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KNAT 522 > Exam 3 > Flashcards

Exam 3 Flashcards

1
Q

what makes up a motor unit

A

nerve (motor neuron aka efferent)
muscle fibers

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2
Q

what are the filaments within the sarcomere

A

actin and myosin

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3
Q

small contractile units

A

sarcomeres

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4
Q

sliding filament theory

A

-action potential causes myosin heads to flex and create cross bridges with actin
-myosin pulls actin toward sarcomere center
-H-band becomes smaller
-Z discs move toward center
-changes in sarcomere length

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5
Q

I-bands

A

contains actin

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6
Q

A-band

A

contains myosin

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7
Q

action potential sequence

A
  1. action potential is released to trigger nerve response at motor end plate
  2. release of Ach at motor end plate initiates muscles response
  3. Ca+2 ions released from SR
  4. Ca+2 ions bind to troponin to slide tropomyosin away from actin binding sites
  5. extended myosin heads attach to actin’s binding sites, creating cross-bridges
  6. myosin contact with actin causes hydrolysis of ATP to ADP and phosphate, producing energy
  7. ADP releases from myosin heads creating “power stroke” as myosin heads move back to uncocked position while attached to actin
  8. new ATP attaches to myosin, detaching myosin from actin
  9. Ca+2 releases from troponin and re-enters SR
  10. tropomyosin covers actin binding sites
  11. sarcomeres returns to proactivity conditions
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8
Q

4 whole muscle functions

A

produce movement
maintain posture
stabilize joints
generate body heat

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9
Q

characteristics of type 1 muscle fiber

A

slow
small
red
greatest resistance to fatigue
lots of mitochondria
high oxidative capacity
oxidative system
endurance/aerobic activity

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10
Q

characteristics of type 2A muscle fibers

A

fast
larger
white
moderate to fatigue
high oxidative capacity
ATP-PC system
high-intensity activity less than 2min

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11
Q

characteristics of type 2B muscle fibers

A

fastest
largest
white
fatigue easily
minimal mitochondria
glycolytic system
max-intensity bursts, less than 30 sec

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12
Q

muscle strength

A

max force a muscle or muscle group can exert
determining factors: genetics, gender, exercise, neural recruitment, lifestyle, muscle fiber type

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13
Q

power

A

strength applied over a distance for a specific time (P = Fxd/T)

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14
Q

components of power

A

strength
speed
coordination
movement efficiency
timing

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15
Q

muscle endurance

A

ability to perform repeated contractions against less than max load

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16
Q

determining factors of muscle endurance

A

energy system used (type 1 recruited first then type 2 if enough stimulation)
quantity of force resisted

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17
Q

T/F endurance is inversely proportional to force intensity

A

true

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18
Q

strength is developed through

A

low reps with high resistance

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19
Q

endurance is developed through

A

high reps with low resistance

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20
Q

rest for strength

A

longer rests between sets and reps

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21
Q

rest for endurance

A

shorter rest periods

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22
Q

sources of muscle fatigue

A

neural system (out of Ach to use)
energy system (out of ATP)
sarcoplasmic reticulum (runs out of Ca+2)

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23
Q

T/F according to the sliding filament theory, action potential causes actin heads to flex and create cross-bridges with myosin filaments

A

false

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24
Q

what fiber type uses oxidative energy system

A

type 1 muscle fibers

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25
Q

T/F efferent input provides afferents response

A

false

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26
Q

force production determinants

A

joint angle
muscle length
muscle size
fiber arrangement
speed of contraction
numbers and type of fibers

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27
Q

muscle fiber recruitment

A

-recruits small (type 1 or 2a) for low intensity and before large (type 2b)

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28
Q

monoarticular muscles

A

recruited before biarticular muscles during low-level activities
-cross only 1 joint ex: vastus medialis
-provides the force

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29
Q

biarticular muscles

A

control direction of movement during joint motion
-cross over 2 joints ex: rectus femoris
-provides control over movement

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30
Q

static/isometric definition

A

tension is produced in the muscle without change in muscles length

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31
Q

advantages of isometrics/statics

A

-early in rehab
-low joint stress
-can be used with weak muscles

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32
Q

disadvantages of isometrics/statics

A

-strength gains isolated to minimal joint angles (not going thru full ROM)
-valsalva maneuver can occur more easily with other exercises

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33
Q

for optimal strength gains to occur the muscles effort must be at

A

66% to 100% of its max output

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34
Q

dynamic definition

A

implies that a change in muscles position occurs

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35
Q

isotonic

A

change in the muscles length occurs during activity
-concentric: muscle shortens
-eccentrics: muscle lengthens

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36
Q

isokinetic

A

velocity is controlled and maintained at a specific speed of movement, but amount of resistance provided to muscles varies (requires equipment)

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37
Q

open kinetic chain activities

A

-distal segments move freely and independently of proximal segments
-produce high velocity movements
-creates shear stress in joints
-have less joint stability
-occur in normal and sports activities

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38
Q

closed kinetic chain activities

A

-distal segment is weight bearing and moves with other segments
-produce forceful movements
-create less shear stress in joints
-have more joint stability
-occur in normal and sports activities

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39
Q

how to evaluate muscle strength

A

MMT
cable tensiometers
isokinetic machines
free weight or weight machines (1RM)
grip or pinch dynamometers

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39
Q

from least active to most active ROM

A

PROM
AAROM (assisted)
AROM
RROM

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39
Q

following major surgery which of the following gradients of muscle activity would you use

A

PROM

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40
Q

when should strength exercises start

A

soon after inflammatory phase of healing and when tissue is in the proliferation phase after flexibility and mobility have been restored

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41
Q

T/F straight plane exercises are used to isolate and strengthen weak muscles

A

true
ex: 4-way ankle

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42
Q

diagonal plane exercises

A

used after weak muscles is strong to perform activity correctly

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43
Q

progression of strengthening program

A

isometrics
single plane isotonics
multiple plane isotonics
functional
performance specific

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44
Q

SNAP principle

A

specific exercises
no pain
attainable goals
progressive overload

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45
Q

SAID principle

A

Specific Adaptations to Imposed Demands
-a muscles will adapt and perform according to the demands placed upon it

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46
Q

term used to identify a tendon that presents with pain, swelling, and impaired function

A

tendinopathy

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47
Q

mechanical stress of tendons

A

repeated stress applied to tendons cause fatigue resulting in tendon failure

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48
Q

vascular supply of tendons

A

tendons lack good blood supply making them more compromised perfusion, which results in tendon failure

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49
Q

neural basis of tendons

A

chronic tendon overuse leads to disproportionate substance P neurotransmitter facilitation, promoting mast cell production

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50
Q

intrinsic factors to tendinopathy

A

age
gender
pathomechanics
genetic or acquired systemic diseases

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51
Q

extrinsic factors to tendinopathy

A

overtraining
poor equipment or training surface
excessive duration or distance
excessive increases in speed

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52
Q

tendinopathy management

A

identify cause
correct the cause
identify level of tendinopathy
use eccentric exercises early

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53
Q

T/F according to sliding filament theory, the H-band becomes larger during muscle fiber contraction

A

false

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54
Q

which type of muscle fiber is white, has moderate fiber size, and high oxidative capacity

A

type 2a

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55
Q

example of lower extremity OKC activity

A

straight leg raise

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56
Q

definition of pylometrics

A

uses quick movement of eccentric activity followed by burst of concentric activity to optimize power output (explosive movements)

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57
Q

mechanical components of pylometrics

A

contractile (sarcomeres)
noncontractile (collage, elastic)

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58
Q

neurological components of pylometrics

A

muscle spindles and GTOs

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59
Q

contractile components

A

myofibrils
-increase speed of cross bridge detachment
-number of cross bridge formations increase
-control the noncontractile components

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60
Q

noncontractile

A

muscles tendons
connective tissues

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61
Q

series elastic components

A

tendons, sheaths, sarcolemma

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62
Q

parallel elastic components

A

muscles CT

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63
Q

concentric contraction

A

muscle force comes from contractile components and stretch is applied to series elastic components (stretch the muscle = stretch the tendon)

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64
Q

eccentric contraction

A

series and parallel components resist the muscle movement as muscle elongates
-contractile components controls speed and quality of movement

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65
Q

eccentric movements produce a stretch or

A

myotatic reflex (aka monosynaptic reflex)

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66
Q

what inhibits muscle activity

A

GTOs
-as muscle shortens the GTOs send signals to spinal cord to limit force production

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67
Q

3 phases of pylometrics exercises

A
  1. eccentric or lengthening phase where the muscle is prestretched
  2. amortization of transition phase amount of time it takes to change from eccentric to concentric
  3. concentric or shortening phase to produce the powerful output
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68
Q

pre-pylometric consideration

A

certain levels of strength, flexibility, and proprioception

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69
Q

intensity of pylometrics

A

-magnitude of effort applied during activity (stress)
-can change increased weight, height, distance, speed

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70
Q

volume of pylometrics

A

quantity of work (setsxreps)
depends on intensity and goals

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71
Q

recovery of pylometrics

A

-amount of rest determines if exercise will be more effective at improving power or endurance
-short = endurance
-longer = power

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72
Q

how often perform pylometrics

A

rest of 48hrs in between sessions

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73
Q

plyometric considerations

A

-age: 16+
-body weight: increase stress on joint in heavy PTs
-comp level: more appropriate level of fitness for plyos over recreational PTs
-surface: shock absorbing
-footwear: supportive and shock absorbing
-proper technique
-goals

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74
Q

precautions of plyomtrics

A

time: avoid long session
DOMS due to nature of plyos

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75
Q

contraindications of plyometrics

A

-acute inflammation
-postoperative conditions
-instability

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76
Q

if you are focusing on endurance, which of the following activity to rest ratios should you use

A

1:2

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77
Q

which of the following best describes the proper landing technique for plyometric activities

A

land on midfoot

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78
Q

functional exercises

A

-before performance-specific
-involve multiplanar activities, increased stressed and demands
-common across different sports

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79
Q

performance-specific exercises

A

-mimic tasks found within the sport
-move PT toward safe return to sport
-include exercises and skill drills

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80
Q

assessment of the PTs ability to perform an exercise or skill drills safely and accurately before being allowed to advance to next level

A

performance evaluation

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81
Q

early to middle program goals

A

-attain full functional levels of flexibility, strength, endurance, and coordination
-achieve full functional ability so normal speed, power, control, and agility are restored

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82
Q

late program goals

A

-restore PTs self confidence in their performance and confidence in injured part
-RTP safely and efficiently

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83
Q

considerations for basic to final phase therapeutic exercise

A

-normal motion
-multifaceted muscle activity
-multiplanar motion and multiple muscle group performance
-stabilization and acceleration changes
-proprioceptive stimulation
-agility and power development
-performance-specific skill development
-confidence development

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84
Q

what is the transition parameter for function or performance specific

A

proprioception

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85
Q

precautions to functional and performance specific

A

-explain the exercise to the PT
-avoid pain and swelling
-understand tissue integrity and healing process
-know their confidence level
-be aware of progression tolerance

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86
Q

step by step evaluation determines when the PT should advance to next stage in functional exercise program

A

final evaluation
-determine if PT is ready to RTP

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87
Q

final functional eval

A

-occurs before PT is allowed to RTP
-highly individualized
-based on specific demands to be placed on PT upon RTP
-should be as objective as possible

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88
Q

RTP participation steps

A
  1. acute S&S of injury are resolved, no pain or edema present
  2. PT has full ROM, normal strength, endurance, cardio endurance, proprioception, agility, coordination in relation to performance skills
  3. PT performs all activities as they could prior to injury
  4. PT has confidence in ability and ability of injured area without hesitation or doubt
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89
Q

performance specific progression would most likely occur in which phase of healing

A

maturation/remodeling

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90
Q

T/F performance specific exercises are multiplanar activities which are foundation for more specific skill activities

A

false

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91
Q

what determine progression of functional activities

A

proprioception

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92
Q

correct order of lower extremity functional progression

A

NWB -> stork standing -> dynamic -> running

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93
Q

massage characteristics

A

-collection of techniques
-muscle spasm relief may enhance lymph drainage
-mechanical energy may stretch CT
-little impact on blood flow
-may stimulate muscle repair

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94
Q

light massage

A

gate control theory explains analgesic benefits (rubbing area overrides nociceptor stimulation)

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95
Q

deep massage

A

activation of descending analgesic pathway explains relied (endogenous opiates)

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96
Q

deep friction massage

A

proposed to increase blood flow and disrupt adhesion

97
Q

myofascial release

A

activity/injury changes length-tension relationship of fascia and muscles
-gamma efferent neurons activity leads to gamma gain, trigger points, myofascial pain syndrome
-gamma activity from input of pain

98
Q

indirect myofascial release

A

place muscle/fascia in relaxed position

99
Q

direct myofascial release

A

stretch fascia to decrease stress on afferent input

100
Q

direct strain-counterstrain

A

apply force against restrictive barrier to improve motion

101
Q

indirect strain-counterstrain

A

move body away from motion-restricting barried to a comfortable position
-slowly move body segment
-hold for 90-120s

102
Q

long standing pain patterns and related to the spine

A

myofascial

103
Q

short-duration pain pattern and during tissue repair and early maturation phase

A

strain-counterstrain

104
Q

joint mobilization

A

restore joint motion, ease pain, improve willingness to move a joint
-uses convex-concave rule
-ex: restore posterior glide of talus post injury

105
Q

when a convex surface moves on a concave surface, roll and glide are in

A

opposite direction

106
Q

when concave surface moves on convex surface, roll and glide are in

A

same direction

107
Q

muscle energy

A

PT actively contracts against counterforce in a specific position
-addresses cause of pain, leads to pain relief and reduced muscle tension/guarding

108
Q

effectiveness of joint mobilizations

A

early posterior mobilization of talus may speed recovery and prevent loss of motion after lateral ankle sprain

109
Q

effectiveness of myofascial release

A

leads to improvement of 4 PTs with carpal tunnel syndrome

110
Q

effectiveness of massage

A

treat LBP, carpal tunnel, and knee osteoarthritis
-low cost, low risk

111
Q

manual cervical traction

A

-PT is supine
-clinician relaxes hands and gradually increases force to increase space between intervertebral bodies
-neck position: neutral for upper spine, flexion for lower spine, side-bending to relieve spinal nerves
-break pain-spasm cycle

112
Q

mechanical cervical traction

A

continuous or intermittent setting
15-25lbs
20-30min
-may relieve pain from intervertebral disc herniation or stenoiss

113
Q

precautions for cervical traction

A

-use manual traction for those with history of cervical spinal injury
-head positioning may compromise vertebral arteries (risk of stroke)

114
Q

contraindications for cervical traction

A

-acute injury
-suspected dens fracture
-osteoporosis and RA

115
Q

lumbar traction characteristics

A

-relieve pressure on spinal nerves
-used for disc injury (lie prone with extension)
-harness hugs above iliac crests and lower ribs
-PT positioned to decrease pain

116
Q

precautions for lumbar traction

A

-belt adjustment on very thin or obese PTs
-inability to tolerate treatment
-claustrophobia from tight belts

117
Q

contraindications for lumbar tractions

A

-pregnancy
-hiatal hernia
-advanced osteoporosis
-conditions that affect integrity of CT

118
Q

intermittent compression characteristics

A

-reduce edema and swelling
-best treatment of persistent swelling and wounds from venous insufficiency
-game ready and normatec

119
Q

considerations of intermittent compression

A

-setup time is time consuming
-PT not actively engages
-pain free active exercises may better assists lymph drainage

120
Q

contraindications of intermittent compression

A

-healing fractures
-gross joint instability
-infection
-thrombophlebitis
-pulmonary edema
-congestive heart failure

121
Q

effectiveness of traction

A

high vs low dose
-reduce cervical spine pain and radicular symptoms

122
Q

effectiveness of intermittent compression

A

comparison of modalities, decrease lower limb and hand edema, effusion post ankle sprain

123
Q

pain relief from light massage may be explained by what

A

gate control theory

124
Q

what is the on time for intermittent compression

A

30-40 seconds

125
Q

sacroilium and pelvis create a

A

closed sacroiliac ring

126
Q

3 lever points that attach to the pelvis

A

spine
2 legs

127
Q

what makes up the lumbopelvic-hip complex

A

pelvis
sacrum
lumbar vertebrae
hip joints

128
Q

dsyfunction

A

lack of stabilization; cause of back and pelvic pain

129
Q

stabilization

A

important in relieving pain and in transmitting forces

130
Q

form closure (SI)

A

-pelvic ring stability provided by joint shape and structure
-reduced with ligament or bone injury/changes

131
Q

force closure (SI)

A

-stability provided by dynamic forces on pelvic
-reduced with muscle (core) injury

132
Q

neuromotor control (SI)

A

-proper activation and sequential recruitment of muscles
-dysfunctional recruitment following injury

133
Q

what makes up the box of the core

A

diaphragm = top
pelvic floor = bottom
paraspinals and gluteals = sides and back

134
Q

ability to maintain and control proper SI positioning to provide trunk stability with correct movement of the pelvic and lower extremities

A

lumbopelvic stabilization

135
Q

what makes up the inner core (deep muscles)

A

transverse abdominis
diaphragm
pelvic floor muscles
internal oblique

136
Q

what makes up the outer core (superficial muscles)

A

erector spinae
rectus abdominis
external oblique
gluteal muscles
thoracolumbar fascia (QL and lats)

137
Q

trunk movers are

A

global muscles (large muscles)

138
Q

trunk stabilizers are

A

local muscles (smaller muscles)

139
Q

pelvis is stable when it is

A

pelvic neutral

140
Q

abdominal hollowing

A

-abdomen drawn in to facilitate transverse abdominis and multifidus
-does not activate outer core muscles (stabilizing)

141
Q

abdominal bracing

A

-abdominal and back muscles activate to co-contract (isometric contraction)
-activates outer core muscles
-provides greater pelvic and spinal stability

142
Q

multifidus is activated when

A

the transverse abdominis is activated
-causes LBP
-palpated when PT is able to relax erector spinae

143
Q

combining local and global muscles

A

maintain pelvic neutral and recruitment of core stabilizers while performing functional and performance specific activities

144
Q

early rehab core exercises

A

dead bug
bird dog
goal: recruit core muscles during simple extremity motions while holding proper neutral position

145
Q

purpose of muscle energy treatment techniques in pelvis and SI

A

relieve barriers and restore balance

146
Q

when identifying SI pathology what should you do first

A

investigate posture, alignment, and lumbar ROM

147
Q

movement test

A

-identifies differences in movement between R and L SI sides
-identify presence of SI dysfunction or side of a lesion

148
Q

standing forward bend test

A

-aka Piedallus test
-identifies side of lesion
-positive test is when one thumb either does not move or moves up (both thumbs should move down)

149
Q

kinetic test

A

-aka Gillet or one-leg stork
-identifies side of SI or IS dysfunction
-positive test: thumb does not move down

150
Q

alignment tests for SI

A

passive and used to identify malalignment and reproduce pain
-leg-length, IC height, ASIS height, ASIS to umbilicus

151
Q

PSIS and Sulci tests

A

positive when one side is deeper than other
-examines levels of PSIS and sulci

152
Q

inferior lateral angle test

A

positive when one side is more posterior and test produces pain

153
Q

sacrotuberous ligament test

A

positive when one side is looser than other

154
Q

SI joints provide a load transfer between

A

spine and lower extremities

155
Q

core activation and stabilization steps

A

-find and maintain pelvic neutral
-abdominal hollowing exercises to recruit transverse abdomnis
-abdominal bracing to activate local and global muscles
-engage abdominal bracing while performing simple ADLs
-engage abdominal bracing while performing sport/work specific tasks

156
Q

nutation

A

proximal sacrum (base) moves into anterior tilt relative to ilium

157
Q

counternutation

A

posterior tilt of sacral base relative to the ilium

158
Q

during lumbar flexion what occurs

A

-sacrum rotates posterior to ilia (counternutates)
-ischial tuberosities move closer together
-iliac crests move apart

159
Q

what occurs during nutation

A

-sacral base moves forward and downward
-IC move closer together
-ischial tuberosities move further apart

159
Q

what occurs during counternutation

A

-sacral base moves backward and upward
-IC moves further apart
-ischial tuberosities move closer together

160
Q

bilateral hip flexion

A

anterior pelvic tilt
-sacrum moves into counternutation

161
Q

bilateral hip extension

A

posterior pelvic tilt
-sacrum moves into nutation

162
Q

what axis does the pelvis rotate on

A

diagonal axis

163
Q

sacral flexion injury

A

MOI: bending and twisting activities, push-pull activities
-common on left side (L sulcus is deeper and L ILA more posterior)
-may feel a pop
-treatment: PT is prone, clinician lifts quad off table and presses on sacrum
-at home: both knees to chest

164
Q

forward torsion injuries

A

-sulci are symmetrical after moving into sphinx position
-most common SI injury (L side)
-MOI: bending with twisting, getting out of car quickly
-pain in back, butt, legs
-one side of sacrum is twisted on other
-at home: chest is prone on table and twist hips so knees are off table (same as treatment)

165
Q

backward torsion injury

A

-sulci becomes deeper after moving into sphinx position
-MOI: sudden bending and twisting
-pain with extension, pain in low back and butt
-treatment: bend over on table and PT slowly walks up as clinician pressures on sacrum
-at home: press ups or standing trunk extension

166
Q

anterior iliac subluxation: upslip

A

-always occurs on R
MOI: fall on butt or step off a curb
-pain on L side, low back, coccyx
-R leg shorter, R IC higher, R sacrotuberous ligament is slack
-treatment: pull R leg while prone

167
Q

posterior iliac subluxation: upslip

A

-occurs only on L
-MOI: fall on butt or step off curb
-L leg shorter, L IC higher, L sacrotuberous ligament is slack
-treatment: pull let while supine

168
Q

anterior iliac rotation

A

-aka anterior innominate lesion
MOI: occurs with other lesions
-IC is low on involved side, ASIS low, PSIS high
-cervical or lumbar symptoms
-treatment: PT prone and involved leg off table and they resists hip flexion (knee is flexed)
-at home: pelvic tilt and knee to chests

169
Q

posterior iliac rotation

A

-aka posterior innominate lesion
-MOI: after a fall or sudden hamstring contraction
-antalgic gait with reduced hip extension on involved side, pain in butt or knee
-ilium posteriorly rotated, ASIS, PSIS, and IC high on involved side; short leg on involved side
-treatment: prone hip extension
-at home: press ups and hip flexor stretches

170
Q

pubic subluxation

A

-superior: isometric hip flexion
-inferior: isometric hip extension
-isometric abduction and adduction
(fixes leg length differences)

171
Q

inflares and outflares

A

-inflare: distance from ASIS to umbilicus is short on affected
-outflare: distance from ASIS to umbilicus is greater on affected
-common in soccer
MOI: falling on IC or direct blow
-groin, leg, hip pain
-treatment: isometric hip adduction (inflares), hip flexion, adduction, medial rotation at same time (outflares)
-at home: inflares same as treatment; outflares same

172
Q

program considerations for SI and pelvis

A

-LBP and hip should be address to eliminate sites of referred pain
-use with hip strengthening and flexibility exercises
-include core exercises, strength, function training for mainenance of pelvic neutral, agility

173
Q

vertebral artery insufficiency S&S

A

dizziniess
lightheadedness
nausea
blurry vision
tinnitus
headaches
facial sensory deficiencies

174
Q

cervical joint mobs

A

-distraction: aka traction
-central posterior-anterior: apply pressure to spinous process
-unilateral PA: apply pressure to transverse process and move side to side

175
Q

thoracic joint mobs

A

-central PA: spinous
-unilateral PA: transverse
-unilateral costovertebral PA: apply pressure where the ribs connect to the vertebrae

176
Q

lumbar joint mobs

A

-central PA: spinous
-unilateral PA: transverse
-rotation: rotate the transverse processes of the lumbar or they can rotate themselves

177
Q

how long should a stretch be held for

A

30 seconds and only once

178
Q

what is required for good posture

A

core support

179
Q

what is necessary for full spinal recovery

A

good posture and mechanics

180
Q

must have endurance for back health

A

local muscles

181
Q

must have strength for back health

A

global muscles

182
Q

types of strengthening exercises for the spine

A

aquatic
swiss-ball
foam roller
weights: dumbbells, pulleys, machines, med balls

183
Q

basic principles of agility and coordination exercises for the spine

A

-start once strengthening exercises are mastered
-include trunk rotation and plyometrics that involve higher forces, quicker movements, and functional multiplane motions
-pelvic stability should be maintained
ex: resisted leg lifts and med ball exercises (Russian twists)

184
Q

problems associated with LBP

A

-reduced proprioception
-reduced muscle endurance
-lack of muscle coactivation
-delayed core muscles recruitment
-hip muscle imbalances
-reduced trunk stability
-muscle coactivation reduces pain

185
Q

LBP treatment program

A

-addresses all the problems
-pelvic neutral
-soft-tissue mobilization
-joint mobs
-proprioceptive, strength, endurance exercises
-functional and performance-specific exercises in pelvic neutral

186
Q

William’s flexion exercises

A
  1. sit up in a flexed knee position to strengthen abs
  2. pelvic tilt to strengthen gluteal muscles
  3. single knee to chest and double knee to chest to stretch erector spinae
  4. seated reach to the toes with knees extended to stretch erector spinae and hamstrings
  5. in quadruped position with 1 knee forward under chest and other hip and knee in extension to stretch TFL and iliofemoral ligament
  6. starting in standing and moving to full squat to strengthen quads
187
Q

McKenzie back program

A
  1. lie prone for 5 min
  2. lying prone with elbows under shoulders for 5 min
  3. prone press-up position; prone with elbows extended out in front of you
  4. standing trunk extension
  5. seated cat cows/ slouch to upright
  6. double knee to chest
188
Q

integrated rehab program for the spine

A

-PTs are active
-early use of modalities
-use manual techniques, exercises, and education
-pelvic neutral
-proper posture and body mechanics
-correction of deficiencies

189
Q

causes of upper and lower crossed syndromes

A

-poor postural habits
-muscle imbalances: tight and lengthened muscles

190
Q

tight muscles of upper crossed syndrome

A

upper trap
levator scapulae
pec

191
Q

lengthened muscles of upper crossed syndrome

A

deep cervical muscles
serratus anterior
rhomboids
middle and lower trap

192
Q

tight muscles of lower crossed syndrome

A

hip flexors and back extensors

193
Q

lengthened muscles of lower crossed syndrome

A

abdominals and gluteals

194
Q

posture characteristics of upper crossed syndrome

A

forward head
rounded shoulders
upper cervical spine lordosis
thoracic kyphosis

195
Q

posture characteristics of lower crossed syndrome

A

lumbar lordosis
protruding abdomen
anterior pelvic tilt
hip flexion
knee hyperextension

196
Q

how to treat crossed syndromes

A

-multifactorial approach
-PT education
-soft tissue and joint treatments
-postural changes
-stretching and strengthening exercises
-changing habits

197
Q

common spine injuries that require rehab

A

-sprains and strains
-spondylosis
-spondylolysis
-spondylolisthesis
-disc lesions
-microdiscetomy
-spinal fusion
-facet injuries
-TOS

198
Q

rehab progression for the spine

A

-perform a thorough exam
-establish a problem list
-establish goal list
-create treatment program (manual and corrective exercises)
-know injury precautions
-reassess and change program periodically
-move through short to long term goals

199
Q

cervical and upper thoracic spine rehab inclusions

A

-core exercises
-posture correction
-all neck and scapular muscles
-lumbar spine

200
Q

lumbar and lower thoracic spine rehab inclusions

A

-core exercises
-posture correction
-hip strengthening
-lats strengthening

201
Q

Fryett’s first law

A

-regards normal vertebral coupled motions
-when lumbar or thoracic spine is in neutral, side-bendings occurs to opposite side of that vertebral levels rotation

202
Q

Fryett’s 2nd law

A

-regards pathological coupled motions
-when spine is in either flexion or extension (out of neutral), side-bending and rotation of the vertebrae will be towards the same side

203
Q

Fryett’s 3rd law

A

-regards total available spinal coupled motions
-if motion of the spine occurs in one plane (side-bending or rotation), motion in other plane is diminished

204
Q

facet dysfunctions

A

-identify positional dysfunction (position in which it is stuck in) and motion restriction (unable to move into it)
-open vs closed
-left vs right

205
Q

TOS treatment program

A

-symptom control via modalities and position instruction
-soft-tissue mobilization of the cervical spine and scapular movements
-improve joint mobility of first rib
-cervical and thoracic spine mobilization
-flexibility and strengthening, once inflammation has subsided
-correction of posture and body mechanics
-breathing instructions

206
Q

what is a common site for a lumbar area trigger point

A

QL

207
Q

what is the final progression of the dead bug exercise

A

stabilization with arm and unsupported leg movement

208
Q

the McKenzie back program can be used for what

A

postural syndromes

209
Q

where is glycogen stored

A

mitochondria

210
Q

during conditioning a volleyball player uses 10lb weight for a elbow curl, his biceps work harder when

A

muscle contracts concentrically

211
Q

you are helping a sprinter to work in improving his power, you know that one way to facilitate the muscle spindles in his quads is to have him

A

stretch quads immediately before sprints

212
Q

which factor provides a muscles additional force during eccentric contractions

A

series elastic components and parallel elastic components contribute to overall tension development

213
Q

true statements regarding plyometric exercises

A

-plyometrics use quick movements of eccentrics followed by burst of concentric to optimize power output
-with eccentric contraction, the speed of cross-bridge detachment increases
-short neurological pathway of the muscle spindles action is relied upon for force production

214
Q

microscopic tears of tendon caused by repeated trauma

A

tendinosis

215
Q

most importnat treatment element in dealing with tendinopathy is

A

identifying and relieving the cause

216
Q

a max isometric contraction can be sustained for how many seconds before fatigue becomes evident

A

5-10s

217
Q

ultimate goal of plyometrics

A

increase power production

218
Q

T/F a normal functional activity is usually performed in a therapeutic exercise program before plyometric

A

false

219
Q

T/F final evaluations prior to returning to activity can be generally subjective

A

false

220
Q

an example of an advanced functional activity for a baseball pitcher

A

throwing a med ball

221
Q

T/F functional testing may include running, jumping, or agility, tests for time or distance

A

true

222
Q

to distract the lower region of the cervical spine, the neck should be placed in

A

flexion

223
Q

what are advanced skills needed for performance-specific exercises

A

speed and control

224
Q

performance specific progression would most likely occur in which phase of healing

A

maturation/remodeling

225
Q

T/F during functional activities, muscles act as stabilizers, accelerators, or decelerators

A

true

226
Q

T/F all PNF extremity movements incorporate rotation and diagonal patterns

A

true

227
Q

indirect release techniques are most likely to

A

decrease gamma gain

228
Q

T/F it is better to overestimate an athletes ability to withstand functional stresses than to underestimate it

A

false

229
Q

contraindications for joint mobs

A

advance osteoporosis
bone to bone end feel
infection

230
Q

long term goals should include

A

RTP

231
Q

pelvic neutral is

A

-one of first positions taught to PT with a weak core
-position in which spine should always be placed

232
Q

T/F SI joint has no motion

A

false

233
Q

an example of a coupled motion occurs when the pelvis moves into a posterior tilt and

A

the hips flex

234
Q

which of the following is a mechanism for backward torsion of SI joint

A

bending and twisting activities

235
Q

T/F muscle energy on the SI joint uses a mild resistance to realign joint segments

A

true

236
Q

the kinetic test could be used to identify

A

SI dysfunction

237
Q

T/F pelvic floor muscles provide pelvic stabilization because of their transverse arrangement in the pelvis

A

true

238
Q

a prone plank exercise strengthens

A

abdominal muscles

239
Q

muscle of the outer core

A

external oblique

240
Q

an SI standing forward bend test indicated

A

side of lesion

KNAT 522 (6 decks)

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