Exercise Principles Flashcards
where are muscle spindles located?
within extrafusal muscles fibers
what do muscles spindles do?
detect muscle length changes
monitor velocity and duration of stretch
muscles spindles are constantly used in ___ and ____ _____ _____
tone, protection of muscles
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
what are the indications for PROM?
unable to move actively
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
what are the contraindications of PROM?
when motion may disrupt healing
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
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
what are the contraindications for AAROM?
when movement would disrupt the healing process
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
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
what are the contraindications for AROM?
unstable cardiac condition
disruption of healing muscle/tendon s/p tear/repair
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
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
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
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
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!!!!!!!!!!!!!!
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
what are the contraindications to stretching?
Bony block limitation
Active inflammation
Sharp pain with movement
When limited mobility is functionally desirable
what are slow oxidative (type 1) fibers?
small diameter
red
aerobic metabolism
slow, longer lasting contraction (100-200 msec)
what are fast oxidative-glycolytic (type 2b) fibers?
intermediate diameter
aerobic and anaerobic metabolism
fast force production, less endurance (<100 msec)
transitional fiber
what are fast glycolytic (type 2b) fibers?
large diameter
white in color
anaerobic metabolism
strong, rapid, yet short lasting
what determines the amount of force developed by a muscle?
the fiber type
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
48
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?
- Infants are weak strengthening
occurs by spontaneous movements
- Increased strength during maturation
- 18-30 y.o. greatest potential to gain strength
- 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
