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PT - Ortho Class 1 > Lecture Exercise Prescription > Flashcards

Lecture Exercise Prescription Flashcards

1
Q

what 3 basic principles should be kept in mind to take optimal advantage of the said principle? (specific adaptation to imposed demand)

A
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2
Q

what are the 3 adaptations to exercise that can be targeted with exercise?

A

1) neurological adaptations
2) metabolic adaptations
3) morphological adaptations

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3
Q

describe neurological adaptations

A
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4
Q

describe metabolic adaptations

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based primarily in changes to the metabolic processes that regulate the functioning of the cardiorespiratory system and of skeletal muscle

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5
Q

describe morphological adaptations

A
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6
Q

describe neuromotor exercise guidelines (6 principles)

A

1) frequent, structured training (typically low intensity, more usually better, min 2 days/week of 20-30 minutes/day)
2) variation (may have poorer performance during session, but better long-term skill retention)
3) mental imagery/cross education (not to be used as substitutes for actual task - ME is visualizing, CE is performing with other side)
4) distribution of training - should be based on capability and availability of patient (massed not ncessarily better than distributed)
5) continuous and discrete movements (movements that can be briken down can be practiced this way)
6) augmented feedback (coming from sources other than the patient - verbal, modeling/demonstration, manual guidance)

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7
Q

effects of a sedentary lifestyle

A
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8
Q

mechanism of adaptation for neuromotor exercise

A

neurological > morphological and metabolic

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9
Q

define balance, static balance, and dynamic balance

A
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10
Q

describe the requisites for balance

A
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11
Q

balance specific training guidelines

A
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12
Q

what are some balance specific training techniques?

A
  • perturb COM (normal sway - ie just standing is enough, external perturbations -therapist push, internal perturbations - movement against resistance, reaching out of BOS)
  • modify BOS (decrease external support, feet together etc)
  • modify sensory feedback (vision, proprioception, vestibular - hard to modfy, but some VOR)
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13
Q

what is better - balance training and walking or just balance training?

A
  • just balance training according to a study - likely due to relatively less balance-specific trianing
  • evidence wrt resistance training in isolation is inconsistant
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14
Q

what are the areobic training guidelines (age, fitness level etc)

A
  • the same guidelines for everyone!!
  • should be in addition to ADLS, in bouts of at least 10 minutes, using large muscle groups
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15
Q

describe aerobic training maintenence

A

Stopping training

–2 weeks - significant ↓ in aerobic fitness

–4-12 weeks – loss of 50% of initial ↑ in V·O2max

–2.5 to 8 months – return to pre-training levels

–N.B. Following years of continuous training, benefits are kept for longer periods of detraining

Reduced training volume

–Up to 15 weeks if intensity is maintained (even with frequency and duration reduced by up to 2/3)

  • V·O2max will ↓ if intensity is reduced by 1/3 or 2/3, even with frequency and duration constant
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16
Q

measures of intensity for cardiorespiratory exercise

A

1) metabolic equivalent task (MET): rate of energy consumtion relative to fixed O2 intake, 1 MET = 3.5 mL O2/kg/min
2) % of maximum oxygen uptake reserve (%VO2R): difference btw VO2 max and O2 uptake at rest
3) percentage HR reserve: diff btw max HR and HR at rest
4) ratio of perceived exertion (RPE): Borg scale (6-20, intended to mirror heart rate of middle aged man), OMNI scale (1-10) - both closely correlated

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17
Q

describe the borg and omni scale of exertions

A
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18
Q

describe FITT for cardiorespiratory exercise

A

Frequency: Moderate intensity (≥5 d/wk), High intensity (3-5 d/wk)

Intensity: deconditioned (Borg:9, omni:4, 55-65%max hr), other individuals (borg:12, omni:5, 55-65% max hr), to improve fitness (borg: 12-17, omni 5-8, 40-90%max hr)

Time: Moderate intensity (≥30 min), Higher intensity (≥20 min)

Type: must use large muscle group, sythmic (aerobic) in nature, can be maintained for at least 10 mins

Volume:

for novice/intermediate = Moderate intensity; 30-60 min/day; 5 days/wk, Vigorous intensity; 20-60 min/day; 3 days/wk, combination of above (≥500-1000 MET·min/wk)

f_or deconditioned_ = 3-5 days/week, light to moderarte, up to 20 mins/day

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19
Q

recomended aerobic training for hypertension

A
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20
Q

aerobic training recomendations for osteoarthritis

A

Increased physical activity Does not exacerbate joint symptoms and Confers significant benefits, including pain relief

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21
Q

aerobic trianing for chronic pain patients

A

A comprehensive physical activity program, including aerobic exercise, should be used for all patients

  • recomendation as for healthy adults
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22
Q

recomended aerobic training for bone health

A

Volume: as for otherwise healthy adults

Mode: weight-bearing endurance activities and activities that involve jumping

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23
Q

maintaining effect for resistance training

A
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24
Q

resistance trianing for hypertension

A

Resistance training reduces BP–Follow ACSM guidelines

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25
Q

resistance trianing for osteoarthritis

A

-Strengthening exercise is associated with relief of pain in knee OA and hip OA

26
Q

resistance training for chrinic pain patients

A

A comprehensive physical activity program, including RT, should be used for all patients

27
Q

recomendations for resistance training - strength

A

*note recomended reps = 8-12 (novice/intermediate), 8-12 (advanced), 10-15 (older adults)

28
Q

secondary variable for stregth training: muscle action

A

Concentric, Eccentric, and Isometric muscle actions should be included for clients of all experience levels (based on program goals)

29
Q

secondary variable for strength training: exercise type

A

Emphasis on multiple-joint exercises

Unilateral and bilateral, single- and multiple-joint exercises may also be included

30
Q

secondary variable for strength training: exercise order

A

Large muscle groups before small

Multiple-joint exercises before single-joint exercises

High-intensity exercises before lower-intensity

Alternate upper / lower body; agonist / antagonist;

31
Q

secondary variable for strength: rest between sets

A

Core, multi-joint exercises: ≥2–3 min between sets

Other exercises: 1-2 min between sets (for endurance shorter rest, 1–2 min for high-repetition sets (≥15–20 reps), <1 min for moderate sets (10–15 reps))

Rest period between sessions: ≥48 hrs between sessions for the same muscle group

32
Q

secondary variable for strength: movement velocity

A

For all experience levels, load should dictate tempo

  • Concentric phase: the intent should be to maximally accelerate the load
  • Eccentric phase: slower, controlled descent

Novice: slow (2:4) and moderate (1:2) velocities

Intermediate: moderate (1:2) velocity

Advanced: continuum of velocities corresponding to intensity

for endurance: Intentionally slow velocities for 10–15 repetitions, Moderate to fast velocities for ≥15–25 repetitions

for power: explosive velocity

33
Q

what are the 3 key principles for strength training?

A
34
Q

what is the 1 RM?

A
  • person would be able to do one more rep at current weight but no more than that
35
Q

training parameters for muscle power

A

Training for power is done concurrently with strength training

36
Q

guidelines for strength training - muscle endurance

A

note that loads should be less than 50% 1RM, shorter rest periods, slow velocity for 10-15 reps, moderate to fast velocity for 15 + reps

37
Q

what is isotonic ve isoinetic exercise vs isometric?

A

isotonic (inculde eccentric and concentric) = resistance dictates movement velocity (tension unchanged, muscle length changes) - tonic = muscle moving!! - eccentric training = more beneficial, but do not do in itself because increased risk of injury

isometric = no change in joint angle with resistance applied - little carry-over strength to other joint angles (MMT and RISOM = isometric!)

isokinetic = movement velocity dictates resistance - a constant rate of speed with a variable resistance force (measured by a dynamometer), which alters through the full distance stroke - requires a special machine!! *note largest training effects seen for trained velocities, requires expensive dynamometers

38
Q

what is plyometric and ballistic training used for?

A
  • to better promote muscle power (ie with goal not to stop at end of movement - up to 40% of concentric phase normally spent decellerating) - eg loaded jump squat
39
Q

describe undulating periodization vs reverse periodization

A

undulating: strength gains optimised through variation of all 3 variables of strength training
reverse: training cycle begins with lower volumes (set and reps) and higher intensities, progressing towards higher volumes and lower intensities

40
Q

describe flexibility training guidelines

A
  • can be done as a session alone or part of a cool-down
  • 2-3 days/week with maximum results daily
  • static, ballistic, or pnf
    static: hold each stretch 10-30s, 2-6 reps (60s total stretch)
    pnf: produces best effect (better than static), 10-30s hold, 4 reps
41
Q

what is the diff btw ROM and flexibility exercises?

A

ROM = intended to improve functional range of a joint movement - load ligaments or joint capsules

flexibility = intended to increase extensibility of muscle group (load muscle-tendon complex)

42
Q

explain viscoelastic strain vs viscoplastic strain

A

viscoelastic: always fully reversed, accounts for most of the tissue deformation produced during flexibility/ROM, not for long-term adaptation
viscoplastic: implies micro-tearing has occured in tissue, allows for adaptation as damage is healed

43
Q

what adaptations are made with ROM and flexibility exercises?

A

1) viscoplastic deformation (- followed by healing - morphological)
2) incrased stretch tolerence (tissue properties unaltered, but patient reports ledd discomfort with greater tissue stretch)
3) myofibrilogenesis (addition of sarcomeres in series, increases muscle resting length, alters length tension curve and therefore max force production occurs at longer length)

** note that decrease in stiffness of tissue not desired using these exercises and tissue stiffness is required for joint stability!!

44
Q

pnf technique - hold relax

A

Hold-relax: the resisted contraction (step 2) is isometric (with the instruction “don’t let me move you”); the subsequent stretch (step 3) is passive (performed by the therapist).

45
Q

pnf technique - contract relax

A

Contract-relax: the resisted contraction is concentric (over a 5-10o range, with the instruction “gently push into my hand”); the subsequent stretch is passive.

46
Q

pnf technique - hold relax with agonist contract

A

Hold-relax with agonist contract: the resisted contraction is isometric; the subsequent stretch is active-assisted (contraction of the agonist muscle to move farther into the stretched position, with assistance from the therapist).

47
Q

pnf technique - contract relax with agonist contract

A

Contract-relax with agonist contract: the resisted contraction is concentric; the subsequent stretch is active-assisted.

48
Q

what are the 3 goals of ROM and flexibility exercises?

A

1) Maintain / increase ROM following acute injury or in a painful / irritable condition
2) ↑ ROM of a hypomobile joint
3) ↑ flexibility of a (relatively) short muscle

49
Q

goal 1: how to increase ROM prescription

A
50
Q

goal 2 parameters: ↑ ROM of a hypomobile joint

A

–Intensity: Moderate sensation of stretch (PROM or AAROM with OP)

–Duration: 10 - 30 sec

–Repetitions: 2 – 6 (total of 60s)

–Frequency: ≥2-3 / wk (2 / wk is absolute minimum to see long-term change, more is better*)

*leave enough time to rest btw bc microtearing

51
Q

parameters of Goal 3: ↑ flexibility of a (relatively) short muscle

A

Intensity: Moderate sensation of stretch (Static (passive vs. active) Ballistic (sport-specific … rarely used in rehab))

Duration: 10 - 30 sec

Repetitions: 2 – 6 (total of 60s)

Frequency: ≥2-3 / wk (2 / wk is absolute minimum to see long-term change, more is better*)

52
Q

describe the “more is better” rule for stretching

A
53
Q

guideline to maintain flexibility

A
  • at least 2 days a week, 10 minutes each time (absolute min!!)
54
Q

describe reasoning behind foam roller massage techniques

A
55
Q

describe flexibility exercise benefits

A
  • does not reduce overall injury rates during exercise (but may reduce musculo tendon type injuries)
  • stretch before or after exercise does not confer protection from D.O.M.S
  • pre-exercise stretching = decreased stiffness of MT complex, Decreased force production & power, Decreased jump height, Improved running economy
  • regular flexibility - Improved force production and velocity of contraction, No effect on economy of motion
  • optimal flexibility determined by sport specific and individual factors, goal of program could be to balance flexibility (body moves through path of least resistance, therefor uneven flexibility affects movement)
56
Q

describe the things contributing to compliance

A
57
Q

how to motivate a patient

A
  1. Educate the pt on the condition
  2. Encourage active participation in the setting of goals and development of the HEP
  3. Ensure the pt’s understanding of the role of the HEP in reaching the mutually-assigned goals
  4. Determine pt willingness, and encourage pt to engage in activities that are appropriate for their condition
  5. Find creative ways to meet pt’s goals and motivate them to strive for the next level
  6. Be non judgmental
  7. Accommodate for different learning styles (visual, auditory, tactile)
58
Q

how should a new exercise program be initiated?

A
59
Q

how to screen for risk of new exercise program for a pt?

A
60
Q

how to manage risks for any given exercise program

A

PT - Ortho Class 1 (9 decks)

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