Exam II Flashcards
1
Q
What type of exercises were used to treat spinal stenosis that biased flexion of the spine?
A
-Williams exercises
2
Q
What was an issue with williams exercises?
A
-they lead to disc herniations
3
Q
What exercises were used to treat radicular symptoms that emphasized extension of the spine?
A
-Mckenzie exercises
4
Q
what was an issue with mckenzie exrcises?
A
-the did not treat the deep stabilizers of the spine
5
Q
What was used to teach proper posture, body mechanics, posture and sleeping postures?
A
-Back schools
6
Q
what was an issue with back schools?
A
-They were too general
7
Q
What is neutral spine?
A
-A position of ROM of the spine that is defined by the patients signs and symptoms, pathology and restrictions
8
Q
What is muscular fusion?
A
-utilizing co-contractions of the deep abdominals, and multifidus to hold the spine in nuetral
9
Q
Where is all movement centered?
A
-The lumbopelvic hip complex
10
Q
Why is spine stabilization surgery important?
A
-Important for posture and balance, increases force production, increase neuromuscular efficiency, and to treat and prevent LBP
11
Q
What muscles are crucial in providing lumbar spine stabilization?
A
-Multifidi, internal obliques and transverse abdominis
12
Q
What muscles dominate and attempt to stabilize the spine when there is dysfunction?
A
-Erector Spinae
13
Q
Why is it an issue when the erector spinae attempt to stabilize the spine?
A
-the are not tonic muscle and not designed to be active all of the time, guarding bound to occur
14
Q
Why aren’t global muscle efficient?
A
-They do not provide segmental stability
15
Q
What happens if you do not train local muscles?
A
-They will be shut down because of the use of global muscles
16
Q
What is the action of the lumbar multifidus?
A
- Back extension when they fire bilaterally
- contralateral rotation when they fire unilaterally
17
Q
What are the first muscles to become weak?
A
-Multifidus
18
Q
How else can the multifidi be affected by back dysfunction?
A
-They can have delayed activation, atrophy (have fatty infiltration) and hange from type I to type II fibers
19
Q
To maintain posture how to the multifidi fire?
A
-Bilaterally
20
Q
What is the deepest abdominal muscle?
A
-Transverse abdominis
21
Q
What is the action of the transverse abdominis?
A
-compression, protection and support the abdomen
22
Q
What is the first muscle to be activated when there is an unexpected loading of the spine?
A
-transverse abdominis
23
Q
How are the transverse abdominis affected by low back pain?
A
-they are no longer recruited first, and global muscle will be recruited first
24
Q
What muscle is just superficial to the transverse abdominis?
A
-internal obliques
25
What produces the greatest stabilizing effect of the spine?
-The internal obliques and transverse abdominis increasing intrabdominal pressure to stabilize the spinal
26
When a person is not injured, what is neutral spine?
-A position in which a vertical force exterted through the spine allow equal weight transference on all weight bearing surfaces
27
When a person is injured, what is neutral spine?
-the position in which the patient is most asymptomatic, can produce the most force and maintain posture and agility
28
What position should you use to train a person experiencing lower back pain?
-The position in which they do not experience pain
29
What can back pain decrease?
-Agility
30
What is a technique used to train co contraction of the deep stabilizers?
-Abdominal drawing
31
Training the deep stabilizers in a prone or quadraped position inhibits what muscle?
-Rectus abdominis
32
When using the abdominal drawing technique, what compensations should you look for?
-depression of the ribcage, and lateral flaring of the waist
33
When using a BP cuff to provide feedback, how much change in mmHg is okay?
-6-10
34
What type of load and duration dosage should you use to train the deep stabilizers?
-Low load, long duration
35
What type of contraction should you use to train the deep stabilizers?
-Isometric
36
What percent contraction do you need to train the deep stabilizers?
-1-25%
37
What else should you train to avoid LBP and injuries?
-Proprioception and agility
38
Why is agility and proprioception important in LBP rehab?
-They are needed to resspond to a stimuli and change direction before injury occurs
39
What is spine stabilization training effective for?
-Decreasing pain, decreasing disability, preventing injury, speeding up recovery and avoiding surgury
40
Who is the most qualified to treat LBP?
-Physical therapists
41
What is the difference between therapeutic exercise and therapeutic activities?
-Therapeutic activities are more functional
42
What is muscle setting?
-A low intensity isometric contraction performed against little to no resistance
43
What is muscle setting used for?
-increase motor recruitment, correct muscle firing, to decrease muscle spasm, promote relaxation and circulation during the acute stage of healing, delay atrophy, and facilitate muscle firing
44
What is stabilization exercises?
-submaximal, sustained level of coconctration
45
What do stabilization exercises help with?
-improves postural stability and dynamic stability of a joint
46
what is used as resistance during stabilization exercises?
-body weight or manual resistance
47
What is a system of isometric exercise in which resistance is applied manually or mechanically at multiple joint positions within available ROM?
-Multiple-angle isometrics
48
When are mutliple angle isometrics helpful?
-When a patient has painful arc to strengthen throught the range
49
What must you do with resistance throughout ROM with multiangle isometrics?
-Change based on where you are in the range
50
Repetitive 6 to 10 second hold can help decrease what?
-Muscle cramping
51
What is the physiological overflow?
-Strengthening in one point in the range will only strengthen within 10 degrees of that angle
52
How many points should you use multiangle isometric throughout rom?
-4 to 6
53
Multiangle isometrics improve what type of strength?
-static (has little impact on dynamic strength)
54
What is a precaution for isometrics?
-Valsalva Maneuver
55
What are the contraindications of isometrics?
-Cardiac Disease, Vascular disorders,
56
What type of exercise would you use to strengthen someones hamstrings who lack deceleration during the termnial swing phase of gate?
-Eccentrics
57
What is the order of force production and mechanical efficiency for the 3 types of contraction from least to greatest?
-Eccentric, isometric, concentric
58
In what type of contraction is force production proportional to the number of units recruited?
-Concentric
59
Which contraction requires more motor unit recruitment, concentric or eccentric?
-Concentric
60
Why dont eccentric contraction require as much motor unit recruitment as concentric?
-Noncontractile component supply some resistance
61
Which contraction uses more energy, concentric or eccentric?
-Concentric
62
Which contraction creates the most DOMs?
-Eccentric
63
When should you use eccentrics?
-For improving strength, dont use post surgically
64
What is some downfall to eccentric training?
-It is more more mode specific, velocity specific, and transfer is limited
65
What principle should be used for eccentric training programs?
-Exercise should mimic function
66
What is effective in preventing DOMS?
-Submaxive exercise
67
What is the repeated bout effect?
-Once soreness is gone and the same exercise is repeated, the same soreness will not result (adaptations have occured)
68
How can you prevent DOMS with eccentric training?
-Gradually increase loads
69
What strength grade must a patient have in order to use isometrics?
-3-/5
70
What types of issues can eccentrics help treat?
-Muscle weakness, disuse, hypermobility and hypomobility
71
Eccentric training is effective in training what at lower loads than concentric?
-type II fibers
72
When should you not use eccentrics?
-When acute inflammation is present
73
What does concentric training improve that eccentrics does not?
-local circulation and capillary density
74
What type of eccentric exercises are recommended in the acute stage?
-NONE
75
What type of eccentric exercises are recommended in the sub-acute stage?
-Sub maximal at low speeds
76
What type of eccentric exercises are recommended in the settled/chronic stage?
-Max load/faster speeds
77
When should you use isokinetic eccentric exercises?
-the final stages of rehab
78
What should you dose eccentrics at for treating tendonopathy?
-3 sets for 15 reps, 2x per day, 7 days per week
79
What should you progress to to improve functionality?
-multiplanar motions
80
What type of exercises apply dynamic resistance against a constant external resistance? (4)
-Free weights, fixed cable systems, weight machines, functional movements
81
What types of exercise apply variable resistance?
-Therabands, adjustable cable systems, weight machines,hydraulic, isokinetic
82
When useing free weights, where should midrange be?
-When the arm is perpindicular to the LOG (parrallel to the floor)
83
What strength grade must a patient have to perform resistance exercise using weight length tension?
-greater than 3/5
84
When using a theraband, where does the band stop being matched to the length tension curve of the muscle?
-When it is perpindicular to the level arm
85
What two things does plyometrics combine?
-Speed and strength
86
What is the purpose of plyometrics?
-to heighten the exictability of the nervous system for improved reactive ability of the neuromuscular system
87
Any exercise that taps into the myostatic stretch reflex is called what?
-Plyometrics
88
What can plyometrics help improve?
-power and reacivity, vertical leap, jumping distance, sprint speed, prevent injury, and improve throwing reactivity/distance
89
With plyometrics, muscles around justs must first do what to produce an explosive movment?
-Stretch
90
What is the goal of plyometrics?
-To decrease the amount of time required between the yailding eccentric muscle contraction and the initiation of the over coming concentric phase
91
What is the stage between concentric and eccentric contractions?
-Amortization
92
What will shortening the amortization phase do?
-decrease the amount of energy wasted
93
What is phase 1 of plyometrics?
-eccentric/preparation stage
94
What is stage 2 of plyometrics?
-amortization/transition
95
What is stage 3 of plyometrics?
-Concentric/outcome
96
What is stage 4 of plyometrics?
-Eccentric/shock attentuation (back into preparation)
97
What is enhanced by increased the rate and force of the stretch?
-Muscle spindle stretch reflex
98
What is the energy available for the concentric phase from the eccentric phase dependent on?
-the amount of time it takes to switch from eccentric to concentric
99
How does the eccentric contraction of stage 4 of pltometrics reduce the risk for injury?
-It distributes reaction forces throughout the body
100
During prestretch, where is energy stored?
-in the SEC
101
During a concetric contraction, the energy in the SEC is move with?
-the SS
102
The ability to tap into the stored elastic energy is governed by what?
-Time, magnitude, and velocity of the stretch
103
Is power greater in a damped or undamped jump?
-undamped
104
How do damped jumps lose energy?
-Through heat
105
What is the only way a concentric contraction can be magnified?
-If the precedning eccentric contraction is short range, quick and without delay
106
What does plyometrics desensitize?
-the GTO
107
As the velocity of the stretch increases, what happens to the firing of the muscle spindle?
-It increase
108
What 3 things is the degree of muscle fiber elongation dependent on?
-fiber length, ultilmate deformation,and the ability of the spindle to elicit a response
109
What is the fiber length proportional to?
-The amount of stretching force applied to the muscle
110
What is the ultimate deformation dependent on?
-the strength of the individual muscle fibers (greater tensile strength+less elongation)
111
Lowering the sensitivity of the muslce spindle will do what to its power?
-Decrease it
112
How does increasing the speed of the stretch reflex improve physiological performance?
-increase the amount of motor units for the task
113
How does desensitiving the GTO improve physiological performance?
-by allowing a greater load to be applied to the MSK system
114
Training with a prestretch improves what?
-Nueromusclcular performance
115
Improving neuromuscular coodination improves what?
-coordination, and enhances the NS to be more automatic
116
What are the general containdications for plyometrics?
-acute inflammation, pain, immediate postop pathology, and gross instability
117
What are the specific contraindications of plyometrics?
-cartilage injuries, capsule/ligaent injuries, arthritis, bone bruises, tendon injuries or being in the acute/early subacute stages
118
What should you always begin with to evaluate if a patient can perform plyometrics?
-an orthopeadic evaluation
119
What type of surfaces should you used for plyometric training?
-resilient
120
What direction should you begin plyometrics in?
-Horizontally, then vertically
121
What should a person train before performing plyometrics?
-strength and power
122
Prior to performing LE plyometrics what should a patient be able to do?
-eccentric training while performing dynamic balance activities
123
Prior to performing UE plyometrics what should a patient be able to do?
-eccentric while performing throw/catch activities
124
How can plyometrics help cartilage?
-loads/unloads it to keep it healthy
125
How can plyometrics help collagen?
-by providing modified tension in the line of stress
126
When are plyometrics the most useful?
-At the end of a workout
127
When should you end plyometric training?
-when proper form cannot be acheived
128
What is the goal of medial-lateral loading plyometrics?
-To increase tissue tensile strength
129
When initially progressing plyometrics should you increase reps or intensity first?
-Reps
130
As you increase the intensity of plyometrics, what should you do to the reps?
-Decrease them
131
what is the goal of rotational loading?
-to increase the tensile strength of: cruciate ligaments, menisci, and the capsule
132
What is more important, the rate of the stretch of length of the stretch?
-The rate
133
When using plyometrics to improve power, what should the work to rest ratio be?
-1:3-4
134
When using plyometrics to improve endurance, what should the work to rest ratio be?
-1:1-2
135
What should you look for in the LE during the eccentric landing phase of plyometrics?
-Valgus (do not let this occur)
136
What is the key element of depth jumping?
-Proper landing
137
What is the key element of depth jumping?
-Proper landing
138
What is the utilization of water for the implementation of quality of life, fitness or general health exercise training?
-Aquatic exercise
139
What is the skilled practice of physical therapy in an aquatic environment by a PT, or PTA?
-Aquatic Physical Therapy
140
What properties of water enhance exercise and functional training for patients accross the age span with all type of conditions?
-Bouyancy support and resistance
141
What all can aquatic physical therapy help to improve?
-aerobic conditioning, andurance, balance, soordination, agility, body mechanics, posture, flexibility, gait, relaxation, muscle strength, power and endurance
142
What are some precautions of aquatic exercise?
-Fear of water, neurological disorders, respiratory disorders, cardiac dysfunction, small open wounds
143
What are the contraindications of aquatic exercise?
-unstable angina, cardiac failure, severe PVD, severe kidney disease, uncontrolled bowels and bladder, and those with open wounds without occlusive dressing
144
Patients with what may have trouble with movement in water and should be closely monitored?
-Ataxia
145
Patients with what may fatigue quickly or have worse symptoms due to warm water?
-MS
146
Patient with what may have trouble in deep water?
-Those who have trouble with lung expansion
147
Why does deep water inhibit lung expansion?
-due to the hydrostatic pressure
148
Patients with a vital capacity less that what should not be submerged?
-1 liter
149
Patients with which cardiac dysfunctions should be closely monitored when performing aquatic exercise?
-Angina, abnormal BP and heart disease
150
What is the upward force that acts opposite of gravity?
-Buoyancy
151
If someone is submerged up to C7, how much percent weight bearing are they?
-10% (90% decrease in body weight)
152
How much weight is a person bearing that is in water at their stermun?
-33%
153
For a person to be 50% weight bearing in water, where should the water level be?
-Their ASIS
154
What is the property of water that exerts pressure on emersed objects?
-Hydrostatic pressure
155
What can hydrostatic pressure help?
-reduce swelling, aid in venous return, induce bradycardia, and improve centralize peripheral blood flow
156
What is the attraction between water molecule that results in resistance to flow?
-Viscosity
157
Increasing velocity in water does what to resistance?
-Increases it
158
Increasing surface area in water does what to resistance?
-Increases it
159
What water temps should you use for a patient with MS?
-82 to 88
160
what water temp should you use for patients with arthrtis or women?
-88 to 92
161
what temperatures should you use for less active patients?
-92
162
What should you use cooler water for?
-Aerobic conditoining
163
Exercise equipment for aquatic exercise changes what two things?
-bouyancy or resistance
164
What is the maximum amount of time a clinician should be in the water consecutively?
-4 hours
165
How much lower will blood pressure be in water?
-20 Bpm
166
What should you use to dose aquatic exerice?
-RPE
167
What two positions are considered buoyancy assisted?
-Seated or upright
168
What position is considered buoyancy suported?
-Supine
169
What hand stabilizes the patient affected limb proximally?
-The fixed ipsilateral hand
170
What hand guides the patients limb through the desired motion?
-The contralateral movement hand
171
What position should the patient be in to stretch their spine into flexion or side flexion?
-supine
172
When performing manual resistance exercise on a patient in water, what hand directs the patients body as the muscle contract to move the body through the water?
-The ipsilateral guide hand
173
What hand is places at the distal end of the contracting segment to apply manual resistance?
-contralateral (resistance) hand
174
What has just as much of an effect or more of an effect at taping?
-Patient communication
175
What is mechanoreceptor 4?
-nociceptor (pain)
176
What 4 things can taping effect?
-Lymphatic drainage, Muscle facilitation, muscle inhibition, and immobilization
177
How can taping cause muscle facilitation?
-increasing neuromuscular control and increasing awareness/proprioception
178
What can taping decrease to cause muscle inhibition?
-decreases pain an muscle tone
179
what does taping not have an effect on?
-Alignment
180
What are the contraindications of apply tape over?
-An active malignancy, active cellulitis or lymphedema,, an infection, open wounds, dvt or fragile skin
181
What are the precautions to taping?
-diabetes, kidney disease, congestive heart failure, haling skin and preganancy
182
For longer duration of immobilization, should you use taping or a brace?
-A brace
183
What is easier to use individiaully, taping or bracing?
-Bracing
184
What is more specific to the individual, taping or bracing?
-Taping
185
What is more expensive over time, taping or bracing?
-Taping
186
How can you prepare the patient for taping?
-Not using lotion in the area, trimming hair, removing oils, using an adhesive spray, and asking about allergies
187
Taping used in a straight line is called what?
-I strip
188
Tape that Diverges into 2 is called what?
-Y strip
189
Tape that is split on both ends is called what?
-X cut
190
What tape has a baae and 4 legs?
-Tenticles
191
What is tenticle tape generally used for?
-Lymphatic drainage
192
The McConnal taping method is generally used for what?
-Immobilization
193
What is an issue with luekotape?
-The glue is more reactive
194
When should you remove leukotape (McConnel method)
-the same day
195
Who created the kinesio taping method?
-Kenso Kase, a japanese chriopractor in the 1970s
196
What is the most popular taping method?
-Kineio taping
197
in kinesiotaping,To inhibit muscle which direction should you tape?
-Distal to proximal
198
in kinesiotaping, What percent stretch should the tape be on to inhibit muscles?
-15-25%
199
in kinesiotaping, To facilitate muucles, which direction should you tape?
-Proximal to distal
200
in kinesiotaping, what percent stretch should be applied to facilitate muscle?
-15 to 35%
201
What is an issue with kinesiotaping?
-evidenc does not support that direction matters, and it guestimates the stretch
202
Who invented the kinematic taping method?
-John Langendeon-Sertel
203
in the kinematci taping method for lymphatic drainage, how shoulde you tape?
-In tentacle pattern, no stretch
204
In the kinematic taping method, how do you inhibit muscles?
-tape in a slightly lengthen position
205
in the kinematic taping method, how do you facilitate muscles?
-Tape in a slightly shortened position
206
In the kinematic taping method, the stretch is what for most techniques?
-10-33%
207
In the Kinematic taping method, when immibilization is the goal, what is the stretch?
-100%
208
In the kinematic taping method, how long can you leave on tape for lymphatic drainage?
-7 days
209
In the kinematic taping method, where should you place the base of the tape for lymphatic drainage?
-Near a lymph node
210
In the kinematic taping method, for sensitive skin or trial tape what should the stretch be?
-10-15% (8 folds)
211
In the kinematic taping method, for everything beside lymphatics and immobilization how long can you leave the tape on?
-3 days
212
In the kinematic taping method, what should the stretch be for muscle facilitation, inhibition, and neurogenic purposes?
-33% (4 folds)
213
What can you never apply to tape?
-HEAT
214
what tape is water proof and latex free?
-3NS Tex Tape
215
******!!!!!*******TAPING IS AN ADJUNCT TO WHAT???****!!!!*!*!*!*!**!*!*!*!
-EXERCISE
