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Therapeutic Exercise > Intro To Excercise & Terms > Flashcards

Intro To Excercise & Terms Flashcards

1
Q

What is Therapeutic Exercise?

A

Continuum health procedure designed to improve or restore an individual’s function, or prevent dysfunction.

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2
Q

What are 5 are purposes as to why one would incorporate therapeutic exercise into their lifestyle.

A
  1. REMEDIATING or PREVENTING impairments*
  2. ENHANCING function*
  3. REDUCING risk of injury/re-injury*
  4. OPTIMIZING overall health
  5. ENHANCING fitness and well-being
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3
Q

What is Stretching?

A

Process of elongation of CONTRACTILE & NON-CONTRACTILE tissues.

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4
Q

What are effects & benefits of stretching?

A

• Increasing flexibility & ROM
• Allowing body to move more efficiently
• Decreasing chance of injury
• Invigorating respiratory, circulatory & lymphatic systems

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5
Q

What are the 3 types of stretching?

A

• PASSIVE STRETCHING
• SELF-STRETCH
• DYNAMIC STRETCH

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6
Q

What is PASSIVE STRETCHING?

A

Sustained or intermittent external end range stretch force, applied with overpressure by manual contact. Shortened tissue is elongated by moving restricted joint just past available ROM, while patient is as relaxed as possible.

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7
Q

What is PASSIVE STRETCHING?

A

Sustained or intermittent external end range stretch force, applied with overpressure by manual contact. Shortened tissue is elongated by moving restricted joint just past available ROM, while patient is as relaxed as possible.

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8
Q

What is SELF-STRETCH?

A

Stretching exercise carried out independently by patient after instruction & supervision by therapist.

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9
Q

What is SELF-STRETCH?

A

Stretching exercise carried out independently by patient after instruction & supervision by therapist.

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10
Q

What is DYNAMIC STRETCH?

A

Active movements that take joints & muscles through their ROM. Can be functional & mimic movements of activity or sport you are about to perform.

Eg. Swimmer may circle their arms before getting into water. Can also be series of movements to get body ready for certain exercise: ie, walking, lunges, leg swings against wall.

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11
Q

What is DYNAMIC STRETCH?

A

Active movements that take joints & muscles through their ROM. Can be functional & mimic movements of activity or sport you are about to perform. Eg. Swimmer may circle their arms before getting into water. Can also be series of movements to get body ready for certain exercise: ie, walking, lunges, leg swings against wall.

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12
Q

What is ELASTIC DEFORMATION?

A

Spring-like response, recoil; stretched material recovers its pretensile dimensions after applied load is removed.

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13
Q

What is PLASTIC DEFORMATION?

A

Putty-like response; linear deformation produced by tensile stress remains even after applied load is removed, resulting in permanent deformation.

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14
Q

What is PLASTIC DEFORMATION?

A

Putty-like response; linear deformation produced by tensile stress remains even after applied load is removed, resulting in permanent deformation.

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15
Q

What is CREEP?

A

When load is applied for extended period of time, tissue elongates, & does not return to its original length. Amount of deformation depends on amount of force & rate at which force is applied.

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16
Q

What is OVERSTRETCH

A

Stretch well beyond normal range of motion of joint & surrounding soft tissue, placing heavy loads on tendons & ligaments (tendons can rupture at 10% increase in length). This causes micro-tearing & inflammation can lead to hypermobility & degenerative arthritis.

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17
Q

What is CONTRACTURE?

A

Adaptive shortening of muscle or other soft tissues that cross joint; which results in limitation of ROM.

Conditions that can produce contractures are prolonged immobilization (cast), restricted mobility (sling), disease (MS), tissue pathology due to trauma (skin grafts, scars), congenital & acquired deformities (scoliosis, torticollis)

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18
Q

What is ACTIVE INHIBITION?

A

Inhibition of muscle by either its own activity, or that of it’s antagonist

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19
Q

What are indications for stretching?

A

• ROM limited because soft tissues have lost extensibility (from adhesions, contractures, scar tissue, etc.)
• Restricted motion may lead to structure deformities that may be preventable
• Muscle weakness & shortening of opposing tissue
have resulted in limited ROM
• Prevent/reduce risk of musculoskeletal injuries
• May be used prior to & after exercise to reduce post-exercise muscle soreness

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20
Q

What are contraindications for stretching?

A

• Bony block that limits joint motion
• Recent fracture
• Evidence of acute inflammation or infection (heat & swelling), or soft tissue healing
• Presence of SHARP, acute pain with joint movement or muscle elongation
• Hematoma or other indication of tissue trauma
• Hypermobility already exists
• When shortened tissue provides necessary joint
stability
• When shortened tissues enable patient with paralysis or severe muscle weakness to perform specific functional skills otherwise not possible

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21
Q

What is Resistance Exercise?

A

Any form of active exercise in which dynamic or static muscular contraction is resisted by an outside force.

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22
Q

What is REPETITION (REP)?

A

Single rendition/occurrence of exercise (one work interval).

• Ex. Pressing two dumbbells straight above head then lowering them back down to shoulders constitutes one complete repetition of dumbbell shoulder press.

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23
Q

What is a SET?

A

Group of consecutive repetitions (group of work intervals) without resting.

• Ex. When 12 repetitions of dumbbell shoulder press have been performed, one set has been
completed. Resting for 1 minute and repeat 12 more repetitions equals 2 sets performed.

24
Q

What is a SET?

A

Group of consecutive repetitions (group of work intervals) without resting.

• Ex. When 12 repetitions of dumbbell shoulder press have been performed, one set has been
completed. Resting for 1 minute and repeat 12 more repetitions equals 2 sets performed.

25
Q

What is RECOVERY/REST INTERVAL?

A

Period of time between sets. This period varies based on type of exercise being performed.

26
Q

What are the 3 goals of resistance exercise?

A

• Increased muscular ENDURANCE
• Increased muscular STRENGTH
• Increased muscular POWER (most likely not included in rehab plan - increased potential for injury)

27
Q

What is Increased muscular ENDURANCE?

A

• Ability of muscle to perform low-intensity, repetitive, or sustained activities over prolonged period of time.
• It’s improved by performing exercise against mild resistance for many repetitions (amount of muscular activity that can be performed without fatigue; tolerance towards moderate levels of work performed for extended periods of time).
• Postural muscles, repetitive work activities, long shift workers

28
Q

What is Increased muscular STRENGTH?

A

• Maximum force that muscle can produce during single contraction
• Procedure of muscle or muscle group lifting, lowering, or controlling heavy loads for relatively low number of repetitions over short time (Maximal amount of resistance you can overcome)

29
Q

What is Increased muscular POWER?

A

*(most likely not included in rehab plan - increased potential for injury)

• Rate of performing work; power = work/time
• Single burst of high-intensity activity: Work (force x distance) produced by muscle per unit of time (force x distance/time)

30
Q

What is Active Resisted (Manual/Mechanical) Resistance Exercise?

A

Application of external load/resistance to
muscle’s active contraction. Therapist, patient, immovable, or movable object may apply external resistance.

31
Q

What is ISOTONIC EXERCISE (DYNAMIC)?

A

Dynamic form of exercise that is carried out against
constant or variable load as muscle lengthens OR
shortens through available range of motion

32
Q

What is Concentric Exercise?

A

Overall shortening of muscle occurs as it generates tension & contracts against resistance.

33
Q

What is Eccentric Exercise?

A

Overall lengthening of muscle occurs as it develops
tension & contracts to control motion against
resistance of outside force; negative work is done.
*Creates more force than concentric actions.

34
Q

What is ISOMETRIC EXERCISE?

A

Muscle contraction in which there is no lengthening
or shortening of muscle & therefore no movement around associated joint.

• Used in initial stages of rehab when joint pain or immobilizing device (cast) restricts or prevents movement, when weakness exists at specific point in ROM, or when individual is in low state of training.
• Provides base for dynamic (isotonic) exercise
• Isometric strength gains ~5% per week every day
over 6-week period
• Can be used to promote static strength or develop sustained muscular control (endurance) – except for
muscle setting
• Helps to DECREASE PAIN, SPASM & MAINTAIN NEUROMUSCULAR PATHWAYS until progression to active free can be accomplished (nerve injury, new exercises – neuromuscular learning phase & athletic visualization)

35
Q

What are 3 types of isometric excercise?

A

• Muscle-setting
• Stabilization
• Multiple Angle*

36
Q

What is Muscle-setting (ISOMETRIC EXERCISE)?

A

• Not considered resistance exercise – because no appreciable resistance is applied
• Low intensity isometric contractions performed against little or no resistance
• Used to decrease muscular pain & promote relaxation & circulation during acute stage of
healing
• Does’nt increase strength except in very weak muscles
• Helps negate muscle atrophy during immobilization, to protect healing tissues

37
Q

What is Stabilization (ISOMETRIC EXERCISE)?

A

• Develops submaximal but sustained level of contraction to improve postural stability or dynamic stability of joint
• Uses midrange isometric. contractions against
resistance in weight-bearing postures
• Focuses on trunk/postural control

38
Q

What is Multiple Angle* (ISOMETRIC EXERCISE)?

A

• Resistance is applied manually or mechanically, at
multiple joint positions within available ROM
• Used to improve strength throughout ROM when
joint motion is available but dynamic resistance exercise is painful or inadvisable

39
Q

What is ISOKINETIC EXERCISE?

A

Form of active-resistive exercise in which speed of movement of limb is controlled by preset rate- limiting device

40
Q

What is Open Kinematic Chain Exercise (Proximal Attachment Fixed)?

A

Movement that occurs with distal segment of limb moving freely in space.

41
Q

What is Closed Kinematic Chain Exercise (Distal Attachment Fixed/Reverse Action Exercise)?

A

Movement that occurs with body moving over fixed distal segment of limb.

*Terminal segment remains fixed, encountered resistance moves proximal segments over stationary distal segments.

42
Q

What are Parameters?

A

• Parameters – training zones; can be determined after 1 Repetition Maximum (1RM) is established
• Used for isotonic &/or isokinetic exercises

• With the purpose of achieving strength adaptations:
Parameter % of Strength Population
Low 30 – 40 % Sedentary, untrained individuals
Medium 50 – 70 % Healthy, untrained individuals
High 70 – 80 % Trained individuals
Very High > 80 % Highly trained individuals

**At beginning of program lower percentage loads & ranges are used to be safe – & to allow focus & learning of correct exercise form & technique – before progression to higher loads
• With purpose of training with significant deficits in muscle strength or establishing training for muscular endurance: Low loads 30%-50%, safe, yet challenging

43
Q

What are CARDIOVASCULAR PRECAUTIONS FOR RESISTANCE EXERCISE?

A

• Avoid VALSALVA maneuver during resistance exercise. Valsalva maneuver should be avoided
during exercise so abnormal stress on CV system & abdominal wall can be avoided

•High-risk patients include:
- Pt with history of CV problems (cerebrovascular accident, myocardial infarction (5 weeks post with clearance), hypertension)
- Geriatric patients
- History abdominal surgery or herniation of abdominal wall

• How do we prevent patients from performing Valsalva maneuver during exercise?
- Caution patient about holding their breath
- Have patient EXHALE when performing targeted motion
- Ask patient to count, talk or breathe rhythmically during exercise

44
Q

What are FATIGUE PRECAUTIONS FOR RESISTANCE EXERCISE?

A

Complex phenomenon that affects functional performance & must be considered in therapeutic exercise program.

• Local Muscle Fatigue: diminished response of muscle to repeated stimulus. Characterized by
reduction in force-producing capacity of neuromuscular system.
• General Muscular (Total-Body) Fatigue: diminished response of person during prolonged physical activity ie. walking or jogging. AKA Cardiopulmonary Fatigue.
• FATIGUE Associated With SPECIFIC PATHOLOGY: some conditions associated with neuromuscular or
cardiopulmonary dysfunction, fatigue may occur
more rapidly or at predictable intervals. E.g. in MS, patient usually reaches peak of fatigue by early afternoon & can become noticeably weaker. This is significant in design (parameters & timing) of patient’s exercise program.

45
Q

What is local Muscle Fatigue?

A

Diminished response of muscle to repeated stimulus. Characterized by reduction in force producing capacity of neuromuscular system.

46
Q

What is General Muscular (Total-Body) Fatigue?

A

Diminished response of person during prolonged physical activity ie. walking or jogging. AKA Cardiopulmonary Fatigue. patient’s exercise program.

47
Q

What is FATIGUE Associated With SPECIFIC PATHOLOGY?

A

Some conditions associated with neuromuscular or
cardiopulmonary dysfunction, fatigue may occur
more rapidly or at predictable intervals. E.g. in MS, patient usually reaches peak of fatigue by early afternoon & can become noticeably weaker. This is significant in design (parameters & timing) of

48
Q

What are changes that occur in muscle during RECOVERY FROM EXERCISE?(PRECAUTIONS FOR RESISTANCE EXERCISE) What will decrease recovery time?

A
  • Adequate time for recovery from fatiguing exercise must be built into every resistance-training program to maximize improvements in long-term physical performance.
  • Changes that occur in muscle during recovery:
  • Lactic Acid is removed from skeletal muscle & blood, around 1 hour post exercise
    -Oxygen stores are replenished in muscles
  • Glycogen is replaced within several hours to several days (depending on duration, intensity of
    exercise, & post-exercise nutrition)
  • Light exercise performed during recovery period will decrease recovery time from exercise
49
Q

What are OVERWORK/OVERTRAINING PRECAUTIONS FOR RESISTANCE EXERCISE?

A

• Progress cautiously to avoid exercising until total fatigue or exhaustion.
• Overwork/overtraining can cause TEMPORARY or PERMANENT deterioration of strength as result of exercise & may occur in normal individuals or in patients with certain neuromuscular conditions.
• NOT always true that MORE is BETTER. Overwork can be avoided if intensity, duration & progression of exercise are increased & monitored, closely
• Some patients will tend to perform more of exercises you give them while others will do less. Take this into consideration when setting parameters

50
Q

What are SUBSTITUTE MOTIONS (Alignment & Stabilization) PRECAUTIONS FOR RESISTANCE EXERCISE?

A

• Can occur if too much resistance is applied to contracting muscle during exercise or when new
exercise is progressed too rapidly & good form is lost
• When muscles are weak because of fatigue, paralysis or pain, patient will attempt to carry out
movements that those weak muscles normally perform by any means possible
• Ensure that patient performs exercise correctly & with good form. Demonstrate exercise & watch patient perform motion.

51
Q

What are OSTEOPOROSIS PRECAUTIONS FOR RESISTANCE EXERCISE? & Factors that increase risk for OP?

A
  • Osteoporotic changes within bone tissue make bone unable to withstand normal stresses & increases risk of pathological fractures (even as result of minor stresses especially in vertebral bodies, hips, wrists & ribs)
  • Factors that increase risk for OP:
  • Post-menopausal women: loss of estrogen at menopause leads to accelerated bone loss
  • Nutritional status (relating particularly to intake of CALCIUM)
  • Lack of weight-bearing (sedentary life-style, prolonged bed-rest, immobilization, wheel-chair)
  • Certain medications (especially corticosteroids) can increase rate of bone loss
  • Modifications to exercise programs for patients with osteoporosis will include:
  • Emphasis placed on endurance exercise, low intensity strength training, core stabilization & balance exercises. Low impact weight bearing activities should be incorporated.
  • Explosive, twisting movements should be avoided
  • Intensity of program increased very gradually
52
Q

What is Acute muscle soreness? What are EXERCISE-INDUCED MUSCLE SORENESS PRECAUTIONS FOR RESISTANCE EXERCISE? * ACUTE MUSCLE SORENESS

A
  • Often develops during or directly after strenuous exercise performed to point of fatigue & is d/t ISCHEMIA (lack of adequate oxygen & temporary build-up of metabolic waste products in exercised muscle).
  • Sensation: burning, aching
  • When adequate blood flow & oxygen is restored to muscle, muscle pain experienced during intense exercise subsides rapidly. Appropriate cool-down period of low-intensity exercise can facilitate process.
53
Q

What are EXERCISE-INDUCED MUSCLE SORENESS PRECAUTIONS FOR RESISTANCE EXERCISE? *DELAYED ONSET MUSCLE SORENESS (DOMS; muscular mechanical hyperalgesia)

A

• After vigorous & unaccustomed exercise or any form of muscular overexertion, muscle tenderness & temporary stiffness may begin at approximately 12 – 24 hours after completion of exercise. Gradually DOMS intensifies, usually peaks 24 – 48 hours after exercise. Can last up to 7 days in worst cases. Muscle pain usually felt in muscle belly &/or at musculotendinous junction.
• Pain is felt when muscle is stretched, contracted or put under pressure, not at rest
• DOMS is reported more frequently & more intensely with ECCENTRIC exercises (lengthening contractions in which muscle fibres are contracting to control exercise load with local CT absorbing some load)

  • Underlying mechanism of DOMS has not been determined**
  • Avoiding DOMS is difficult at onset of new exercise program after period of inactivity. To decrease severity of DOMS you can try:
    ▪ Gradually increasing intensity & duration of exercise program;
    ▪ Perform low-intensity warm-up & cool-down exercises
    ▪ Avoid prolonged static stretching post exercise
54
Q

What are 3 CONTRAINDICATIONS TO RESISTANCE EXERCISE?

A

• INFLAMMATION
• PAIN
• SEVERE CARDIOPULMONARY DISEASE

55
Q

What is INFLAMMATION? (CONTRAINDICATIONS TO RESISTANCE EXERCISE)

A

Dynamic resistance exercises are contraindicated when muscle or joint is inflamed or swollen. Use of resistance can lead to increased swelling & more damage to muscle or joints. Low-intensity isometric exercises (muscle setting) can be performed in presence of inflammation if activity does not increase pain levels

56
Q

What is PAIN? (CONTRAINDICATIONS TO RESISTANCE EXERCISE)

A

If Pt experiences severe joint or muscle pain during exercise or for more than 24 hours after exercise, activity should be ELIMINATED or SUBSTANTIALLY REDUCED. If reducing resistance does not eliminate pain, exercise should be stopped.

57
Q

What is SEVERE CARDIOPULMONARY DISEASE? (CONTRAINDICATIONS TO RESISTANCE EXERCISE)

A

Severe cardiac or respiratory disorders associated with acute symptoms are contraindicated for resistance training. Pt with severe coronary artery disease, carditis, cardiac myopathy, congestive heart failure (CHF), or UNCONTROLLED hypertension or no dysrythmias should not participate in VIGOROUS physical activities.

Therapeutic Exercise (5 decks)

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