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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
goal with isotonic exercise it to have normal strength through ___
full ROM
26
downside of isometric training:
adds stress to joints
27
isometric exercise often used with:
- acute injuries | - older/weaker patients
28
muscular adaptation:
- hypertrophy of existing fibers - hyperplasia: fiber splitting - capillary: vascular changes
29
neural adaptation:
- greater number of motor units recruited - larger motor units more easily recruited - increased frequency of discharge * *improved efficiency of conduction
30
Main thing patient is gaining with exercise is:
improving neural influence
31
isometric training parameters:
3-10 seconds 5-10 reps 1-3 min. rest between contractions
32
ACSM PRE guidelines for isotonic training:
8-12 reps 1-3 sets train 2-3 days a week
33
exercise selection criteria
- patient position - stabilization - axis of movement - joint movements performed - type of resistance - prime movers - muscles/joints in stabilization
34
PNF D1 flexion pattern
hip: flex, add, ER knee: extension ankle: DF, Inv ext
35
PNF D2 flexion pattern
hip: flex, abd, IR knee: extension ankle: DF, Eversion toes: ext
36
PNF D1 extension pattern
hip: ext, abd, IR knee: extension ankle: PF, Eversion toes: flex
37
PNF D2 Extension pattern
hip: ext, add, ER knee: extension ankle: PF, Inversion toe: flex
38
transudate
clear fluid, no cells
39
exudate
fluid, protein, and leukocytes
40
steps of cellular response during inflammation
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
cellular response with inflammation:
- 1st few days neutrophils - 5-7 days macrophages - chemical substances to stimulate tissue repair
42
diapedesis
: when activated, neutrophils squize through endothelial gaps into tissues
43
hemostatic response during inflammation:
1. platelet activation and adherence 2. platelet release reaction 3. platelet aggregation (plug) 4. fibrin production and clotting (walling off damaged area; mesh)
44
characteristics of acute inflammation:
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
chronic inflammation
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
parts of the proliferative phase
1. granulation 2. fibroblastic stage 3. maturation
47
granulation stage
- fibroblast and endothelial cells - vasodilation; lack of collagen support - skin: 3 days - ligament: 7 days
48
fibroblastic stage:
- fibers synthesized - stimulated by low O2, enzymes, Vit C - skin: 7-10 days - ligament: 2-6 weeks
49
maturation stage:
- myofibroblasts help to contract wound edges - H bonding then covalent of collagen - 8-10 weeks - time and mechanical stress
50
remodeling phase:
1. collagenase | 2. mechanical stress (tension causes collagen to line up in direction of stress)
51
time frame of capillary budding:
24 hours
52
time frame of fibroblast formation
24 hours
53
time frame of muscle/skin wound closure
5-8 days
54
time frame of tendon/ligament wound closure:
3-5 weeks
55
time frame of scar being stretchable:
8-10 weeks
56
time frame for scar tissue to complete repair
6-12 months
57
treatment progression is dictated by:
- time frames | - cardinal signs
58
ligament treatment:
-3 weeks A/PROM | 4-6 weeks WB ROM
59
tendon treatment
-3 weeks PROM 4-6 weeks light concentric AROM -eccentric AROM, WB activity
60
with synovial joint effusion the joint assumes position of:
- maximal volume | - loose pack position
61
vascular tendons heal by:
cells and fibrin (clot) from paratenon
62
highest metabolic activity of a tendon is at:
musculotendinous junction | -greater collagen turnover rate
63
dimensions of wellness
1. spiritual 2. social 3. environmental 4. physical 5. intellectual 6. emotional 7. financial
64
components of physical fitness:
1. body composition 2. aerobic capacity 3. muscle strength 4. endurance 5. muscle length
65
treat ____ until you can get to the underlying problem:
symptoms | -sometimes the area is really irritated/sore/swollen
66
end points of AROM are:
physiological barriers
67
end points of PROM are:
anatomical barriers
68
parts of PROM evaluation:
- quantity of motion - quality of motion - end feel - provocation of symptoms
69
assessing PROM quantity:
- physiological: estimate/measure with a goniometer | - acessory: 0-6 scale
70
PROM treatment effects:
1. mechanical: tissue stretching, synovial fluid movement, normalize joint congruity 2. neurological effects: normalize muscle tone, pain modification
71
parameters to begin PROM treatment:
1 rep/sec for speed | go for 90 seconds (look for change of symptoms but not too long if it doesn't work)
72
treatment applications:
- 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
when is a good time to choose manual resistance?
: first couple times to see when they may have symptoms
74
effect of strength training on metabolism:
-increases muscle mass which is metabolically active
75
each pound of muscle tissue may increase resting metabolism by:
up to 35 calories per day
76
mechanical resistance benefits:
- lot of resistance available - time saving for therapist - objective evidence of progress - can be reproduced at home/IND
77
goal of isotonic exercise:
want normal strength through entire available ROM
78
factors in tissue repair:
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
treatment based on:
1. tissues involved 2. biomechanics of the tissue 3. severity of the damage 4. stage of inflammatory/healing 5. goals
80
tensile strength of a scar after 8 weeks?
25-35%
81
tensile strength of scar after 1 year with early active motion?
90-95%
82
tensile strength of a scar after 98 days?
60%
83
sprain
injury to inert tissue stabilizing a joint
84
grade I sprain
- tissue stretched but not torn (microtear) - minimal swelling - minimal pain on palpation - no breath in tissue palpated - no appreciable laxity (0-5 mm)
85
grade II sprain
- 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
grade III sprain
- complete rupture - severe pain, palpation, bleeding, and swelling initially - tissue breach palpated - significant laxity (10-15 mm or more)
87
how do sprain grades line up with the accessory motion scale?
grade I is 4 (slight increased movement) grade II is 5 (considerable increased movement) grade III is 6 (grossly unstable)
88
vascularization of sheathed tendons:
avascular | -granulation tissue from the tendon sheath when immobilized
89
primary blood and cells of sheathed tendons are:
from the sheath
90
first type of cells to arrive during inflammation:
polymorphonuclear neutrophils
91
Muscle/tendon 1st degree strain
- tear of few fibers - minor pain and swelling - little to no weakness - little to no loss of ROM - strong and painful
92
muscle/tendon 2nd degree strain
- increased tissue damage - increased weakness - increased pain and swelling/bleeding - loss of ROM - weak and painful
93
muscle/tendon 3rd degree strain
- complete rupture - marked decrease strength - increased swelling/bleeding - weak and painless
94
tissue result of immobilization:
fibrous tissue, primarily fibrocartilage
95
tissue result of intermittent AROM
hyaline but mostly fibrocartilage
96
tissue result of continuous PROM:
more hyaline than fibrocartilage
97
cells of fibrocartilage:
fibroblasts | chondroblasts
98
fibers of fibrocartilage:
type I and type II collagen | -circular/multi-directional

Therapeutic Exercise (2 decks)

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