Final Flashcards
1
Q
What does zero mean in MMT?
A
No activity
2
Q
What does T mean in MMT?
A
Trace
3
Q
What does P mean for MMT?
A
Poor
4
Q
What does F mean for MMT?
A
Fair
5
Q
What does G mean for MMT?
A
Good
6
Q
What does N mean for MMT?
A
Normal
7
Q
How long should you apply resistance over in MMT?
A
Gradually for 2-3 sec
8
Q
Why do you gradually add resistance in MMT?
A
Allows for pt motor units to recruit and stabilize
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
10
Q
What does WAR mean?
A
Within available range
11
Q
What does 2- mean?
A
Able to move through partial range in minimized gravity position
12
Q
What does 2+ mean?
A
Partial range against gravity OR full AROM in gravity minimized position and holds against pressure
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)
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
15
Q
What does power mean?
A
F x distance/time; rate of performing work
Power training
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
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
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
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
20
Q
What factors influence tension generation in skeletal muscle?
A
Energy stores and blood supply - contract, generate tension, and resist fatigue
21
Q
How do muscles recover from exercise?
A
- Microtrauma tears - need rest to rebuild
- Between 24-48 hours
22
Q
What should the rest period be for power exercise?
A
More rest because body needs to perform at a higher level
23
Q
What should rest periods be for endurance exercises?
A
Shorter rest periods for more activity
24
Q
When do neural adaptations occur?
A
-Increased EMG activity within the first 4-8 weeks
25
What are skeletal muscle adaptations?
- Hypertrophy
- Hyperplasia
- Muscle fiber adaptation
26
When does hypertrophy occur?
-Occurs after 4-8 weeks or 2-3 weeks with high intensity
27
What is hyperplasia?
Increase in the number of muscle cells
28
What are type I muscle fibers?
Slow twitch
| IE Endurance
29
What are type II muscle fibers?
Fast twich
| IE. Sports
30
Can type I turn to type II?
Yes, but not vice versa
31
What are adaptations of CT?
Tendons and ligaments increase tensile strength
CT in muscle thickens
Bone density increases
32
What are determinants of resistance exercise?
```
Alignment
Stabilization
Intensity
Volume
Exercise order
Frequency
Rest interval
Duration
Mode
Velocity
Periodization
Integration into functional activities
```
33
What is intensity for resistance exercise?
- 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
34
What is a beginners training zone?
30-40%
35
What is a highly trained individuals training zone?
80%
36
What is a healthy, untrained individuals training zone?
40-70%
37
What is volume in resistance exercise?
Total reps during session x intensity
38
What is the average volume of an untrained adult?
Load of 75%
1 RM
Able to complete 10 reps before rest
39
What is the common set recommendation?
2-4 sets
40
What are benefits to sets of an exercise?
Improve strength and endurance
41
What if fatigue is not experienced after reps are completed?
Intensity is not appropriate
42
How do you improve muscle endurance?
Increase reps first and then load in small increments or time
43
What is the proper exercise order?
- Large Mm before small Mm
- Multijoint before single
- High intensity before lower
44
How do you determine frequency?
It depends
45
How do you determine duration?
Time to achieve goal vs maintaining optimal function
46
What is the recommended rest interval?
- Dynamic rest - alternate muscle groups
| - Integrate rest into exercise
47
What determines the mode of exercise?
- 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
48
What is periodization training?
Peak performance - intensity, volume, frequency, and rest vary
49
How do you integrate training to functional activities?
- Balance of stability and mobility
- Strength, power, and endurance
- Task specific movement patterns with resistance
50
What is DOMS?
Delayed onset muscle soreness
51
What is happening during DOMS?
- 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"
52
What is an isokinetic exercise?
- Constant velocity, but resistance and force vary
- Can accommodate to fatigue - still perform despite F
- Accommodate painful arc of motion
53
How do you implement resistance exercise?
-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)
54
What are the precautions to resistance exercise?
- Intensity - IE. Osteoporosis
- Reps/sets - progression
- Type - high impact, velocity, spine and hip positions
- Balance
- Group exercise
55
What are contraindications to resistance exercise?
- 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)
56
What are mechanical R exercises?
-External R applied by equipment
57
What are special considerations to R exercise to children?
- 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
What are special considerations to R exercise with older adults?
- Less rigorous initially
| - Be aware of poor vision, impaired balance, and age-related postural changes
59
What is the cut off for R training for children?
Should not be younger than 7
At risk for growth plate injuries
60
Where should you start with R training for older adults?
Start at 30-40% of 1 RM with impaired balance or age-related postural problems
61
What is the definition of overload?
Threshold to obtain hypertrophy
62
What is progressive resistance exercise (PRE)?
Constant external load (free weight or machine) that incrementally increases
63
What do studies state is the best PRE to improve strength?
2-3 sets of 6-12 reps
Increase R 5-10% when reps are complete without significant fatigue
64
What is circuit weight training?
- 8-12 muscle groups for total body conditioning
- Usually higher reps, but lower intensity
- Order is important
65
What is RPE?
Rate of perceived exertion
66
What are cam machines?
Claims load will be heaviest at mid-range
67
What does hydraulic mean?
The faster the piston = the more R being applied
68
What is limb loading?
- Once core is stabilized then we add limb movement
- Goal to maintain contraction while breathing
- Load the spine with UE first then LE
69
How is the strength of the pelvic floor measured?
0-6 scale
Perineometer - 3 contractions with 10 sec hold
-Record avg or highest of 3
-Length of contraction can also be measured
70
What are clinical conditions that can result from trauma or pathology?
- Dysfunction
- Jt dysfunction
- Contracture
- Adhesions
- Muscle guarding
- Muscle weakness
- Myofascial compartment syndrome
71
What is a Grade 1 tissue injury?
- First degree
| - Mild pain and swelling
72
What is a Grade 2 tissue injury?
- Second degree
- Moderate pain
- Significant increased pain - stress and palpation
- Ligaments may be torn
73
What is a Grade 3 tissue injury?
- Third degree
- Severe pain
- Near complete or complete ligament tear
- Tendon avulsion
- Jt instability
74
What is the anterior pillar of the spine?
- Made from bodies and discs
| - WB and shock absorbing portion
75
What is the posterior pillar of the spine?
- Consists of articular processes, facet joints, TPs, and SPs
- Responsible for gliding motion
76
Why do we lose height as we age?
- Lose hydration in the disc
| - Leads to pain
77
What do we do if someone has a "stuck facet"?
Joint glides/joint mobs
78
If someone has a disc herniation and they flex the spine what will happen?
Make posterior herniation worse
79
What is spondylolithesis?
Vertebrae above slides on the one below
Shear force
80
Why does lateral shearing occur?
Poor posture and body mechanics
Vertebrae above slides laterally to the one below
81
What is the best way to keep the spine stable?
Recruit muscles of the spine
82
What type of muscle fibers do our bodies use during our ADLs?
Type I - endurance
83
How much muscle contraction is needed during our usual activities?
~10%
84
What is feedforward control?
Anticipate load from limb movement to maintain spinal stability
85
What effects do limb movements have on spinal stability?
- Without stabilization there would be excessive stress
- Localized muscle fatigue
- Muscle imbalance
86
What happens if there is too little pressure on the spine?
Too much room for movement
87
What if there is too much pressure on the spine?
Compressive force
88
What is the cause of pain?
Effects of mechanical stress
Effects of impaired posture
Pain syndromes
89
What is postural fault pain syndrome?
No structural impairment
90
What is postural pain syndrome?
Postural fault over time; no functional strength or flexibility impairments yet
91
What is postural dysfunction?
Shortening and weakness
92
What are postural habits?
Need good ones to avoid pain and dysfunction
93
What is kinesthetic training of the spine?
Total body training
- Head nodding and pelvic tilts
- Neutral spine
94
What is stabilization training of the spine?
Deep segmental muscle activation
| Superficial global muscle control
95
What is functional training of basic body mechanics of the spine?
Bed mobility
Transfers
Walking
96
What are the elements of kinesthetic training of the spine?
Position of symptom relief
Effects of movement on the spine
97
What is directional preference or bias?
- Expecting 1D movement to relieve symptoms
| - Not everyone is the same
98
What are the goals of muscle performance of the spine?
- 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
What are global muscle stabilization exercises?
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
What is the goal of cardiopulmonary endurance?
Develop cardiopulm fitness for overall endurance and well-being
101
What is the goal of functional activity?
To progress to independence safely
102
How to figure out an individuals max HR?
220-age
103
What is the definition of physical fitness?
Based on energy expenditure during physical work
104
How is physical fitness measured?
VO2 max
105
What is VO2 max?
Max O2 consumed per min when max effort has been reached
106
What influences VO2 max?
Age, gender, heredity, inactivity, and disease
107
How is VO2 max measured?
Usually during walking, running, or swimming
108
What are energy systems?
Intensity and duration of activity determined when and to what extent each system contributes
109
What are the 3 major energy systems?
Phosphagen ATP-PC
Anaerobic glycolytic
Aerobic system
110
What is the phosphagen ATP-PC system?
- 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
What is the anaerobic glycolytic system?
-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
What is the aerobic system?
- Oxygen is required
- Max capacity is great, power is small
- Predominates other systems after 2 min of exercise
- What marathoners use
113
What is energy expenditure?
- Expressed as kcal
- Light, mod, or heavy based on energy cost
- Affected by mechanical efficiency and body mass
114
What are METs?
Energy expenditure
115
What is light energy expenditure?
2.0-2.9 METs
Walking less than 2.5 mph
116
What is moderate energy expenditure?
3.0-5.9 METs
Mowing lawn, walking with power mower
117
What is high energy expenditure?
6.0-8.8 METS
Running 5.0 mph
118
What is the physiological response to aerobic exercise?
- 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
What is the formula for cardiac output?
HR x SV
120
How to test healthy individuals for exercise programs?
- Timed 1.5 mil or distance in 12 min
- 1-mile walk test, 6 MWT, and step test
- TM or cycle for VO2max
121
How to test for exercise programs using stress test?
- 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
What systems contribute to balance control?
```
Visual system
Somatosensory system
Vestibular system
Sensory organization
Types of balance control
```
123
How does the visual system contribute to balance?
Head position relative to environment
Direction and speed of head movement
124
How does somatosensory system contribute to balance?
Position and motion of body/body parts relative to each other and support surface
125
How does the vestibular system contribute to balance?
Position and movement of head with respect to gravity and inertial forces
126
Where is sensory info organized?
Cerebellum
Basal ganglia
Motor cortex
127
T/F the somatosensory has the the fastest processing time for rapid responses?
True
2 for visual and 3 for vestibular
128
What happens if the sensory system is impaired?
CNS suppresses inaccurate input and selects from the other two systems
129
What is the cerebellum responsible for?
Coordination tasks and motor response to judge that coordination
130
What is the motor cortex responsible for?
Houses motor response after receiving sensory input
131
What are the three postural reactions?
- Feedforward
- Anticipatory control
- Closed loop control
132
What is feedforward control?
Automatic, fast movements and processing time, and cannot anticipate
133
What is anticipatory control?
Activating postural muscles before performing movement
134
What is closed loop control?
Precision movements that require sensory feedback
IE. Balance beam or standing on BOSU
135
What are the most common risk factor for falls among the elderly?
- 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
How to respond to an RA exacerbation
- 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
What is stress incontinence?
Involuntary urination caused by physical movement or activity
138
What are some exercise implications with GERD?
Moderate activity may help with acid reflux, while higher level activity can aggravate it
139
Exercise implications for those with SLE?
Exercise may help stiffened joints, but too much may cause more pain and damage
140
What are the exercise implications for patient's undergoing chemo for bone cancer?
Patients experience fatigue and nausea when on chemo. Too much exercise may cause greater fatigue and increase nausea/other symptoms
