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Therapeutic Exercise > Exam 1 > Flashcards

Exam 1 Flashcards

1
Q

What is the main focus of PTA 2021

A

ROM
Muscle Performance
Stretching Techniques
Neuromuscular Control Exercises

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2
Q

Define Disablement Process

A

Refers to the impact/s of chronic and acute conditions on the function of specific body systems, on basic human performance and on peoples functioning in desired roles in society.

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3
Q

What are the differences between the ICIDH, NAGI and ICF disability models?

A

ICIDH- functional limitation and disability are not differentiated

NAGI- considers distinction between functional limitation and disability

ICF- integrates functioning and disability, places less emphasis on disease and a greater emphasis on how people affected by heath conditions live.

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4
Q

What is the NAGI scheme?

A

Active Pathology - Impairment - Functional Limitation - Disability

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5
Q

Define Risk Factors

A

Influences or characteristics that predispose a person to the process of disablement

  • Biological: age, family history
  • Lifestyle: smoking, obesity
  • Environment: ergonomics at home or work
  • Socioeconomic Factors: low income, no access to health care
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6
Q

Define Pathology/Pathophysiology

A

Disruption of body’s homeostasis due to:

  • disease
  • disorder
  • condition
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7
Q

Define Impairment

A
  • Consequences of pathological conditions
  • Loss or abnormality of anatomic, physiologic or psychologic structure or function (cardio/pulm, integumentary, musculoskeletal, neuromuscular)
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8
Q

Define Functional Limitations

A

A restriction of the ability to perform, at the level of the whole person, a physical activity or task in an efficient manner.

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9
Q

Define Disability

A

The inability to perform or participate in activities to one’s self, the home, work, recreation or community normally.

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10
Q

Define Functional Excursion

A

The distance a muscle is capable of shortening after it has been elongated to its maximum.

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11
Q

What are the requirements for someone to have normal ROM?

A

Adequate length of the following tissues:

  • Joint Capsule
  • Ligaments
  • Tendons
  • Muscles
  • Fascia
  • Skin
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12
Q

What is the Cycle of Causes and Effects to Decreased Mobility?

A 
Pain
Disuse
Decreased Loading
Weakness
Adaptive Shortening of Soft Tissues
Compensation
Mobility Limitataion
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13
Q

Define Passive Range of Motion (PROM)

A

Movement with unrestricted ROM for a body segment that is produced entirely by an external force (little or no voluntary muscle contraction)

External force can be gravity, machine, or another body segment or individual

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14
Q

Define Continuous Passive Motion (CPM)

A

Passive Motion that is performed by a machine device that moves the joint slowly and continuously through a pre-set controlled ROM.

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15
Q

Why would you use PROM?

A

In areas where acute or inflamed tissue is present where active motion would be detrimental to the healing process.

Patient is not able or not suppose to actively move a body segment. (Comatose, paralyzed or bed rest)

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16
Q

What are the goals of PROM?

A
  • Decrease complications that occur with immobilization
  • Maintain mechanical elasticity of muscle
  • Assist with circulation
  • Enhance synovial movement for cartilage nutrition
  • Decrease pain
  • Assist with healing process after injury
  • Help maintain patient’s awareness of movement
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17
Q

What does PROM not help?

A
  • Will not prevent muscle atrophy
  • Will not increase strength or endurance
  • Will not assist with circulation as an active voluntary contraction would
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18
Q

Define Active-Assistive Range of Motion (AAROM)

A

Type of ROM with assistance provided by an external force either manually or mechanically

Aides the muscles that cross the joint in completing the motion

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19
Q

Define Active Range of Motion (AROM)

A

Movement within the unrestricted ROM for a body segment that is produced by an active contraction of the muscle crossing the joint.

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20
Q

Why would you use AAROM or AROM?

A
  • Patient is able to actively contract muscles with or without assistance
  • Patient has weak musculature and is unable to move joint through desired range, AAROM assists muscle
  • AROM can be used in aerobic conditioning programs
  • When one segment is immobilized, AROM can be used at segment above or below.
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21
Q

What are the goals of AAROM or AROM?

A
  • Maintain physiologic elasticity and contractility of the muscles
  • Provide sensory feedback from contracting muscles
  • Provide stimulus for bone and joint tissue integrity
  • Increase circulation and prevent thrombus formation
  • Develop coordination and motor skills for functional activities
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22
Q

What does AAROM or AROM not help?

A
  • Will not maintain or increase strength of strong muscles (3/5 MMT)
  • Will not develop skill or coordination except in the movement patterns used.
  • You have to challenge a muscle in order to strengthen it.
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23
Q

What are some Precautions and Contraindications on determining is ROM is appropriate?

A
  • Unexpected Pain
  • Unstable Fracture
  • Decreased or absent sensation
  • Avoid when motion is disruptive to healing process
  • Avoid when patient’s response or condition is life threatening
  • Use post-surgical protocols and diagnosis to determine how much ROM is safe to apply
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24
Q

What are types of Self Assisted ROM examples?

A
  • Self-assisted
  • Wand or T-bar exercises
  • Wall Climbing
  • Overhead Pulleys
  • Skate board
  • Reciprocal Bike/ Arm Bike
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25
Q

If the goal is to decrease effects of immobilization what kind of reps would we want the patient to do?

A

High Reps

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26
Q

If the goal is coordination and sensory feedback what kinds of reps would we want the patient to do?

A

Low Reps with the focus on quality of movement to re-train the movement patterns.

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27
Q

Define Mobility

A

Ability of structures to move to allow the presence of range of motion for functional activities OR the ability of an individual to initiate, control or sustain active movement of the body to perform simple to complex motor skills

28
Q

Define Flexibility

A

The ability to move a single joint or series of joints smoothly and easily through unrestricted, pain-free ROM

29
Q

Define Dynamic Flexibility

A

Degree to which an active muscle contraction moves a body segment through ROM

30
Q

Define Passive Flexibility

A

Degree to which a body segment can be moved through ROM by an external force (passively)

31
Q

Define Selective Stretching

A

A process whereby the overall function of a patient may be improved by applying stretching techniques selectively to some muscles and joints but allowing other to develop a limitation of motions.
-SCI: Want to lengthen hamstrings, shorten low back extensors, hypo mobile finger flexors

32
Q

What is the difference between Hypomobility and Hypermobility?

A
  • Hypo: decreased mobility

- Hyper: increased mobility

33
Q

What is an Elastic change?

A

Ability of the soft tissue to return to its original length after stretch for is removed
-Contractile and Non-Contractile tissues

34
Q

What is a Plastic change?

A

Tendency of a soft tissue to assume a new and greater length after the stretch force is removed
-Contractile and Non-Contractile tissues

35
Q

What is a Viscoelastic change?

A

Time dependent property of soft tissue

Initially it resists change in length then gradually will lengthen. Will gradually return to original length after stretch force is removed.
-Non-Contractile tissue

36
Q

Examples of Contractile Tissue?

A

Muscle Fibers
Myofibrils
Sarcomeres
Myofilaments

37
Q

What do Sarcomeres give Muscle?

A

The ability to contact and relax

38
Q

What is Sarcomere Give?

A

Abrupt Lengthening due to mechanical disruption

39
Q

What is Sarcomere Absorption?

A

Reduction in the number of sarcomeres in series within myofibrils

40
Q

What do the Muscle Spindles do?

A

Monitor changes in length and the velocity of changes

41
Q

What do the Golgi Tendon Organs do?

A

Monitor changes in tension and muscle-tendon unit

Autogenic Inhibition=Low Intensity, prolonged stretch

42
Q

What are the properties of Non-Contractile Tissue?

A

The primary source of a muscles resistance to passive elongation is the connective tissue framework

Endomysium- innermost layer that separates individual muscle diners and myofibrils

Perimysium- encases fiber burrelles

Epimysium- enveloping fascial sheath around entire muscle

43
Q

What are the properties of Connective Tissue?

A

Stress-Strain Curve

  • Toe Region: Considerable deformation without much force
  • Elastic Region: Complete recovery from deformation
  • Elastic Limit: Tissue remodeling
  • Plastic Range: permanent deformation
  • Region of necking: approaching tissue failure
44
Q

What factors affect the Stress-Strain Response?

A
  • Immobilization: weakening of collagen & adhesion formation
  • Inactivity: weakness
  • Age: response is slower
  • Corticosteroids: decrease tensile strength
  • Injury: decrease tensile strength
  • The higher the temperature the greater the degree of elongation with stress
45
Q

Low Load stretching for a prolonged duration results in what?

A

Viscoelastic and Plastic changes

46
Q

Define Static Stretching

A
  • Involves placing muscle in fully elongated position and holding for a period of time
  • Duration of stretch in determined on patients tolerance and response
  • Suggested that GTO contributes to muscle elongation by overriding Afferent Fibers
  • Applied with low load, prolonged stretch
47
Q

What are the Advantages of Static Stretching?

A
  • Reduce potential muscle soreness
  • Easily taught to patients
  • Safe
  • Relatively Pain Free
48
Q

What are the Disadvantages of Static Stretching?

A

-Takes more time for patient to perform

49
Q

What kind of patients is Static Stretching best for?

A
  • Patients that can with stand a longer stretch and have a mild to low pain level
  • Good for most patients
50
Q

What is the Mechanism for Action for Static Stretching?

A
  • Autogenic Inhibition
  • Creep

*Want to avoid Activation of Stretch Reflex

51
Q

What is the Technique for Static Stretching?

A
  • Hold stretch for 10-60 secs
  • 5-15 reps
  • Rest between reps for 5-10 secs
  • Low load with prolonged stretch

3x a week to improve flexibility
1x a week to maintain

52
Q

What is the Technique for Cyclic Stretching?

A
  • Hold stretch for 5-10 secs
  • 5-15 reps
  • Short Duration
53
Q

What is the Mechanism for Action for Cyclic Stretching?

A
  • Autogenic Inhibition
  • Stretch Reflex

*Want to decrease Creep

54
Q

What are the Advantages of Cyclic Stretching?

A
  • Takes less time
  • Less painful for patients that have higher levels of pain
  • Easy to teach for independent use
55
Q

What are the Disadvantages of Cyclic Stretching?

A

-Less Effective

56
Q

What kind of patients is Cyclic Stretching best for?

A
  • For patients that are in more pain and can’t hold a stretch for a longer period of time
  • Post-surgical
  • Youth/Peds patients
57
Q

What is the Technique for Ballistic Stretching?

A

Bounce at the end of the stretch NOT through the whole motion

58
Q

What is the Mechanism of Action for Ballistic Stretching?

A

Activate the Stretch Relflex

59
Q

What are the Advantages of Ballistic Stretching?

A

-Gets the muscle ready to perform in more athletic activities

60
Q

What are the Disadvantages of Ballistic Stretching?

A

-Could injury muscle if done incorrectly

61
Q

What kind of patients is Ballistic Stretching best for?

A

-Advanced Athletes that have good strong muscles and tendons

62
Q

What is the Technique for PNF (Hold Relax/Contract Relax)?

A

-Patient and PT work together to perform stretch and try to gain muscle length

63
Q

What is the Mechanism of Action for PNF?

A
  • GTO

- Autogenic Inhibition

64
Q

What are the Advantages of PNF?

A
  • Overhead resistance helps to lengthen muscle

- Effective

65
Q

What are the Disadvantages of PNF?

A
  • Painful
  • Need help and can’t be easily taught for independent stretching at home
  • Most time consuming
66
Q

What kind of patients is PNF best for?

A
  • A patient that has a really tight muscle or muscle group

- Patients with a lot of muscle guarding

Therapeutic Exercise (5 decks)

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