L9a: Exercise Prescription for Muscular Fitness, Balance and Flexibility Flashcards
What are 4 types of muscular training?
- Strength
- Power
- Endurance
- Neuromuscular Control
What is strength (muscular training)?
The ability to generate maximal force
What is power (muscular training)?
The ability to generate force quickly (strength &velocity)
What is endurance (muscular training)?
The ability to generate sustained or repeated force
What is neuromuscular control (muscular training)?
The ability to perform a skilled task with precision & accuracy
What are the guidelines for muscular training?
What are 3 types of muscle contraction?
- Isometric
- Isotonic
- Isokinetic
What are 2 chains of movements?
- Opened chained movements
- Closed chained movements
What is the type and chain movement dependent on?
Dependent on the severity and nature of disease or injury
In a patient with TKR in an older person, what type and chain of movement?
- Strengthening quadriceps –> isometric contraction
- Isotonic contractions
In a patient with symptomatic lower limb OA in an older person, what type and chain of movement?
- Closed kinetic chain exercises done in weight bearing will increase joint compression of already irritable and painful joints and limit the ability to work through full ROM but are more similar to functional tasks
- Open kinetic chain are a better option, commonly performed in non-weight bearing. But compression and load can still occur (esp. when working against gravity, controlling and supporting the weight a limb, working with external moments
- Determine which one by clinical reasoning and patient preference, pain tolerance levels
What are 3 types balance and sensorimotor training?
- Static
- Dynamic
- Reactive
What are 4 characteristics of balance and sensorimotor training?
- Limits of stability
- Sensory conditions
- Dual Tasks; Perturbations
- Base of Support
What are 4 types of base of support?
- Wide stance
- Narrow stance
- Tandem stance
- Single leg stance
What are examples of unstable base for sensory conditions?
- Unstable base –> rely on proprioceptive information
- Care with patients with peripheral neuropathy
- Must assess in solid firm base first
What are 4 types of flexibility?
- Static
- Contract-Relax
- Dynamic
- Ballistic
What are the FITT principles for flexibility (recommended guidelines)?
- 2-3 days/week –↑joint ROM
- Stretch to point of tightness/ slight discomfort
- Holding a stretch for 10-30s recommended for most adults
- In older adults, 30-60 s hold may have greater benefit
When is static stretching better?
Older
What is the problem with dynamic and ballistic stretching sometimes?
Great risk of injury
What are 2 features that occur due to natural ageing?
- Loss of extensibility in tendons and muscles
- Formation of osteophytes, bony spurts in the joints
What are 5 special considerations as a result of ageing?
- Tendon Ruptures
- ↑ collagen cross-linkages = ↑ tendon friability
- Neural Tension
- Loss of extensibility in neuro-vascular sheath
- ↓ soft tissue compliance/flexibility = stiff joints
- Back Pain
- ↓ water content in intervertebral cartilage
- Loss of flexibility and ROM
- Post-Menopause
- Rapid bone loss associated with ↓ oestrogen levels
- Influences skeleton’s ability to adapt to loading
- ↑ Risk of osteoporosis & fractures
- Incontinence
- Leakage of urine: ↑ Intra-abdominal pressure in absence of detrusor contraction
- Lifting, walking, dancing, running, sit-to-stand, coughing, laughing
- Restricted physical activity participation
What occurs in tendon ruptures as a result of ageing?
↑ collagen cross-linkages = ↑ tendon friability
- As tendons age, they become more stiff/less elastic
- Higher risk of pathology and pain
- Hormonal protective effects until post-menopause
- Common sites —> exposed to a lot of stress –> can rupture with small force
- Achilles tendon
- Lateral elbow
- Rotator cuffs
What are 2 characteristics of neural tension as a result of ageing?
- Loss of extensibility in neuro-vascular sheath
- ↓ soft tissue compliance/flexibility = stiff joints
What are 2 characteristics of back pain as a result of ageing?
- ↓ water content in intervertebral cartilage
- Loss of flexibility and ROM
What are 3 characteristics of post-menopause as a result of ageing?
- Rapid bone loss associated with ↓ oestrogen levels
- Influences skeleton’s ability to adapt to loading
- ↑ Risk of osteoporosis & fractures
What are 3 characteristics of incontinence as a result of ageing?
- Leakage of urine: ↑ Intra-abdominal pressure in absence of detrusor contraction
- Lifting, walking, dancing, running, sit-to-stand, coughing, laughing, Stress incontinence
- Restricted physical activity participation or resilience to take part in exercise program either during or outside a therapy session
What is the Otago Exercise Program?
What are 4 characteristics of the Otago Exercise Program?
- Exercises progress in difficulty
- Individually prescribed
- Delivered at home
- Nice example of range of exercises that can be selected for patient While not using the whole program Note: an exercise that just includes walking will not reduce falls
What is the aim of the Otago Exercise Program?
Prevent and reduce falls
What are 5 important characteristics in goal-setting for Older Adults?
- ‘Functionally relevant’
- Participation in ADLs
- ↑ Quality of life
- Return to Masters sport
- Prevention/Adaptation
- SMART goals
- Encourage older patients to take an active role in exercise
- ↑ Adherence
- Clear objectives of exercise
- Individual vs. group exercise
- Social interaction
What are 3 features of functionally relevant goal setting for older adults?
Participation in ADLs ↑ Quality of life Return to Masters sport
What are 4 features of prevention/adaptation goal setting for older adults?
• Promote these key ideas rather than “resolution” • Falls • Disease progression Risk of fracture
What is a SMART goal?
Specific, measurable, agreed upon, reasonable, timed
What are 4 features to increase adherence in goal setting for older adults?
› Clear objectives of exercise › Individual vs. group exercise › Social interaction
