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Therapeutic Exercise > Final > Flashcards

Final Flashcards

1
Q

What does zero mean in MMT?

A

No activity

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2
Q

What does T mean in MMT?

A

Trace

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3
Q

What does P mean for MMT?

A

Poor

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4
Q

What does F mean for MMT?

A

Fair

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5
Q

What does G mean for MMT?

A

Good

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6
Q

What does N mean for MMT?

A

Normal

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7
Q

How long should you apply resistance over in MMT?

A

Gradually for 2-3 sec

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8
Q

Why do you gradually add resistance in MMT?

A

Allows for pt motor units to recruit and stabilize

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9
Q

Will someone who has a contracture be able to have a 3 score in MMT?

A

No - more so 0-2, but could have a 3 or higher WAR

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10
Q

What does WAR mean?

A

Within available range

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11
Q

What does 2- mean?

A

Able to move through partial range in minimized gravity position

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12
Q

What does 2+ mean?

A

Partial range against gravity OR full AROM in gravity minimized position and holds against pressure

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13
Q

What does 2+ mean for PF?

A

WB complete with partial heel raise OR performed supine and pt can take max resistance (full AROM)

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14
Q

What is the definition of strength?

A

Greatest measurable F that can be exerted by a muscle or group to overcome R during 1 max effort

Low reps in short time period

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15
Q

What does power mean?

A

F x distance/time; rate of performing work

Power training

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16
Q

What is the definition of endurance?

A

Ability of muscle to contract repeatedly against a load (R)

Light load for many reps or sustained muscle contraction over an extended period of time

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17
Q

What is the Overload Principle?

A

Load that exceeds metabolic capacity of the muscle must be applied

ST (strength training): R is increased, add time component, and manipulate R
ET (endurance training): time of muscle contraction must be applied, high reps, hold position by increased time but not necessarily R or load

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18
Q

What is the SAID Principle?

A

Specificity of training

  • Endurance vs strength; mode, velocity, joint angle
  • Transfer of training: significantly less than effects of specificity: FUNCTIONAL
  • Body systems adapt to stress
  • Breaking down task
  • Trial and error
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19
Q

What is the Reversibility Principle?

A
  • Begins in 1-2 weeks
  • Incorporate gains into ADLs early in rehab program
  • Muscles can atrophy within 48 hours at the cellular level
  • Use it or lose it
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20
Q

What factors influence tension generation in skeletal muscle?

A

Energy stores and blood supply - contract, generate tension, and resist fatigue

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21
Q

How do muscles recover from exercise?

A
  • Microtrauma tears - need rest to rebuild

- Between 24-48 hours

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22
Q

What should the rest period be for power exercise?

A

More rest because body needs to perform at a higher level

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23
Q

What should rest periods be for endurance exercises?

A

Shorter rest periods for more activity

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24
Q

When do neural adaptations occur?

A

-Increased EMG activity within the first 4-8 weeks

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25
Q

What are skeletal muscle adaptations?

A
  • Hypertrophy
  • Hyperplasia
  • Muscle fiber adaptation
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26
Q

When does hypertrophy occur?

A

-Occurs after 4-8 weeks or 2-3 weeks with high intensity

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27
Q

What is hyperplasia?

A

Increase in the number of muscle cells

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28
Q

What are type I muscle fibers?

A

Slow twitch

IE Endurance

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29
Q

What are type II muscle fibers?

A

Fast twich

IE. Sports

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30
Q

Can type I turn to type II?

A

Yes, but not vice versa

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31
Q

What are adaptations of CT?

A

Tendons and ligaments increase tensile strength

CT in muscle thickens

Bone density increases

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32
Q

What are determinants of resistance exercise?

A 
Alignment
Stabilization
Intensity
Volume
Exercise order
Frequency
Rest interval
Duration
Mode
Velocity
Periodization
Integration into functional activities
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33
Q

What is intensity for resistance exercise?

A
  • Submax vs max ex load
  • Initial ex load (amount of resistance) and documentation
  • Rep max - use rep max
  • Alternate methods of determining baseline strength or initial exercise load - IE. dynamometer and percentage of body weight
  • Training zone
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34
Q

What is a beginners training zone?

A

30-40%

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35
Q

What is a highly trained individuals training zone?

A

80%

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36
Q

What is a healthy, untrained individuals training zone?

A

40-70%

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37
Q

What is volume in resistance exercise?

A

Total reps during session x intensity

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38
Q

What is the average volume of an untrained adult?

A

Load of 75%
1 RM
Able to complete 10 reps before rest

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39
Q

What is the common set recommendation?

A

2-4 sets

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40
Q

What are benefits to sets of an exercise?

A

Improve strength and endurance

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41
Q

What if fatigue is not experienced after reps are completed?

A

Intensity is not appropriate

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42
Q

How do you improve muscle endurance?

A

Increase reps first and then load in small increments or time

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43
Q

What is the proper exercise order?

A
  • Large Mm before small Mm
  • Multijoint before single
  • High intensity before lower
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44
Q

How do you determine frequency?

A

It depends

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45
Q

How do you determine duration?

A

Time to achieve goal vs maintaining optimal function

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46
Q

What is the recommended rest interval?

A
  • Dynamic rest - alternate muscle groups

- Integrate rest into exercise

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47
Q

What determines the mode of exercise?

A
  • Type of muscle contraction
  • Positioning - WB vs NWB
  • Forms of resistance - manual, constant or variable, BW or partial BW
  • Energy systems
  • Range of movement
  • Mode of exercise and application to function
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48
Q

What is periodization training?

A

Peak performance - intensity, volume, frequency, and rest vary

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49
Q

How do you integrate training to functional activities?

A
  • Balance of stability and mobility
  • Strength, power, and endurance
  • Task specific movement patterns with resistance
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50
Q

What is DOMS?

A

Delayed onset muscle soreness

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51
Q

What is happening during DOMS?

A
  • Microtrauma is healing
  • Empty stores - emptying energy
  • Lactic acid partially
  • Tell pt “your muscles have not worked like this in awhile. We expect some soreness to happen, but we do not want an increase in your pain. Pain such as burning, tingling, or intense pain”
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52
Q

What is an isokinetic exercise?

A
  • Constant velocity, but resistance and force vary
  • Can accommodate to fatigue - still perform despite F
  • Accommodate painful arc of motion
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53
Q

How do you implement resistance exercise?

A

-Warm up
-Placement of resistance
-Direction of resistance
-Stabilization
-Intensity of exercise/amount of R
Verbal/written instructions
-Monitor pt - before, during, and after
-Cool down (~2-3 min)

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54
Q

What are the precautions to resistance exercise?

A
  • Intensity - IE. Osteoporosis
  • Reps/sets - progression
  • Type - high impact, velocity, spine and hip positions
  • Balance
  • Group exercise
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55
Q

What are contraindications to resistance exercise?

A
  • Pain - severe during AROM, MMT, or does not decrease with reduced R
  • Inflammation - acute for dynamic, static is okay, inflammatory disease
  • Severe cardiopulmonary disease - IE. post MI or CABG (no R for at least 5 weeks post)
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56
Q

What are mechanical R exercises?

A

-External R applied by equipment

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57
Q

What are special considerations to R exercise to children?

A
  • Can use R to gain strength, but still questionable studies on benefit to sports related injuries
  • Use BW as a source of R
  • Use specific equipment designed for youth
58
Q

What are special considerations to R exercise with older adults?

A
  • Less rigorous initially

- Be aware of poor vision, impaired balance, and age-related postural changes

59
Q

What is the cut off for R training for children?

A

Should not be younger than 7

At risk for growth plate injuries

60
Q

Where should you start with R training for older adults?

A

Start at 30-40% of 1 RM with impaired balance or age-related postural problems

61
Q

What is the definition of overload?

A

Threshold to obtain hypertrophy

62
Q

What is progressive resistance exercise (PRE)?

A

Constant external load (free weight or machine) that incrementally increases

63
Q

What do studies state is the best PRE to improve strength?

A

2-3 sets of 6-12 reps

Increase R 5-10% when reps are complete without significant fatigue

64
Q

What is circuit weight training?

A
  • 8-12 muscle groups for total body conditioning
  • Usually higher reps, but lower intensity
  • Order is important
65
Q

What is RPE?

A

Rate of perceived exertion

66
Q

What are cam machines?

A

Claims load will be heaviest at mid-range

67
Q

What does hydraulic mean?

A

The faster the piston = the more R being applied

68
Q

What is limb loading?

A
  • Once core is stabilized then we add limb movement
  • Goal to maintain contraction while breathing
  • Load the spine with UE first then LE
69
Q

How is the strength of the pelvic floor measured?

A

0-6 scale
Perineometer - 3 contractions with 10 sec hold
-Record avg or highest of 3
-Length of contraction can also be measured

70
Q

What are clinical conditions that can result from trauma or pathology?

A
  • Dysfunction
  • Jt dysfunction
  • Contracture
  • Adhesions
  • Muscle guarding
  • Muscle weakness
  • Myofascial compartment syndrome
71
Q

What is a Grade 1 tissue injury?

A
  • First degree

- Mild pain and swelling

72
Q

What is a Grade 2 tissue injury?

A
  • Second degree
  • Moderate pain
  • Significant increased pain - stress and palpation
  • Ligaments may be torn
73
Q

What is a Grade 3 tissue injury?

A
  • Third degree
  • Severe pain
  • Near complete or complete ligament tear
  • Tendon avulsion
  • Jt instability
74
Q

What is the anterior pillar of the spine?

A
  • Made from bodies and discs

- WB and shock absorbing portion

75
Q

What is the posterior pillar of the spine?

A
  • Consists of articular processes, facet joints, TPs, and SPs
  • Responsible for gliding motion
76
Q

Why do we lose height as we age?

A
  • Lose hydration in the disc

- Leads to pain

77
Q

What do we do if someone has a “stuck facet”?

A

Joint glides/joint mobs

78
Q

If someone has a disc herniation and they flex the spine what will happen?

A

Make posterior herniation worse

79
Q

What is spondylolithesis?

A

Vertebrae above slides on the one below

Shear force

80
Q

Why does lateral shearing occur?

A

Poor posture and body mechanics

Vertebrae above slides laterally to the one below

81
Q

What is the best way to keep the spine stable?

A

Recruit muscles of the spine

82
Q

What type of muscle fibers do our bodies use during our ADLs?

A

Type I - endurance

83
Q

How much muscle contraction is needed during our usual activities?

A

~10%

84
Q

What is feedforward control?

A

Anticipate load from limb movement to maintain spinal stability

85
Q

What effects do limb movements have on spinal stability?

A
  • Without stabilization there would be excessive stress
  • Localized muscle fatigue
  • Muscle imbalance
86
Q

What happens if there is too little pressure on the spine?

A

Too much room for movement

87
Q

What if there is too much pressure on the spine?

A

Compressive force

88
Q

What is the cause of pain?

A

Effects of mechanical stress

Effects of impaired posture

Pain syndromes

89
Q

What is postural fault pain syndrome?

A

No structural impairment

90
Q

What is postural pain syndrome?

A

Postural fault over time; no functional strength or flexibility impairments yet

91
Q

What is postural dysfunction?

A

Shortening and weakness

92
Q

What are postural habits?

A

Need good ones to avoid pain and dysfunction

93
Q

What is kinesthetic training of the spine?

A

Total body training

  • Head nodding and pelvic tilts
  • Neutral spine
94
Q

What is stabilization training of the spine?

A

Deep segmental muscle activation

Superficial global muscle control

95
Q

What is functional training of basic body mechanics of the spine?

A

Bed mobility
Transfers
Walking

96
Q

What are the elements of kinesthetic training of the spine?

A

Position of symptom relief

Effects of movement on the spine

97
Q

What is directional preference or bias?

A
  • Expecting 1D movement to relieve symptoms

- Not everyone is the same

98
Q

What are the goals of muscle performance of the spine?

A
  • Activate and develop neuromuscular control of deep segmental and global spinal muscles to support the spine against external load
  • Develop endurance and strength in muscles of axial skeleton for function
  • Develop control of balance in stable and unstable situations
99
Q

What are global muscle stabilization exercises?

A

Progressions
-Mm activation, increase time or #, add UE/LE movement (partial then full range), resistance (progress through), unstable surfaces, endurance and strength principles repeated for fxn

100
Q

What is the goal of cardiopulmonary endurance?

A

Develop cardiopulm fitness for overall endurance and well-being

101
Q

What is the goal of functional activity?

A

To progress to independence safely

102
Q

How to figure out an individuals max HR?

A

220-age

103
Q

What is the definition of physical fitness?

A

Based on energy expenditure during physical work

104
Q

How is physical fitness measured?

A

VO2 max

105
Q

What is VO2 max?

A

Max O2 consumed per min when max effort has been reached

106
Q

What influences VO2 max?

A

Age, gender, heredity, inactivity, and disease

107
Q

How is VO2 max measured?

A

Usually during walking, running, or swimming

108
Q

What are energy systems?

A

Intensity and duration of activity determined when and to what extent each system contributes

109
Q

What are the 3 major energy systems?

A

Phosphagen ATP-PC
Anaerobic glycolytic
Aerobic system

110
Q

What is the phosphagen ATP-PC system?

A
  • No oxygen required
  • When muscle rested - ATP replenished
  • Max capacity is small, max power is great
  • Short, quick bursts of energy
  • Major energy source for the 1st 30 sec of intense exercise
111
Q

What is the anaerobic glycolytic system?

A

-Glucose is fuel
-No oxygen required
-Lactic acid produced
Max capacity and power are intermediate
-Provides energy for moderate activity for short duration
-Major energy released during 30-90 sec of exercise

112
Q

What is the aerobic system?

A
  • Oxygen is required
  • Max capacity is great, power is small
  • Predominates other systems after 2 min of exercise
  • What marathoners use
113
Q

What is energy expenditure?

A
  • Expressed as kcal
  • Light, mod, or heavy based on energy cost
  • Affected by mechanical efficiency and body mass
114
Q

What are METs?

A

Energy expenditure

115
Q

What is light energy expenditure?

A

2.0-2.9 METs

Walking less than 2.5 mph

116
Q

What is moderate energy expenditure?

A

3.0-5.9 METs

Mowing lawn, walking with power mower

117
Q

What is high energy expenditure?

A

6.0-8.8 METS

Running 5.0 mph

118
Q

What is the physiological response to aerobic exercise?

A
  • CV response - SNS (fight or flight) and total peripheral resistance (blood shunted from non-working mm)
  • Increased oxygen extraction - more oxygen extracted from each L of blood
119
Q

What is the formula for cardiac output?

A

HR x SV

120
Q

How to test healthy individuals for exercise programs?

A
  • Timed 1.5 mil or distance in 12 min
  • 1-mile walk test, 6 MWT, and step test
  • TM or cycle for VO2max
121
Q

How to test for exercise programs using stress test?

A
  • Changing workloads by increasing TM speed and/or grad or bike R
  • Low workload for ~1 min and terminating test if symptoms of ECG present abnormally
  • Purpose - dx heart disease, cardio functional capacity
122
Q

What systems contribute to balance control?

A 
Visual system
Somatosensory system
Vestibular system
Sensory organization 
Types of balance control
123
Q

How does the visual system contribute to balance?

A

Head position relative to environment

Direction and speed of head movement

124
Q

How does somatosensory system contribute to balance?

A

Position and motion of body/body parts relative to each other and support surface

125
Q

How does the vestibular system contribute to balance?

A

Position and movement of head with respect to gravity and inertial forces

126
Q

Where is sensory info organized?

A

Cerebellum
Basal ganglia
Motor cortex

127
Q

T/F the somatosensory has the the fastest processing time for rapid responses?

A

True

2 for visual and 3 for vestibular

128
Q

What happens if the sensory system is impaired?

A

CNS suppresses inaccurate input and selects from the other two systems

129
Q

What is the cerebellum responsible for?

A

Coordination tasks and motor response to judge that coordination

130
Q

What is the motor cortex responsible for?

A

Houses motor response after receiving sensory input

131
Q

What are the three postural reactions?

A
  • Feedforward
  • Anticipatory control
  • Closed loop control
132
Q

What is feedforward control?

A

Automatic, fast movements and processing time, and cannot anticipate

133
Q

What is anticipatory control?

A

Activating postural muscles before performing movement

134
Q

What is closed loop control?

A

Precision movements that require sensory feedback

IE. Balance beam or standing on BOSU

135
Q

What are the most common risk factor for falls among the elderly?

A
  • Muscle weakness
  • Hx of falls
  • Gait, visual, and balance deficit
  • Use of AD
  • Arthritis
  • Impaired ADLs
  • Depression
  • Cognitive impairment
  • Greater than 80 years old
136
Q

How to respond to an RA exacerbation

A
  • Use cold packs during flare ups
  • If strengthening during flare up reduce weight or resistance
  • Do not stretch during flare up
  • Hydrotherapy can reduce the stress
137
Q

What is stress incontinence?

A

Involuntary urination caused by physical movement or activity

138
Q

What are some exercise implications with GERD?

A

Moderate activity may help with acid reflux, while higher level activity can aggravate it

139
Q

Exercise implications for those with SLE?

A

Exercise may help stiffened joints, but too much may cause more pain and damage

140
Q

What are the exercise implications for patient’s undergoing chemo for bone cancer?

A

Patients experience fatigue and nausea when on chemo. Too much exercise may cause greater fatigue and increase nausea/other symptoms

Therapeutic Exercise (2 decks)

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