Exam II Flashcards

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1
Q

What type of exercises were used to treat spinal stenosis that biased flexion of the spine?

A

-Williams exercises

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2
Q

What was an issue with williams exercises?

A

-they lead to disc herniations

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3
Q

What exercises were used to treat radicular symptoms that emphasized extension of the spine?

A

-Mckenzie exercises

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4
Q

what was an issue with mckenzie exrcises?

A

-the did not treat the deep stabilizers of the spine

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5
Q

What was used to teach proper posture, body mechanics, posture and sleeping postures?

A

-Back schools

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6
Q

what was an issue with back schools?

A

-They were too general

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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

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8
Q

What is muscular fusion?

A

-utilizing co-contractions of the deep abdominals, and multifidus to hold the spine in nuetral

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9
Q

Where is all movement centered?

A

-The lumbopelvic hip complex

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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

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11
Q

What muscles are crucial in providing lumbar spine stabilization?

A

-Multifidi, internal obliques and transverse abdominis

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12
Q

What muscles dominate and attempt to stabilize the spine when there is dysfunction?

A

-Erector Spinae

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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

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14
Q

Why aren’t global muscle efficient?

A

-They do not provide segmental stability

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15
Q

What happens if you do not train local muscles?

A

-They will be shut down because of the use of global muscles

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16
Q

What is the action of the lumbar multifidus?

A
  • Back extension when they fire bilaterally

- contralateral rotation when they fire unilaterally

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17
Q

What are the first muscles to become weak?

A

-Multifidus

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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

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19
Q

To maintain posture how to the multifidi fire?

A

-Bilaterally

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20
Q

What is the deepest abdominal muscle?

A

-Transverse abdominis

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21
Q

What is the action of the transverse abdominis?

A

-compression, protection and support the abdomen

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22
Q

What is the first muscle to be activated when there is an unexpected loading of the spine?

A

-transverse abdominis

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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

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24
Q

What muscle is just superficial to the transverse abdominis?

A

-internal obliques

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25
Q

What produces the greatest stabilizing effect of the spine?

A

-The internal obliques and transverse abdominis increasing intrabdominal pressure to stabilize the spinal

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26
Q

When a person is not injured, what is neutral spine?

A

-A position in which a vertical force exterted through the spine allow equal weight transference on all weight bearing surfaces

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27
Q

When a person is injured, what is neutral spine?

A

-the position in which the patient is most asymptomatic, can produce the most force and maintain posture and agility

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28
Q

What position should you use to train a person experiencing lower back pain?

A

-The position in which they do not experience pain

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29
Q

What can back pain decrease?

A

-Agility

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30
Q

What is a technique used to train co contraction of the deep stabilizers?

A

-Abdominal drawing

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31
Q

Training the deep stabilizers in a prone or quadraped position inhibits what muscle?

A

-Rectus abdominis

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32
Q

When using the abdominal drawing technique, what compensations should you look for?

A

-depression of the ribcage, and lateral flaring of the waist

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33
Q

When using a BP cuff to provide feedback, how much change in mmHg is okay?

A

-6-10

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34
Q

What type of load and duration dosage should you use to train the deep stabilizers?

A

-Low load, long duration

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35
Q

What type of contraction should you use to train the deep stabilizers?

A

-Isometric

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36
Q

What percent contraction do you need to train the deep stabilizers?

A

-1-25%

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37
Q

What else should you train to avoid LBP and injuries?

A

-Proprioception and agility

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38
Q

Why is agility and proprioception important in LBP rehab?

A

-They are needed to resspond to a stimuli and change direction before injury occurs

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39
Q

What is spine stabilization training effective for?

A

-Decreasing pain, decreasing disability, preventing injury, speeding up recovery and avoiding surgury

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40
Q

Who is the most qualified to treat LBP?

A

-Physical therapists

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41
Q

What is the difference between therapeutic exercise and therapeutic activities?

A

-Therapeutic activities are more functional

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42
Q

What is muscle setting?

A

-A low intensity isometric contraction performed against little to no resistance

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43
Q

What is muscle setting used for?

A

-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

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44
Q

What is stabilization exercises?

A

-submaximal, sustained level of coconctration

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45
Q

What do stabilization exercises help with?

A

-improves postural stability and dynamic stability of a joint

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46
Q

what is used as resistance during stabilization exercises?

A

-body weight or manual resistance

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47
Q

What is a system of isometric exercise in which resistance is applied manually or mechanically at multiple joint positions within available ROM?

A

-Multiple-angle isometrics

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48
Q

When are mutliple angle isometrics helpful?

A

-When a patient has painful arc to strengthen throught the range

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49
Q

What must you do with resistance throughout ROM with multiangle isometrics?

A

-Change based on where you are in the range

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50
Q

Repetitive 6 to 10 second hold can help decrease what?

A

-Muscle cramping

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51
Q

What is the physiological overflow?

A

-Strengthening in one point in the range will only strengthen within 10 degrees of that angle

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52
Q

How many points should you use multiangle isometric throughout rom?

A

-4 to 6

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53
Q

Multiangle isometrics improve what type of strength?

A

-static (has little impact on dynamic strength)

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54
Q

What is a precaution for isometrics?

A

-Valsalva Maneuver

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55
Q

What are the contraindications of isometrics?

A

-Cardiac Disease, Vascular disorders,

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56
Q

What type of exercise would you use to strengthen someones hamstrings who lack deceleration during the termnial swing phase of gate?

A

-Eccentrics

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57
Q

What is the order of force production and mechanical efficiency for the 3 types of contraction from least to greatest?

A

-Eccentric, isometric, concentric

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58
Q

In what type of contraction is force production proportional to the number of units recruited?

A

-Concentric

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59
Q

Which contraction requires more motor unit recruitment, concentric or eccentric?

A

-Concentric

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60
Q

Why dont eccentric contraction require as much motor unit recruitment as concentric?

A

-Noncontractile component supply some resistance

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61
Q

Which contraction uses more energy, concentric or eccentric?

A

-Concentric

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62
Q

Which contraction creates the most DOMs?

A

-Eccentric

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63
Q

When should you use eccentrics?

A

-For improving strength, dont use post surgically

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64
Q

What is some downfall to eccentric training?

A

-It is more more mode specific, velocity specific, and transfer is limited

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65
Q

What principle should be used for eccentric training programs?

A

-Exercise should mimic function

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66
Q

What is effective in preventing DOMS?

A

-Submaxive exercise

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67
Q

What is the repeated bout effect?

A

-Once soreness is gone and the same exercise is repeated, the same soreness will not result (adaptations have occured)

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68
Q

How can you prevent DOMS with eccentric training?

A

-Gradually increase loads

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69
Q

What strength grade must a patient have in order to use isometrics?

A

-3-/5

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70
Q

What types of issues can eccentrics help treat?

A

-Muscle weakness, disuse, hypermobility and hypomobility

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71
Q

Eccentric training is effective in training what at lower loads than concentric?

A

-type II fibers

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72
Q

When should you not use eccentrics?

A

-When acute inflammation is present

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73
Q

What does concentric training improve that eccentrics does not?

A

-local circulation and capillary density

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74
Q

What type of eccentric exercises are recommended in the acute stage?

A

-NONE

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75
Q

What type of eccentric exercises are recommended in the sub-acute stage?

A

-Sub maximal at low speeds

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76
Q

What type of eccentric exercises are recommended in the settled/chronic stage?

A

-Max load/faster speeds

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77
Q

When should you use isokinetic eccentric exercises?

A

-the final stages of rehab

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78
Q

What should you dose eccentrics at for treating tendonopathy?

A

-3 sets for 15 reps, 2x per day, 7 days per week

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79
Q

What should you progress to to improve functionality?

A

-multiplanar motions

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80
Q

What type of exercises apply dynamic resistance against a constant external resistance? (4)

A

-Free weights, fixed cable systems, weight machines, functional movements

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81
Q

What types of exercise apply variable resistance?

A

-Therabands, adjustable cable systems, weight machines,hydraulic, isokinetic

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82
Q

When useing free weights, where should midrange be?

A

-When the arm is perpindicular to the LOG (parrallel to the floor)

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83
Q

What strength grade must a patient have to perform resistance exercise using weight length tension?

A

-greater than 3/5

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84
Q

When using a theraband, where does the band stop being matched to the length tension curve of the muscle?

A

-When it is perpindicular to the level arm

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85
Q

What two things does plyometrics combine?

A

-Speed and strength

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86
Q

What is the purpose of plyometrics?

A

-to heighten the exictability of the nervous system for improved reactive ability of the neuromuscular system

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87
Q

Any exercise that taps into the myostatic stretch reflex is called what?

A

-Plyometrics

88
Q

What can plyometrics help improve?

A

-power and reacivity, vertical leap, jumping distance, sprint speed, prevent injury, and improve throwing reactivity/distance

89
Q

With plyometrics, muscles around justs must first do what to produce an explosive movment?

A

-Stretch

90
Q

What is the goal of plyometrics?

A

-To decrease the amount of time required between the yailding eccentric muscle contraction and the initiation of the over coming concentric phase

91
Q

What is the stage between concentric and eccentric contractions?

A

-Amortization

92
Q

What will shortening the amortization phase do?

A

-decrease the amount of energy wasted

93
Q

What is phase 1 of plyometrics?

A

-eccentric/preparation stage

94
Q

What is stage 2 of plyometrics?

A

-amortization/transition

95
Q

What is stage 3 of plyometrics?

A

-Concentric/outcome

96
Q

What is stage 4 of plyometrics?

A

-Eccentric/shock attentuation (back into preparation)

97
Q

What is enhanced by increased the rate and force of the stretch?

A

-Muscle spindle stretch reflex

98
Q

What is the energy available for the concentric phase from the eccentric phase dependent on?

A

-the amount of time it takes to switch from eccentric to concentric

99
Q

How does the eccentric contraction of stage 4 of pltometrics reduce the risk for injury?

A

-It distributes reaction forces throughout the body

100
Q

During prestretch, where is energy stored?

A

-in the SEC

101
Q

During a concetric contraction, the energy in the SEC is move with?

A

-the SS

102
Q

The ability to tap into the stored elastic energy is governed by what?

A

-Time, magnitude, and velocity of the stretch

103
Q

Is power greater in a damped or undamped jump?

A

-undamped

104
Q

How do damped jumps lose energy?

A

-Through heat

105
Q

What is the only way a concentric contraction can be magnified?

A

-If the precedning eccentric contraction is short range, quick and without delay

106
Q

What does plyometrics desensitize?

A

-the GTO

107
Q

As the velocity of the stretch increases, what happens to the firing of the muscle spindle?

A

-It increase

108
Q

What 3 things is the degree of muscle fiber elongation dependent on?

A

-fiber length, ultilmate deformation,and the ability of the spindle to elicit a response

109
Q

What is the fiber length proportional to?

A

-The amount of stretching force applied to the muscle

110
Q

What is the ultimate deformation dependent on?

A

-the strength of the individual muscle fibers (greater tensile strength+less elongation)

111
Q

Lowering the sensitivity of the muslce spindle will do what to its power?

A

-Decrease it

112
Q

How does increasing the speed of the stretch reflex improve physiological performance?

A

-increase the amount of motor units for the task

113
Q

How does desensitiving the GTO improve physiological performance?

A

-by allowing a greater load to be applied to the MSK system

114
Q

Training with a prestretch improves what?

A

-Nueromusclcular performance

115
Q

Improving neuromuscular coodination improves what?

A

-coordination, and enhances the NS to be more automatic

116
Q

What are the general containdications for plyometrics?

A

-acute inflammation, pain, immediate postop pathology, and gross instability

117
Q

What are the specific contraindications of plyometrics?

A

-cartilage injuries, capsule/ligaent injuries, arthritis, bone bruises, tendon injuries or being in the acute/early subacute stages

118
Q

What should you always begin with to evaluate if a patient can perform plyometrics?

A

-an orthopeadic evaluation

119
Q

What type of surfaces should you used for plyometric training?

A

-resilient

120
Q

What direction should you begin plyometrics in?

A

-Horizontally, then vertically

121
Q

What should a person train before performing plyometrics?

A

-strength and power

122
Q

Prior to performing LE plyometrics what should a patient be able to do?

A

-eccentric training while performing dynamic balance activities

123
Q

Prior to performing UE plyometrics what should a patient be able to do?

A

-eccentric while performing throw/catch activities

124
Q

How can plyometrics help cartilage?

A

-loads/unloads it to keep it healthy

125
Q

How can plyometrics help collagen?

A

-by providing modified tension in the line of stress

126
Q

When are plyometrics the most useful?

A

-At the end of a workout

127
Q

When should you end plyometric training?

A

-when proper form cannot be acheived

128
Q

What is the goal of medial-lateral loading plyometrics?

A

-To increase tissue tensile strength

129
Q

When initially progressing plyometrics should you increase reps or intensity first?

A

-Reps

130
Q

As you increase the intensity of plyometrics, what should you do to the reps?

A

-Decrease them

131
Q

what is the goal of rotational loading?

A

-to increase the tensile strength of: cruciate ligaments, menisci, and the capsule

132
Q

What is more important, the rate of the stretch of length of the stretch?

A

-The rate

133
Q

When using plyometrics to improve power, what should the work to rest ratio be?

A

-1:3-4

134
Q

When using plyometrics to improve endurance, what should the work to rest ratio be?

A

-1:1-2

135
Q

What should you look for in the LE during the eccentric landing phase of plyometrics?

A

-Valgus (do not let this occur)

136
Q

What is the key element of depth jumping?

A

-Proper landing

137
Q

What is the key element of depth jumping?

A

-Proper landing

138
Q

What is the utilization of water for the implementation of quality of life, fitness or general health exercise training?

A

-Aquatic exercise

139
Q

What is the skilled practice of physical therapy in an aquatic environment by a PT, or PTA?

A

-Aquatic Physical Therapy

140
Q

What properties of water enhance exercise and functional training for patients accross the age span with all type of conditions?

A

-Bouyancy support and resistance

141
Q

What all can aquatic physical therapy help to improve?

A

-aerobic conditioning, andurance, balance, soordination, agility, body mechanics, posture, flexibility, gait, relaxation, muscle strength, power and endurance

142
Q

What are some precautions of aquatic exercise?

A

-Fear of water, neurological disorders, respiratory disorders, cardiac dysfunction, small open wounds

143
Q

What are the contraindications of aquatic exercise?

A

-unstable angina, cardiac failure, severe PVD, severe kidney disease, uncontrolled bowels and bladder, and those with open wounds without occlusive dressing

144
Q

Patients with what may have trouble with movement in water and should be closely monitored?

A

-Ataxia

145
Q

Patients with what may fatigue quickly or have worse symptoms due to warm water?

A

-MS

146
Q

Patient with what may have trouble in deep water?

A

-Those who have trouble with lung expansion

147
Q

Why does deep water inhibit lung expansion?

A

-due to the hydrostatic pressure

148
Q

Patients with a vital capacity less that what should not be submerged?

A

-1 liter

149
Q

Patients with which cardiac dysfunctions should be closely monitored when performing aquatic exercise?

A

-Angina, abnormal BP and heart disease

150
Q

What is the upward force that acts opposite of gravity?

A

-Buoyancy

151
Q

If someone is submerged up to C7, how much percent weight bearing are they?

A

-10% (90% decrease in body weight)

152
Q

How much weight is a person bearing that is in water at their stermun?

A

-33%

153
Q

For a person to be 50% weight bearing in water, where should the water level be?

A

-Their ASIS

154
Q

What is the property of water that exerts pressure on emersed objects?

A

-Hydrostatic pressure

155
Q

What can hydrostatic pressure help?

A

-reduce swelling, aid in venous return, induce bradycardia, and improve centralize peripheral blood flow

156
Q

What is the attraction between water molecule that results in resistance to flow?

A

-Viscosity

157
Q

Increasing velocity in water does what to resistance?

A

-Increases it

158
Q

Increasing surface area in water does what to resistance?

A

-Increases it

159
Q

What water temps should you use for a patient with MS?

A

-82 to 88

160
Q

what water temp should you use for patients with arthrtis or women?

A

-88 to 92

161
Q

what temperatures should you use for less active patients?

A

-92

162
Q

What should you use cooler water for?

A

-Aerobic conditoining

163
Q

Exercise equipment for aquatic exercise changes what two things?

A

-bouyancy or resistance

164
Q

What is the maximum amount of time a clinician should be in the water consecutively?

A

-4 hours

165
Q

How much lower will blood pressure be in water?

A

-20 Bpm

166
Q

What should you use to dose aquatic exerice?

A

-RPE

167
Q

What two positions are considered buoyancy assisted?

A

-Seated or upright

168
Q

What position is considered buoyancy suported?

A

-Supine

169
Q

What hand stabilizes the patient affected limb proximally?

A

-The fixed ipsilateral hand

170
Q

What hand guides the patients limb through the desired motion?

A

-The contralateral movement hand

171
Q

What position should the patient be in to stretch their spine into flexion or side flexion?

A

-supine

172
Q

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?

A

-The ipsilateral guide hand

173
Q

What hand is places at the distal end of the contracting segment to apply manual resistance?

A

-contralateral (resistance) hand

174
Q

What has just as much of an effect or more of an effect at taping?

A

-Patient communication

175
Q

What is mechanoreceptor 4?

A

-nociceptor (pain)

176
Q

What 4 things can taping effect?

A

-Lymphatic drainage, Muscle facilitation, muscle inhibition, and immobilization

177
Q

How can taping cause muscle facilitation?

A

-increasing neuromuscular control and increasing awareness/proprioception

178
Q

What can taping decrease to cause muscle inhibition?

A

-decreases pain an muscle tone

179
Q

what does taping not have an effect on?

A

-Alignment

180
Q

What are the contraindications of apply tape over?

A

-An active malignancy, active cellulitis or lymphedema,, an infection, open wounds, dvt or fragile skin

181
Q

What are the precautions to taping?

A

-diabetes, kidney disease, congestive heart failure, haling skin and preganancy

182
Q

For longer duration of immobilization, should you use taping or a brace?

A

-A brace

183
Q

What is easier to use individiaully, taping or bracing?

A

-Bracing

184
Q

What is more specific to the individual, taping or bracing?

A

-Taping

185
Q

What is more expensive over time, taping or bracing?

A

-Taping

186
Q

How can you prepare the patient for taping?

A

-Not using lotion in the area, trimming hair, removing oils, using an adhesive spray, and asking about allergies

187
Q

Taping used in a straight line is called what?

A

-I strip

188
Q

Tape that Diverges into 2 is called what?

A

-Y strip

189
Q

Tape that is split on both ends is called what?

A

-X cut

190
Q

What tape has a baae and 4 legs?

A

-Tenticles

191
Q

What is tenticle tape generally used for?

A

-Lymphatic drainage

192
Q

The McConnal taping method is generally used for what?

A

-Immobilization

193
Q

What is an issue with luekotape?

A

-The glue is more reactive

194
Q

When should you remove leukotape (McConnel method)

A

-the same day

195
Q

Who created the kinesio taping method?

A

-Kenso Kase, a japanese chriopractor in the 1970s

196
Q

What is the most popular taping method?

A

-Kineio taping

197
Q

in kinesiotaping,To inhibit muscle which direction should you tape?

A

-Distal to proximal

198
Q

in kinesiotaping, What percent stretch should the tape be on to inhibit muscles?

A

-15-25%

199
Q

in kinesiotaping, To facilitate muucles, which direction should you tape?

A

-Proximal to distal

200
Q

in kinesiotaping, what percent stretch should be applied to facilitate muscle?

A

-15 to 35%

201
Q

What is an issue with kinesiotaping?

A

-evidenc does not support that direction matters, and it guestimates the stretch

202
Q

Who invented the kinematic taping method?

A

-John Langendeon-Sertel

203
Q

in the kinematci taping method for lymphatic drainage, how shoulde you tape?

A

-In tentacle pattern, no stretch

204
Q

In the kinematic taping method, how do you inhibit muscles?

A

-tape in a slightly lengthen position

205
Q

in the kinematic taping method, how do you facilitate muscles?

A

-Tape in a slightly shortened position

206
Q

In the kinematic taping method, the stretch is what for most techniques?

A

-10-33%

207
Q

In the Kinematic taping method, when immibilization is the goal, what is the stretch?

A

-100%

208
Q

In the kinematic taping method, how long can you leave on tape for lymphatic drainage?

A

-7 days

209
Q

In the kinematic taping method, where should you place the base of the tape for lymphatic drainage?

A

-Near a lymph node

210
Q

In the kinematic taping method, for sensitive skin or trial tape what should the stretch be?

A

-10-15% (8 folds)

211
Q

In the kinematic taping method, for everything beside lymphatics and immobilization how long can you leave the tape on?

A

-3 days

212
Q

In the kinematic taping method, what should the stretch be for muscle facilitation, inhibition, and neurogenic purposes?

A

-33% (4 folds)

213
Q

What can you never apply to tape?

A

-HEAT

214
Q

what tape is water proof and latex free?

A

-3NS Tex Tape

215
Q

**!!!!!TAPING IS AN ADJUNCT TO WHAT???!!!!!!!!**!!!!

A

-EXERCISE