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Therapeutic Exercise > Exam 1 > Flashcards

Exam 1 Flashcards

1
Q

components of physical fitness:

A
  1. body composition
  2. endurance
  3. muscular strength
  4. aerobic capacity
  5. muscle length
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2
Q

Accessory ROM grading scale:

A 
0=ankylosed
1=considerable limitation
2=slight limitation
3=normal
4=slight increase
5=considerable increase
6=grossly unstable
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3
Q

Grade I therapy movement

A

-small amplitude movement at beginning of ROM

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4
Q

Grade II therapy movement

A

large amplitude movement within a resistance-free part of ROM

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5
Q

Grade III therapy movement

A

large amplitude movement performed into resistance or up to the limit of ROM (end part)

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6
Q

Grade IV therapy movement

A

small amplitude movement into resistance or up to limit of ROM (at the end)

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7
Q

Grade V therapy movement

A
  • high velocity
  • short amplitude
  • thrust performed at the limit of ROM
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8
Q

What PROM treatment would you use if the patient felt pain before resistance?

A

-acute injury

Grade I

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9
Q

What PROM treatment would you use if the patient felt pain at same time as resistance?

A

sub-acute

Grade II

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10
Q

What PROM treatment would you use if the patient felt resistance before pain?

A

chronic

Grade III or Grade IV

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11
Q

What PROM treatment should be chosen with limited ROM,
normal end feel, and
n/c pain EROM?

A

III+ or IV+

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12
Q

What PROM treatment should be chosen with small limitation of ROM,
normal EF
little to n/c pain at EROM

A

Grade V

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13
Q

Direct method approach

A
  • engage the restrictive barrier

- attempt to move the barrier closer to normal point in ROM

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14
Q

Exaggeration method approach

A
  • movement in th edirection opposite the restrictive barrier

- usually the pain-free movement

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15
Q

Indirect method approach

A
  • movement away from the restrictive barrier
  • find a point of freedom or ease
  • hold or maintain this position for 5-90 sec
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16
Q

Type I mechanoreceptors

A
  • located in the superficial joint capsule
  • slowly adapting
  • changes in tension
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17
Q

Type II mechanoreceptors

A
  • deeper layers of capsule and fat pads
  • rapidly adapting
  • at onset/acceleration
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18
Q

Type III mechanoreceptors

A
  • in ligaments at attachments
  • high threshold
  • extremes of ROM
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19
Q

Type IV mechanoreceptors

A
  • located everywhere (capsule, fat pads, ligaments, blood vessels)
  • there for protection
  • extreme ranges
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20
Q

desired effects of resisted exercise:

A
  • improve/maintain joint ROM
  • improve strength
  • improve endurance
  • decrease/manage pain
  • dynamic stabilization of joints
  • improve quality of movement/efficiency
  • cardiovascular
  • other
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21
Q

most important desired effect of resisted exercise:

A

improve quality of movement/efficiency

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22
Q

manual resistance benefits:

A
  • totally accommodating
  • hands on
  • continued evaluation
  • patient’s own IAR (instantaneous axis of rotation)
  • multi-directional
  • quick changing between exercises
  • cheap
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23
Q

another name for isotonic:

A

dynamic constant resistance

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24
Q

Holten Curve deals with:

A

calculating 1 RM

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25
Q

goal with isotonic exercise it to have normal strength through ___

A

full ROM

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26
Q

downside of isometric training:

A

adds stress to joints

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27
Q

isometric exercise often used with:

A
  • acute injuries

- older/weaker patients

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28
Q

muscular adaptation:

A
  • hypertrophy of existing fibers
  • hyperplasia: fiber splitting
  • capillary: vascular changes
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29
Q

neural adaptation:

A
  • greater number of motor units recruited
  • larger motor units more easily recruited
  • increased frequency of discharge
  • *improved efficiency of conduction
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30
Q

Main thing patient is gaining with exercise is:

A

improving neural influence

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31
Q

isometric training parameters:

A

3-10 seconds
5-10 reps
1-3 min. rest between contractions

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32
Q

ACSM PRE guidelines for isotonic training:

A

8-12 reps
1-3 sets
train 2-3 days a week

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33
Q

exercise selection criteria

A
  • patient position
  • stabilization
  • axis of movement
  • joint movements performed
  • type of resistance
  • prime movers
  • muscles/joints in stabilization
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34
Q

PNF D1 flexion pattern

A

hip: flex, add, ER
knee: extension
ankle: DF, Inv
ext

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35
Q

PNF D2 flexion pattern

A

hip: flex, abd, IR
knee: extension
ankle: DF, Eversion
toes: ext

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36
Q

PNF D1 extension pattern

A

hip: ext, abd, IR
knee: extension
ankle: PF, Eversion
toes: flex

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37
Q

PNF D2 Extension pattern

A

hip: ext, add, ER
knee: extension
ankle: PF, Inversion
toe: flex

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38
Q

transudate

A

clear fluid, no cells

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39
Q

exudate

A

fluid, protein, and leukocytes

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40
Q

steps of cellular response during inflammation

A
  1. margination: move to periphery of vessels
  2. pavementing: adhere to vessel wall
  3. emigration: out of vessels and endothelial cell junction
  4. chemotaxis:
    mvmt of WBCs in response to chemical gradient
  5. aggregation: WBCs, mast cells, macrophages at site of injury
  6. phagocytosis: engulfment of debris and bacteria
41
Q

cellular response with inflammation:

A
  • 1st few days neutrophils
  • 5-7 days macrophages
  • chemical substances to stimulate tissue repair
42
Q

diapedesis

A

: when activated, neutrophils squize through endothelial gaps into tissues

43
Q

hemostatic response during inflammation:

A
  1. platelet activation and adherence
  2. platelet release reaction
  3. platelet aggregation (plug)
  4. fibrin production and clotting (walling off damaged area; mesh)
44
Q

characteristics of acute inflammation:

A
  1. stimulus of brief duration
  2. prominent vascular changes
  3. little connective tissue changes
  4. 24-36 hours (mild)
  5. PROM pain comes before resistance
45
Q

chronic inflammation

A
  1. stimulus persists
  2. less obvious vascular changes
  3. more prominent connective tissue changes
  4. greater than 4-6 weeks
  5. PROM pain comes after resistance
46
Q

parts of the proliferative phase

A
  1. granulation
  2. fibroblastic stage
  3. maturation
47
Q

granulation stage

A
  • fibroblast and endothelial cells
  • vasodilation; lack of collagen support
  • skin: 3 days
  • ligament: 7 days
48
Q

fibroblastic stage:

A
  • fibers synthesized
  • stimulated by low O2, enzymes, Vit C
  • skin: 7-10 days
  • ligament: 2-6 weeks
49
Q

maturation stage:

A
  • myofibroblasts help to contract wound edges
  • H bonding then covalent of collagen
  • 8-10 weeks
  • time and mechanical stress
50
Q

remodeling phase:

A
  1. collagenase

2. mechanical stress (tension causes collagen to line up in direction of stress)

51
Q

time frame of capillary budding:

A

24 hours

52
Q

time frame of fibroblast formation

A

24 hours

53
Q

time frame of muscle/skin wound closure

A

5-8 days

54
Q

time frame of tendon/ligament wound closure:

A

3-5 weeks

55
Q

time frame of scar being stretchable:

A

8-10 weeks

56
Q

time frame for scar tissue to complete repair

A

6-12 months

57
Q

treatment progression is dictated by:

A
  • time frames

- cardinal signs

58
Q

ligament treatment:

A

-3 weeks A/PROM

4-6 weeks WB ROM

59
Q

tendon treatment

A

-3 weeks PROM
4-6 weeks light concentric AROM
-eccentric AROM, WB activity

60
Q

with synovial joint effusion the joint assumes position of:

A
  • maximal volume

- loose pack position

61
Q

vascular tendons heal by:

A

cells and fibrin (clot) from paratenon

62
Q

highest metabolic activity of a tendon is at:

A

musculotendinous junction

-greater collagen turnover rate

63
Q

dimensions of wellness

A
  1. spiritual
  2. social
  3. environmental
  4. physical
  5. intellectual
  6. emotional
  7. financial
64
Q

components of physical fitness:

A
  1. body composition
  2. aerobic capacity
  3. muscle strength
  4. endurance
  5. muscle length
65
Q

treat ____ until you can get to the underlying problem:

A

symptoms

-sometimes the area is really irritated/sore/swollen

66
Q

end points of AROM are:

A

physiological barriers

67
Q

end points of PROM are:

A

anatomical barriers

68
Q

parts of PROM evaluation:

A
  • quantity of motion
  • quality of motion
  • end feel
  • provocation of symptoms
69
Q

assessing PROM quantity:

A
  • physiological: estimate/measure with a goniometer

- acessory: 0-6 scale

70
Q

PROM treatment effects:

A
  1. mechanical: tissue stretching, synovial fluid movement, normalize joint congruity
  2. neurological effects: normalize muscle tone, pain modification
71
Q

parameters to begin PROM treatment:

A

1 rep/sec for speed

go for 90 seconds (look for change of symptoms but not too long if it doesn’t work)

72
Q

treatment applications:

A
  • patient position
  • therapist position
  • hand placement
  • technique to be used
  • desired result
  • relaxation of patient and PT
  • amount of pressure
  • rhythm of movement
  • area of contact
  • speed of movement
  • direction of movement
  • duration
  • medium used
73
Q

when is a good time to choose manual resistance?

A

: first couple times to see when they may have symptoms

74
Q

effect of strength training on metabolism:

A

-increases muscle mass which is metabolically active

75
Q

each pound of muscle tissue may increase resting metabolism by:

A

up to 35 calories per day

76
Q

mechanical resistance benefits:

A
  • lot of resistance available
  • time saving for therapist
  • objective evidence of progress
  • can be reproduced at home/IND
77
Q

goal of isotonic exercise:

A

want normal strength through entire available ROM

78
Q

factors in tissue repair:

A
  1. nature of tissue
  2. nutrition
  3. size/shape of wound
  4. drugs (nsaid, steroid)
  5. age
  6. foreign material
  7. blood supply
  8. degree of immobilization
79
Q

treatment based on:

A
  1. tissues involved
  2. biomechanics of the tissue
  3. severity of the damage
  4. stage of inflammatory/healing
  5. goals
80
Q

tensile strength of a scar after 8 weeks?

A

25-35%

81
Q

tensile strength of scar after 1 year with early active motion?

A

90-95%

82
Q

tensile strength of a scar after 98 days?

A

60%

83
Q

sprain

A

injury to inert tissue stabilizing a joint

84
Q

grade I sprain

A
  • tissue stretched but not torn (microtear)
  • minimal swelling
  • minimal pain on palpation
  • no breath in tissue palpated
  • no appreciable laxity (0-5 mm)
85
Q

grade II sprain

A
  • partial tear
  • some bleeding/bruising noted
  • moderate swelling and pain
  • moderate pain upon palpation
  • mild tissue breath may be palpated
  • some laxity (5-10 mm)
86
Q

grade III sprain

A
  • complete rupture
  • severe pain, palpation, bleeding, and swelling initially
  • tissue breach palpated
  • significant laxity (10-15 mm or more)
87
Q

how do sprain grades line up with the accessory motion scale?

A

grade I is 4 (slight increased movement)
grade II is 5 (considerable increased movement)
grade III is 6 (grossly unstable)

88
Q

vascularization of sheathed tendons:

A

avascular

-granulation tissue from the tendon sheath when immobilized

89
Q

primary blood and cells of sheathed tendons are:

A

from the sheath

90
Q

first type of cells to arrive during inflammation:

A

polymorphonuclear neutrophils

91
Q

Muscle/tendon 1st degree strain

A
  • tear of few fibers
  • minor pain and swelling
  • little to no weakness
  • little to no loss of ROM
  • strong and painful
92
Q

muscle/tendon 2nd degree strain

A
  • increased tissue damage
  • increased weakness
  • increased pain and swelling/bleeding
  • loss of ROM
  • weak and painful
93
Q

muscle/tendon 3rd degree strain

A
  • complete rupture
  • marked decrease strength
  • increased swelling/bleeding
  • weak and painless
94
Q

tissue result of immobilization:

A

fibrous tissue, primarily fibrocartilage

95
Q

tissue result of intermittent AROM

A

hyaline but mostly fibrocartilage

96
Q

tissue result of continuous PROM:

A

more hyaline than fibrocartilage

97
Q

cells of fibrocartilage:

A

fibroblasts

chondroblasts

98
Q

fibers of fibrocartilage:

A

type I and type II collagen

-circular/multi-directional

Therapeutic Exercise (2 decks)

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