9 - Therapeutic Exercise Part 2 Flashcards
What is strength?
The amount of tension/force a muscle can develop
What is power?
the max force and velocity (work/time) So, force x distance divided by time
What is endurance
ability to generate force repeatedly over time
What is intensity?
load prescribed for the muscle
What is volume?
total number of reps
What is frequency?
total number of sessions per time unit
What is duration?
the time period
What is a rest interval?
The time between sets and reps (time used to clear metabolites in the system)
What is an isometric contraction?
No change in length, loose packed positions, less tension placed on the tissues surrounding the joint.
Used early in the healing process
What is an isotonic contraction? And what are the two types?
Same resistance/force throughout
Concentric - muscle shortening
Eccentric - muscle lengthening
What is a isokinetic contraction?
Same velocity throughout
What is an open kinetic chain exercise?
The distal end is free to move around (ex. seated knee extension)
What is a closed kinetic chain exercise?
The distal end is fixed to a surface and the proximal end moves (ex. squat)
What is a plyometric exercise?
Used to improve power
Jump higher, ballistic movements, increase speed and faster contractions
What is the overload principle?
Progressively loading muscle by manipulating intensity and time
What is the Specific Adaptation to Imposed Demand (SAID) principle?
To improve a specific muscle performance element, the resistance program should be matched to the element
Wolff’s law - body systems adapt over time to the stresses placed on them
What is the principle of reversibility?
Training effects will exist as long as you continue to train (use it or lose it)
Gains in strength and endurance are incorporated into daily activities as early as possible
What motor unit type is recruited first?
Slow twitch
What is the order of motor unit recruitment?
Slow, fast fatigue resistant, then fast fatiguable
OR
Slow oxidative, fast oxidative glycolytic, then fast glycolytic
Which has a higher innervation ratio, slow oxidative or fast glycolytic?
Fast glycolytic
Which type of fibers will fatigue last
Slow twitch
How long does it take to see muscle hypertrophy?
8-12 weeks
How early from the start can you see strength improvements?
2 weeks
How do you get increased strength?
Increased motor unit recruitment
Increased firing rate
Improved synchronization of motor unit firing
Improved coordination of primary movers
Improved inhibition of antagonists (reduced co-contraction)
Improved descending drive (motivation)
What is balance?
When someone can keep their CoM within their BoS
What is coordination?
When someone can move more efficiently
What is agility?
When someone can move more quickly, change their direction
What is function?
An activity, it is person dependant
What is capacity?
What the person can do in a controlled environment
What is performance?
Activity and participation, what a person can do in their usual environment
True or false: patient identified problems and mainly activity and participation limitations?
True
True or false: non-patient identified problems are things the clinician will find, like weak glutes.
True
What are things to keep in mind about isometric strengthening?
Joint angle and muscle length do not change
May be less stressful as a pain free range can be used
Increased BP more an isotonic exercises
Strength gains are restricted to the small range where exercise is performed
What are things to keep in mind about concentric strengthening?
Muscle/tendon unit shortens
Progress these types of exercises by increasing the load and/or number of reps
What are some things to keep in mind about eccentric strengthening?
Muscle/tendon unit lengthens
Progress these types of exercises by increasing the load and possibly speed of contraction
What are some types of resistance?
Elastic bands/tubing Free weights Pulleys Machines Body Weight Manual resistance (by PT)
What types of muscles need high endurance?
Postural muscles, joint stabilizing muscles and prime movers
What is core stability
The ability of the body to control the trunk/core by using the right muscles at the right time and at the right intensity to provide adequate control required for the task
True or false: stability before mobility?
True
True or false: strengthen the limbs before the core?
False, spine and core first before girdles and limbs
How many stages of motor learning are there?
Three
What is stage one of motor learning?
Cognitive: High level of concentration with minimal distractions
What is stage two of motor learning?
Associative: Able to perform the activity simultaneously with other functions but still require a conscious effort
What is stage 3 of motor learning?
Autonomous: Automatic with minimal to no conscious effort
How do you increase the challenge of an exercise/task?
Unstable surfaces
Decreased weight bearing surfaces (2 legs to one leg)
Reduced base of support (side to side versus tandem stance)
What do we as therapists look for with motor patterning?
We recognize the poor movement pattern and determine why it occurs (tight tissues, weak tissues, or bad habits)
What occurs in phase one of patient rehab?
Patient education Protect the injured tissue Prevent adverse effects of immobility PROM and Isometric of injured area AROM and Resisted and functional exercises of areas above and below
What occurs in phase two of patient rehab?
Patient education
Manage pain and inflammation
Initiate active exercises
(multiple angle, sub max isometric, AAROM and AROM, muscle endurance, protected weight bearing)
Initiate progression of stretching (warm tissue, muscle relaxation techniques, progress manual therapy)
What occurs in phase three of patient rehab?
Patient education
Progress stretching (intensity and duration)
Progress muscle performance (isolate muscles as needed, go from simple to complex patterns, simulate specific demands of activities, trunk/core stability and balance)
Return to high demand activities (exercise drills that simulate work or sport, increase reps and speed, introduce surprise and uncontrolled events)
