Exam 1 Flashcards
What is the definition of therapeutic exercise
the systematic, planned performance of physical movements, postures, or activities intended to provide a patient/client with 4 key things.
Therapeutic exercise 1.remediates or _____ impairments of body functions and structure. 2. Improve, restore or enhance activities and _____ 3. Prevent or reduce ____ ____ 4. _____ overall health, fitness, or sense of well-being
- prevents 2. participation 3. risk factors 4. optimize
Therapeutic exercise falls under the category of procedural _______.
interventions
How many types of procedural interventions are commonly selected by physical therapists?
9
What forms the core of most physical therapy plans of care?
The 9 types of procedural interventions
List the first three types of therapeutic exercise interventions
- aerobic conditions and reconditioning 2. Muscle performance exercise like strength, power, and endurance 3.Stretching techniques like joint mobs/manipulation and muscle lengthening
List the second three types of therapeutic exercise interventions
- Neuromuscular control and postural awareness 2. Postural control and stabilization 3. Balance and agility training
List the last three types of therapeutic exercise interventions
- Relaxation exercises 2. Breathing exercises and ventilator muscle training 3. Task-specific functional training
What are the clinical considerations regarding examination that direct the type of therapeutic intervention used on a patient
Pathology, impairments, functional limitations, disability, risk reduction, and health/wellness needs
Instead of saying impairment, what should we technically say
body structure and function repairments
Consequences of pathological conditions that display signs and symptoms that reflect abnormalities within the body are _______
impairments
What body systems do PTs generally address impairments to
musculoskeletal, neuromuscular, cardiovascular/pulmonary, and integumentary
Instead of saying functional limitation, what should we technically say
activity limitations
Functional limitations occur at the level of the ______ person
whole
What is the result of body function and structure impairment
a functional limitation/activity limitation
_____ is characterized by reduced ability of a person to perform actions or components of motor skills in an efficient or typically expected manner
Functional/activity limitations
Decreased ROM of shoulder may lead to an inability to reach overhead while trying to brush hair. What is this an example of
functional/activity limitations
List some common functional/activity limitations
lifting/carrying throwing/catching squatting/kneeling
What is the inability to perform or participate in activities or tasks related to one’s self, the home, work, recreation, or the community in a manner or to the extent that the individual or community as whole perceive as normal
disability/participation restriction
Instead of saying disability, we should technically say _______
participation restriction
To make sure the patient has a safe environment to exercise in, what are three things to consider?
- Patient’s Hx and current health 2. Prepare the environment 3. Accuracy of body alignment, intensity, speed, and duration
True or False: Ther-ex designed by PTs are generalized programs that help the patient achieve optimal function
False, they are not generalized they are individualized
What is the definition of a patient
An individual with impairments and functional limitations diagnosed by a PT and receiving PT care to improve function and prevent disability
What is the definition of a client
An individual without diagnosed dysfunction who engages in PT services to promote health and wellness and prevent dysfunction
What are some questions to ask the patient to establish patient-centered goals and outcomes
“What activities do you like doing and what activities do you need help with?” “What are your goals for PT and how soon do you want to reach them?” “Which problems can we try to eliminate first?”
As a PT, how am I going to give the patient exercise instructions effectively?
Be in a non-distracting environment and demonstrate the movement in front of the patient. Use clear, concise verbal and written directions. Use pictures and provide feedback. Teach program in small increments
What are some ways to foster adherence to an exercise program?
Point out progress the patient has made, allow input from the patient, explain the rationale and importance of each exercise
The ability to align body segments against gravity to maintain or move the body within the available base of support without falling is ________
balance
The ability to move the body in equilibrium with gravity through interactions of sensory and motor systems is _____
balance
The ability to perform low-intensity, repetitive, total body movements over an extended period of time like walking, jogging, swimming is_________
Cardiopulmonary fitness
The correct timing and sequencing of muscle firing combined with the appropriate intensity if muscular contraction leading to the effective initiation, guiding, and grading of movement is ______
coordination
The ability to move freely, without restriction and is used interchangeably with mobility
flexibility
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
mobility
What is the capacity of muscle to produce tension and do physical work that encompasses strength, power, and muscular endurance
muscle performance
The interaction of the sensory and motor systems that enables synergists, agonists, and antagonists as well as stabilizers and neutralizers to anticipate or respond to proprioceptive and kinesthetic information and, subsequently to work in correct sequence to create coordinated movement
Neuromuscular control
______ is used interchangeably with static or dynamic balance
Postural control, postural stability or equilibrium
The ability of the neuromuscular system through synergistic muscle actions to hold a proximal or distal segment in a stationary position or to control a stable base during superimposed movement is ______
stability
______ is the maintenance of proper alignment of bony partners of a joint by means of passive and dynamic component
Joint stability
____ is the force per unity area
stress
_____ is a force or load placed on the material/tissue
stress
What is a strain?
Change in size and shape of material/tissue; deformation
What are the different types of stresses or loads
Tension, compression bending, shear, torsion, or combined
What are the different regions of the stress-strain curve in order of which they occur
Toe region, elastic region, plastic range, failure
Which region of the stress-strain curve is the slack is the tissue at the beginning of the graph
toe region
Which region of the stress-strain curve is the region where direct proportional ability of the tissue to resist the force
Elastic range
what is another term for the elastic range
linear phase
Which region of the stress-strain curve is the point to which tissue does not return to its original shape or size
Elastic limit
Which region of the stress-strain curve is where permanent changes of tissue occur
plastic range
Which region of the stress-strain curve occurs when the stress or load is too much and the tissue breaks, tears, or fails.
failure
What term describes the permanent deformation due to load applied over an extended period
creep
what term describes material that deforms when it is loaded for a prolonged tie
creep
True or False: Creep occurs because a load is placed on a tissue for a long period of time. As the tissue changes, the load also changes
False, the load is constant even as the material deforms
A dynamic splint is used for patients with a limited ROM. If a patient is in the splint for 10 weeks and the muscle shortens over time, this is an example of ____
creep
What two factors does creep rely on?
Strain and time
Explain the concept of stress-relaxation
A force or load is applied to stretch or strain a tissue and the length/strain is kept constant
In stress relaxation stretch, does the force/load increase, decrease, or stay the same as the tissue is deformed
decreases
_____-_____ occurs when material/tissue is strained or deformed to a given dimension with load and maintained at that strain
Stress-relaxation
Serial casting is used when a child walks on their toes too much. The child is put into dorsiflexion and over two weeks the tissue starts to relax and the load is lessened. This is an example of _____
stress-relaxation
According to the tissue stress model, what is a common denominator in most tissues
They require stimulation of non-destructive stresses to maintain health like the SAID principle
what does the SAID principle stand for
Specific adaptation to imposed demands
What does the term “non-destructive stress” mean?
Putting a stress or load on a tissue within normal limits like walking and getting up and moving for the tissue to stay healthy
Cartilage nutrition, muscle strength, ligament strength & their bony attachments, tensile strength of tendon are all promoted by _______ activity or ________ forces/stresses
increased; controlled
True or False: Prolonged immobilization and non-weight bearing has detrimental effects on tissues
true
Various tissues need ____ levels of stress or loads
optimal
If there is too little stress on a tissue, _____ occurs. IF there is too much stress on a tissue ______ occurs
weakness; destructive force/damage
What are the three main factors of optimal loading zone alteration
- age 2. Adaptive change/shortening 3. Injury/disease
What are the specialized types of connective tissue
bone, cartilage, adipose tissue, and blood
What are the two branches of connective tissue proper
loose and dense
What are the two sub-branches of dense connective tissue
regular and irregular
What type of connective tissue are tendons, ligaments, and joint caps
Regular dense connective tissue
Remobilization for (muscle/tendon) is lengthy rehabilitation that is necessary to restore muscle performance especially with longer immobilization
muscle
Remobilization for (muscle/tendon) is controlled mechanical stress that increases tensile strength, and energy absorption capacity, facilitates normal gliding and soft tissue relationships, and prevents excessive scar formation
tendon
The remobilization of a ______ can restore structural and mechanical properties of ligaments but takes longer than the original immobilization period
ligaments
Remobilization of _______ have effects of time and load dependent; progressive joint deterioration may ensue with inappropriate loading post-immobilization
articular cartilage
Remobilization of ____ depends upon the quality prior immobilization, may return to normal faster or bone changes may not be reversed
bone
When performing ROM which structures in the region are affected
all of them
To maintain normal ROM, segments must be moved through their available ranges _______
periodically
What three factors can lead to a decreased ROM
- Systemic, joint, neurological, or muscular disease 2. Surgical or traumatic insults 3. Inactivity or immbolization
What is therapeutic ROM administered to do?
maintain join and soft tissue mobility to minimize loss of tissue flexibility and contracture formation
What are the types of ROM Exercises
Passive, active, active-assisted
Which type of ROM exercise is the movement of a segment within the unrestricted ROM that is produced entirely by an external force; little or no voluntary muscle contraction
PROM
What are some examples of external forces?
gravity, a machine, another individual, or another part of the individual’s own body
Which type of ROM exercise is the movement of a segment within the unrestricted ROM that is produced by active contraction of the muscles crossing the joint
AROM
Which type of ROM exercise is a type of AROM in which assistance is provided manually or mechanically by an outside force because the prime mover muscle need assistance to complete the motion
AAROM
What is an example of an AAROM
over the door pulleys, shoulder exercises with a dowel rod
What are the indications of PROM
acute, inflamed tissue, when a patient in not able or supposed to actively move a segment of the body because of surgery, best rest, comatose, or paralysis
True or False AROM is beneficial in a region where there is acute or inflamed tissue
False, it would be detrimental. PROM is beneficial
What is the main goal of PROM
Decrease complications that can occur with immobilization
What are the indications of AROM/AAROM
When a patient is able to contract muscles with or without assistance.
Types of ROM- _____ should be started on weak muscles then progress to full ____ as patient is able
AAROM; AROM
Types of ROM- If a patient has a segment immobilized, ______ is used on the segments above and below to maintain mobility
AROM
What are the goals of AROM/AAROM
Maintain elasticity and contractility of muscles, provide sensory feedback from muscles and for bone and joint integrity, increase circulation/prevent thrombus, develop coordination and motor skills
ROM exercises- Limitations of ______ are that it does not prevent atrophy, does not increase strength or endurance, and does not assist with circulation
PROM
ROM exercises- Limitations of _____ are that is does not maintain or increase strength, and it does not develop skill or coordination except in the movement patterns used
AROM
What are two contraindications of ROM exercises
- If the movement is disruptive to the healing process 2. If patient response of the condition is life-threatening
What are the signs that too much or the wrong ROM exercise is being used
increased pain or inflammation
When can the progression from PROM to AROM be made?
once healing restrictions from injury or surgery are gone or once light muscle activation is not painful to the patient
When can the progression from AAROM to AROM be made?
when the patient is able to tolerate less assist from self or device being used for AAROM. It is usually easy for the patient to judge their own tolerance
When progressing from one ROM exercise to another, the patient may be required to do _____ initially and slowly _____ reps back up
less; increase
_____ ______ is any form of active exercise in which dynamic or static muscle contraction is resisted by an outside force applied manually or mechanically
Resistance Exercise
Resistance exercise is an essential element for rehab of persons with impaired ______ _______
muscle performance
What does muscle performance refer to?
the capacity of a muscle to do work
What is the definition of work
force x distance
What are 3 Key elements of muscle performance
strength, power, and edurance
What is the ability of a contractile tissue to produce tension and a resultant force based on the demands placed on the muscle
Strength
What is the ability of the neuromuscular system to produce, reduce, or control forces, contemplated or imposed, during functional activities, in a smoot, coordinated manner
functional strength
What is the systematic procedure of a muscle or muscle group lifting, lowering, or controlling heavy loads for a relatively low number of repetitions over a short period of time
strength training
What is defined as work produced by a muscle per unit of time or the rate of performing work
power
what is the equation for power
force x distance/time
The relationship of force and velocity are factors that affect ____ ____
muscle power
In terms of power training, ____ _____ is a necessary foundation for developing muscle power
muscle strength
The (greater/lesser) the intensity of exercise and the (longer/shorter) the time period taken to generate force, the greater the muscle power
greater; shorter
What is the ability to perform low-intensity, repetitive, or sustained activities over a prolonged period of time
endurance
True or False: Strength and muscle endurance are always correlated with each other
False, some people are very strong and can over come a force but they can’t do it over a longer period of time
What is characterized by having a muscle contract and lift or lower a light load for many repetitions or sustain a muscle contraction for an extended period of time
endurance training
True or False: Many patients with impaired muscle performance have seen a greater impact from resistance training over strength training
true
what are the three principles that guide resistance training
- Overload principle 2. SAID principle 3. Reversibility Principle
Which principle of resistance training states that If muscle performance is to improve, the muscle must be challenged to perform at a level greater than that to which it is accustomed
overload principle
Which principle of resistance training states If the demand remains constant after the muscle has adapted, the level of muscle performance can be maintained but not increased.
overload principle
What does the application of the overload principle look like
Focus on the progressive loading of the muscle by manipulating the intensity or volume of the exercise
What is the definition of intensity
how much weight is imposed on the muscle
What is the definition of volume
encompasses variables such as repetitions, sets, or frequency of exercise
In a strength program, how is the overload principle applied
the amount of resistance applied to the muscle is incrementally and progressively increased
During endurance training, how is the overload principle applied
more emphasis on increasing the time a muscle contraction is sustained or increase the number of reps rather than increasing resistance
What are the precautions of the overload principle
It must be applied in context to a persons age, pathology, stage of healing, fatigue, and ability of the patient. The muscles must also be given time to adapt to increased demands before load or reps are increased again
What does SAID stand for
specific adaptations to imposed demands
The said principle is an extension of which law
Wolff’s law
What is Wolff’s law
Body systems adapt over time to stresses placed on them
Which principle of resistance training helps the therapist determine the exercise prescription and which parameters of exercise should be selected to create specific training effects that best meet specific functional needs
SAID principle
Which principle of resistance training is highly specific to the training method employed and always emphasizes task specific practice
SAID principle
How does the SAID principle have effects on transfer or training relating to strength and endurance
Strength is good for endurance athletes, but endurance is not always helpful for strength athletes
Which resistance exercise principle states that changes made through strength/endurance training are short-lived unless training-induced changes are used regularly for functional activities or unless individuals participate in a maintenance program of resistance exercise
Reversibility principle
Which resistance exercise principle relates to the statement “If you don’t use it, you lose it”
Reversibility Principle
When does detraining begin after sopping a resistance exercise program?
within a week or two after stopping it
What are some factors that can affect the muscle’s ability to develop and sustain tension?
energy stores, fatigue, recovery from exercise, age, gender, and cognitive status
What is the diminished response of muscle to a repeated stimulus and reflected in the progressive decrease in the muscle’s ability to fire
Muscle fatigue
What are signs of fatigue
discomfort or pain, tremors in contracting muscle, jerky active movements, inability to complete the movement, and a decline in peak torque
_____ time for recovery from exercise is a must with every resistance program
adequate
Light exercise may aid in recovery of resistance training, most likely due to _____ and _____ influences
neural and circulatory
A precaution of recovery from resistance training is that long term improvements in muscle performance is only achieved if the patient is allowed _______ time to recover from fatigue
adequate
Alignment, stabilization, dosage, mode, velocity, periodization, and integration of exercise are considered _______ of resistance exercise
determinants
Why is alignment and stabilization an important determinant of resistance exercise
To strengthen a specific muscle effectively and avoid substitute motions, appropriate positioning of the body and limb is essential
____ is the amount of resistance imposed on the contracting muscle during each repetition of an exercise
intensity
____ is the summation of the total number of repetitions and sets of a particular exercise during and single exercise session multiplied by the resistance used.
volume
True or false: The order of exercises during a session can have an impact on muscle fatigue
true
What is the order resistance exercise should be in to control fatigue?
Large muscle groups before small multi joints before single joints higher intensity before lower intensity
What are the two factors that frequency of resistance training is dependent on
intensity and volume
The total number of weeks or months during which a resistance exercise program is carried out is _____
duration
____ ____ is a critical element, necessary to allow time for the body to recuperate from the acute effects of exercise associated with muscle fatigue or to offset adverse responses such as muscle soreness
rest interval
What is the term that refers to the form of exercise, type of contraction, and manner its carried out
modes of exercise
Modes of exercise for resistance training should mimic _____ ______
functional activity
What is the velocity of exercise
the speed at which muscles contract that affects muscle tension, muscular strength, and endurace
_____Builds systematic variations in exercise intensity and repetitions, sets, or frequency at regular intervals over a specified period of time
periodization
What are the different types of resistance exercises
Manual, mechanical, isometric, dynamic, DCER,, isokinetic, open chain, closed chain
Which type of resistance exercise involves resistance that is provided by a therapist
Manual resistance
Manual resistance is useful in the (early/late) stages of exercise program
Early
Which type of resistance exercise is a form of active-resistive exercises in which resistance is applied through the use of equipment or mechanical apparatus
Mechanical resistance
Mechanical therapy is useful when resistance necessary is (greater/lesser) than what therapist can apply manually
greater
Isometric exercise is also called a _____ exercise
static
Which type of resistance exercise is a static form of exercise in which a muscle contracts and produces force without noticeable change in length of muscle and without visible joint motion
Isometric exercise
Which type of resistance exercise includes holding against a force applied manually, holding a weight in a particular position, pushing or pulling an immoveable object
isometric
What are the three categories of isometric exercises
- muscle setting 2. stabilization 3. Multi-angle isometrics
Muscle setting in isometrics 1. (high/low) intensity contraction 2. (some/none) appreciable resistance 3. (does/does not) improve strength
- low 2. none 3. does not
Why are isometric exercises used to treat?
decrease pain and spasm, promote relaxation and circulation
What is the term that is used to develop a sustained level of co-contraction to improve posture or dynamic stability of a joint by means of mid-range contractions against resistance in antigravity and WB positions when allowed
stabilization isometrics
