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Ther Ex > Lecture 5 - Therapeutic Strength > Flashcards

Lecture 5 - Therapeutic Strength Flashcards

1
Q

Is therapeutic exercise different from regular exercise?

A

You must know: the mechanism of the injury, stage of healing, degree of the injury, patient’s previous exercise background, how much time (realistic) they have for rehab
You must know functional anatomy and the biomechanics of movement and sport

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2
Q

Gray’s Rules of Rehabilitation

A

Create an environment for optimal healing
Above all else do no harm
Be as aggressive as you can, but do not break rule #2

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3
Q

Salter’s General MSK Rehab Rules

A

Do no harm
Base treatment on accurate diagnosis and prognosis
Select treatment with SPECIFIC aims
Cooperate with the laws of healing
Be realistic & practical in your treatment
Select treatment for your patient as an individual

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4
Q

Potach’s and Grinstaff’s View

A

First: healing tissue must not be overstressed as this can create damage to new structures that are being formed.
Therefore, need to chose a load that neither overload or under loads the athlete/patients healing tissue
Second: the athlete/patient must have specific objectives to progress from one phase of healing to the next

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5
Q

Causes of Strength Deficits - Muscular

A 
Atrophy/lack of use 
muscle imbalances (agonist/antagonist etc.)
Structural integrity
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6
Q

Causes of Strength Deficits - Neural

A

Neural inhibition/damage

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7
Q

Causes of Strength Deficits - Pain

A

Reflex inhibition/ pain-spasm cycle

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8
Q

Causes of Strength Deficits - Poor Mechanics

A

Faulty movement patterns

Decreased motor control

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9
Q

What is the goal? Stages of Healing: Inflammation

A

PIER, depending on the injury and individual, may include ROM, and exercises proximal and distal to the area of injury.
Remember to address the unaffected side so the athlete can maintain.

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10
Q

What is the goal? Stages of Healing: Repair Phase

A

Maintain CV fitness and muscular function of the injured area, strengthening exercises, exercises for neuromuscular control etc.

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11
Q

What is the goal? Stages of Healing: Remodeling Phase

A

Continue to progress your exercise selection

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12
Q

Needs Analysis

A

Evaluation of the Sport
Assessment of the Athlete
Training Status (injuries, level of training)
Conducting any Physical Testing and Evaluation (may provide us answers to strength, flexibility, muscular endurance etc.)
Being aware of the Energy system utilized in the sport and applying the parameters to Rehab

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13
Q

Dosage Dilemma

A

-We need to give them enough to overload the patient but don’t want to over-train them
-Start with an exercise they can do at least 10-12 times
-There must be no discomfort, no compensations and good biomechanical technique
-Slowly progress the patient to 12-15 reps then ↑ load
I-f retraining is your goal then breaking exercise up is more effective (prevents compensation)
-Don’t want pain or discomfort, inflammation, altered function, heat, decreased range of motion, decreased strength or muscle compensations

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14
Q

What are compensations?

A

When muscles are weak, the body will attempt to perform required movements by any possible means (path of least resistance)

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15
Q

What must you address with compensations?

A 
Strength
Motor control
Segmental stability
Muscle patterning/timing
Correcting muscle imbalances
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16
Q

Where to start?

A

Watch the patient walk into the clinic
History
Assessment of functional movement
Therapist should attempt to address injured tissue, injured quadrant and whole body

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17
Q

Factors influencing the rehab decision

A 
Pathology
Severity of injury
Presence of secondary deficits
Stage of healing
Age
Level of fitness
Ability to learn
Individual lifestyle     needs
18
Q

Contraindications

A

Pain
Inflammation
Severe cardiopulmonary disease

Sometimes you have to be creative and be able to work around Contra’s

19
Q

Describe Isometrics. When to use?

A

Tension is developed but no change in length of muscle
Optimal time under tension is 6 sec but can use 5-10 sec but tension will ↓
Move from middle to outer ranges
When to use:
Early stages of rehab
When immobilized

20
Q

Isometrics: Studies have shown that there can be as much as a ___% overflow to the joint angle at which training is performed

A

20%

21
Q

Consider the application of isometrics at multiple angles - _____Isometrics

A

Functional Isometrics

22
Q

Functional Isometrics: could be used until the healing process ______

A

progresses

23
Q

What is concentrics? When to use?

A

Shortening of muscle during contraction
Force produced to overcome load being acted upon
When to use:
Throughout rehab after initial inflammatory stage
To introduce strengthening for less active individuals

24
Q

Concentric portion of an exercise should require ____ seconds

A

1-2 seconds

25
Q

Muscles tend to ____ more rapidly with Concentric contractions as opposed to Eccentric contractions

A

fatigue

26
Q

What are eccentrics? When to use?

A 
Lengthening of muscle during contraction
When to use:
Tendonitis/osus pathologies
Later in rehab progression
Simulating ADLs (i.e. descending stairs)
As a component of power/agility training (plyometric)
27
Q

Eccentrics require a much lower level of _____ activity to achieve force.

A

Motor unit

28
Q

Eccentrics: Since fewer motor units are firing to produce a specific force, additional _____ can be recruited to generate force. Therefore more resistant to fatigue ( less ____ use)

A

Motor units. Oxygen

29
Q

Try each exercise regiment ___ before progressing (rule of ____)

A

twice, two

30
Q

Give as many cues (____, ____, ____) as you can

A

tactile, visual, verbal

31
Q

Define Rule of Two

A

If the individual can perform 2 or more repetitions over his or her assigned repetition goal in the last set in 2 consecutive workouts, you can increase the weight/resistance. Eg. 3 sets of 10 squats
Individual is able to complete 12 reps in set # 3 for 2 consecutive sessions.

32
Q

For each exercise ask????

A

Am I stressing the injured tissue?
What are my goals in prescribing this exercise?
Is the exercise below, the same or at a greater level than what the patient has previously done?
What are the biomechanical and physiological implications for each exercise?
Does the exercise(s) mirror the actual activity/sport movement.
SAID principle-Specific Adaptation to Imposed Demands
Make sure to maintain Muscle Balance across joints and between opposing muscles
Multi-joint vs. Single-joint exercises

33
Q

CKC vs. OKC

A

Open: distal segment moves freely in space
Closed: distal segment is weight bearing and body moves over hand or foot
CKC puts less shear on joints

34
Q

Isolation vs. Co-contraction

A

CKC stabilization occurs due to co-activation of opposing muscle groups
OKC allows muscle to work when weight-bearing is contraindicated

35
Q

CKC preferred but OKC appropriate for conditions where _______ should be avoided (A/C jt, Effusion, meniscus)

A

compression

36
Q

What does CKC exercises do?

A 
Increased joint compressive forces
Increased joint congruency
Therefore Stability
Decreased shear forces
Decreased acceleration forces
Co-activation/Co-contraction of agonist and antagonist muscles
37
Q

What does OKC exercises do?

A

Help to isolate the specific joint movement.
This proves beneficial because if using only CKC exercises the joints proximal and distal to the injury might not show the deficit
OKC exercises may help identify deficits

38
Q

The brain looks at movement patterns and creates _______ between all the muscles needed

A

coordination

39
Q

Isolated ____ development does not play a major role in motor pattern development

A

muscle

40
Q

Training movement: progressions

A
  • Analyze or Train movement as if it is a pyramid.
  • Start from the bottom up, build a solid base
  • Functional Movement>Functional Performance>Functional Skill

Ther Ex (10 decks)

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