Lecture 35- EXERCISE V Flashcards
what is adherence?
The extent to which a person continues with the agreed-upon mode of treatment under limited supervision when faced with conflicting demands
what are the 5 factors that relate to a persons adherence
- health systems
- social/economic
- condition-related (co-morbidities)
- therapy-related (poor instructions)
- patient-related (memory, forgetfulness)
list some examples of things that affected adherence in PT practice (based on studies reported)
- older age women
- comorbidities
- unemployed
- lower level of education
- lower income
- living farther from facilities
- lower levels of physical activity at baseline
- low self-efficacy
- depression/anxiety
- poor social support
- higher BMI
- greater time between visits
- etc.
what are some specific organizational predictors of adherence in PT practice?
time between the schedule date and appointment date, time between current and prior appointment, clinic location, month of year, and day of week.
what are the 3 ways we can facilitate adherence as a clinician?
- selecting and fitting the recommendation
- Advancing self-determination and learning of patient
- Supporting Implementation and Habit Formation (what patients to remember even after you discharge them)
what is the goal of motor learning?
Acquisition of a new movement, or reacquisition and/or modification of movement.
what 3 things are necessary for any learned skill?
- efficiency
- consistency
- transferable (different environments)
describe declarative or explicit learning
conscious recall of facts or knowledge, example: using a krutch during an injury
describe nondeclarative or procedural learning
able to perform the movement without conscious thought ex. riding a bike
what are the stages of motor learning
- cognitive - understanding task
- associative - modifying movement
- autonomous - reduced attention needed
purposeful and functional movement involves what 3 things?
- individual
- task
- environment
what are some variables related to the individual when performing a task?
Arousal
Attention
Motivation, fear, belief, emotional stability/instability
Memory: Declarative vs. procedural
1. Verbal
2. Visual (in front a mirror)
3. Kinaesthetic
definition of practice conditions:
manner in which the task or exercise is repeated with respect to rest periods, the amount of exercise, and the sequence in which these tasks or exercises are performed.
what is distributed practice?
Time between practice sets is equal to or greater than the amount of time devoted to practicing a particular task or activity such that the rest period is spread out throughout
practice.
what is massed practice?
The rest period is much shorter in relation to amount of time the task or exercise is practiced.
what are the 4 examples of type of movement/ practice environment?
- Whole learning - entire task at one time
- Pure-part learning - learn parts separately than put them together
- Progressive-part learning - components of skill combined in sequence
- Whole-part learning - rotation between whole and parts practice
what type of learning would you use for a simple and discrete task?
whole learning
what type of learning would you use for complex skills?
whole part learning
what type of learning would you use for intermediate skill and serial tasks?
progressive part
what are the 2 types of verbal feedback you can give to a client related to a task?
- knowledge of performance (concurrent) - when task is being performed
- knowledge of results (terminal) - given at conclusion of the task
what systems exist to help a client learn a task? (3)
- feedback - sensory info (ex. mirror)
- internal - motivation or sensation post/during task
- extrinsic - cue from therapist/verbal feedback
explain a closed environment for task completion
stationary.
* Practice the skill in a predictable manner.
* Plan the movement in advance
* Perform the movement with minimal
distractions or challenges.
name some of the goals of performing passive ROM.
- Maintain jt. and connective tissue mobility.
- Minimize the effect of contractures.
- Maintain elasticity of muscles.
- Assist circulation and vascular dynamics.
- Enhance synovial movt for cartilage nutrition and diffusion of materials in jts.
- Reduce/inhibit pain.
- Assist with healing process post injury or surgery.
- Help patient maintain awareness of movement.
name some of the goals of performing active and active-assisted ROM.
- Maintain physiological elasticity and contractility of the participating muscles.
- Provide sensory feedback from the contracting muscles.
- Provide a stimulus for bone and joint tissue integrity.
- Increase circulation and prevent thrombus formation.
- Develop coordination and motor skills for functional activities.
when would we use self-assisted ROM?
to protect healing tissue when more intensive muscle contraction is contraindicated. (following myocardial infraction or surgery)
what are some things that can cause us to lose soft tissue extensibility?
- adhesions, contractures, scar tissues
- Restricted motion leading to structural deformities that are otherwise preventable.
- Muscle weakness and shortening of opposing tissues causing limited ROM.
T or F: stretching can be performed pre or post-vigorous exercise to help reduce muscle soreness
true
list the contraindications of stretching:
- Bony block limiting motion.
- Recent fracture and incomplete union.
- acute inflammatory or infectious process or soft tissue healing.
- Sharp acute pain with jt. movt or muscle elongation.
- Hematoma or other indication of tissue trauma.
- Hypermobility.
- Shortened soft tissues providing necessary joint stability in place of normal structural mobility or neuromuscular control.
(Shortened soft tissues enable a patient with paralysis or severe muscle weakness to
perform specific functional skills otherwise not possible.)
list the precautions of stretching
- known or suspected osteoporosis, prolonged bed rest, age, steroid use.
- Protect newly united fractures.
- Avoid vigorous stretching of muscles and connective tissues that have been immobilized for an extended period of time.
- Progress dosage to minimize soft tissue trauma and postexercise muscle soreness.
- Avoid edematous tissue.
- Avoid overstretching weak muscles that support body structures in relation to gravity.
- Avoid “No pain, No Gain” mantra.
- DO NOT use stretching as a warm-up activity.
what are the determinates of a stretching protocol given to a client (7).
- Alignment,
- Stabilization,
- Intensity,
- Duration,
- Speed,
- Frequency,
7.Mode.
when thinking of prescribing a stretch: ____________ influences tension and available ROM
alignment
in stretching, how do we measure the intensity of the stretch?
Determined by load placed on soft tissue to elongate it.
- low intensity = low load over long duration
define total elongation time
Cumulative time of all stretch cycles
T or F: a guide to stretch prescription is: The shorter the duration of a single stretch cycle, the greater the number of repetitions applied during the stretching session.
true
define static stretching
Soft tissues elongated just past the point of tissue resistance and held in a lengthened position with a sustained stretch force over a period of time.
what is cyclic (intermittent) stretching?
Relatively short-duration stretch force that is repeatedly but gradually applied, released, and then reapplied.
what is the average stretch cycle for cyclic stretching?
5-10sec
T or F: static stretching is more comfortable than cyclic stretching at a compatible intensity
false, cyclic stretching is more comfortable
define ballistic stretching
Rapid forceful intermittent stretch – high-speed and high-intensity stretch. (bouncing movements)
T or F; ballistic stretching has the potential for greater residual muscle soreness than static stretching
true
when is ballistic stretching most often used?
conditioning programs for young healthy individuals.
what is a contraindication of ballistic stretching?
elderly or sedentary individuals, MSK pathology, chronic contractures.
who would perform high-velocity stretching?
- highly trained athletes, like gymnasts
- athletes returning to high-demand activities after an MSK injury
what is high-velocity stretching?
Rapid but low-intensity (low-load) stretches with attention to stabilization.
what is manual stretching?
Controlled, end-range, static, progressive stretch applied at an intensity consistent
with patient’s comfort level.
why would you perform manual stretching (2)?
- Early stage of stretching program; determine patient response to various intensities or duration.
- Lack of neuromuscular control of the body segment to be stretched.
what kind of stretching does the PNF (proprioceptive neuromuscular facilitation) technique involve?
active/facilitative stretching
definition of active stretching
Integrates active muscle contraction into stretching to inhibit or facilitate muscle activation and to increase the likelihood that the muscle to be lengthened remains as relaxed as possible as it is stretched.
what are the agonist and antagonist in muscle stretching?
- “Agonist” – muscle opposite the range-limiting target muscle. muscle that lengthens
- “Antagonists” – range limiting muscle. muscle that shortens
describe the FITT principle for flexibility training
when would we use submaximal loading for tissue resistance?
- Early stages of soft tissue healing when injured tissues must be protected.
- After prolonged immobilization.
- Initially learning an exercise to emphasize correct form.
- For most children and adults.
- Goal of improving muscle endurance
- To warm-up or cool-down prior to or after a session of exercise.
- During slow-velocity isokinetic training to minimize compressive forces on joints.
when would we use near-maximal or maximal loading?
- Goal of improving muscle strength, power, or muscle size.
- Advanced phase of rehabilitation in preparation for return to high demanding occupational or recreational activities.
- Conditioning program for individuals with known pathology.
- Training for competitive weigh lifting or body building.
T or F: During maximum effort concentric muscle contraction, as the velocity of muscle shortening increases, the force the muscle generates decrease
true
T or F: During maximum effort eccentric contraction, as the velocity of active muscle lengthening increases, force production in the muscle initially increases to a point but then quickly levels off
true
T or F: maximum effort CON training leads to greater training-induced gains in muscle strength and mass than ECC
False, Maximum-effort ECC training leads to greater training-induced gains in muscle
strength and mass.
T or F: CON contractions are more efficient metabolically and generate less fatigue than ECC
false, ECC contractions are more efficient metabolically and generate less fatigue.
T or F: ECC has the potential for more severe DOMS than CON
true
Adaptations to the neuromuscular system that create the desired training
effects occur primarily during the ________ ______.
recovery phase
why is adequate recovery between sessions important
to allow trained muscles time
to restore glycogen and build or rebuild protein.
what are the short term and long term benefits of rest and recovery?
describe the cycle of rest and recovery following exercise
what is periodization?
The art of skillfully modifying program
variables over time to effectively
transition a program from a more
generalized approach toward a
program that addresses the specific
needs, demands, and desires of an
individual.
what is cardiopulmonary fatigue?
not enough oxygen into the circulation to reach exercising tissues: due to blood volume, or the increase on O2 demand of the respiratory muscles for active inspiration
