Chapters 1-2 (both books)

Question 0

What is Therapeutic Exercise?

Answer 0

The systemic, planned performance of bodily movements, postures, or physical activities intended to provide a patient/client with the means to accomplish a positive outcome.

Question 1

What details are included in a POC?

Answer 1

• Goals
• Outcomes
• Predicted improvement & length of time to reach that level
• Specific Interventions
• Proposed frequency/duration of interventions
• Discharge Goals

Question 2

What are the purposes of Therapeutic Exercise?

Answer 2

1. Remediate or prevent impairments
2. Improve, restore or enhance physical function
3. Prevent or reduce health-related risk factors
4. Optimize overall health status, fitness or sense of well-being

Question 3

What is balance?

Answer 3

The ability to align body segments against gravity to maintain or move the body (center of mass) within the available base of support without falling.

The ability to move the body in equilibrium with gravity via interaction of the sensory and motor systems.

Question 4

What is Cardiopulmonary Fitness?

Answer 4

The ability to perform moderate-intensity, repetitive, total body movements (walking, jogging, cycling, swimming) over an extended period of time.

A/K/A Cardiopulmonary Endurance

Question 5

What is coordination?

Answer 5

The correct timing and sequencing of muscle firing combined with the appropriate intensity of muscular contraction leading to the effective initiation, guiding, and grading of movement.

It is the basis of smooth, accurate efficient movement and occurs at a conscious or automatic level.

Question 6

What is flexibility?

Answer 6

The ability to move freely, without restriction; used interchangeably with mobility.

Question 7

What is mobility?

Answer 7

The ability of structures or segments of the body to move or be moved in order to allow the occurrence of ROM for functional activities (functional ROM).

Question 8

What is mobility dependent upon?

Answer 8

Soft tissue extensibility.

Active mobility also requires neuromuscular activation.

Question 9

What is muscle performance?

Answer 9

The capacity of muscle to produce tension and do physical work.

Question 10

What 3 things are encompassed in muscle performance?

Answer 10

1. Strength
2. Power
3. Endurance

Question 11

What is neuromuscular control?

Answer 11

Interaction of the sensory and motor systems
that enables
synergists, agonists and antagonists, & stabilizers to
anticipate or respond to proprioceptive and kinesthetic information
and, subsequently to work in correct sequence
to create coordinated movement.

Question 12

What are
Postural Control
Postural Stability &
Equilibrium?

Answer 12

Interchangeable terms used with static or dynamic balance.

Question 13

What is stability?

Answer 13

The ability of the neuromuscular system
through synergistic mm actions
to hold a proximal or distal body segment in a stationary position or to control a stable base during superimposed movement.

Question 14

What is Joint Stability?

Answer 14

The maintenance of proper alignment of bony partners of a joint by means of passive and dynamic components.

Question 15

What are the 8 areas of physical function which describe the groundwork for all movement necessary to perform at an optimal level?

Answer 15

Balance

1. Cardiopulmonary Fitness
2. Coordination
3. Flexibility
4. Mobility
5. Muscle Performance
6. Neuromuscular Control
7. Postural Control / Postural Stability / Equilibrium
8. Stability

Question 16

What are the 5 basic components of patient management?

Answer 16

1. Examination
2. Evaluation
3. Diagnosis
4. Prognosis
5. Interventions

Question 17

What is the goal of Therapeutic Exercise?

Answer 17

For the patient to achieve an optimal level of symptom free movement during basic to complex physical activities.

Question 18

Is Gait Training considered therapeutic exercise?

Answer 18

No

Question 19

What 9 types of interventions are considered therapeutic exercise?

Answer 19

1. Aerobic conditioning and reconditioning
2. Mm performance ex
3. Stretching techniques
   Includes: mm lengthening, joint mobilization/manipulation
4. Neuromuscular control, inhibition & facilitation techniques & postural awareness training
5. Postural control, body mechanics, and stabilization exercises
6. Balance ex and agility training
7. Relaxation ex
8. Breathing ex & ventilatory mm training
9. Task-specific functional training

Question 20

What are 2 ways we know the best practices in developing effective treatment procedures to assist our patient in achieving the goals set forth in the POC?

Answer 20

Clinical Decision-Making
and
Evidence Based Practice

Question 21

What are 3 reasons evidence based practice is important?

Answer 21

Help stay current with treatments
Ensure Effectiveness of treatments
Facilitates best possible outcome for the patient

Question 22

What section of a SOAP note should include HEPs?

Answer 22

Objective

Question 23

List the 4 “No Fail” references for PTAs

Answer 23

APTA
AzPTA
ARS & Rules
AZ PT Board of Licensure

Question 24

What are open ended questions?

Answer 24

Questions that require more than a yes/no answer

Question 25

What is the purpose of open ended questions?

Answer 25

They encourage patients to share feelings, thoughts, concerns and opinions. Ex: "Tell me about your pain." "What do you think about this exercise?

Question 26

What kinds of questions are used in close-ended questions?

Answer 26

Who Which When Where

Question 27

What is the purpose of close ended questions?

Answer 27

They are for finding facts, obtaining specific responses and filling in details.

Question 28

What is a summary statement?

Answer 28

Information that is given about the avg performance of several repetitions of a motor skill (K&C) It checks a patient's understanding, helps patients clarify thinking and they provide direction for the clinician (Shankman) Ex: "So your back only hurts at night?"

Question 29

When is it appropriate to use summary statements when interviewing patients?

Answer 29

When trying to elicit information needed for an objective assessment.

Question 30

What is the difference between prompting and cuing?

Answer 30

Prompting can be viewed like presenting a question (the patient has to think about what to do and come up with a solution). Cuing is more of a direction - telling the patient specifically what you want them to do.

Question 31

What is patient-related instruction?

Answer 31

The means by which a therapist helps a patient learn how to reduce his/her impairments and functional deficits to get better by becoming an active participant in the rehabilitation process. Important for patient to understand how they can best get better and to help with the process.

Question 32

What 4 things does Therapeutic Exercise work on?

Answer 32

1. Remediate or prevent impairments 2. Improve, restore, or enhance physical function 3. Prevent or reduce health-related risk factors 4. Optimize overall health status, fitness, or sense of well-being

Question 33

What are impairments in body function?

Answer 33

Problems associated with body systems including physiological & psychological functions

Question 34

What are impairments in body structure?

Answer 34

Problems with the anatomical features of the body, such as significant deviation or loss, affecting all body systems.

Question 35

What are activity limitations?

Answer 35

Difficulties an individual may have in executing actions, tasks, or activities.

Question 36

What are participation restrictions?

Answer 36

Problems an individual may experience in involvement in life situations including difficulties participating in self care, responsibilities in the home, workplace, or the community, and recreational, leisure and social activities

Question 37

What are Contextual Factors?

Answer 37

The entire background of an individual's life and living situation Composed of Environmental and Personal Factors

Question 38

What are Environmental Factors?

Answer 38

Factors associated with the physical, social, and attitudinal enviornment in which people conduct their lives; factors may facilitate functioning (facilitators) or hinder functioning and contribute to disability (barriers).

Question 39

What are Personal Factors?

Answer 39

Features of the individual that are not part of the health condition or health state. Includes: age, gender, race, lifestyle habits, coping skills, character, affect, cultural and social background, education, etc.

Question 40

List the types of Musculoskeletal impairments managed with therapeutic exercise

Answer 40

1. Pain 2. Muscle weakness/reduced torque production 3. Decreased muscular endurance 4. Limited ROM due to: - Restriction of the joint capsule - Restriction of periarticular connective tissue - Decreased mm length - Joint hypermobility - Faulty Posture Mm length/strength imbalances

Question 41

List 6 Neuromuscular impairments managed with therapeutic exercise?

Answer 41

1. Pain 2. Impaired balance, postural stability, or control 3. Incoordination, faulty timing 4. Delayed motor development 5. Abnormal tone (hypotonia, hypertonia, dystonia) 6. Ineffective/inefficient functional movement strategies

Question 42

List 3 Cardiovascular / Pulmonary impairments managed with therapeutic exercise

Answer 42

1. Decreased aerobic capacity (cardiopulmonary endurance) 2. Impaired circulation (lymphatic, venous, arterial) 3. Pain with sustained physical activity (intermittent claudication)

Question 43

Why would therapeutic exercise be used to manage an integumentary problem?

Answer 43

Skin hypomobility Ex: Immobile or adherent scarring

Question 44

List 9 areas of functioning associated with participation restrictions and disability:

Answer 44

1. Self-Care 2. Mobility in the Community 3. Occupational Tasks 4. School-Related Tasks 5. Home management (indoor & outdoor) 6. Caring for dependents 7. Recreational & leisure activities 8. Socializing with friends & family 9. Community responsibilities and service

Question 45

What are 4 biological risk factors for disability?

Answer 45

1. Age, sex, race 2. Height / weight relationship 3. Congenital abnormalities or disorders 4. Family history of disease (genetic predisposition)

Question 46

List 8 Behavioral/Psychological/Lifestyle Factors which are risk factors for disability:

Answer 46

1. Sedentary Lifestyle 2. Cultural Biases 3. Use of tobacco, alcohol, other drugs 4. Poor Nutrition 5. Low level of motivation 6. Inadequate Coping Skills 7. Difficulty Dealing with Change or Stress 8. Negative Affect

Question 47

What are 2 physical environment characteristics which are risk factors for disability?

Answer 47

1. Architectural barriers in the home, community, and workplace 2. Ergonomic characteristics of the home, work or school

Question 48

List 4 Socioeconomic factors which are risk factors for disability

Answer 48

1. Low economic status 2. Low level of education 3. Inadequate access to health care 4. Limited family or social support

Question 49

What is the difference between Discharge & Discontinuation?

Answer 49

Discharge - goals were met | Discontinuation - cessation of services prior to achieving goals

Question 50

What is Primary Prevention?

Answer 50

Preventing a target problem or condition in an individual or in a community at risk. Ex: Fitness program for children to prevent obesity

Question 51

What is Secondary Prevention?

Answer 51

Early diagnosis and reduction of the severity or duration of existing disease and sequelae. Ex: Developing resistance programs for individuals with osteoporosis

Question 52

What is Tertiary Prevention?

Answer 52

Use of rehabilitation to reduce the degree or limit the progression of existing disability and improve multiple aspects of function in persons with chronic irreversible health conditions. Ex: Developing fitness programs for individuals with spinal cord injuries

Question 53

What factors may influence a patient's safety during exercise?

Answer 53

``` Health conditions (known & unknown) Medications Environment Accuracy of exercise performance Fatigue ```

Question 54

What is the difference between a patient Goal vs Outcome?

Answer 54

Goals are directed at reducing or eliminating physical s/s of pathology and impairments of body function and/or structure which are limiting a patient's functions vs. Outcomes are associated with the improvement of functional deficits and participation restrictions to the greatest extent possible.

Question 55

List 2 examples of task-specific functional training.

Answer 55

Sit-to-Stand | Stairs

Question 56

What is the implication of disablement as it pertains to PT?

Answer 56

It allows the therapist to shift the focus from the strict treatment of the disease process to the IMPACT of the disease on the patient's overall level of function.

Question 57

How does a PTA know if an intervention has been effective?

Answer 57

Must be a decrease or elimination of the functional deficit AND a decrease in the risk of future dysfunction

Question 58

List 7 examples of determinants of patient satisfaction

Answer 58

1. Interpersonal attributes of the therapist 2. Perception of a therapist's clinical skills 3. Extent of functional improvement during the episode of care 4. Extent of participation in goal setting in the POC 5. The acuity of the patient's condition (higher satisfaction in acute conditions) 6. Convenience of access to service 7. Administrative issues, such as continuity of care, flexible scheduling, wait time, duration of tx, and cost of care

Question 59

What 2 conditions are frequently associated with musculoskeletal imvolvement?

Answer 59

Inflammation & Pain

Question 60

What are the stages of motor learning?

Answer 60

Cognitive Associative Autonomous

Question 61

What is a Discrete motor task?

Answer 61

It involves an action or movement with a recognizable beginning and end - isolates and contracts a specific mm group Ex: quad setting, grasping object, push-ups, locking w/c, kicking a ball, lifting and lowering weights, self-stretching

Question 62

What is a Serial motor task?

Answer 62

It is composed of a series of discrete movements that are combined in a particular sequence. Ex: Eat w/fork, w/c transfers

Question 63

What are Continuous motor tasks?

Answer 63

They involve repetitive, uninterrupted movements that have no distinct beginning and ending. Ex: walking, ascending and descending stairs, cycling

Question 64

What is a closed environment?

Answer 64

Objects around the patient and the surface on which the task is performed do not move.

Question 65

What is an open environment?

Answer 65

Objects or other people are in motion or the support surface is unstable during the task. The movement is not under the control of the patient. Ex: Maintaining sitting or standing balance on a movable surface standing on a moving train or bus, ascending/descending stairs in a crowded stairwell, crossing a street at a busy intersection

Question 66

What happens in the cognitive stage of motor learning?

Answer 66

The patient learns what to do - the goal/purpose and the requirements of the exercise or functional task. How to do the motor task safely and correctly. The patient needs to think about each component or sequencing

Question 67

What happens in the Associative stage of motor learning?

Answer 67

Fine tuning Producing most consistent and efficient movements Timing and distances are moved slight variations and modifications of movement Different environmental conditions Self-correction Limited feedback from PT/PTA

Question 68

What happens during the Autonomous stage of motor learning?

Answer 68

Movements are automatic. Patient does not have to pay attention to the movements. Patient adapts to variations in task demands and environmental conditions. Little if any instruction

Question 69

What is Intrinsic Feedback?

Answer 69

It comes from all of the sensory systems of the learning (not the therapist

Question 70

What is Augmented Feedback?

Answer 70

Information about the performance or results of a task in addition to intrinsic feedback which comes from a therapist. The therapist has control of the type, timing, and frequency of the feedback.

Question 71

What is knowledge of performance?

Answer 71

Therapist feedback which focuses on the quality of the patient's performance of a task. Feedback is ongoing throughout the performance

Question 72

What is Knowledge of Results?

Answer 72

Feedback from the therapist directing the patient's attention to the outcomes of the movements (not the details of the movements themselves) Study indicates that patients retain the motor skill better this way.