Exercise Principles Flashcards by Tahlia Wasserman

where are muscle spindles located?

within extrafusal muscles fibers

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what do muscles spindles do?

detect muscle length changes

monitor velocity and duration of stretch

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muscles spindles are constantly used in ___ and ____ _____ _____

tone, protection of muscles

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what is the GTO?

located within the tendon to protect from over stretch

stimulated by tension of passive stretch or muscle contraction

produces relaxation of muscles

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what are the indications for PROM?

unable to move actively

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what are the goals of PROM?

maintain joint/soft tissue mobility

prevent contracture/adaptive shortening

enhance nutrition to cartilage and other joint-related structures

improve circulation and assist with healing

stimulation of mechano, proprioceptors

demonstration of desired activity

assessment purposes

relaxation

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what are the contraindications of PROM?

when motion may disrupt healing

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what are the indications for AAROM?

muscle strength is between trace and poor

when apprehension or pain is present

when guidance is needed for correct performance of an activity

when muscle activation is allowed or desired

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what are the goals of AAROM?

same as those noted for PROM

provides some assistance to weak muscle and thus promotes N-M re-education, strengthening, ROM

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what are the contraindications for AAROM?

when movement would disrupt the healing process

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what are the indications for AROM?

when muscle is capable of voluntary contraction and is desired

must have fair grade to perform against gravity

precursor to resistance exercise

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what are the goals of AAROM?

as for PROM

maintain muscle contractibility

diminished bone resorption

diminishes muscular effects of hypomobility

limited ability to strengthen (< 3/5 strength)

enhances neuro-muscular performance

promotes independence

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what are the contraindications for AROM?

unstable cardiac condition

disruption of healing muscle/tendon s/p tear/repair

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what is static stretching?

1.)Stretch held at greatest length for period of time

2.)Hold minimum 15-30 sec

3.)Less force required and therefore safer

4.)Less energy required and therefore easier

5.)Facilitated GTO, inhibits Muscle Spindle

6.)Performed manually or mechanically

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what is ballistic stretching?

1.)Quick movements used to impose change in soft tissue length

2.)Initiated by antagonists to muscles being stretched

3.)Increased risk of injury, soreness

4.)Appropriate for certain populations only

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what is active inhibition stretching (PNF)?

1.)Enhancement of muscle relaxation through stimulation of GTO

2.)Use of antagonist muscle to those being stretch without quick or forceful motions

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what are the indications for stretching?

1.)Mobility impairment due to contractures, adhesions,

scar tissue, etc that leads to shortening of periarticular soft tissue

2.)When mobility impairment may lead to preventable
structural deformity

3.)When mobility impairments effect function

4.)To enhance strengthening activities

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what are the goals of stretching?

1.)Restoration of optimal mobility of joints and periarticular soft tissue

2.)Prevention of injury

3.)Achieve optimal function!!!!!!!!!!!!!!

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what are the precautions for stretching?

New Fracture

Osteoporosis

Vigorous stretching after period of immobilization

Significant pain > 24 hours post procedure

Edematous tissue

Chronically weak muscles

Transient vs long term force production decrease

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what are the contraindications to stretching?

Bony block limitation

Active inflammation

Sharp pain with movement

When limited mobility is functionally desirable

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what are slow oxidative (type 1) fibers?

small diameter

red

aerobic metabolism

slow, longer lasting contraction (100-200 msec)

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what are fast oxidative-glycolytic (type 2b) fibers?

intermediate diameter

aerobic and anaerobic metabolism

fast force production, less endurance (<100 msec)

transitional fiber

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what are fast glycolytic (type 2b) fibers?

large diameter

white in color

anaerobic metabolism

strong, rapid, yet short lasting

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what determines the amount of force developed by a muscle?

the fiber type

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do type 1 or type 2 fibers atrophy first?

type 1??? 99% sure this is supposed to be type 2

do type 1 or 2 fibers have a smaller diameter and less force generating capabilities?

type 1 fibers

what muscle arrangment is best for force production?

pennate

what muscle arrangement is best for excursion?

long, parallel muscles

what is the SAID principle?

Specific Adaptable to Imposed Demands

what are ways to progress an exercise?

more weight, more sets, more reps, higher levels, more exercises, less rest, more difficulty, changing type, changing exercise, more sessions/week

what happens when we perform strengthening?

hypertrophy

how long does it generally take for hypertrophy?

4-8 weeks of moderate to high intensity resistance training

when is hypertrophy thought to be the greatest?

in eccentrics

what fibers most readily hypertrophy?

type 2b

what are the determinants of resistance exercises?

Alignment Stabilization Intensity Volume Exercise Order Frequency Rest Interval Duration Mode of exercise Velocity Periodization Integration into Functional Activity

what is external stabilization?

manual stabilization by PT or by patient, belts, straps, back of chair

what is internal stabilization?

isometric contraction of adjacent segments (proximal muscle has to be strong enough)

what is the overload principle?

we have to expose the muscles to loads greater than those usually incurred

what factors determine the intensity of an exercise?

volume frequency order of exercise length of rest

t/f: intensity of exercise is generally lower in rehab settings

true

what is submax loading?

Early stages of soft tissue healing: protection After prolonged immobilization: ---> Artic cartilage not able to withstand full load ----> Possible bone demineralization (Inc risk of pathological fx ----> Evaluate pts response to exercises Initially learning an exercises (looking for correct form) Most children and older adults Goal is muscle endurance Warm-up & cool-down Slow velocity isokinetic training to minimize joint compressive forces

what is max loading?

Goal is to inc muscle strength & power and possibly size Otherwise healthy population in advanced stages of rehab programs post msk injury (preparation for return to high demand occupation or recreational activities In conditioning programs with no known pathology Competitive weight lifting or body building

what is rep max?

maximum amount of weight a muscle can move through full available ROM with control a specific # of times

t/f: assessing for 1 RM is usually unsafe for pts

true, it better to use 6-10 rep max

what is form fatigue?

point at which patients performance technique begins to degrade (reduced ROM and unable to stabilize)

in a sedentary untrained pt, what % RM should they initially be working at?

30-40% RM

in a healthy untrained pt, what % RM should they initially be working at?

40-70%

in a highly trained pt, what % RM should they initially be working at?

80%

t/f: you should start pts at lower % RM to teach form

true

t/f: elderly and children should initially work at low to moderate % RM

true

if a pt has significant strength deficits, what % RM should they initially work at?

30-50% RM

what is the volume of exercises?

total reps and sets

how many reps should the average untrained pt be doing at 75% RM?

10 reps

how many reps should the average untrained pt be doing at 60% RM?

15 reps

how many reps should the average untrained pt be doing at 90% RM?

4-5 reps

what is the Delorm method for RM?

find 10 RM and slowly increase % RM 10x @ 50% 10RM 10x @75% 10RM 10x @ 100% 10RM warm up and rest periods built in

what is the Oxford method for RM?

find 10 RM 10x @ 100% 10RM 10x @75% 10RM 10x @ 50% 10RM reduces fatigue specific to patient no warm-up

what is the Dapre method of RM?

find 6 RM set #1: 10x @ 50% 6RM set #2: 10x @ 75% 6RM set #3: Max reps @ 6RM set #4: Max reps at adjusted RM eliminates arbitrary progression more room for error

what is the common recommendation for sets for adults?

2-4

t/f: a single set of low intensity is common in very early rehab phase

true

when fatigue is no longer achieved with exercise, what should be done?

increased sets or resistance (lower reps if increased resistance)

how do do we work endurance?

do many reps at submaximal load high reps with low load 3-5 sets of 40-50 reps use early in rehab

when increasing the reps and sets in inefficient, what should be done?

increased resistance

should large or small muscle groups be exercised first?

large

should single or multiple jt exercises be done first?

single jt exercises

should high or lower intensity exercises be done first?

high intensity

t/f: initially do multiple session per day, then move to 3-5 days a week

true

how many sessions should the elderly and children do per week?

2-3

what are the early strength gains due to?

neural adaptations

when does muscles hypertrophy usually begin?

6-12 weeks

___ intensity=____ rest

greater, greater

how long should rest bw sets be with moderate intensity exercises?

2-3 minutes

how long should rest bw sets be with high intensity multi jt exercises?

>3 minutes

__ hour rest bw sessions is recommended

t/f: more muscle mass/higher loads require longer rest periods

true

what are the 3 forms of resistance?

manual accomodative resistance

concentrics with increased velocity=____ force production

reduced

eccentrics with increased velocity=____ force production

increased

what elements of exercise require proprioception?

agility balance coordination

what is a key factor in the ability to perform tasks with dexterity, mastery, and proficiency

proprioceptors

what are somatic receptors?

sensory receptors (other than eyes ears, nose, and mouth) that provide afferent info to the CNS

what are the 3 groups of somatic receptors?

exteroreceptors interoceptors proprioceptors

what are exteroreceptors?

provide info on the external environment

what are interoreceptors?

provide info about body’s internal environment

what are proprioceptors?

provide info about body or segment’s position in space

what is proprioception?

the body's ability to transmit position sense, interpret info and respond consciously or unconsciously to this stimulation through appropriate execution of posture and movement

what are examples of proprioception?

position sense w/o visual input balance maintenance smooth writing jump, run, cut and throw all activities of life

what is kinesthesia?

sensation of limb movement and position

where are mechanoreceptors in the body?

skin, jts, ligs, muscles, tendons

what are the requirements for balance?

proprioception oculomotor system vestibular system strength

what is a common balance assessment?

star excursion balance test (SEBT) with 8 vector positions

what is the principle of overflow in exercise?

with increased voluntary effort or prolonged effort, motor activity spreads to additional motor units of the same muscle and to motor units of other muscles

what are the requirements for coordination?

balance activity perception feedback and feedforward repetition inhibition

what is the feedback system?

interpretation of mss, visual, auditory, several other afferent systems to the results of the action then makes appropriate adjustments

what is the feedforward system?

response to the environment based on previous knowledge and activity that can give the body info by which it can perform the activity with accuracy and predictability not based on error correction but on previous experience

what is agility?

ability to control direction of body or segment during rapid movement involves rapid changes in direction and sudden stops and starts

what are the requirements for agility?

coordination flexibility speed power skill

how do we progress agility?

start with simple task drills increased complexity or speed of task

what is the flow to regain proprioception?

balance-->coordination-->agility

what are age related changes?

1. Infants are weak strengthening occurs by spontaneous movements 2. Increased strength during maturation 3. 18-30 y.o. greatest potential to gain strength 4. Elderly increase strength due to neural factors, increased fatigability and disuse

what is immediate muscle soreness due to?

inadequate blood flow, oxygen, build up of lactic acid

what is DOMS?

12-48 hrs post exercise soreness involving microtears