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hlth3017 - exercise physiology for special populations > Exam Study > Flashcards

Exam Study Flashcards

1
Q

Define Impairment

A

Any loss or abnormality of psychological, physiological or anatomical structure or function.

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2
Q

Define Disability

A

Any inability to perform an activity in the manner or within the range considered normal for a human being.

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3
Q

Define Handicap

A

A disadvantage for a given individual, resulting from an impairment or a disability, that limits or prevents the fulfilment of a role that is normal.

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4
Q

What is the main hallmark of the Social Model approach to disability?

A

It focuses on the person, not the disability, to give them normal life experiences and self-efficacy.

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5
Q

What are the three levels of motor control?

A
  1. Volitional movement
  2. Reflex movement
  3. Autonomic functions
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6
Q

Where do upper motor neurons originate?

A

In the motor region of the cerebral cortex or the brain stem.

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7
Q

Where do lower motor neurons originate?

A

In the anterior grey column of the spinal cord.

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8
Q

Which type of motor neurons cross the midline of the body?

A

Upper motor neurons

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9
Q

All voluntary movements rely on which type of motor neuron?

A

Lower motor neurons

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10
Q

Spinal cord lesions can affect the ________ nervous system anywhere _______ the lesion’s location.

A

A. autonomic
B. below

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11
Q

What is Babinski’s reflex?

A

A flaring of the toes resulting from planta stimulation. This is a paediatric assessment conducted to assess for lower motor neuron dysfunction.

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12
Q

What is a Marionette gait pattern and when is this most common?

A

Hypertonia in the legs, hips and pelvis means these areas become flexed, giving the appearance of crouching, while tight adductors produce extreme adduction.
This is most common in diplegic and paraplegic cerebral palsy.

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13
Q

What are the signs of lower and upper motor neuron damage for an individual’s reflexes, muscle atrophy and tone?

A

Upper motor neuron damage:
- Reflexes: normal or increased
- Atrophy: late or mild (due to disuse)
- Tone: normal or increased

Lower motor neuron damage:
- Reflexes: decreased or absent
- Atrophy: rapid and severe (neurogenic)
- Tone: decreased or absent

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14
Q

What is a common problem with thermal regulation for individuals with spinal cord injuries?

A

They have difficulty regulating temperature and therefore will get cold/hot more easily than others. They may not be able to sweat below the point of injury.

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15
Q

Define Tetraplegia.

A

Complete or incomplete paralysis of the arms and legs.

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16
Q

Define Paraplegia.

A

Complete or incomplete paralysis of the legs.

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17
Q

What is Autonomic Dysreflexia and what precautions can be taken to avoid it during exercise?

A

An exaggerated response of the ANS resulting in acute and uncontrolled hypertension.
Voiding the bladder before exercise can prevent this from occurring.

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18
Q

What is Orthostatic Hypotension?

A

A sudden drop in blood pressure that occurs when a person transitions from lying down or sitting to standing upright.

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19
Q

All lesions to the spinal cord can be ________ and non-_________.

A

Traumatic.

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20
Q

What is a common impact on fertility for A) Men, and B) Women to consider with SCI?

A

A) Men may have their fertility affected
B) Women do not show signs of fertility dysregulation with SCI.

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21
Q

Define the levels of function in the five-point grading scale for motor function.

A

0 - absent (total paralysis)
1 - trace
2 - poor
3 - fair
4 - good
5 - normal

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22
Q

What is the rate of depression among people with SCI compared to the general population?

A

Four times greater.

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23
Q

What are some common exercise interventions that individuals with SCI can be programmed?

A
  • Bodyweight Supported Treadmill Training (BWSTT)
  • Neuromuscular electrical stimulation (NMS)
  • EMG Biofeedback (only if incomplete)
  • GPP Exercise prescription for fitness and health.
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24
Q

What are the recommended exercise prescriptions for individuals with SCI?

A
  • > 30 min moderate exercise 5 days/week
  • > 20 min of vigorous exercise >3 days/week
  • > 2 strength training sessions per week.
  • > 2 flexibility sessions per week focusing on internal rotators.
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25
Q

Define non-traumatic spina bifida.

A

Neural tube defects that result in malformation of the brain, spinal cord, or spinal cord coverings.

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26
Q

What are the three forms of spina bifida?

A
  1. Spina bifida occulta- The spinal column is not completely closed
  2. Meningocele - When the meninges may protrude through an opening in the back
  3. Myelomeningocele- When a portion of the spinal cord itself protrudes through an opening in the back
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27
Q

What are the strength implications for individuals with spinal bifida?

A

Muscle weakness or paralysis below the level of the incompletely closed spinal column.

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28
Q

According to 2018 ABS data, how many Australians (and what percentage) are living with a disability?

A

4.4 million (17.7%)

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29
Q

Define:
A) Voluntary movements
B) Reflex movements
C) Autonomic functions

A

A) Voluntary actions
B) From an external factor
C) Spontaneous, involuntary movements, and not always due to an external factor.

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30
Q

What are myotomes?

A

A group of muscles which are innervated by a single spinal root.

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31
Q

What are dermatomes?

A

Areas of skin that rely on specific nerve connections on the spine.

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32
Q

What is a positive Babinski’s reflex a sign of?

A

There is a spread of sensory input generally due to a spinal lesion.

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33
Q

Define Diplegia and identify what condition it is commonly associated with.

A
  • Symmetrical paralysis, usually affecting either the arms or legs.
  • Commonly associated with Cerebral Palsy.
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34
Q

What is Tenodesis Grip?

A

A movement of the wrist to allow hand function with limited function of the finger muscles:
- Flexion of the wrist –> fingers extend
- Extension of the wrist –> fingers flex

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35
Q

Define Cerebral Palsy.

A

A group of permanent movement disorders that appear in early childhood and affect body movements and muscle coordination.

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36
Q

A) What are the four types of Cerebral Palsy?
B) What are their symptoms?

A
  1. Spastic CP
    - stiff, jerky movements
  2. Athetoid CP
    - slow, writhing movements
  3. Ataxic CP
    - problems with balance/coordination
  4. Mixed CP
    - two or more types of CP symptoms
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37
Q

What is the prevalence of Cerebral Palsy in Australian children?

A

1 in 500

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38
Q

What are some key environmental considerations when conducting exercise sessions with an individual with ID?

A
  • The temperature
  • The noise level
  • The music choice
  • Crowd size
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39
Q

What criteria are required for a diagnosis of ADHD?

A
  • Must have evidence of hyperactive-impulsive or inattentive symptoms before 12 yo.
  • Noted in at least 2 settings.
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40
Q

What are the three categories of ADHD?

A
  1. ADHD with impulsivity
  2. ADHD with inattentiveness
  3. ADHD with inattentiveness and hyperactivity
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41
Q

What is a common comorbidity with ADHD?

A

Developmental coordination disorder

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42
Q

What is an important consideration for training with Down Syndrome in hot environments?

A

There is the potential that the individual may not be able to sweat.

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43
Q

What are the four most common comorbidities for individuals with Down Syndrome?

A
  1. Congenital heart defects
  2. Low thyroid levels
  3. Osteoporosis
  4. Weight management issues
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44
Q

Name the five considerations when prescribing exercise for someone with Down Syndrome.

A
  1. Generalised muscle weakness
  2. Poor cardiovascular fitness (reduced aerobic capacity/peak HR)
  3. Impaired motor coordination
  4. Poor exercise economy
  5. Reduced cognitive function which may impede adherence
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45
Q

Exercise can lead to a __% improvement in symptoms of ASD, specifically behavioural and academic improvement.

A

37%

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46
Q

What effect can exercise have on self-stimulating behaviours among individuals with ASD?

A

Increased aerobic exercise can have a short-term, dose-dependent decrease in the frequency of negative, self-stimulating behaviours, while not decreasing other positive behaviours.

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47
Q

Name the 6 Fs in the International Classification of Functioning, Disability and Health according to the Social Model of Disability.

A
  1. Fitness
  2. Function
  3. Friends
  4. Family
  5. Fun
  6. Future
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48
Q

Define Pain.

A

An unpleasant sensory and emotional experience associated with, or resembling that is related to actual or potential tissue damage.

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49
Q

Pain is not an input, it is a what?

A

An experience.

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50
Q

Short-term pain can be ________, but long-term pain can be ________.

A

A) adaptive
B) maladaptive

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51
Q

Tissue damage is sensed by what receptor, and where are these signals sent?

A

A) Nociceptors
B) Dorsal root ganglion

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52
Q

What structure are pain signals sent to in the brain?

A

The thalamus.

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53
Q

Define allostasis.

A

Normal physiological changes that occur when individuals experience a stressful event.

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54
Q

Define allostatic load.

A

The cost of chronic exposure to elevated or fluctuating endocrine or neural responses resulting from chronic or repeated challenges that the individual experiences as stressful.

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55
Q

Define Chronic Pain.

A

Pain that continues after an injury has healed or after an illness has passed.

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56
Q

Define the Biopsychosocial Model.

A

A general model positing that biological, psychological(which includes thoughts, emotions, and behaviours), and social (e.g., socioeconomic, socioenvironmental, and cultural) factors, all play a significant role in health and disease.

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57
Q

What are the seven main factors that can be focused on to build resilience to tolerate pain and allostatic load in a biopsychosocial model?

A
  1. Improve daily movement habits.
  2. Improve sleep patterns.
  3. Improve nutrition and hydration.
  4. Consider work habits.
  5. Inclusion of mindfulness and gratitude habits.
  6. Pacing and gradual exposure to stress.
  7. Re-phrasing the language we use.
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58
Q

How can gradual exposure to painful movements aid in rehabilitation from chronic pain?

A

Fear avoidance can become maladaptive while slowly reintroducing painful or ‘unsafe’ movements or positions helps to re-train the brain that they are safe.

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59
Q

What pain rating (1-10) is suitable for rehabilitation exercises?

A

3-4/10

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60
Q

What type of injury is it generally not ok to push through mild pain?

A

Fractures.

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61
Q

What are the top five risk factors for lower back pain?

A
  1. Poor sleep
  2. Monotonous work
  3. Mental distress
  4. Time driving
  5. Prolonged sitting/standing
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62
Q

Back pain is viewed as a physical problem; however, data suggests it is influenced by physical, __________ and _________ factors and so treatment should reflect that.

A

A) Psychological
B) Social

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63
Q

What is the chance (%) that imaging will show signs of lumbar spinal disc degeneration after the age of 30?

A

52%

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64
Q

What is the term for an overuse injury?

A

A training load error injury.

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65
Q

What are the rates of injury reduction (%) associated with the following training methods:
A) Stretching
B) Multiple exposure programming
C) Proprioceptive training
D) Strength training

A

A) 4%
B) 38%
C) 45%
D) 69%

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66
Q

Soft tissue injuries include what four tissues?

A

Cartilage
Muscle
Tendon
Ligament

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67
Q

What are the three types of ligaments?

A

A) Intra-articular
B) Capsular
C) Extra-capsular

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68
Q

What is an Intra-articular ligament? Give an example.

A
  • A ligament that is localised within a joint or inside the joint capsule
  • The cruciate ligaments
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69
Q

What is a Capsular ligament? Give an example.

A
  • Where the ligament projects as a thickening of the joint capsule
  • Anterior talofibular ligament
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70
Q

What is an Extra-capsular ligament? Give an example.

A
  • A ligament that is localised outside the joint capsule
  • Calcaneofibular ligament
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71
Q

Capsular ligaments have _________ healing potential. Why?

A

A) Excellent
B) Due to a good blood supply

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72
Q

To assist with proprioception, ligaments contain (A)________ _______ _______ that transmit information about (B)________, ______ and _________ to the CNS

A

A) Peripheral nerve endings
B) Position, pain, and movement

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73
Q

There is a high rate of reinjury to ligaments due to what mechanism?

A

Previous injury can result in a reduction of proprioceptive feedback given by the peripheral nerve endings within the affected ligaments causing a heightened risk of reinjury.

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74
Q

Ligaments serve as an ideal spring in the _______ zone as long as the change in length does not exceed about __%.

A

A) Elastic
B) 4%

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75
Q

Collagen fibres that make up ligaments will rupture if ____% deformation occurs. This is known as the ______________ and ____________ zones.

A

A) >4%
B) Deformation
C) Rupture

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76
Q

What are the two main training adaptions in ligaments?

A
  1. Increased CSA
  2. Change in material properties so that the ligament becomes stronger per unit area.
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77
Q

Normal daily activity maintains what percentage of ligaments’ mechanical properties?

A

80-90%

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78
Q

A few weeks of immobilisation can reduce a ligament’s strength up to what percentage?

A

50%

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79
Q

Define a Grade 1 ligament injury.

A

Structural damage at the microscopic level with local tenderness.

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80
Q

Define a Grade 2 ligament injury.

A

Partial tears, visible swelling, notable tenderness, but does not affect joint stability

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81
Q

Define a Grade 3 ligament injury.

A

Usually results in a complete rupture with significant swelling and joint instability.

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82
Q

Tendon ruptures often occur with what type of force?

A

Eccentric.

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83
Q

Define Tendonitis/tendinopathy

A

Tendon inflammation.

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84
Q

Define Tenosynovitis

A

Tendon sheath inflammation.

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85
Q

Define tenoperiostitis

A

Inflammation of tendon insertions and origins.

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86
Q

what are the names of the following conditions related to the tendon:
a) Tendon inflammation
b) Tendon sheath inflammation
c) Inflammation of the tendon insertion and origin?

A

a) Tendonitis/tendinopathy
b) Tenosynovitis
c) Tenoperiostitis

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87
Q

What is the suffix that denotes the presence of inflammation in an injury?

A

“itis”

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88
Q

a) If force causes a change in a tendon’s length greater than ___% individual collagen fibres will rupture.
b) Why is this a problem for sports?
c) Therefore, tendonitis is often associated with repetitive ____-__________.

A

a) 4%
b) Many sports require repetitive loading above a 4% change in length.
c) micro-traumas.

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89
Q

Bone remodels continuously in response to what four main variables?

A

a) Mechanical loading
b) Systemic hormones
c) Calcium homeostasis
d) osteoblast and osteoclast activity.

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90
Q

_____ reps of extensive plyometrics are good for bone growth, however, _____ reps are no longer optimal for bone growth.

A

a) <100
b) >100

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91
Q

Bones love _________ for adaptation.

A

Variety.

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92
Q

What three types of training are best for bone health?

A
  1. Change of direction
  2. accel/decel training
  3. Mechanical loading
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93
Q

What is a specific red flag for shin splints?

A

Pain at night through the anterior shank.

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94
Q

What difference is generally reported between training with shin splints and tendinopathy?

A

Tendinopathy will feel better as training continues whereas shin splints will feel worse.

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95
Q

How do shin splints occur?

A

With an increased training load, there is an increase in micro-trauma, circulatory compromise, and accelerated remodelling with increased osteoclast and decreased osteoblast activity.

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96
Q

What are the main causes of shin splints?

A
  • Training load errors.
  • Muscle fatigue.
  • Lower extremity malalignment.
  • The training surface.
  • Footwear.
  • RED-S.
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97
Q

What are the three elements that comprise cartilage?

A
  1. Connective tissue
  2. Cells
  3. Extracellular matrix
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98
Q

What are the three types of cartilage?

A
  1. Hyaline
  2. Fibrocartilage
  3. Elastic
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99
Q

What type of cartilage is most common in joints?

A

Hyaline.

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100
Q

___________ and water is greater in the cartilage of _______ athletes and declines ______ ______.

A

A) Proteoglycan
B) Younger
C) With age.

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101
Q

Does cartilage possess high or low amounts of:
A) Vascularity
B) Nerve cells
C) Lymphatics?

A

Cartilage possesses none of any of these.

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102
Q

How does cartilage receive oxygen and nutrients, and how does it dispose of waste matter?

A

The cellular elements absorb oxygen and nutrients from surrounding tissue and articular fluid and dispose of waste matter via diffusion.

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103
Q

Rate fibrocartilage’s strength and flexibility as high or low.

A
  • Strength: High
  • Flexibility: High
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104
Q

Where in the body is fibrocartilage mostly found?

A

In the intervertebral discs and the insertion of ligaments and tendons.

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105
Q

What is the main function of fibrocartilage?

A

It helps to facilitate joint congruency and absorb shock.

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106
Q

How does fibrocartilage adapt to training loads?

A

It adapts similarly to other tissues in that it”
- becomes stronger with appropriate load,
- immobilisation impairs its function and homeostasis, and
- too much loading may reduce its biological properties.

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107
Q
A
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108
Q

In ____% of cases, acute knee ligament injury is accompanied by _________________ injury.

A

A) 5-7%
B) Full-thickness cartilage

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109
Q

The stress-deformation curve for hyaline cartilage shows the following relationship between load and deformation:
_____ Region - Loading begins: ________ fibres have a _____ appearance.
_____ Area - Deformation increases _______ with increasing _____: ______ fibres straighten.
_______ - Too much: _______ occurs, initially in ________________ and later in larger ____________.

A
  • TOE region: Loading begins: COLLAGEN fibres have a WAVEY appearance.
  • LINEAR area: Deformation increased LINEARLY with increasing LOAD: COLLAGEN fibres straighten.
  • RUPTURE - Too much: TEARING occurs, initially in INDIVIDUAL FIBRES and later in larger GROUPS OF FIBRES.
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110
Q

Muscle injury risk is generally higher during what type of loading?

A

Eccentric.

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111
Q

What three mechanisms usually cause muscle injuries?

A
  1. Distention (strains or “pulled” muscles)
  2. Direct trauma resulting in contusion
  3. Unaccustomed eccentric loading (DOMS)
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112
Q

Muscle injuries resulting from eccentric muscle actions usually occur at the __________ __________ during ____________ eccentric muscle action.

A

A) Myotendinous junction
B) Maximal

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113
Q

Following a muscle injury, what is muscle tissue replaced with and what is the result of these muscles’ contractibility?

A

A) Fibrous scar tissue
B) Reduced contractibility.

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114
Q

What can muscle hematomas lead to if not treated correctly?

A

Myositis ossification or calcification.

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115
Q

What percentage of athletes who suffer muscle hematomas end up with myositis ossification or calcification?

A

20%.

116
Q

What are some of the worst treatments you can give for muscle hematomas?

A

Massage, heat, and movement.

117
Q

RICER is now an antiquated protocol for acute injury treatment. What has it been replaced with and what are the steps?

A

M - Movement, not rest
O - Options: other options for cross-training
V - Vary rehabilitation with strength, balance and agility
E - Easy back into activity.

118
Q

Why is movement so important for acute injury management?

A

It increases blood flow and helps with ROM.

119
Q

Injuries occur when athletes are ___________ and/or ___________ unable to tolerate the prescribed workload or are fit and well-trained but have inadequate _______.

A

A) Psychologically
B) Physically
C) Rest

120
Q

Define internal and external training load.

A

External Load:
- The external stimulus applied to an athlete in training and competition. It provides information about the work completed and the athlete’s performance capacity.

Internal Load:
- It triggers training-induced adaptations, which are the individual’s physiological and psychological response to the external load.

121
Q

What are some examples of External and Internal Load variables?

A

External Load: the completed physical work, such as the number of reps, weight lifted, total distance, etc.

Internal Load: daily life factors, environmental stressors, fatigue, work, family issues, or underlying biological factors.

122
Q

List 5 methods of tracking internal training load.

A
  • RPE
  • sRPE (RPE x Duration)
  • Psychological inventories
  • Recovery stress questionnaire for athletes
  • Sleep (QQRT)
  • Biochemical/hormonal/immunological assessments
  • Heart rate (HR)
  • HR recovery (HRR)
  • HR variability (HRV)
  • Blood lactate concentrations
  • Nutrition
123
Q

The “optimal” workload is a _______ _______.

A

Moving target.

124
Q

When the training load increases by _____% from the preceding week, the risk of injury increases by up to almost _____%.

A

A) ≥15%
B) 50%

125
Q

List the ACWR ratio categories.

A

< 0.8 - Undertraining
0.8-1.3 - Optimal Training
>1.5 - ‘Danger Zone’

126
Q

In _____, _________et al proposed that “the performance of an athlete in response to training can be estimated from the difference between a __________ _________ (_________) and a ___________ _________ (________).”

A

A) 1975
B) Banister
C) Negative function (‘fatigue’)
D) Positive function (‘fitness’)

127
Q

For ACWR, state the calculation of acute and chronic workloads.

A
  • Acute: 7-day average
  • Chronic: preceding 4-week (28-day) average
128
Q

What are the three main points guiding progression for an athlete’s return to play from injury?

A
  1. Resist external pressure to return to play.
  2. Increase workload progressively (<10%/week).
  3. Let the athlete’s feedback and perceived wellness scores guide load progression.
129
Q

When using the Visual Analogue Scale (VAS), what are the three broad categories and subsequent recommendations from reported scores?

A
  • 0-2/10: Continue training as normal
  • 3-5/10: Modify training load
  • > 5/10: Stop training or change the training method.
130
Q

What does FOOSH stand for and what injury does it relate to?

A

A) Fall on out-stretched hand
B) Clavical fractures and AC joint injuries.

131
Q

An AC Joint injury often occurs due to a ______ ______ to the ____________________ from, for example, _______________, ____________________________, or _________.

A

A) Direct blow
B) Tip of the shoulder
C) An awkward fall
D) An impact with another player
E) FOOSH

132
Q

What percentage of shoulder dislocations are anterior and posterior?

A
  • Anterior: 75%
  • Posterior: 20%
133
Q

Anterior dislocations can cause fracture of the __________ as well as _______ tears.

A

A) Clavicle
B) Labral

134
Q

State the muscles of the rotator cuff.

A
  • Supraspinatus
  • Infraspinatus
  • Subscapularis
  • Teres Minor
135
Q

What are the movements that Supraspinatus is involved with?

A
  • Assists in stabilizing the shoulder joint and resisting downward dislocation.
  • Assists in holding the head of the humerus in the glenoid fossa.
  • Initial abduction of the arm from 0 – 15 degrees.
136
Q

What are the movements that Infraspinatus and Teres Minor are involved with?

A
  • External rotation of the arm.
  • Prevents impingement during flexion and abduction.
  • Prevents dislocation.
  • Weak adductor.
137
Q

What are the movements that Subscapularis is involved with?

A
  • Stabilizer of GHJ – especially during external rotation.
  • Depresses humeral head.
  • Internal rotation.
138
Q

SAPS is a general term for what?

A

Pain within the shoulder area under the acromial space.

139
Q

List three clinical signs and symptoms of SAPs.

A
  • Client history and symptoms
  • Generally, swimmers, throwers or occupational demands.
  • Night pain with difficulty lying on the affected shoulder.
  • A painful arc abduction - ~70-130 degrees of abduction.
  • Supraspinatus muscle atrophy.
  • TOP (tenderness on palpation).
  • ROM limits in shoulder abduction, internal rotation, and flexion.
140
Q

What is TOP?

A

Tenderness on Palpation.

141
Q

List the five generalised causes of back pain.

A
  1. Strain of the lumbar muscles
  2. Degeneration of the intervertebral discs
  3. Facet joint inflammation/injury
  4. Neural issues
  5. Unknown/non-specific
142
Q

Lower Back Pain:
Generally, patients have rapid improvement within the first ____ weeks
After this period, the improvement slows, and over ___% of patients may develop ___________. About ___________ of patients who initially recover suffer _____________ in the _________.

A

A) 6
B) 40%
C) Chronic LBP
D) One third
E) Episodes of reoccurrence
F) Next year

143
Q

What are the three main symptoms of neural causes of lower back pain?

A
  1. Tingling – pins & needles
  2. Burning
  3. Symptoms are referring below the knee.
144
Q

Neural-based lower back pain is usually made worse by what type of movements?

A

Movements that close the intervertebral foramen, e.g., forward and lateral flexion of the spine.

145
Q

How much of the annulus fibrosus is comprised of water?

A

70-88%

146
Q

What is the effect of aging on spinal discs?

A

Age-related degradation is normal with the annulus fibrorus losing its ability to bind water.

147
Q

A spinal disc injury MAY be present if pain worsens with what movement?

A

Spinal flexion.

148
Q

List the four main indications of a facet joint injury.

A
  • Pain on extension (usually).
  • Pain on rotation/side flexion to the injured side.
  • The pain is never referred to below the knee.
  • Muscle spasms of the surrounding muscles may also occur to protect the joint.
149
Q

What are the four steps recommended to treat facet joint pain?

A
  • Manage training load.
  • Look at biomechanics & technique (normal for that individual).
    -Flexion-based exercises (generally) to start and then progress.
  • Look at other factors, such as sleep, stress, etc.
150
Q

What is now recognised as the primary source of lateral hip pain?

A

Tendinopathy of the glute med/min.

151
Q

How does lateral glute tendinopathy generally present?

A

As pain or tenderness over the greater trochanter of the femur.

152
Q

Lateral glute tendinopathy can occur with or without what other injury?

A

Trochanteric bursitis.

153
Q

The ____ can compress the tendons of G-Med and G-min at their insertion into the _____________________.

A

A) ITB
B) Greater trochanter

154
Q

What biomechanical error in running technique can cause lateral glute tendinopathy?

A

Medial foot-fall, i.e., the feet landing toward the midline.

155
Q

What common strength imbalance in the hips can lead to lateral glute tendinopathy?

A

The G-max and TFL muscles can become too strong compared to G-med and G-min. This will create excessive tension through the ITB and compress the lateral glutes into the greater trochanter of the femur and the trochanteric bursa.

156
Q

Increasing cadence by ___% has been shown to increase ___________.

A

A) 10%
B) G-med activity

157
Q

For the management of lateral glute tendinopathy, it is recommended to minimise high ________ _________ loads such as _________ and __________ then specifically strengthen.

A

A) Eccentric adductor
B) Hopping and bounding

158
Q

Stretching activities for lower limb ____________ ____________ are not recommended.

A

Insertional tendinopathies.

159
Q

What mechanisms of injury are associated with hip labral tears?

A
  • Direct trauma
  • Repetitive sporting movements, i.e., kicking, cycling, etc.
160
Q

What percentage of hip joints were found by Register et al. (2012) to have asymptomatic labral tears?

A

69%

161
Q

What are the common signs and symptoms of a hip labral tear?

A
  • Clicking and/or catching
  • Family history
  • Pain in lateral hip
  • Can refer to knees, back or outside of the hip
  • Worse with hip flexion and as exercise progresses
  • Eases generally with hip extension
162
Q

Is labrum considered to be vascular or avascular?

A

Avascular.

163
Q

What does FAI stand for?

A

Femoral Acetabular Impingement

164
Q

What are the three types of FAI?

A
  1. Pincer
  2. Cam
  3. Combination
165
Q

What are the differences between a cam and a pincer FAI?

A

A pincer FAI occurs when bone growth is present at the anterior acetabular rim, while a cam FAI occurs when additional bone grows along the anterior portion of the femoral head-neck junction.

166
Q

FAI can cause what other injury to the hip?

A

Labral tear.

167
Q

Why is the long head of the biceps femoris often associated with kicking?

A

Because it crosses both the hip and the knee, when both knee extension and hip flexion occur, passive insufficiency may cause excessive force relative to the length of the muscle.

168
Q

The __________ portion of the _________ __________ functions as if it were a part of the hamstring.

A

A) Posterior
B) Adductor magnus

169
Q

Hamstring muscle belly injuries are usually associated with __ __________ ________ which can be either due to __________ load or excessive ____________.

A

A) A specific event
B) Eccentric
C) Stretching

170
Q

What does it usually mean if a hamstring muscle belly injury is not associated with a specific event?

A

This generally means that pain is referred.

171
Q

For hamstring injuries, athletes must have full _____________ and no ______ with strength testing to return to sports.

A

A) ROM
B) Pain

172
Q

What is considered an appropriate limb symmetry index score for an athlete to return to sport?

A

<10%

173
Q

What is the most commonly diagnosed condition in adolescents and adults with knee complaints?

A

Patellofemoral pain syndrome.

174
Q

What percentage of running injuries are attributed to PFPS?

A

25%

175
Q

What events are often reported as painful for people with PFPS?

A
  • Squatting
  • Prolonged sitting
  • Kneeling
  • Jumping and landing
  • Stair climbing
176
Q

What three main physiological factors is PFPS associated with?

A
  1. High Q-angles.
  2. Relatively weak hip abductor muscles.
  3. Lower knee extensor strength.
177
Q

What is generally the cause of PFPS?

A

Training Load Errors.

178
Q

_________ shoes and an increased ________ of ____ saw the greatest reduction in patellofemoral joint loading.

A

A) Minimalist
B) Cadence
C) 10%

179
Q

What are the origin and insertion points of the ITB?

A
  • Origin: Illiac crest
  • Insertion: Gerdy’s tubercle
180
Q

With the knee flexed ___ degrees the ITB lies on or behind the _______ _________ _________ and with extension of the knee the ITB moves _________ to this bony prominence.

A

A) 30
B) Lateral femoral condyle
C) Anterior

181
Q

ITB friction syndrome results from inflammation of the _______ ____ and the _______ which lies deep to the ITB and over the __________ ________ __________.

A

A) Distal ITB
B) Bursa
C) Lateral femoral condyle.

182
Q

What are the two main causes of ITB syndrome?

A

A) Training load errors.
B) Gluteal weakness.

183
Q

What is the purpose of the ACL?

A

To prevent forward movement of the tibia from the femur and to control rotation of the tibia relative to the fibula.

184
Q

Studies are now suggesting that ACLr can increase the risk of what condition?

A

Osteoarthritis.

185
Q

Case studies have shown that an athlete can return to sport after ACL injury with exercise interventions only. How long do these athletes take to return to competition?

A

12-18 months.

186
Q

Instead of “chronic degenerative diseases”,

Use…

A

Normal age changes.

187
Q

Instead of “Instability”,

Use…

A

Needs more strength and control.

188
Q

Instead of “wear and tear”,

Use…

A

Normal age changes.

189
Q

Instead of “don’t worry”,

Use…

A

Everything will be ok.

190
Q

Instead of “damage”,

Use…

A

Reparable harm.

191
Q

Instead of “effusion”,

Use…

A

Swelling.

192
Q

Instead of “Diagnostics”,

Use…

A

X-ray or scan.

193
Q

Athletes returning from ACL injury must continue to conduct specific ____________, ____________ control, ________, and _______-specific training following return to sport.

A

A) Strengthening
B) Neuromuscular
C) Balance
D) Sport-

194
Q

Psychological factors such as A) ___-_________ ___________ , B) _________ and C) ____ __ ___________ towards rehabilitation and exercise were the main reasons patients chose to have a ACLR surgery.

A

A) Pre-existing preferences
B) Beliefs
C) Lack of motivation

195
Q

Are non-surgical ACL rehabilitation timeframes faster or shorter compared to ACLR surgery?

A

Shorter

196
Q

What is an important factor to consider when rehabilitating an athlete after ACLR surgery when considering graft originating location?

A

Strengthen up in-line with where the graft has come from, i.e., if patella tendon was used, strengthen the knee extensors; if HS was used, strengthen the knee flexors.

197
Q

What anatomical structures are involved with a “Terrible Triad” injury?

A

ACL, MCL, and meniscus.

198
Q

How long can ACL grafts take to adhere?

A

Up to 6 months.

199
Q

What is the “usual” RTS timeline for ACLR?

A

9-12 months. Nine months is considered extremely accelerated. More likely 12+ months.

200
Q

Rehabilitation starts at ____ __ _______, not after surgery.

A

The time of injury.

201
Q

What does initial rehab for ACL injury focuses on?

A

Pain free ROM

202
Q

What percentage of symmetry is recommended before ACLR surgery to improve outcomes.

A

≤ 20%

203
Q

In the initial stages of ACL rehab, ___________ ________ _________ does not affect knee laxity and can decrease incidence of anterior knee pain.

A

Immediate weight bearing.

204
Q

In stage 2 of ACL rehabilitation, large ________ are expected so ______ and _________ must be assessed to progress the exercises appropriately.

A

A) Variations
B) ROM
C) Strength

205
Q

Stage 3 of ACL rehabilitation should start to introduce ______-_________ training as well as progressing _________ and _____________ to build new neural pathways.

A

A) Sport-specific
B) Strength
C) Proprioception

206
Q

Although there a no standardised RTS protocols for Stage 4 of ACL rehabilitation, this stage should include __________/_________, ___________, and __________ training especially for athletes from COD sports.

A

A) Jumping/landing
B) Plyometric
C) Rotation

207
Q

What is a Bucket-handle injury related to and what is the key sign/symptom of this?

A

A meniscus tear.

Buckling or catching at the knee.

208
Q

Are surgical or non-surgical methods vastly recommended for meniscus injuries?

A

Non-surgical.

209
Q

What muscles should strengthening exercises for meniscus rehabilitation should focus on?

A

All muscles that cross the knee, i.e., quadriceps, hamstrings, glutes, and calves.

210
Q

Achilles tendinopathy is associated with a weakness of what muscle?

A

Soleus.

211
Q

Achilles tendinopathy not due to __________ but rather it is a ______ _________ ___________.

A

A) Inflammation
B) Failed healing response

212
Q

What is the main mechanism of Achilles tendinopathy?

A

Training load error.

213
Q

What additional muscles are often injured with lateral ankle injuries?

A

Peroneal muscles.

214
Q

What four indicators would suggest a scan is required for a lateral ankle injury?

A
  1. Severe pain and swelling
  2. Not healing within a few days
  3. No end feel during testing
  4. Complete NWB.
215
Q

What does “PEACE & LOVE” stand for?

A
  • Protection
  • Elevation
  • Avoid anti-inflammatories
  • Compression
  • Education
  • Load
  • Optimism
  • Vascularisation
  • Exercise
216
Q

Shin splints will present as _____cm of pain, whereas stress fractures present as _____cm.

A

A) > 5cm
B) < 5cm

217
Q

Is pain from shin splints or stress fractures more localised?

A

Stress fractures.

218
Q

In what portion of the lower leg do shin splints generally occur?

A

The lower third but can be up as high as middle third.

219
Q

All stress fractures are a combination of what two issues?

A
  1. Training load error
  2. Energy deficiency
220
Q

Which injury is it NOT safe to train through if pain remains <4/10, stress fractures or shin splints?

A

Stress fractures.

221
Q

In the management of tibial stress fractures, what is the initial rest period, and what other factors must be considered?

A
  • 4-8 weeks of minimal weight bearing.
  • RED-S, sleep, and stress.
222
Q

What does RED-S stand for?

A

Relative energy deficiency in sport.

223
Q

The contributing relative energy deficiency in RED-S can be due to _______ __________ _______ and not disordered eating.

A

High training load.

224
Q

What are the three contributing factor in RED-S for female athletes?

A
  1. Bone health
  2. Energy availability
  3. Menstrual function
225
Q

What are the main functions of the following hormones:
A) Progesterone
B) Follicle-stimulating Hormone
C) Luteinising Hormone

A

A) The pregnancy hormone - thickens the uterus lining.
B) Helps the follicles mature
C) Stimulates ovulation.

226
Q

Define primary amenorrhea.

A

Any adolescent who has not reached menarche by age 15 years.

227
Q

Define secondary amenorrhea.

A

Lack of menses exceeding 90 days.

228
Q

What is secondary amenorrhea also termed as?

A

Hypothalamic amenorrhea.

229
Q

What is anovulation?

A

When a normal menstrual cycle is present, however, there is no ovulation.

230
Q

Define oligomenorrhea.

A

No menstrual cycle for 35 days or more.

231
Q

State the classification of amenorrhea in terms of number of cycles per time-frame.

A

Less than three cycles in the previous 12-months or non in the last 6-months.

232
Q

Order the following groups according to BMD from least to most:
A) Eumenorrheic runners
B) Amenorrheic runners
C) Eumenorrheic non-trained
D) Amenorrheic non-trained

A

Least - Amenorrheic non-trained
2nd least - Amenorrheic runners
2nd most - Eumenorrheic non-trained
Most - Eumenorrheic runners

233
Q

What are the long-term consequences of low energy availability on body composition?

A

Increased body fat and decreased lean mass and BMD.

234
Q

In terms of BMD and RED-S, what is the most sensitive skeletal structure?

A

The lumbar spine.

235
Q

What are the effects of oral contraception on the ability to identify amenorrhea?

A

Oral contraception masks amenorrhea with withdrawal bleeds.

236
Q

Pregnancy is a state of _______, not _______.

A

A) Health
B) Illness.

237
Q

What four main exercise related alterations result from MSK changes during pregnancy?

A
  1. Altered posture
  2. Centre of gravity
  3. Joint stability
  4. Balance
238
Q

What is the name of the resultant separation of the rectus abdominis that occurs during pregnancy?

A

Diastasis Recti Abdominis (DRA).

239
Q

What is the fall rate of women when pregnant? What other population is this similar to?

A

A) 28%
B) Older adults

240
Q

Rate the following variables as increased, decreased, or minimal change during pregnancy:
A) Q
B) SV
C) HR
D) Systolic BP
E) Diastolic BP
F) O2 Consumption
G) Thermoregulation

A

A) Increased
B) Increased
C) Increased
D) Minimal change
E) Decrease at mid-pregnancy, unchanged at full-term
F) Increased
G) Decreased

241
Q

What changes occur to fetal HR when the mother performs exercise? What does this mean for exercising when pregnant?

A

A) No change.
B) It is safe.

242
Q

Is HR a valid assessment of exercise intensity when pregnant?

A

No

243
Q

What is an important consideration for energy demands and intensity and volume when prescribing exercise for a pregnant woman?

A

There is a shift in glucose metabolism to favor foetal growth and therefore, prolonged (>45min) or highly strenuous exercise can significantly reduce the mother’s blood glucose levels.

244
Q

How do exercise recommendations differ for pregnant women compared to general population?

A

They mostly don’t. However, for previously inactive women, it is recommended that they start with shorter sessions of 15-20min and build to 30min.

245
Q

What is the safe upper limit for exercise intensity for pregnant women?

A

There is no evidence-based safe upper limit for exercise intensity for pregnant women.

246
Q

Relate the FITT principle to exercise while pregnant.

A

Frequency - most, if not all, days of the week.
Intensity - can safely complete up to vigorous intensity exercise.
Type - Low-impact exercises (i.e.,. walking/swimming/light resistance exercises).
Timing - 150-300 minutes of moderate intensity activity accumulated over the week, or 75 minutes of vigorous intensity activity.

247
Q

What is the pregnancy-specific screening tool that should be used for pregnant women, and who should this be completed by?

A

A) PARmed-X.
B) The mother and obstetrician.

248
Q

What is a main consideration when conducting safe strength training while pregnant.

A

Do not use the Valsalva movement.

249
Q

When working with pregnant elite athletes, what can occur when performing heavy strength training or strenuous exercise?

A

This can put the athlete at risk of pelvic floor damage which can result in a prolapse of the pelvic floor muscles.

250
Q

After how many weeks of pregnancy is it recommended that mothers do not lay on their backs?

A

16 weeks.

251
Q

Emerging evidence suggests that there may be a positive influence between exercise and ___________ performance for children and adolescents.

A

Cognitive.

252
Q

At what age is a decline in youth PA seen?

A

~6-years-old.

253
Q

How can exercise and increased PA help the development of children in a holistic biopsychosocial model?

A

PA also has cognitive effects that can positively influence social self-efficacy and academic attainment.

254
Q

What are the WHO recommendations for PA in children?

A

At least 60min of moderate-vigorous intensity PA every day.

255
Q

What are four main reasons why children require different exercise assessments to adults?

A
  1. Increased HR and lower SV
  2. Different sRPE
  3. Less focus and effort capacity
  4. Most tests only have adult normative data and guidelines.
256
Q

How does sweat rate differ in children to adults?

A

Children generally have a 40% decreased sweat rate.

257
Q

Rate the following variables as higher, lower, or similar for children compared to adults:
A) Absolute O2 uptake
B) Relative O2 uptake
C) HR

A

A) Lower
B) Higher
C) Higher

258
Q

Rate the following variables as higher, lower, or similar for children compared to adults:
A) Absolute O2 uptake
B) Relative O2 uptake
C) HR

A

A) Lower
B) Higher
C) Higher

259
Q

Define DCD

A

Developmental Coordination Disorder: Impairment of motor performance sufficient to produce functional performance deficits that are not explained by the child’s chronological age, intellect or other diagnosable neurological or psychiatric disorders.

260
Q

When is DCD generally noticed?

A

During the early periods of development.

261
Q

What is the prevalence of DCD?

A

5-15%

262
Q

What is the ratio of boys to girls that have been diagnosed with DCD?

A

2:1

263
Q

What are the five most common comorbidities for DCD?

A
  1. Learning difficulties
  2. ADHD
  3. Cerebral Palsy
  4. Autism
  5. Down Syndrome
264
Q

What is the main social affect of DCD on children?

A

They tend to withdraw socially because they don’t want to participate or they don’t fit in.

265
Q

For children with DCD, what is the affect on physical fitness and rate of fatigue? Why?

A

They have a lower level of physical fitness and shorter time to fatigue.
This is often due to reduced movement efficiency and levels of participation.

266
Q

Recent findings indicated motor competence explained ___% of psychosocial well-being in a cohort of adolescent females. Those with lower motor competence recorded higher rates of _________ and ________ __________.

A

A) 44%
B) Hyperactivity
C) Emotional problems

267
Q

What type of skill acquisition practice best suits children with DCD?

A

An alternation between part and whole practice.

268
Q

When designing movement interventions for children with DCD, what is meant by:
A) Process orientation approaches, and
B) Task orientation approaches?

A

A) The use of an activity to target the underlying performance problem.
B) The use of an activity to address the performance itself which still facilitates participation.

269
Q

When working with children, consideration of ___________ age, not __________ age is important.

A

A) Developmental
B) Chronological

270
Q

Physical activity is _________ for older adults

A

Medicine.

271
Q

When working with older adults, it is important to make exercise __________ and aim for ___________.

A

A) Functional
B) Independence

272
Q

What are four methods that could be used to monitor improvements in respiratory quality in older adults?

A
  1. HR
  2. O2 Saturation
  3. RPE
  4. BP
273
Q

T2DM is more likely to develop in individuals who are ___________ ________.

A

Insufficiently active.

274
Q

What are the main two mechanisms by which exercise can help those with, or at risk of T2DM?

A
  1. It utilises readily available blood glucose without the need for insulin.
  2. It can increase insulin sensitivity by up to 24 hours post-exercise.
275
Q

What is the main cause of exercise exclusion for older adults?

A

Co-morbidities.

276
Q

What are the three absolute contraindications for exercise with older adults without clearance from an allied health professional?

A
  1. Myocardial infarction within six months
  2. Angina or symptoms of heart failure
  3. Resting systolic BP of >200mmHg
277
Q

ACSM no longer require individuals with __________ ______ to be automatically referred for medical clearance before the initiation of an exercise program.

A

Pulmonary disease.

278
Q

What four exercises comprise the Goof Life with Arthritis: Denmark (GLA:D) protocol?

A
  1. Pelvic lift
  2. Sliding and stepping lunge
  3. Step up
  4. Chair stands and squats.
279
Q

Define Sarcopenia.

A

The slow and inevitable loss of age-related muscle mass and consequential physical function.

280
Q

What is the reported rate of sarcopenia?

A

1-2% loss per year >50 years.

281
Q

When completing resistance exercises with an older adult, you should aim to move through a __________ ROM to enhance strength and __________.

A

A) Functional
B) Flexibility

282
Q

What is an important cue to give to older adults when completing resistance training to avoid excessively increasing BP?

A

Breathe out with the effort.

The Valsalva maneuver elevates BP, impedes venous blood flow and results in lightheadedness.

283
Q

What are the WHO recommendations for exercise for people older than 65?
Provide details for:
1. Total weekly duration,
2. Aerobic exercise session duration,
3. Duration for additional health benefits,
4. Balance training, and
5. Strength training frequency.

A
  1. 150min of moderate or 75min of vigorous-intensity aerobic exercise.
  2. Bouts of at least 10min.
  3. 300min of moderate or 150min of vigorous-intensity aerobic exercise.
  4. Three days per week.
  5. Two or more days.
284
Q

What is the recommended frequency for older adults to complete balance training?

A

Three days per week.

285
Q

Older adults with poor __________ should complete balance exercises to prevent _______ on ___ or more days per week.

A

A) Mobility
B) Falls
C) 3

286
Q

What are the values for the following exercise variables when training older adults:
A) Frequency
B) Volume & Intensity (3 levels)
C) Progression
D) Exercise selection
E) ROM
F) Breathing

A

A) 2-3 non-consecutive days per week
B) Begin with 1 x 10-15 @ 40-60% and progress to multiple sets of 10-15 @ 60-70%, 8-12 @ 70-80%, and 4-8 @ 80-90%.
C) ~5%
D) Mostly compound with isolated exercises for supplementing muscle groups.
E) Pain-free functional ROM.
F) Continuously breathing with exhales on the effort.

287
Q

Falls in older people are not ________ ______but can be predicted by assessing several _______ _________.

A

A) Random events
B) Risk factors

hlth3017 - exercise physiology for special populations (1 decks)

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