Intro to TherEx

Question 1

Define impairment

Answer 1

Losses or abnormalities of an anatomical, physiological, mental or emotional nature. (Nagi)

Question 2

Examples of impairments in physical therapy

Answer 2

Limited ROM
muscle weakness
impaired balance
decreased sensation
limited circulation

Question 3

Define pathology

Answer 3

interruption or interference with normal process and the simultaneous body efforts to heal itself or regain a normal state. (Nagi)

Question 4

Define functional limitation

Answer 4

abnormalities or limitations in an individual’s ability to carry out a meaningful action, task, or activity.

Question 5

Examples of functional limitation

Answer 5

ADL’s: moving in bed, transferring from one surface to another, rising from a chair, ambulating, dressing, bathing

Question 6

Define disability

Answer 6

the inability or limitation in performing socially defined roles and tasks that would normally be expected of an individual within a given culture or environment. (Nagi)

Question 7

Define intervention

Answer 7

an act that alters the course of a disease. (internet)

Question 8

List the goals of therapeutic treatment***

Answer 8

Development, improvement, restoration, or maintenance of normal/functional:

1. Muscular strength and endurance
2. Mobility and flexibility- prevent contractures, decrease muscle tone, prevent injury
3. Cardiovascular fitness/endurance
4. Coordination, skill, balance, functional ability
5. Stability
6. Relaxation

Question 9

What are the three phases of healing?

Answer 9

Phase 1: Inflammatory Response- Acute
Phase 2: Repair and Regeneration- Subacute
Phase 3: Remodeling and Maturation- Chronic

Question 10

What are the signs and symptoms of the inflammatory response- acute phase of healing?

Answer 10

Signs of inflammation still present.

ROM painful throughout

Question 11

What are the signs of inflammation?

Answer 11

Redness, swelling, heat, pain, and loss of function

Question 12

Why is ROM painful throughout during the acute phase?

Answer 12

Altered chemical state irritating nerve endings.
Edema increasing tissue tension.
Muscle guarding.

Question 13

What is the duration of the inflammatory response- acute phase?

Answer 13

4-6 days

Question 14

What are the signs and symptoms of the repair and regeneration- subacute phases?

Answer 14

Signs of inflammation decreasing to absent.
ROM painful at end ranges only.
Muscle weakness

Question 15

What is the duration of the repair and regeneration- subacute phase?

Answer 15

10-17 days in length (14-21 days from injury)

up to 6 months

Question 16

What are the signs and symptoms of the remodeling and maturation- chronic phase?

Answer 16

No signs of inflammation.
Stretch pain at end ranges.
Possible muscle weakness, endurance, decreased motor control.

Question 17

What is the duration of the remodeling and maturation- chronic phase?

Answer 17

lasts up to 6 months to 1 yr

Question 18

How do you manage soft tissue injuries in the Acute State?

Answer 18

1. patient education
2. Protection of injured tissue (RICESupport)
3. prevention of secondary complications (tissue specific vs general movement)
4. Specific interventions (PROM, Grade 1 &2 jt mobilizations, muscle setting, massage)
5. interventions for associated areas (ROM, m. strength, functional, circulation)

Question 19

What is the principle of the acute state?

Answer 19

Protection phase

Question 20

What is muscle setting in the acute state?

Answer 20

wimpy, very light isometric exercises

Question 21

What is contraindicated during the acute state?

Answer 21

stretching and resistance exercises at site of inflamed tissue.

Question 22

What are the precautions for the acute state?

Answer 22

must use proper dosage of rest and movement

Question 23

What are the signs of too much movement in the acute state?

Answer 23

increased pain or increased inflammation

Question 24

How do you manage soft tissue injury in the Sub-acute phase?

Answer 24

1. patient education
2. management of pain and inflammation
3. initiation of Active Exercise (multi angle, and submaximal isometrics, AROM, m. endurance, protected weight bearing- closed chain)
4. initiation or progression of stretching
5. Correct contributing factors (posture, strength, flexibility)

Question 25

What is the principle of the sub-acute phase?*

Answer 25

Controlled motion

Question 26

What are the techniques of stretching?

Answer 26

1. warm tissue 2. inhibition techniques 3. jt mobilization 4. stretching 5. Massage 6. Strengthen new ROM

Question 27

How do you manage soft tissue injury in the chronic phase?*

Answer 27

1. patient education 2. progression of stretching 3. Progression of muscle performance (strength, endurance, power) 4. Return to function

Question 28

What are the signs of over/excessive stress?***

Answer 28

1. Soreness that does not decrease after 4 hours and is not resolved after 24. 2. Exercise or activity pain that comes on earlier or is increased over the previous session. 3. Progressively increased feelings of stiffness and decreased ROM. 4. Swelling, redness, and warmth in the healing tissue 5. Progressive weakness over several exercise sessions 6. Decreased functional usage of the involved part

Question 29

Define Wolff's Law?

Answer 29

"The skeletal system adapts to the forces placed upon it" kisner and colby

Question 30

What are the effects of prolonged bedrest?

Answer 30

1. Decubidi 2. Atrophy 3. Orthostatic hypotension 4. Edema 5. Reduced lung volume 6. reduced motivation 7. Venous Thrombosis 8. Atelectasis (collapsed lung) 9. Disturbance of sleep/wake cycle 10. Metabolic alteration 11. Decreased strength of 1-1.5% per day

Question 31

What are the effects of deconditioning (from lack of activity)?

Answer 31

1. increased heart rate 2. decreased physical work capacity 3. decreased adaptation to position change 4. decreased circulating blood volume 5. Decreased lung volume and vital capacity 6. decreased contractile strength of muscle 7. Decreased metabolic rate

Question 32

What is therapeutic exercise?

Answer 32

Systematic and planned performance of bodily movement, postures or physical activities intended to provide a patient a means to: 1. remediate or prevent impairments 2. improve, restore, or enhance physical function 3. prevent or reduce health related risk factors 4. Optimize overall health status, fitness, and/or sense of well being.

Question 33

Are all energy systems used at a given time during activity?

Answer 33

Yes! The extent to which each is used depends on intensity and duration of activity

Question 34

What is a sprain?

Answer 34

Severe stress, stretch, or tear of soft tissues, such as joint capsule, ligament, tendon, or muscle. Frequently used to refer specifically to injury of a ligament and graded 1st, 2nd, 3rd degree

Question 35

What is a strain?

Answer 35

Overstretching, overexertion, overuse of soft tissue: tends to be less sever than a sprain. Frequently used to refer specifically to some degree of disruption of the musculotendinous unit.

Question 36

What is a dislocation?

Answer 36

Displacement of a part, usually the bony partners of a joint, resulting in a loss of the anatomical relationship and leading to soft tissue damage, inflammation, pain, and muscle spasm.

Question 37

What is subluxation?

Answer 37

An incomplete or partial dislocation of the boney partners in a joint that often involves secondary trauma to surrounding soft tissue.

Question 38

What is synovitis?

Answer 38

inflammation of the synovial membrane: excess of normal synovial fluid in a joint or tendon sheath cause by trauma or disease.

Question 39

What is hemarthrosis?

Answer 39

bleeding into a joint, usually due to severe trauma

Question 40

What is a ganglion?

Answer 40

Ballooning of the wall of a joint capsule or tendon sheath. May arise after trauma, and sometimes occur with RA

Question 41

What is a contusion?

Answer 41

bruising from a direct blow, resulting in capillary rupture, bleeding, edema, and an inflammatory response

Question 42

What is overuse syndrome?

Answer 42

Repeated, submaximal, overload and/or frictional wear to a muscle or tendon resulting inflammation and pain.

Question 43

What are factors that affect healing of soft tissue?

Answer 43

1. length and strength imbalances 2. rapid/excessive eccentric demands 3. Muscle weakness 4. Structural mal-alignment/weak support 5. Change in intensity/demands of an activity 6. Too rapid return to activity 7. Sustained awkward postures/motions 8. environmental factors 9. Age-related factors 10. Training errors (pg. 326 kisner & colby)