Exam 1 Flashcards
- Plan ahead both mentally and physically
- Position yourself close to the object
- Increase your stability / widen your base of support
- Lower your center of gravity
- Keep your VGL within your BOS
- Use the stronger muscles of your body to lift
- Roll, push, or pull rather than lift if possible
- Avoid trunk rotation and flexion
- Move your feet during a lift involving rotation
- Know your own physical capascity
- Remember to breathe
Key Principles of Good Body Mechanics
COG
Center of Gravity
- Where the three cardinal planes intersect.
- Anterior to the 2nd sacral segment
BOS
Base of Support
-The part of your body which is in contact with a supportive surface (such as the floor, a bed, a chair…)
VGL
Vertical Gravity Line
-An imaginary vertical line which passes through the center of gravity of an object
Common lifting techniques
- Deep Squat Lift
- Power Lift
- Straight Leg Lift
- One Leg Stance Lift (Golfer’s Lift)
- Half Kneeling Lift
- Stoop Lift
- Traditional Lift
Deep Squat Lift
- Squat with hip crease below knees
- Elbows extended
- Used for heavier object on the ground
Power Lift
- Squat with hip crease above knees
- Used when object is not heavy enough for deep squat
Straight Leg Lift
- Lifters knees are slightly flexed to fully extended
- Feet may be staggered
- Used when having to reach for a light object
One-Leg Stance Lift (Golfer’s Lift)
- Balancing on one leg with knee slightly flexed to fully extended
- Opposite hand reaches for object
- Used for picking up light object from floor without fully flexing knees
Half-Kneel Lift
- Lifter positions themself into a lunge, grabs object and places it onto thigh, and stands
- Used for people with weak upper extremity strength and people with poor balance
Traditional Lift
-Same as deep squat lift, but elbows are flexed
Relationship of TherEx to Function
- Muscle Performance
- Aerobic Conditioning/Pulmonary Function
- Mobility/Stretching Activities
- Neuromuscular Control/Coordination
- Spinal Stability
- Balance/Posture
Contraindications for TherEx
- Severe Pain in a joint
- Rheumatoid Arthritis
- Infected Joint
- Osteogenesis Imperfecta
- Unstable Fractures
- Sudden Pain
- Unexpected Symptoms
- Blood Pressure
Type of ROM- external force, no voluntary muscle contraction
PROM
Indications for PROM
- If there is acute, inflammed tissue and PROM will not disrupt healing
- If patient is unable to move body part voluntarily
Contraindications and Precautions for ROM
- If ROM is disruptive to the healing process
- If ROM increases pain and inflammation
- If there is a possibility of a thrombus or venous stasis ulcer
- If the pt. has certain cardiac conditions or procedures
A form of active exercise whereby an external force is used to help the patient perform the exercise
Active Assistive ROM (AAROM)
The movement of a joint or body segment produced by active, voluntary muscle contractions by the patient within the unrestricted, normal ROM
Active ROM (AROM)
Indications for AROM
- To achieve active contraction of muscles
- Initial phases of muscle strengthening
- Prevention of atrophy
End feel which is compressing or stretching soft tissue
Soft End Feel
End feel which is stretching joint capsules or ligaments
Firm End Feel
End feel which is a bony block
Hard End Feel
End feel which cannot be felt due to pain
Empty
Compare and contrast PROM and stretching
For PROM, you only go to the end feel and back off.
For stretching, you go to the end feel and beyond.
The extent of osteokinematic motion available for movemet activities, functional or otherwise, with or without assistance
Range Of Motion
How to perform ROM (reps, sets, holds)
1 x 5-10 reps of each movement
The ability of a muscle to lengthen, allowing one joint or a series of joints in a limb to move through range of motion
Muscle Flexibility
The muscle is slowly elongated to tolerance (a mild stretch, short of pain) and the position is held for 30 seconds. Mild tension should be felt in the muscle being stretched
Static Stretching
How to perform a static stretch (reps, sets, holds)
Hold for 30-60 seconds
Indications for stretching
- ROM limited due to adhesions, contractures, scar tissue, causing functional limitations/disability
- Structural limitations otherwise preventable
- Muscle weakness/shortening of opposing tissue
- Part of the fitness program
- To minimize post exercise muscle soreness
Contraindications for stretching
- Bony block limits joint motion
- Recent fracture
- Evidence of an acute infection
- Soft tissue healing could be disrupted
- Sharp pain with joint movement
- Hematoma or tissue trauma
- Hypermobility
- Short tissue is beneficial to Pt.
Type of stretch where
- the limb is moved passively to the end ROM
- the pt. contracts the muscle for 10 seconds
- the limb is moved further into the ROM
Autogenic Inhibition
Type of stretch where
- the limb is moved passively to the end ROM
- the pt. performs concetric contraction in the opposite muscle, causing a greater stretch of the muscle
- the pt. relaxes and the stretch is held 10-15 seconds
Reciprocal Inhibition
Muscle tension occurs, but there is no movement or change in muscle length
Isometric Contraction
What is the recommended hold time for Isometric Exercises
6-10 seconds
Muscle contraction which occurs against a constant resistance, and results in joint motion
Isotonic Contraction
Muscle contraction which results in shortening of the muscle
Concentric Contraction
Muscle contraction which results in lengthening of the muscle
Eccentric Contraction
Isotonic exercise which results in the distal segment moving
Open Chain Exercise
Isotonic exercise which results in the proximal segment moving
Closed Chain Exercise
Muscle contractions in which the speed of movement is controlled so that the limb speed is at constant velocity
Isokinetic Contraction
Which type of contraction is most likely to result in DOMs
Eccentric Contraction
How to perform isotonic exercises (sets, reps, holds)
3 sets of 10 reps
How to make an effective TherEx program
TherEx programs should incorporate a variety of theraputic exercises which are designed to improve function
Define 1 rep Max
The amount of resistance/weight in which a muscle can overcome in a single movement 1 time
How is a patient’s 10 rep Max used in PT practice?
The patient will usually do an exercise in 3 sets of 10 reps. The first set would be 50% of their 10 rep max weight, the second would be 75%, and the third would be 100% (DeLorme’s Progressive Resistance Exercise)
- Pain in muscles- typically dull/diffuse
- Stiffness and tenderness to touch
- May last for up to one week, but generally resolves in 72 hours
Delayed Onset Muscle Soreness (DOMS)
The amount of blood pumped by the heart in one minute
Cardiac Output
The amount of blood pumped by the heart with one beat
Stroke Volume
Normal resting heart rate
60-100 BPM
Normal resting blood pressure
<120/<80
What is the normal responce to blood pressure during aerobic activity
Systolic pressure should rise with the amount of exertion, but Diastolic pressure should rise no higher than 10 mmHG
Abnormal responses to Exercise
- Angina
- Unusual or severe shortness of breath
- Abnormal diaphoresis
- Pallor, cyanosis, cold and clammy skin
- Central nervous system symptoms (vertigo, ataxia, gait problems, or confusion)
- Leg cramps or intermittent claudication
- Physical or verbal manifestations of severe fatigue or shortness of breath
Blood pressure guidelines for aerobic activity
Stop if:
- SBP drops by 20 mmHG or doesn’t rise
- SBP >260, DBP >115
Reduction of cell size
Atrophy
Increase in cell size
Hypertrophy
Increase in number of cells
Hyperplasia
Decrease in number of cells
Involution/Hypoplasia
Change of a cell from one type to another
Metaplasia
What are the cardinal signs of inflammation
- Heat
- Redness
- Swelling
- Pain
When a joint has reached it’s end ROM, because the surrounding soft tissue cannot stretch any further
Passive Insufficiency
When a muscle cannot contract anymore, because it has shortened as much as it possibly can
Active Insufficiency
