions. Pair work 8. Practise therapist-patient dialogues using the examples above. You can as well come up with your own examples. 9. Translate into English, using the new vocabulary: 1. Recomandarea unui program de exerciii terapeutice nu se poate face fr o examinare amnunit a pacientului. 2. Orice informaii cu privire la datele personale ale pacientului, la un diagnostic anterior i medicamentaie se pot dovedi extrem de importante n recomandarea terapiei ulterioare. 3. Pe toat durata examinrii pacientul trebuie s se simt relaxat, protejat, fiind asigurat de confidenialitatea discuiilor sale cu terapeutul. 4. Terapeutul poate sesiza n mod indirect anumite caracteristici motrice ale pacientului, prin simpla observare a

English in Kinetotherapy. A practical English handbook

posturii sale corporale, a inutei generale i a mersului acestuia. 5. Palparea pacientului i testarea gradului su de mobilitate sunt indicii clare n stabilirea afeciunii prezente i indicarea tipurilor de exerciii corespunztoare.

UNIT 5
TYPES OF INJURIES PASSIVE MODAL CONSTRUCTIONS PRESENT TENSE SIMPLE AND PRESENT PERFECT THERAPIST-PATIENT DISCOURSE PATIENT`S SYMPTOMS AND COMPLAINTS FORMAL AND INFORMAL MEDICAL TERMS 1. Read the following extracts and check the glossary below for new words. Then translate these texts into Romanian: Patient rehabilitation after fractures Patient rehabilitation should begin immediately, depending on the type of fracture and soft tissue stability. Adjacent joints should be mobilized as soon as possible; however, in open fractures motion of musculotendinous units over fracture surfaces will irritate the soft tissues and may decrease resistance to infection. Immobilization of adjacent joints can be done by using splints, braces or foot attachments to external fixation systems. Physical therapy should include active exercises for joint mobilization, weight-bearing exercises, as well as range of motion and strengthening exercises, all practised under the close supervision of both the physician and the kinetotherapist. (Adapted from Thomas A. Russell General Principles of Fracture Treatment)

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Hip dislocation Hip dislocation is an orthopaedic emergency and must be reduced immediately. It occurs primarily in conjunction with severe multiple trauma from high-speed motor vehicle accidents. The longer the hip remains dislocated, the more likely is the possibility of complications, including avascular necrosis of the femoral head and posttraumatic arthritis. Most dislocations of the hip can be reduced by close manipulation and this treatment should take precedence over treatment of all other skeletal injuries. (Adapted from David G. LaVelle Acute Dislocations) Sprains or ligamentous injuries Most sprains or ligamentous injuries can be treated by immobilization. Even though immobilization allows the stretching of ligaments, quickly relieves pain and may be beneficial in reducing the swelling, many specialists report that early mobilization for these injuries produces superior results to immobilization. (Adapted from S. Terry Canale Ankle Injuries) Rupture of muscles and tendons The most frequent cause of partial or complete rupture of a muscle or tendon is eccentric overload of the muscle-tendon unit. Muscle strains are initially treated with ice, rest and antiinflammatory medication, followed by a gentle stretching and progressive strengthening program as symptoms resolve. Failure to regain full flexibility and normal strength of the muscle-tendon unit results in increased risk of further recurrent injury. (Adapted from Barry B. Phillips - Rupture of muscles and tendons)
GLOSSARY

rehabilitation = reabilitare fracture = fractur adjacent joint = articulaie adiacent to decrease = a reduce, diminua

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to increase = a mri, intensifica splint = atel brace = ortez foot attachment = dispozitiv de fixare a piciorului weight-bearing exercise = exerciiu de susinere a greutii corporale range of motion = grad de mobilitate strengthening exercises = exerciii de ntrire muscular to occur = a se petrece, a avea loc in conjunction with = n legtur cu avascular necrosis = necroz avascular femoral head = cap femural arthritis = artrit to take precedence over smth = a avea loc nainte, a avea prioritate fa de skeletal injury = leziune a sistemului scheletic sprain = luxaie, scrntire to relieve pain = a alina durerea swelling = umfltur rupture = ruptur, hernie overload = ncrcare excesiv muscle strain = ntindere muscular failure = eec, insuficien further = ulterior, adiional 2. Scan the texts above for modal constructions (can, may, should, must etc) and write them down. Then, underline the passive ones as in the examples below: Example: Should begin Should be mobilized

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GRAMMAR PASSIVE MODAL CONSTRUCTIONS All scientific languages make use of passive constructions to express impersonal observations, avoid mentioning unknown or indefinite subjects and focus on action and effect rather than on the agent that caused them. Even though the process of converting active constructions into passive ones seems to be artificial, it may prove to be useful and practical in situations when passives are preferred to active constructions. Here are some examples of passives constructions illustrated for modal verbs: Excessive flexion and extension of the neck should be avoided in spinal injuries. Clinical instability may be caused by trauma, neoplastic or infections disorders. Spinal alignment can be obtained by skeletal traction. The pathologic anatomy must be carefully defined before treatment is determined. These pills must be taken twice a day, on an empty stomach. With modal verbs the transformation from active voice to passive voice is made by keeping the modal unchanged and using a passive infinitive: Active Voice Passive Voice

Should avoid should be avoided (modal + BE + past participle short inf.+ ED )

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Must take must be taken (modal + BE + past participle the 3rd form of irregular verbs) 3. Insert the following modal constructions in their corresponding context, choosing the active or passive form that best completes the sentence:

must be applied should wear first direct should be confirmed must be covered should not be done should not be rubbed

must be used should may be selected may be

1. Open hand wounds . immediately with a sterile dressing to prevent further contamination. 2. If bleeding continues, manual or digital pressure to the wound through the dressing. 3. At times it helpful to elevate the arm with the patient lying supine. 4. Cleaning the wound .. in a hurry. 5. Both the examiner and the patient .. masks when the wound is examined. 6. Sterile instruments and gloves .. 7. The examiner his attention to the circulation and skin and then to bones, tendons and nerves. 8. The depth of the wound with a sponge or a brush. 9. Suspected damage to tendons and nerves . by direct vision. 10. A regional block or general anesthetic depending on the patient`s age and the severity of the injury. 4. Rewrite the following sentences in the passive voice, making the

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words in italics the subject of the sentence and placing, when necessary, the agent at the end of the sentence: Example: The surgeon should closely follow the progress of patient`s regeneration. The progress of patient`s regeneration should be closely followed by the surgeon (agent). 1. The examiner should advise the patient as to the extent of his injuries. 2. The surgeon must evaluate the extent of the skin loss from the injury. 3. The surgeons may delay the repairs of nerve and tendons. 4. During surgical procedures the assistants should use a double binocular microscope. 5. Surgeons can master microsurgical techniques only after countless hours of practice. 6. The surgeon must avoid coffee just before surgery. 7. If suitable instruments are available and if the surgeon is rested he may undertake repair of severed nerves on the day of injury. 8. During weeks after nerves repair operation the patient should pay careful attention to avoid fixed contractures. 9. After the operation the patient should begin progressive strengthening exercises. 10. The patients should also make monthly clinical evaluations.

5. Translate into English using passive modal constructions: 1. Pacientul suspectat de fractur a coloanei vertebrale nu trebuie mutat pn la sosirea ajutorului calificat. 2. Dac este imperativ ca pacientul s fie mutat,

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capul, gtul i toracele lui trebuie susinute n poziia lor iniial de ctre mai multe persoane. 3. Aceast plag ar trebui curat imediat iar fractura deschis ar trebui imobilizat. 4. Primul ajutor n caz de rnire trebuie s fie ntotdeauna rapid, eficient i de preferin efectuat de ctre personal calificat. 5. Programul de recuperare motorie a pacientului ar trebui nceput la cteva sptmni dup operaie. THERAPIST-PATIENT DISCOURSE Patient`s symptoms and complaints Formal and informal medical terms Patients and therapists/doctors do not always use the same language, even if they are speaking about the same things. There is a certain difference between a formal medical language used between doctors and medical care takers, the scientific language of all medical texts and an informal medical language that non-specialists (patients) use to describe their symptoms or disabilities. In therapist-patient communications a common informal language should be used to ensure proper communication. Here are some examples of the same notions with different formal vs. informal medical terms: Formal term contusion tenosynovitis arteriosclerosis sedative analgesic Informal term bruise Translation contuzie, vntaie inflamed tendons tenosinovit hardening of the arteroscleroz arteries sleeping pill, dope sedativ pain killer analgezic, calmant

6. Match the formal term in column A with its corresponding informal term in column B:

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A 1. thyroid cartilage 2. halitosis 3. maxilla 4. alopecia 5. spine 6. tachycardia 7. mandible 8. myocardial infarction 9.ankylosing spondylitis 10. subluxation 11. thorax 12. influenza 13. hypoglycaemia 14. uterus 15. vertigo

B a. dizziness b. bamboo spine c. lower jaw d. palpitations e. heart attack f. Adam`s apple g. low blood sugar h. bad breath i. womb j. backbone k. flu l. chest m. dislocation n. upper jaw o. baldness

Without assuming to cover at least part of the symptoms and problems that patients may have when coming to see a kinetotherapist, some examples of common complaints are presented below: Patient`s symptoms and complaints: I have sprained my left ankle. (Mi-am rsucit/ luxat glezna stng) I have strained my deltoid muscle. (Am o ntindere muscular la deltoid.) I have pulled a hamstring muscle. (Mi-am ntins un tendon muscular.) I have torn a ligament in my right knee. (Am o ruptur ligamentar la genunchiul drept.) I have snapped a tendon in my left thigh. (Am o ruptur de tendon la coapsa dreapt.)

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I have got a cartilage problem in my left knee joint. (Am o problem la nivelul cartilajului articulaiei genunchiului stng.) I have got chilblains in my toes. (Am suferit degerturi la degetele de la picioare.) I have pins and needles in my feet all the time. (Simt furnicturi n picioare tot timpul.) I feel a tingling sensation in my fingers. (Simt o senzaie de furnicturi n degete.) I have got a severe pain in my left heel. (Am o durere puternic n clciul stng.) I get cramp in my calves. (Am crampe la gambe.) I have got swelling of my ankles. (Am gleznele umflate.) I have got numb fingers/legs when I wake up. (Am degetele/picioarele amorite cnd m trezesc.) My fingers tremble a lot and even my hands have started shaking.(mi tremur degetele i chiar i minile.)

GRAMMAR Present Perfect and Present Tense Simple are the tenses normally used to express complaints in the above sentences. 7. Identify each tense in the sentences above and say how they are formed. Example: Have sprained = Present Perfect Simple; formation: the auxiliary verb have + past participle of the regular verb sprain (short infinitive + -ed) Have torn = Present Perfect Simple; formation: the auxiliary verb have + past participle of the irregular verb tear (tear, tore, torn)

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Present Perfect Simple is used in the above-mentioned complaints to express previous causes/injuries that still have a certain effect in the present, while Present Tense Simple makes these complaints a general fact, the symptoms presented are something felt as usual. 8. Put the verbs in brackets into the Present Tense Simple or Present Perfect: 1. _______ you ever ________ (sprain) your ankle? It`s not so bad but you have to stay in bed for a while. 2. _______ it _________ (hurt) if I touch your swollen ankle? ______ you _______ (feel) a burning sensation? 3. My aunt`s fingers always __________ (tremble) when she ________ (give) me my monthly allowance. 4. I am still in hospital. I ________________ (not recover) yet. I always ______ (get) cramps in my calves in the morning. 5. I ________ already _________ (practise) this stretching exercise three times. Yes, but you still ___________ (not do) it right. 9. Translate into English using Present Perfect Simple and Present Tense Simple as in the above-presented examples of patient`s complaints; sometimes modal verbs are to be used as well: 1. Nu pot s-mi ndoi cotul drept. Cred c mi l-am luxat. 2. Mi-am fracturat oldul i am nevoie de exerciii de reabilitare. 3. Mi-am dislocat umrul stng. A dori s am un grad mai mare de mobilitate. 4. Mi-am rupt trei coaste ntr-un accident de schi. Am fost n spital ase sptmni. 5. Am adesea crampe durerose n ambele gambe dup terminarea meciului de fotbal.

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6. Cnd m scol dimineaa nu-mi simt picioarele de la genunchi n jos. 7. Am dureri de spate acute. Am fost la muli doctori i m-am hortt s ncerc i nite exerciii terapeutice. 8. Am o ntindere muscular suprtoare la nivelul gtului. Am nevoie de cteva exerciii de ntindere pentru a-mi redobndi flexibilitatea. 9. Am o ruptur de tendon n deltoid i nu-mi pot continua programul de antrenament pentru Olimpiad. 10.Am contracii musculare n gamba stng iar fora mea muscular nu mai este aceeai. 10. Place yourself in a patient`s situation and complain about your symptoms, asking your colleagues future kinetotherapists for help and advice.

UNIT 6
THERAPEUTIC EXERCISES WORD FORMATION DERIVATION THERAPIST-PATIENT DISCOURSE RECOMMENDING DIFFERENT THERAPEUTIC EXERCISES 1. Read the following text and write down the new words; then translate it into Romanian, using the glossary below. THERAPEUTIC EXERCISES The goals of therapeutic exercises include the prevention of dysfunction as well as the development, improvement, restoration or maintenance of strength, endurance and cardiovascular fitness, mobility and flexibility, stability, relaxation, coordination, balance and

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functional skills. Strength is the ability of a muscle or muscle group to produce tension and a resulting force during a maximal effort, either dynamically or statically, in the relation to the demands placed upon it. To increase strength, a load that exceeds the metabolic capacity of the muscle must be used during exercise. To produce greater muscular tension, a high-intensity exercise (exercise performed against heavy loads) must also be used, but for a relatively low number of repetitions. Muscular endurance is the ability of a muscle to contract repeatedly or generate tension, sustain that tension and resist fatigue over a prolonged period of time. It is necessary for performing repeated motor tasks in daily living, such as walking or climbing stairs. Active exercises that challenge the oxygen transport system will increase endurance - the major goal of cardiac rehabilitation programs. Exercises are usually directed to large muscle groups, as in walking, running, swimming and cycling and are to be prolonged and performed for 15 to 45 minutes or more. Mobility of soft tissues and joints is necessary for the performance of normal functional movements. Flexibility is the ability to move a single joint or series of joints through an unrestricted, pain-free range of motion. It is dependent upon the extensibility of muscles, which allows muscles that cross a joint to relax, lengthen and yield to a stretch force. Stability is usually required in more proximal structures, such as the trunk, hips and shoulder girdle, for effective positioning and motion of the arms and hands or legs and feet.Stabilization exercises are the means by which a patient can learn to control proximal areas of the body and, at the same time, maintain a stable, well-aligned position while carrying out functional activities. Relaxation refers to a conscious effort to relieve tension in muscles.Exercises promoting relaxation are based on the therapeutic use of reflexive and conscious processes. Thus, the patient should be placed in a comfortable position, with all body parts well supported and be taught to progressively contract and relax the musculature.This

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process is often coupled with deep-breathing exercise to further promote relaxation. Coordination, balance and the acquisition of functional skills are all interrelated and are complex aspects of motor control. Coordination refers to the ability to use the right muscles at the right time with appropriate intensity. It is the basis of smooth and efficient movement that can occur on a voluntary or involuntary level. Balance refers to the ability to maintain the center of gravity over the base of support, usually while in an upright position. It is a dynamic phenomenon that involves a combination of stability and mobility. Finally, functional skills refer to the varied motor skills necessary to function independently in all aspects of daily living. Learning functional motor tasks involves constant repetition of simple to more complex motor activities, use of sensory cues (tactile, visual) to enhance motor performance and as the quality of movement improves, so should the speed and timing of movements. (Adapted from Carolyn Kisner&Lynn Allen Colby Therapeutic Exercise. Foundations and Techniques) GLOSSARY dysfunction = disfuncie restoration = refacere, restabilire maintenance = meninere strength = for, vigoare endurance = rezisten fizic cardiovascular fitness = tonus cardiovascular balance = echilibru functional skills = abiliti funcionale load = greutate a high-intensity exercise = exerciiu cu intensitate crescut fatigue = oboseal motor tasks = sarcini motorii

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to challenge = a solicita range of motion = grad de mobilitate to lengthen = a se lungi, ntinde to yield to = a ceda, a nu rezista la stretch force = for de ntindere stable = stabil well-aligned position = poziie corect adoptat carry out = a ndeplini, a realiza to relieve = a destinde, relaxa deep-breathing exercise = exerciiu de respiraie profund acquisition = dobndire, obinere smooth movement = micare lin, fr ntreruperi upright position = poziie vertical sensory cues = indici senzoriali to enhance = a mri, intensifica motor performance = randament motoriu timing = sincronizare Pair-work 2. Question-answer exercise: Reread the text above on paragraphs. One student will ask his/her colleague one or two questions for each paragraph and he/she should answer it either by reproducing fragments from the text or by freely expressing a summary of that fragment. Here is an example for the first paragraph: Example: What are the main goals of therapeutic exercises? Well, if I remember corectly, the goals of therapeutic exercises are. How is strength defined in the text? Well, let my see, strength is defined as ..

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What should be done to produce greater muscular tension? Well, it says here that a high-intensity exercise. 3. Question-answer exercise: Try to find out how much you really know about your physical abilities. Ask your deskmate to make a self-evaluation of his/her physical abilities (strength, muscular endurance etc.); in your answers you can make use of the following assessment patterns or come up with new ones: Well, my strength is quite bad/ is not so bad/ is actually quite good/ is excellent. Muscular endurance is not my stong point, if you get my meaning. As for my mobility and flexibility, it goes without saying that all I need is a little practice, to get back into shape. Well, my stability depends a lot on my mental stability; a state of nervousness will certainly be detrimental to my stability. I have always had problems with balance; to me, it is sometimes that does not improve with practice; you either have it or not.

WORD FORMATION DERIVATION Derivation with suffixes and prefixes is one of the means of word formation. Generally, there are some typical noun/ adjective/ adverb/ verb forming suffixes and prefixes, but there are cases when the same prefix or suffix is used to form different categories. For instance the suffix al is used to form both nouns like in arrival, refusal, proposal and adjectives like in functional, educational. The suffix ing is used to form the present participle that can be used as a verbal category (She came walking across the field.), as a noun (Walking can sometimes be very relaxing.) or as an adjective (He was reading a very amusing novel.). The suffix ly is the most common adverbforming suffix (rapidly, daily, usually). Still, there are some adjectives

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that contain the ly suffix: daily schedule, monthly payment. The following exercises are meant as forms of practising the word formation process. 4. Extract from the text above (Therapeutic exercises) all the derivational nouns and include them into their corresponding suffix category as shown in the example: Example: -ion: prevention -ment: development -ance: maintenance -ness: fitness -ity: mobility -ing:walking 5. Find the corresponding base forms (verbs, adjectives) and the corresponding suffixes for every derivational noun in the same text: Example: prevention prevent (verb) + -ion (suffix) mobility mobil (adjective) + -ity (suffix) 6. Extract from the text above (Therapeutic exercises) all the derivational adjectives and include them into their corresponding suffix category: Example: -ic: therapeutic -al: functional -ing: resulting -ed: prolongued -ive: effective -ly: daily -(i)ous: conscious -able: comfortable

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-y: sensory 7. Find the corresponding base forms (nouns, verbs) and the corresponding suffixes for every adjective in the text: Example: therapeutic therapeut (noun) + -ic (suffix) 8. Extract from the text above (Therapeutic exercises) all the derivational adverbs and include them into their corresponding suffix category: Example: -ly: relatively -ally: dynamically 9. Find the corresponding base forms (adjectives) and the corresponding suffixes for every adverb: Example: relatively relative (adjective) + -ly (suffix) There are many nouns in English that have an identical form with their corresponding verbs: Verbs to pressure to question to estimate to exercise Nouns pressure question estimate exercise

Yet, sometimes there are some slight spelling differences between the noun and its corresponding verb that can easily pass unnoticed: Verbs To practise To respond Nouns practice response

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10. Give other examples of nouns that have the same form as their corresponding verbs and write contexts in which the same word functions both as a noun and as a verb. 11. Write in the second column the corresponding nouns for the verbs listed in the first column. The first one has been done for you as an example: include 1. 2. 3. 4. 5. 6. 7. 8. 9. 10. 11. 12. 13. examine prescribe operate assess decide retire interpret confirm immobilize rehabilitate swell treat dislocate inclusion_ ________ ________ ________ ________ ________ ________ ________ ________ ________ ________ ________ ________ ________

12. Rewrite the sentences below using the nouns in the second column (exercise 11) instead of their corresponding verbs. Do not change the meaning of the sentences: Example: It was more than vital to include Mr. Dean in our clinical study. Mr. Dean`s inclusion in our clinical study was more than vital. 1. I will be able to tell you more after I examine the patient.

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2. You should not take these pills if the doctore did not prescribe them. 3. The surgeons operated on the injured man immediately. 4. After the therapist assesses the patient`s needs, he will also decide a further treatment. 5. As Mrs. Strauss retires next month, she will have more time for her therapy. 6. After the doctor interprets the results of your X-rays, he will probably confirm your need for surgery. 7. To immobilize the patient`s fractured leg is one of the first aid measures to be taken. 8. Our clinic is specialized in rehabilitating patients who suffered severe injuries. 9. What can I do if my ankle swells over night? 10. I cannot treat patients without their full consent and cooperation. 11. If the patient`s shoulder is dislocated, an emergency intervention is needed. THERAPIST-PATIENT DISCOURSE Recommending different therapeutic exercises Listening to the patients`complains and symptoms will normally be followed by the therapist`s recommandations regarding different therapeutic techniques and exercises. Here are some examples of such kinetotherapy exercises that therapists may recommend to their patients:

Kinetotherapist`s recommandations: You should start with a very simple relaxation technique. A deep-breathing exercise will help you relax.

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Some massage sessions will be good for your local circulation. Passive stretching exercises will lengthen your shortened tissues. You can practise these self-stretching exercises as part of your home exercise program. As a gymnast, do not forget to practise your overstretching exercises. Considering your long-term immobilization, you need to practise strengthening exercises every day. The best solution for you to regain your balance is to practise weight-bearing exercises. I recommend you to continue with joint mobilization techniques to treat your muscular stiffness. In treating your spine injury, traction techniques are a good option.

13. Translate the above sentences into Romanian and say whether you are familiar with these exercises; give examples of such types of exercises. 14. Consider yourself as a kinetotherapist; choose one type of the exercises above and explain the basic procedure to a colleaguepatient of yours. 15. Consider yourself as a patient with a certain dysfunction (you can choose one of the symtoms presented in Unit 5) and ask your colleague-therapist what exercises he would recommend you. 16. Translate into English using the new vocabulary: 1. Este foarte important s-i alegi un program de exerciii care s-i fie cu adevrat de ajutor.

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2. Exerciiile de meninere a greutii corporale ar trebui s nceap cu renvarea schimbrii greutii corporale. 3. Dac vrei s-i corectezi postura corporal defectuoas ar trebui s ncepi cu exerciii de ntrire a musculaturii slbite. 4. Exerciiile de ntindere sunt recomandate persoanelor n vrst, indivizilor sedentari i persoanelor care se refac dup operaii sau o imobilizare prelungit. 5. Creterea rezistenei musculare va duce implicit la mbuntirea tonusului cardiovascular. 6. Tehnicile de mobilizare a articulaiilor sunt folosite n tratarea atrofiei cartilajului articular, a slbirii ligamentoase, a hipomobilitii articulare .a.m.d. 7. Tehnicile de traciune sunt practicate pentru a se redobndi flexibilitatea, fora, rezistena i stabilitatea coloanei vertebrale. 8. Poi s-i menii echilibrul timp ndelungat pe o suprafa ngust i fiind legat la ochi? 9. Rezistena muscular nu este intotdeauna rezultatul antrenamentelor susinute. Urcatul i cobortul scrilor ntr-un bloc fr lift, alergatul dup autobuz sau mersul pe jos ne in n form n fiecare zi. 10.Toate capacitile noastre fizice pot fi perturbate atunci cnd sunt nevoii s fim imobilizai la pat pentru o perioad prelungit de timp.

UNIT 7
THERAPEUTIC PATIENT PROCEDURES IN HANDLING THE

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PASSIVE VERBAL CONSTRUCTIONS THERAPIST-PATIENT DISCOURSE positioning and handling the patient 1. Read the following extracts and then solve the tasks that follow them: Movements at a joint are determined by the shape of the articular surfaces. For instances, the following movements are possible at the shoulder joint: flexion and extention about the transverse axis with the movements occurring in the saggital plane; abduction and adduction about the anteroposterior axis, in which case the movement is made in the frontal plane; and finally, rotation about the vertical axis including pronation (medial rotation) and supination (lateral rotation), with the movement occurring in the horizontal plane. (R. D. Sinelnikov Atlas of Human Anatomy) Weight-bearing control and stability Develop ability to shift the body weight. If the patient cannot bear full weight, begin in the parallel bars with part of the weight borne on the hands. The patient shifts anteriorly, side to side, and obliquely. Manual resistance to the motion is added with pressure against the patient`s pelvis. To increase flexion of the hip with the knee extended Hand placement: With the patient`s knee fully extended, support the patient`s lower leg with your arm or shoulder. Stabilize the opposite extremity along the anterior aspect of the thigh with your other hand or a belt or with the assistance of another person. With the knee in maximum extension, flex the hip as far as possible. Alternate position. Kneel on the mat and place the patient`s heel against your shoulder. Place both of your hands along the anterior aspect of the distal femur

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to keep the knee extended. The opposite extremity is stabilized in extension by a belt or towel and held in place by the therapist`s knee. To increase dorsiflexion of the ankle with the knee extended Hand placement Grasp the patient`s heel (calcaneus) with one hand. Stabilize the anterior aspect of the tibia with your other hand. Pull the calcaneus downward with your thumb and fingers and gently push upward on the heads of the metatarsals. To increase wrist extension Hand placement Pronate the forearm and grasp the patient at the palmar aspect of the hand. Stabilize the forearm. To lengthen the wrist flexors, extend the patient`s wrist, allowing the fingers to passively flex. Alternate position: Support the patient`s forearm on the table but allow the hand to drop over the edge of the table. Then passively extend the wrist. This may be more comfortable for the therapist or necessary if the patient has a severe wrist flexion contracture. (Carolyn Kisner&Lynn Allen Colby Therapeutic Exercise. Foundations and Techniques) TASKS 1. Enumerate the movements that are possible at the shoulder joint. 2. Name the type of therapeutic exercise that deals with controlling body weight. 3. What is hand placement? 4. Which parts needs to be stabilized in: hip flexion, ankle dorsiflexion and wrist extension? 5. What should the therapist do to to lengthen the wrist flexors? 6. What is recommended if the patient has a severe wrist flexion

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contracture? 7. What objects does the therapist use in handling the patient? 8. Pair work: Choose one of the last three therapeutic procedures and illustrate them, respecting the indications offered in the texts. 9. Pair work: Repeat the task at point 8, this time with the therapist describing the procedure (in his /her own words) while illustrating it in front of the class. 10. Invent one type of exercise for a certain purpose, first practise it with your deskmate and then, describe it to your audience. 2. Complete the missing correspondent in the following verb-noun pairs: VERBS NOUNS flexion extension abduction adduction rotation resistance pressure to stabilize to lengthen to support 3. Complete the missing correspondent in the following adjectiveadverb pairs: ADJECTIVE possible manual ADVERB anteriorly

to pronate to supinate

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obliquely comfortable necessary gently passively fully horizontal severe GRAMMAR PASSIVE VERBAL CONSTRUCTIONS In Unit 5 we have already introduced the issue of Passive Voice and exemplified its use in dealing with passive modal constructions. Learning how to use the passive forms of the most frequently used verbal tenses is the objective of this unit. As a general rule, the passive voice is formed by putting the verb to be into the same tense as the verb in the active voice and adding the past participle of the active verb. The direct object of the active verb becomes the subject of the passive verb, while the subject of the active verb becomes the agent of the passive verb. Example: Therapists sometimes hypnotize their patients. subject direct object The patients are sometimes hypnotized by their therapists. subject agent

Read the chart below to see how the active to passive

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transformation works for the main verbal tenses:


TENSES Present Tense Simple Present Tense Continuous Past Tense Simple Past Tense Continuous Present Perfect Past Perfect Future Tense Simple Future Perfect Conditional Perfect Conditional Gerund ACTIVE VOICE treat PASSIVE VOICE am/is/are treated is/are being examined was/were injured was/were being transported has/have been found had been discharged will/shall be included will/shall have been healed would be recovered would have been saved being practised

is/are examining injured


was/were transporting has/have found had discharged will/shall include will/shall have healed would recover would have saved practising

4. Put the verbs in brackets into the passive voice of the tense indicated: Example: The range of motion of the ankle is restored (restore Present Tense Simple) by performing stretching exercises. 1. The ankle ___________________ (immobilize Present Tense Simple) in a short cast for 3 to 4 weeks. 2. The patient`s lower leg ___________________ (elevate

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Present Tense Continuous) now. 3. Successive weight-bearing stresses ________________ (impose Past Tense Simple) on the feet. 4. These faulty foot postures __________________ (cause Present Perfect) by the excessive adduction of the forefoot. 5. The rehabilitation program ________________ (start Future Tense Simple) as soon as possible. 6. Little effort _______________ (require Present Tense Simple) to maintain this position for extended periods. 7. Ankle and foot motions ________ previously ____________ (perform Past Perfect) by the patient. 8. The same motion ____ now ____________ (repeat Present Tense Continuous) with the patient in alternate position. 9. Many balance activities _________________ (practise Past Tense Simple) but without any result. 10. Muscular endurance _________________ (increase Present Perfect) by performing the same exercises for a repeated number of times. 5. Change the following sentences from Active Voice into Passive Voice; the underlined direct objects will become the subjects of the passive sentences: Example: The patient sometimes describes pain from muscle spasm as a headache. Pain from muscle spasm is sometimes described as a headache. 1. If the patient is experiencing acute inflammation, he should be placed in a less irritating position. 2. If a disk lesion is the cause of the acute back pain, the therapist will first take measures to alleviate the pain. 3. Injury or degeneration of the disk affects spinal mechanics in general.

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4. The patient with acute disk lesions has avoided sitting with the hips and knees flexed or leaning forward. 5. The patient needs bed rest during the first 2days when symptoms are highly irritable. 6. The therapist will instruct the patient to avoid flexion activities that increase intradiskal pressure. 7. In one of my patients with spondylosis, traction exercises temporarily relieved the pressure. 8. Many patients have often expressed emotional stresses as increased tension in their lumbar region. 9. The patient performs elongation exercises only within tolerance during the early healing phase. 10. Imbalances in the shoulder girdle will perpetuate faulty postures. THERAPIST-PATIENT DISCOURSE Positioning and handling the patient Pair work 6. Read the following positioning indications to your colleaguepatient who will then illustrate them in front of the classs: The patient is supine, with arms in resting position. The patient is side-lying, with the affected hip up. The patient is hook-lying. The patient is cross-sitting. The patient is heel-sitting. The patient is on hands and knees. The patient is prone, with hands placed under the shoulders. The patient is supine, with the foot pointing upright to keep the hip neutral to rotation. The patient is sitting, with the forearm supported on the treatment table, wrist over the edge of the table.

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The patient is standing, with the hands placed in the low-back area.

Team work 7. Read the following hand placement and stabilization procedure indications to a therapist-patient pair who will then illustrate them in front of the classs. Grasp the patient`s wrist with your lower hand. Place your thumb on the anterior surface of the proximal end of the clavicle. Place a belt around your shoulder and under the patient`s thigh to help hold the weight of the lower extremity. Support the patient`s leg with the fingers of the top hand under the patient`s knee and the lower hand under the heel. Stabilize the patient`s pelvis with the top hand or arm. Stabilize the patient`s pelvis by flexing the opposite hip and holding the thigh with the hands. The hip to be mobilized is in resting position. Sitting on a low stool, stabilize the leg between your knees and place one hand on the anterior aspect of the tibia.

Team work 8. Read the following therapeutic techniques to a therapist-patient pair who will then illustrate them in front of the classs: Perform elbow flexion and extension with the forearm pronated as well as supinated. Flex the patient`s hip and knee to 90 degrees; support the knee with the top hand. Pull the foot away from the long axis of the leg in a distal direction by leaning backward. Flex the elbow to 90 degrees and abduct the shoulder to 90

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degrees. Rotate the humerus by moving the forearm like a spoke on a wheel. Flex the patient`s knee until discomfort is experienced in the anterior thigh. Instruct the patient to arch the back by pressing against the floor with the back of the neck and the sacrum.

9. Translate into Romanian all the sentences from the exercises 6, 7 and 8 above. Pair work 10. One student will be given a hand out containing indications for a therapeutic exercise. He or she will read the text and then start illustrating the stages of the exercise. The task for the other student is to write down the content of the exercise while watching it. The exercise will be repeated several times. At the end the teacher or a third student will compare the two texts and comment on their degree of similarity. Here is an example of a hand out: Example: The patient is standing, with the hands placed on the shoulders. The patient bends his body sideways with one hand over his head. The movement is repeated three times for each side. Then the patient returns to the initial position. 11. Create your own therapeutic exercises, using the examples provided in this unit and read them to your colleagues. 12. Translate into English, using the new vocabulary of this unit: 1. Plasai pacientul n poziie de supinaie, cu

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minile ntinse lateral. 2. Prindei ncheietura minii pacientului i rotii-i braul. 3. Indicai-i apoi pacientului s ncerce s fac aceeai micare singur. 4. Poziie iniial: pacientul aflat n sprijin pe mini i genunchi. 5. Indicai-i pacientului s-i menin greutatea corporal pe mini i genunchiul stng i s-i ntind uor genunchiul drept n spate. 6. Greutatea corporal va fi apoi mutat pe mini i pe genunchiul drept iar piciorul stng va fi ntins. 7. Poziie iniial: pacientul este n poziia stnd pe clcie. Indicai-i pacientului s se aplece n fa, cu capul ntre braele ntinse, pn ce abdomenul se va odihni pe coapsele anterioare. 8. Poziie iniial: pacientul este aezat pe-o parte, pe masa terapeutului, cu capul plasat la marginea mesei. 9. Indicai-i pacientului s-i ntind mna de deasupra peste cap, lsnd-o s atrne pe lng mas. Poziia trebuie meninut pentru cteva minute. 10.Aceeai micare se va repeta pentru braul opus, cu pacientul aezat n poziie simetric.

UNIT 8
MUSCULOSKELETAL AND CONNECTIVE TISSUE DISORDERS PRONOUNCING TONGUE-TWISTERS DESCRIBING SYMPTOMS AND RECOMMENDING THERAPEUTIC EXERCISES 1. Read the following definitions and match the names of the

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disorders listed below with their corresponding definitions: 1. 2. 3. 4. 5. 6. 7. Osteoarthritis Rheumatoid Arthritis Ankylosing Spondylitis Osteoporosis Low Back Pain Tendinitis and Tenosynovitis Amyotrophic Lateral Sclerosis

A. A systemic inflammatory disorder affecting primarily the spinal column and the large peripheral joints and eventually resulting in hardening and deformity of the affected skeleton. B. A generalized, progressive reduction of bone mass as bone resorption outstrips bone formation, causing skeletal weakness and fractures. C. A chronic degenerative disease process occurring primarily in the hips and knees and characterized by deterioration of the joint cartilage, formation of new bone in subchondral areas and joint margins, and joint hypertrophy. D. May be caused by a muscle sprain or strain, arthritis, a tumor, or a ruptured cartilage disk between vertebrae. Other causes are poor posture, obesity, enlarged prostate gland, sagging abdominal muscles, sitting for prolonged periods of time, or excessive physical effort involving the back muscles. E. A rapidly progressive, degenerative disease of the upper and lower motor neurons characterized by atrophy of the hands, arms, legs, and, eventually, the entire body. Seventy percent of individuals die within 5 years of diagnosis.

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F. A chronic systemic degenerative disease characterized by inflammation of the connective tissues and manifested primarily in and around peripheral joints. G. An inflammation of the tendon and lining of the tendon sheath characterized by pain on movement of the associated joint. 2. Translate the definitions above into Romanian, using the words in the glossary:

GLOSSARY

disorder = disfuncie, afeciune, boal primarily = n primul rnd to harden = a ntri bone resorption = resorbie osoas to outstrip = a depi, ntrece subcondral areas = zone subcondrale ruptured cartilage disk = disc cartilaginos rupt poor posture = postur defectuoas sagging muscles = muchi czui, lsai lining = ngroare tendon sheath = teac/nveli al tendonului
PRONOUNCING TONGUE-TWISTERS

Mastering stress-emphasis is one of the keys to pronouncing multisyllable medical terms. English makes use of a primarily/strong stress ( that has this graphic symbol: ') placed before the stressed syllable and of a secondary/weaker stress (that has this graphic symbol ) that usually precedes the primarily stress, especially in multi-syllable words. Example:

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circulation [s: kju'lein ] inflammation [infl'mein ]

Note for the following pronounciation exercises each student should make use of an English dictionary that contains phonetic transcription. 3. Place the following two-syllable words in their corresponding stress-emphasis pattern:spinal, disease, column, weakness, fracture, prostate, muscle, tumor, posture, rotate, treatment, ankle, discharge, bandage, acute. Example: first syllable stress

second syllable stress

spi - nal

ro - tate

4. Place the following three-syllable words in their corresponding stress-emphasis pattern: atrophy, progressive, reduction, skeleton, excessive, cartilage, formation, disorder, arthritis, physical, systemic, lateral, sclerosis, surgery, maximum, resistance, endurance, effective. Example: first syllable stress

second syllable stress


a - tro phy

sys - te - mic

5. Place the following four-syllable words in their corresponding stress-emphasis pattern: vaccinated, peripheral, saturated, pulmonary, pneumonia, diagnosis, emergency, compatible, penicillin, deformity, circulation, independent, hypertrophy, spondylitis, tendinitis, ability, relaxation, alternative, combination, voluntary, phenomenon, restoration.

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Example: first syllable stress

second syllable stress


vac-ci-na-ted third syllable stress

pneu-mo-ni-a

in-de-pen-dent 6. Find the corresponding stress-emphasis pattern for the following multi-syllable words and draw their graphic reprezentation: degenerative, deterioration, individual, osteoarthritis, osteoporosis, tenosynovitis, amyotrophic, cardiovascular, rehabilitation, musculoskeletal, extensibility, pathophysiologic. Example: De-ge-ne-ra-tive

AND RECOMMENDING

DESCRIBING SYMPTOMS THERAPEUTIC EXERCISES

Read about the main causes and symptoms of the musculoskeletal and connective tissue disorders in the following chart: The disorder 1. Osteoarthritis Causes
The etiology is unknown but is believed to be related in some way to aging and genetics. Men and women are equally affected, but the

Symptoms
early symptoms: deep, aching joint pain that is aggravated by exercise and that worsens as the day progresses; stiffness following inactivity. midcourse symptoms:

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2.Rheumatoid Arthritis

The etiology is unknown but the disease is often characterized as an autoimmune disorder, and a familial link is suspected; women are three times more likely than men to be affected.

3.Ankylosing Spondylitis

the exact cause is unknown. A higher than expected level of HLA-B27 tissue antigen is seen in 90% of individuals with the disease. It is three to four

English in Kinetotherapy. A practical English handbook times more common in men than in women, and onset typically occurs between 20 and 40 years of age. or limited range of motion in affected joints; fatigue; fever; anorexia; weight loss; diminished chest expansion; red, painful eyes. late symptoms: kyphosis, fixed flexion of hips, vertebral fractures, impotence, incontinence, diminished bladder and rectal sensation, angina, pericarditis, pulmonary fibrosis (rare). A dull, aching, constant pain and spasm; column diminishes, lordosis leading to compression in the the bones, back muscle spinal mass dorsal increase, multiple fractures particularly chest; the

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4. Osteoporosis

Inadequate calcium intake, early menopause, sedentary life-style, a familial hystory of the disease, endocrine disorders, prolongued immobility

kyphosis and cervical

of the spine and a 5. Low Back Pain Muscle sprain or strain, arthritis, a tumor, or a ruptured cartilage reduction in height. The pain may be accompanied by muscle weakness or spasms. It may radiate down the

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ADINA RDULESCU disk between vertebrae; poor posture, obesity, enlarged prostate gland, sagging abdominal muscles, sitting for prolonged periods of time, or excessive physical effort involving the back muscles. Repetitive movements, strain, or excessive, unaccustomed exercise; underlying systemic disease (rheumatoid arthritis, gout, sclerosis); middleaged and older adults and athletes or individuals with occupations requiring repetitive motion are at greatest risk. The etiology of amyotrophic lateral sclerosis (ALS) is unknown, but proposed explanations include genetics, metabolic disturbances, and back of one or both legs, as in sciatica. It may be started or increased by coughing, sneezing, rising from a seated position, lifting, stretching, bending, or turning.

6. Tendinitis and Tenosynovitis

The involved tendons usually show visible swelling; the joint may be tender and hot to the touch; motion of the joint causes pain.

7.Amyotrophic Lateral Sclerosis

early symptoms: weakness, cramps in the hands and forearms. midcourse symptoms: fatigue; dyspnea; slurred speech; dysphagia; asymmetric spread of muscle weakness to the rest of

English in Kinetotherapy. A practical English handbook external agents. the body; spasticity; fasciculations; hyperactive deep tendon and extensor plantar reflexes. late symptoms: paralysis of vocal cords; paralysis of chest muscles, necessitating ventilatory support.

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Pair work 7. Check if your deskmate has attentively read the chart by asking him/her questions like these: What are the main causes of low back pain? What are the early symptoms in Amyotrophic Lateral Sclerosis? What are the late symptoms in Ankylosing Spondylitis? The symptom of which disease is the visible swelling of tendons? Which parts of the body are affected by pain in Ankylosing Spondylitis? In which diseases does stiffness affect various parts of the body? Take turns in asking and answering various questions. 8. Extract or create sentences using the chart above and ask your deskmate to say if they are true or false. Example: Athlets or individuals with occupations requiring repetitive movements are very likely to suffer from Tendinitis and Tenosynovitis. True

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Men are three times more likely than women to be affected by Rheumatoid Arthritis. False 9. Translate the content of the chart above using a medical dictionary. 10. Match the disorders in the first column with their corresponding therapeutic exercises in the second column. Check the symptoms in the chart above so as to make the appropriate choice of the therapeutic exercises: The disorder
1. Osteoarthritis

Therapeutic exercises a. Therapy and exercise to increase


range of motion, strength, and endurance; balance of activity and rest; splints, canes, walkers to aid mobility; moist compresses, paraffin gloves to reduce pain and edema. b. The patient should sleep on a firm mattress with the knees flexed and supported. Pain killers, muscle relaxants, and tranquilizers may help, as may applying dry or moist heat. When the pain subsides, the patient may increase activity if fatigue is avoided. A corset or back brace may be required. The patient should use a straight-backed chair and not cross or extend the legs. c. Moist heat compresses to joint; rest of joint with controlled progressive exercise program. d. Physical therapy, exercise, postural training; traction/back brace in special cases. e. Physical therapy to maintain muscle

2. Rheumatoid Arthritis

3.Ankylosing Spondylitis 4. Osteoporosis 5. Low Back Pain

English in Kinetotherapy. A practical English handbook strength; occupational therapy for activity of daily living support; speech therapy to aid communication; splints for neutral joint alignment; leg braces, canes, walkers to aid ambulation. f. Exercise: isometric, isotonic, isokinetic, strengthening, stretching, range of motion, balance exercise; rest; massage, moist heat for pain; elastic bandages for support; canes, walkers to aid mobility. Avoid: soft chairs, recliners, pillows under knees; use firm bed and hard chairs; wear sturdy, lowheeled shoes. g. Consistent exercise regimen, including weight-bearing hyperextension and resistance exercises to slow calcium loss and strengthen musculature; heat and massage for muscle spasm; orthopedic supports for back and neck to prevent stress fractures.

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6. Tendinitis Tenosynovitis

and

7. Amyotrophic Lateral Sclerosis

Pair work 11. Consider yourself as a kinetotherapist and choose the best way to recommand the corresponding therapeutic exercises to your colleague - patient who may ask you many questions regarding the duration, the difficulty and the expected results of such an exercise programme. Use the charts with medical information, symptoms and treatments above. Here are some examples to help you: Example: Therapist`s recommandations: Considering your aggravated joint pain and your stiffness

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following inactivity, it is to your best interest that you should start these therapeutic exercises. I do not want to put any pressure on you, but I do believe that you should consider starting your physical therapy as soon as possible. Your low back pain now radiates down the back of both your legs. And as things are not getting better, you should really take some urgent measures and start your therapy.

Patient`s questions: In what way will my general condition be improved after starting these therapeutic exercises? How long will this therapy be and how many sessions a week are necessary? Will this therapy be painful? How difficult are the exercises? Do I have to make any changes in my diet or in my daily routine? Will this short-term therapy prevent the disease from getting worse?

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UNIT 9
POSTURAL PROBLEMS CONDITIONAL CLAUSES THERAPIST-PATIENT DISCOURSE COMMUNICATION IMPROVING

1. Read the following text, consult the glossary below and translate the text into Romanian: POSTURAL PROBLEMS Posture is a position or attitude of the body, the relative arrangement of body parts for a specific activity, or a characteristic manner of bearing one`s body. A postural fault is a posture that deviates from normal alignment but has no structural limitations. The postural pain symdrome refers to the pain that occurs from mechanical stress when a person maintains a faulty posture for a prolongued period; the pain is usually relieved with activity. There are no abnormalities in muscle strength or flexibility, but if the faulty posture continues, strength and flexibility imbalances will eventually develop. Lordotic posture This posture is characterized by an increase in the lumbosacral angle,

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an increase in the lumbar lordosis, and an increase in the anterior pelvic tilt and hip flexion. This is often seen with an increased thoracic kyphosis and forward head and is called a kypholordotic posture. Relaxed or slouched posture This posture is also called swayback. The entire pelvic segment is shifted anteriorly, resulting in hip extension and the thoracic segment is shifted posteriorly, resulting in flexion of the thorax on the upper lumbar spine. This results in an increased lordosis in the lower lumbar region, an increased kyphosis in the lower thoracic region, and usually a forward head. When standing for prolongued periods, the person usually assumes an asymmetric stance in which most of the weight is borne on one lower extremity, with periodic shifting of weight to the opposite extremity. Flat low-back posture This posture is characterized by a decreased lumbosacral angle, a decreased lumbar lordosis, hip extension, and a posterior tilting of the pelvis. Flat upper back posture This posture is characterized by a decrease in the thoracic curve, depressed scapulae, depressed clavicle, and a flat-neck posture. It is associated with an exaggerated military posture but is not a common postural deviation. It is not normal for a person to always maintain good posture. Therefore, the patient should be instructed to use cues throughout the day to check posture. For example, the patient can be instructed to check the posture every time he or she walks past a mirror, waits at a red light while driving a car, sits down for a meal, enters a room, or begins talking with someone. If the patient becomes aware of his/her daily routines, they can be used as reminders to practise maintaining a good posture. (Carolyn Kisner&Lynn Allen Colby Therapeutic Exercise. Foundations and Techniques)

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to bear one`s body = a-i susine corpul postural fault = defect postural mechanical stress = solicitare mecanic imbalance = dezechilibru eventually = n cele din urm pelvic tilt = nclinare/aplecare pelvian forward head = cap mpins ctre anterior to slouch = a se grbovi. cocrja swayback = nclinare spre spate to shift = a deplasa, schimba stance = poziie, postur bear, bore, borne = a purta, a duce flat low-back posture = postur aplatizat a zonei inferioare a spatelui flat upper-back posture = postur aplatizat a zonei superioare a spatelui thoracic curve = curbur toracic depressed scapulae = omoplai czui, lsai flat-neck = gt ntins cues = indicii throughout the day = pe toat durata zilei 2. Check your reading comprehension by solving the following tasks: 1. After reading about the four faulty postures, try demonstrating each of them in front of the classroom. 2. Define in your own words what a postural fault is. 3. When does postural pain syndrome occur? 4. What happens if a patient continues to maintain a faulty posture? 5. What are the visible signs of kypholordotic posture? 6. What postural habit does the slouched patient manifest while

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7. 8. 9. 10.

standing? What are the characteristics of flat upper-back posture? What methods can a patient use to correct a faulty posture? What are the causes of faulty postures, in your opinion? How do you correct your faulty postures when you become aware of them?

GRAMMAR CONDITIONAL CLAUSES Conditional clauses consist of two parts: the subordinate clause or the if-clause and the main clause. There are three main types of conditional clauses and various mixed types. Each type is used to express different real/unreal, present/past conditions, using certain pairs of tenses. There are also many exceptions from each type but students dealing with conditionals for the first time should simply concentrate on the basic rules that will be presented in the following chart: Types
Type I

If-clause
Present tense simple If the faulty posture continues, Present simple If the increases, tense pain

Main clause
Future tense simple strength imbalances will develop. Modal verbs the patient must/should see a doctor. Imperative take a break and then start again.

Meaning
Real situation, present or future oriented

Present tense simple If you get tired,

English in Kinetotherapy. A practical English handbook Type II Past tense simple/continuous would could + short should infinitive might I would try the new procedure. he could come to his sessions. she might have a chance to avoid surgery. would could + have + should past might participle I could have helped the injured cyclist. you would have felt better. Unreal, hypothetic situation, present or future oriented, unlikely to happen Imaginary situation, past oriented (regrets, unfulfilled plans, wishes to change the past)

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If I were you, If he had more time, If she did what the doctor says, TypeIII Past perfect simple/continuous

If I had known anything about first help, If you had practised your therapeutic exercises,

3. Fill in the gaps with the verbal constructions in the box to complete the following conditional clauses:

may simply disappear would not have felt had performed is

begins knew check

should get up cannot relax could control

1. If the patient . to feel discomfort, ask him to corret the faulty posture. 2. If you were able to notice what posture causes your low back

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pain, you it. 3. If you modify your sleeping posture, your morning pains . 4. If he . his relaxation exercises, he would not have got stiff-necked. 5. If you are experiencing any pain, . posture. 6. If you have a sedentary job, you .. and walk every hour. 7. If the mattress .. too soft, the patient sags and stresses ligaments. 8. If the mattress is too firm, some patients . 9. If she had slept in a comfortable bed, she .. so tired in the morning. 10. If I what my ideal sleeping posture is, I would not hesitate to immediately adopt it. 4. Put the verbs in brackets into the correct tense: a) I met my wife in hospital ten years ago. I had fallen on ice and broken my leg. She was a nurse in my orthopaedics ward. Just imagine! If I (1).. (not fall) on ice and (2) . (not brake) my leg, I (3) . (never meet) her. So I could say that there is nothing so bad as not to be good for something. b) If this desk height (4) (be) adequate, I (5) . (not have to) lean over my work. My back is killing me! Not to mention the chair! If it (6) .. (not be) so high, my feet (7) . (rest) comfortably on the floor. I should complain about all these to our personnel manager. If more employees (8) .. (express) their complaints, some measures (9) . (passive

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take).

c) You know what they say, that it all happens for a reason Take my example. If (10) .. (passive not be) injured in that car accident last year, I (11) (accept) that job offer in Paris. But here I am now working in this rehabilitation clinic If people (12) (know) how to deal with their disabilities, they (13) . (be able) to accept them more easily. 5. Rewrite the following sentences, using an if construction: Example: a) The patient suffers from osteoporosis. Then, he will need physical therapy, exercise and postural training. If the patient suffers from osteoporosis, then he will need physical therapy, exercise and postural training. b) The patient did not sleep on a firm mattress. He had to take pain killers and muscle relaxants for his poor back. If the patient had slept on a firm mattres, he would not have had to take pain killers and muscle relaxants for his poor back. 1. This injury is severe. That is why the patient may run the risk of paralysis. 2. He got injured in a football match. He had his left leg broken. 3. I worked hard to finish my science project. I had mild low back pain for a week after. 4. My mother has a low resistance. She catches diseases very easily. 5. The old man got panic-striken. His heart started beating more rapidly.

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6. He has the surgery right now. The chances of success may increase to about 20%. 7. The infection spread. That is why he needed that urgent treatment. 8. The diagnosis is correct. The family will have to evaluate their options. 9. You do not spend enough time relaxing. That is why you are always complaing about being tired. 10. These therapeutic exercises are to be practised every day. They prevent the patient`s condition from getting worse. 6. Translate the following conditional sentences into English: 1. Dac practici aceste exerciii regulat, vei dobndi flexibilitatea i rezistena necesare pentru meninerea stabilitii spinale. 2. Dac vrei s-i uurezi acest durere acut, trebuie n primul rnd s-i modifici obiceiurile posturale. 3. Nu poi obine stabilitate postural dac nu nvei s-i controlezi greutatea corporal. 4. Dac a fi tiut c oboseala muscular mrete riscul de accidentare, nu m-a mai fi antrenat att de mult. 5. Dac eti obosit i te simi mult mai relaxat ntr-o poziie grbovit, corecteaz-i imediat aceast tendin nesntoas. 6. Dac persistai n a v menine defectele posturale pentru mult timp, aceasta va duce la slbire muscular i la rezisten muscular redus. 7. Dac meseria v solicit s stai aplecai pentru perioade ndelungate de timp, nu uitai s facei o pauz scurt din or-n or i s v facei

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exerciiile de ntindere. 8. Dac pacienii ar fi mai contieni de programul lor de micri sigure, nu le-ar mai fi team de o nou accidentare. 9. Dac un pacient cu handicap fizic vrea s fie independent, el va trebui s nvee cum s-i modifice mediul nconjurtor: patul, scaunele, scaunul din main, locul de munc etc. 10.Dac pacienii doresc ca programul lor de exerciii s fie eficient, ar trebui s cunoas mai nti foarte bine tehnicile posturale i numai apoi s le i execute. THERAPIST-PATIENT DISCOURSE Improving communication 7. Insert the sentences below in their corresponding semantic class:
A. THERAPIST`S INSTRUCTIONS B. CHECKING IF THE PATIENT GOT THE MESSAGE C. OFFERING ASSISTANCE FOR THE PATIENT D. ENCOURAGING THE PATIENT E. BUILDING MUTUAL TRUST F.GETTING A POST-PRACTISE FEED-BACK FROM THE PATIENT

Example: Do you see my point?B.(CHECKING IF THE PATIENT GOT THE


MESSAGE)

1. Lean backward and hold the stretch!

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2. 3. 4. 5. 6. 7. 8. 9. 10. 11. 12. 13. 14. 15. 16. 17. 18. 19. 20. 21. 22. 23. 24. 25. 26. 27. 28. 29. 30.

Did you get it right? Is this too difficult for you? I`m right here if you need me! Don`t worry! I`ll keep an eye on you! You can do it! Give it another try! Need I say this again? You have to trust me on this! Have the cramps gone away now? Lean forward, resting your abdomen on the anterior thighs. Does this make any sense to you? Don`t hesitate to ask for my help! You had to deal with worse than this before! Can you manage practising this exercise by yourself now? You have to take my word for it! Are you with me on this? Don`t give up! One more try! Have you experienced any muscle spasms during this exercise? Bend your trunk laterally and hold the position. Did you take my hint? If you need a helping hand I`m not going anywhere! Do your best! It`s worth trying! Does it still hurt when you flex your knee? You will have to learn to trust me. Tuck in your chin and lift your head. Did you get my message? Do you still feel pins and needles in your feet? I give you my word on this! Don`t you doubt it! Lift both arms simultaneously. Are your fingers still numb now?

8. Create your own therapist-patient dialogues using the semantic classes above and the examples provided for each class. Follow the logical order of asking questions (first the instructions, then the

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checking part and so on so forth). 9. Read the following types of dialogues and match them with their corresponding titles: 1. 2. 3. 4. 5. 6. Fixing an appointment Changing an apointment Returning a call Taking a family history Taking a social history Examining a patient

A. Dr. Thomson: Well, are you married? Mr. Stiff: Yes, of course, who isn`t ? Dr. Thomson: Do you have any children? Mr.Stiff: Yes, but they are no longer living with us. Dr. Thomson: What about your parents? Are they in good health? Mr. Stiff: My mother died last year. Bone cancer. And my father suffers from osteoarthritis. Dr. Thomson: I`m sorry to hear that. B. Secretary: Wilkinson Rehabilitation Centre. Hello, may I help you? Mr. Jones: Yes, hello. I am calling to fix an appointment, to see Dr. Wilkinson. Secretary: Right. Let me check his schedule. Er how about 25th of September? Mr. Jones: Oh, I `m afraid it is a bit late. I have an urgent matter, you see Secretary: Well, what about 21st of September, at 11 a.m.? Mr. Jones: Oh, that`s better, thank you. Secretary: Call us, please, in case you can`t make it. Mr. Jones: Thank you, it would not be the case.

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C. Dr. Richards: Could you just take off your clothes so that I can examine you? Mr. Spike: Okay, I have done this many times Dr. Richards: Would you, please, lie flat on the couch for a few minutes? Can you now show me where it hurts? Mr. Spike: Right here, in my left thigh. Dr. Richards: Can you raise your left leg for me? And hold it for a second? Does it hurt when you rotate it? Mr. Spike: A little bit, when I return to the initial position. D. Mrs. Slender: Hello, Dr. Walsh? Dr. Walsh: Speaking. Mrs. Slender: Ah, Mrs. Slender here. Dr. Walsh: Yes, hello, Mrs. Slender. It is good that you returned my call. Mrs. Slender: Is there anything wrong, doctor? Dr. Walsh: No, nothing to worry about. I have just received your Xrays and it looks that your ankle is not broken, but just sprained. Mrs. Slender: Oh, what a relief! Dr. Walsh: Please, come to see me tomorrow and we`ll discuss more about it.

E. Secretary: Wilkinson Rehabilitation Centre. Hello, may I help you? Mr. Jones: Yes, hello. I`m Jones, I called you a couple of days ago Secretary: Yes, Mr. Jones. What can I do for you? Mr. Jones: It is about my appointment. I won`t be able to make it. I wonder if we could possibly move it to the 25th of September? Secretary: First of all, Mr. Jones, you change your appointment at

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short notice and then you want to fix the day for your future appointment? Mr. Jones: I`m very sorry if I have cause you any inconvenience. Shall I call back another time? Secretary: We have your phone number and if someone cancels an appointment we`ll let you know. Mr. Jones: Thank you for your trouble. F. Dr. Thomson: Yes, you are still working, isn`t it? Mr. Stiff: Yes, two more years till my retirement. Dr. Thomson: Have you pushed yourself too hard lately? Mr. Stiff: You know how things are. I am no longer young and keeping up with the newly hired Dr. Thomson: What about your working hours? Have you considered working part-time? Mr. Stiff: I`m afraid this is not an option in my field. Dr. Thomson: Then, I hate to bring you the bad news, but you should consider retiring. Otherwise.. Pair work 10. Create your own dialogues, starting from the following titles: Introductory dialogues, The first examination, Programming the first session, Recommending a better treatment, Proposing a new experimental programme, Explaining how the devices work, How to focus your effort, Dealing with home exercises programme, etc.

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UNIT 10
REVISION EXERCISES 1. Complete the following sentences using the nouns in the box:

dislocation cartilage balance postural fault

muscular dystrophy fracture spinal column joints cardiovascular disease range of motion exercise

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1. The .. is made up of 33 vertebrae that are separated by spongy disks and protects the spinal cord that runs inside of it among other things. 2. The connections between bones are called each being classified according to structure and movability as fibrous, cartilaginous, or synovial. 3. The .. is a tissue made of cells and fibers, that connects and supports. It is found mostly in the joints, the chest, and stiff tubes of all sorts, as the voicebox (larynx), windpipe (trachea), nose, and ear. 4. In all forms of there is a slow loss of strength with increasing disability and deformity. 5. is the displacement of any part of the body from its normal position; this applies most often to a bone moved from its normal position with a joint. 6. A is an injury to a bone in which the tissue of the bone is broken. 7. A .. may cause problems with the heart and blood vessels. 8. .. refers to the ability to maintain the center of gravity over the base of support, usually while in an upright position. 9. .. any body action involving the muscles, joints, and movements in natural directions of arms and legs. 10. A is a posture that deviates from normal alignment but has no structural limitations. 2. Choose the right version that best completes the sentence: 1. Being placed in a supine position means: a) lying flat or face downwards;

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2.

3.

4.

5.

6.

b) lying or resting on the back, with the face, palm, etc upwards; c) sitting cross-legged; d) side-lying, with one arm up. To adduct the arm means: a) to draw or pull the arm towards the median axis of the body; b) to flex and elongate the arm successively; c) to pull away the arm from the median axis of the body; d) to turn the arm around its own axis. .. is a generalized, progressive reduction of bone mass as bone resorption outstrips bone formation, causing skeletal weakness and fractures. a) Osteomyelitis; b) Osteoarthritis; c) Rheumatoid Arthritis; d) Osteoporosis. Inadequate calcium intake, early menopause, sedentary lifestyle, endocrine disorders, prolongued immobility are some of the causes of .. a) Osteoarthritis; b) Ankylosing Spondylitis; c) Osteoporosis; d) Amyotrophic Lateral Sclerosis. An abnormal, increased degree of forward curvature of any part of the spine is the characteristic of . a) kypholordotic posture; b) lordotic posture; c) slouched posture; d) flat low-back posture. . are necessary to treat joint dysfunctions such as stiffness, reversible joint hypomobility, or pain. a) strenghtening exercises;

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b) stretching exercises; c) weight-bearing exercises; d) joint mobilization exercises. 7. is the ability of a muscle to contract repeatedly or generate tension, sustain that tension and resist fatigue over a prolonged period of time. a) muscle strength ; b) muscular endurance ; c) muscular contraction ; d) mulcular extensibility. 3. Find the root-verbs that the following nouns are derived from: examination, treatment, assessment, decision, diagnostician, information, retirement, development, selection, questioning, interpretation, palpation Example: examination examine (the root-verb) 4. Derive the corresponding nouns, adjectives and adverbs from the following verbs: affect, aggravate, compress, contract, diminish, disturb, explain, expect, function, immobilize, include, increase, limit, paralyse, propose, radiate, reduce, repeat, suspect, swell. Example: verb repeat

noun repetition, repeater,

adjective repeatable, repeated, repeating, repetitional

adverb repeatedly

5. Find the corresponding stress-emphasis pattern for the

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following two/three/four/multi-syllable words and pronounce them accordingly: affected, aggravated, alignment, compression, contracture, deformity, disease, duration, fasciculation, hyperextension, inactivity, kypolordotic, lumbosacral, pericarditis, recliner, strengthening, stiffness, subluxation, tranquilizer.

6. Complete each space with a word formed from the words in capitals. A. Warming up soft tissues prior to stretching will increase the (1) of the shortened tissue. Warm muscles relax and (2). more easily, making stretching more (3) .. for the patient. As the temperature of muscle increases, the amount of force required to elongate noncontractile and contractile tissues and the time the stretch force must be (4) . decrease. Although stretching is often thought of as a warmup activity and performed prior to (5) exercise, the clinician and patient must always remember that an appropriate warm-up must also occur in the (6) .. for stretching. It is (7) whether heating should occur prior to or during the stretching procedure.

EXTEND LENGTH COMFORT

APPLY

VIGOUR

PREPARE DEBATE

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B. Some anger may serve a (1) purpose; much anger however, is purely (2).. The energy that goes into its arousal could often be more (3) .. spent in solving the problem. Here are some ways in which anger can be controlled: reinterpreting the stimulus in a more positive light; many situations contain ambiguities which allow (4) .. to be made; being realistic in our (5). of other people; giving oneself (6) to make a mistake, as it is part of being human to make mistakes (7).. distancing oneself; if circumstances seem to be overwhelming, one can try stepping back mentally to get a more (8) . view; introducing humour at (9).. moments; when a person smiles and laughs the (10) . response takes over.

USE DESTRUCT PROFIT

REINTERPRET EXPECT PERMIT OCCASION

OBJECT SUIT RELAX

7. Read the text below and choose the version that best completes the empty spaces: Pain is often the reason why the patient has come for attention in the first place. Always remember that pain is a/an (1) .. to the patient who may find that it is making his or her life (2) . Pain is a/an (3).. experience and any measurement must

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incorporate a degree of (4) . . Reactions to pain vary widely (5) . different people and depend (6) . many different physical and mental factors. Specific diseases and injuries and the health, pain (7) ., fear and anxiety, and ethnic background all affect reactions to pain. Patients will describe pain (8) .. in terms of its sensory qualities, for example shooting, sharp, burning or in terms of its affective qualities, for example vicious, cruel, sickening, or in terms of its evaluative qualities, for example intense, unbearable, annoying. Severe pain causes pale skin, cold sweat, "(9).. bumps," wide pupils, and higher levels of pulse, breathing rate, blood (10) .., and muscle (11) . When brief, strong pain starts to go away, the pulse may be slower and the blood pressure lower than before the pain began. If pain occurs often or is long term, the pulse (12) . and blood pressure may not go up much. If pain lasts for many days, the (13) to fight infections may be lost. The patient's tone of voice, speed of speech, cries, groans, or other sounds, face and body movements, or attempts to withdraw are noted by the physician. It is hard to (14) strong or long-term pain, but a patient can learn to live almost (15) .. even with some pain. 1. a) illusion 2. a) intolerable 3. a) individual 4. a) objectivity 5. a) to 6. a) on 7. a) point 8. a) or 9. a) hen 10. a) group 11.a) bulk 12. a) rate 13. a) talent b) reality b) impossible b) objective b) doubt b) among b) of b) limit b) either b) road b) relation b) tension b) rhythm b) volition c) dream d) perception c) easier d) irritating c) personal d) subjective c) subjectivity d) error c) with d) from c) in d) with c) degree d) level c) neither d) nor c) goose d) heat c) test d) pressure c) spasm d) strain c) beat d) tempo c) ability d) capacity

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14. a) relieve b) cure c) release d) solace 15. a) usually b) patiently c) regularly d) normally 8. Turn the following sentences from active voice into passive voice. Begin the passive sentences with the underlined words: 1. Total body streching, such as toe touches, may maintain or overstretch a mobile area. 2. Strengthening programs tend to overemphasize flexion exercises. 3. When performing this kind of stretch, you must keep your shoes on. 4. Patients should perform flexibility exercises prior to and after a strengthening program. 5. An effective stretching or flexibility routine should not cause pain or excessive stress to tissues. 6. Patients should slightly bend their knees when performing forward-bending exercises. 7. You will warm up the tissues with gentle rhythmic activities. 8. Increase the pace of activity so that you can maintain the target heart rate for 10 to 20 minutes. 9. To avoid injuries from stress, you should use appropriate equipment, such as correct footware. 10. People often use inappropriately the phrase No pain, no gain as the guideline for intensity of stretch. 9. Identify the type of the following conditional sentences and fill in the missing tenses or modal constructions to complete them: 1. If pain begins while exercising, you (decrease) effort and rest between sessions. 2. You would have avoided overuse symdromes if you (perform) proper warm-up. 3. If she really wanted to protect vulnerable joints, she ... (not stress) joints and ligaments at the end

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of the range. 4. If he wanted to increase his muscular endurance, he . (perform) the exercises with many repetitions and minimal resistance to the point of muscle fatigue. 5. If you .. (keep) your knee straight, the gastrocnemius is stretched. 6. If you do not want to be injured during your aerobic program, you (avoid) running, jogging or aerobic dancing on hard surfaces such as asphalt and concrete. 7. If your sister had practised aerobic activity 3 to 5 times per week, she . (feel) much better. 8. If you bend your knee, the soleus . (be) stretched. 9. Concentrate on stretching the tight muscles, if there (be) decreased flexibility between antagonistic muscle groups. 10. If your patient were excessively mobile in a segment of his body, it (be) safer to selectively stretch tight structures than the total body. 10. Translate intoRomanian, without using a dictionary: a) Inability to reverse the normal lumbar lordosis on flexion occurs in degenerative arthritis. Limited lumbar flexion is characteristic of ankylosing spondylitis. Localized bone pain suggests such disorders such as osteomyelitis, leukemia, primary or metastatic cancer, compression fracture or herniated disk. b) Normally, when a patient had limited range of motion, the therapeutic approach was to stretch the region with passive stretching techniques. Over the past 30 years, therapists have identified and learned techniques that deal more directly with stretching the source of limitation, and thus they are managing dysfunctions better and with less trauma. Muscle elongation or active inhibition techniques are used to counteract the loss of flexibility in the contractile elements of

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muscles; cross-fiber massage techniques are used to increase mobility in selected ligaments and tendons; and joint mobilization and manipulation techniques are used to safely stretch or snap structures to restore normal joint mechanics with less trauma than passive stretching. c) It could be argued that smoking has more to do with relaxation than smoking abstinence has, and many people become smokers because they perceive cigarettes as being a source of mental calm. However, many such people then wish to quit smoking. Quitting is associated with stress, which means that the same people may be seeking relaxation training. Health care professional increasingly find themselves faced with groups of people who are struggling to give up cigarettes and for whom relaxation training hes been prescribed. 11. Translate into English: a) Stai ntini sau aezai ntr-o poziie pe care o simii comod. nchidei ochii. Simii cum ncepei s v relaxai. Pe msur ce trupul i mintea se calmeaz, permitei-i locului dumneavoastr special s ia contur n imaginaia dumneavoastr. Observai privelitea, sunetele i mirosurile acestui loc. Apoi, ncercai s simii cum muchii se relaxeaz, eliminnd tensiunea de peste zi. b) Stai aezai, cu tlpile unite ctre interior i cu genunchii ndreptai lateral ctre exterior. Plasai-v minile n jurul gleznelor i odihnii-v coatele pe coapse. Apsai uor cu coatele asupra coapselor. Apoi odihnii-v. Apsai apoi din nou. Ar trebui s simii o ntindere plcut n zona oldului. c) Pentru a nva s conducei relaxai, n primul rnd

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identificai grupele musculare de care avei nevoie pentru condus. Dac observai c aceste grupe sunt tensionate, relaxai-le. Verificai dac i muchii pe care nu-i solicitai cnd conducei, cum ar fi muchii feei, sunt relaxai. Nu uitai zona umerilor. Meninei-v relaxai i atunci cnd virai sau schimbai viteza. d) Exerciiile de ntindere sunt att de utile pentru c ajut la meninerea elasticitii. Elasticitatea este una dintre proprietile esutului muscular care nu numai c permite muchilor s funcioneze mai bine, dar i i protejeaz fa de o posibli accidentare. De multe ori, obinuim la modul incontient s ne ntindem, dup ce am stat mult timp n aceeai poziie. Se pare c trupul nostru ne-o cere. Ne ntindem dup ce dormim, dup ce stm cu orele la birou, dup ce lucrm aplecai n grdin

GLOSSARY
spine/spinal column/backbone = vertebra, -ae/bony ring = spinal cord/marrow = rib = articular cartilage = sternum/breastbone = thoracic cage = shoulder girdle = coloana vertebral vertebr mduva spinrii coast cartilaj articular stern cuc toracic centur scapular

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scapula/shoulder blade = clavicle/collarbone = sacrum = coccyx = articulation/joint = fibrous joint = synovial joint = hip joint = knee joint = ankle joint = cranium/skull = tissue = connective tissue = calcaneus/heel = limb = nostril = thyroid cartilage/Adam`s apple = nape (of the neck) = axilla/armpit = carpus/wrist = knuckle = hip = thigh = calf, calves = shin/cannon bone = patella, -ae/knee cap = instep = sole = bowels = diaphysis = epiphysis = epiphyseal cartilage = blood vessels = muscle bulk = muscular contraction /cramp =

omoplat, scapul clavicul os sacral coccis articulaie articulaie fibroas articulaie sinovial articulaia oldului articulaia genunchiului articulaia gleznei craniu esut esut conjunctiv clci membru nar cartilaj tiroidian ceaf axil, subsuoar ncheietura minii articulaia degetului old coaps gamb, -e tibia, fluierul piciorului rotul scobitura gleznei talp intestine diafiz epifiz cartilaj epifizar vase sanguine mas muscular contracie muscular

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muscular endurance = muscle fatigue = muscular hypertrophy = muscle tone = hypotonic muscles = hypertonic muscles = muscle rigidity = muscle spasm = spasticity = muscle sprain = muscle strain = muscle strength = muscular tension = muscular weakness = hypokinesia = hyperkinesia = stasis = muscular dystrophy = electromyography = cartilage disk = arthritis = medical history = medical examination sheet = testing devices = tape measure = goniometer = reflex hammer = cotton wool = test tube = gait = mien =

rezisten muscular oboseal/extenuare muscular hipertrofie muscular tonus muscular muchi hipotonici muchi hipertonici rigiditate muscular spasm muscular spasticitate luxaie ntindere muscular for muscular tensiune muscular slbire muscular hipokinezie hiperkinezie staz distrofie muscular electromiografie disc cartilaginos artrit anamnez foaie de observaie clinic instrumente de testare rulet, panglic de msurat goniometru ciocnel pentru testarea reflexelor vat eprubet umblet, mers inut, comportament

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atel ortez exerciiu de susinere a greutii corporale range of motion = grad de mobilitate exerciii de ntrire strengthening exercises = muscular avascular necrosis = necroz avascular skeletal injury = leziune a sistemului scheletic umfltur swelling = rupture = ruptur, hernie sterile dressing = pansament steril anesthetic = anestezic contuzie, vntaie contusion/bruise = tenosynovitis/inflamed tendons = tenosinovit arteriosclerosis/hardening of the arteroscleroz arteries = sedative/sleeping pill/dope = sedativ analgesic/pain killer = analgezic. calmant myocardial infarction/heart infarct miocardic attack = halitosis/bad breath = halitoz alopecia/baldness = alopecie tachycardia/palpitations = tahicardie hypoglycaemia/low blood sugar hipoglicemie = hyperglycaemia/ high blood hiperglicemie sugar = ankylosing spondylitis/bamboo spondilit anchilozant spine = sprain one`s ankle/wrist= a-i luxa glezna/ncheietura minii strain one`s muscle = a suferi o ntindere muscular a-i ntinde un tendon pull one`s hamstring muscle = splint = brace = weight-bearing exercise =

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tear/pull a ligament = snap a tendon = chilblain/frostbite = cardiovascular fitness = plaster bandage = plaster cast = sticking plaster =

muscular a suferi o ruptur ligamentar a suferi o ruptur de tendon degertur tonus cardiovascular pansament gipsat form/matri de gips leucoplast

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BIBLIOGRAPHY Buschbacher, R. M., Randall, L. B. Musculoskeletal Disorders. Diagnosis Butterworth Heinemann, 2002. Practical Guide to and Rehabilitation,

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Cobuild, C. - English Guides. Word Formation, Haeper Collins Publishers, 1991. Donatelli, R. and Owens-Burkhart, H. - Effects of immobilization on the extensibility of periarticular connective tissue. Journal of Orthopaedic and Sports Physical Therapy, 1981. Garrison, S. J. - Handbook of Physical Medicine and Rehabilitation Basics, J. B. Lippincott Company, 1995. Gray, H. - Anatomy. Descriptive and Surgical, London, the Promotional Reprint Company Ltd.,1991. Hollis, M. and Yung, P. - Patient Examination and Assessment for Therapists, Blackwell Scientific Publications, first published 1985. Holme, R. - ESP ideas. Recipes for teaching professional and academic English, Longman, first published 1996. Howley, E. T. and Franks, B. D. - Health/Fitness Instructors Handbook. Human Kinetics, Champaign, I. L., 1986. Hutchinson, T. and Waters, A. - English for Specific Purposes, Cambridge University Press, first published 1987. Kisner, C. and Colby, L. A. - Therapeutic Exercise. Foundations and Techniques, Philadelphia, F. A. Davis Company, 1996. Maher, J. C. - International Medical Communication in English, Edinburgh University Press, Edinburgh, 1990. McCarthy, M. - Vocabulary, Oxford University Press, first published 1990. Oxford Advanced Learner`s Encyclopedic Dictionary, Oxford:Oxford University Press, first published 1989. Prlog, H. - English Phonetics and Phonology, Ed. ALL, Bucureti, 1997. Payne, R. A. - Relaxation Techniques. A Practical Handbook for the Health Care Profesional, Churchill Livingstone, New York, 1995 Quirk, R., Greenbaum, S., Leech, G., Svartvik, J. - A Comprehensive Grammar of the English Language, Longman, 1985. Randall, L. B. - Physical Medicine and Rehabilitation, second edition, W. B. Saunders Company, 2000. Riley, D. - Check Your Vocabulary for Medicine. A Workbook for

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Users, Peter Collin Publishing. Sinelnikov, R. D. - Atlas of Human Anatomy, vol.1 The Science of Bones, Joints, Ligaments and Muscles, MIR Publishers, Moscow, first published 1988. The Merk Manual of Diagnosis and Therapy, Sixteenth Edition, Merk Research Laboratories, U. S. A., 1992. The Oxford-Duden Pictorial English Dictionary. Science and Medicine, Oxford University Press., Thomson, A.J. and Martinet, A.V. - A Practical English Grammar, Oxford University Press, 1986. Zaharia, C. - Elemente de patologie a aparatului locomotor, Ed. Paideia, Bucureti, 1994.