Lecture Practice Flashcards

1
Q

what are the 4 types of cryotherapy

A

ice massage, ice pack, cold immersion, and whirlpool

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2
Q

what is the temperature for cold immersion

A

4-10 degrees celsius

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3
Q

what is the temperature for whirlpool (cold)

A

10-15 degrees celsius

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4
Q

what can be done alongside cryotherapy

A

compression, elevation, and exercise

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5
Q

what are the time frames for CBAN

A

C = 1-3, B = 2-7, A = 2-7, N = 5-12+, numbness lasts for 3-5 minutes

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6
Q

what are the indications for cryotherapy

A

pain, spasm, inflammation/swelling

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7
Q

what are the precautions for cryotherapy

A

diminished sensation, poor local circulation, over superficial nerves, slow healing wounds, medically unstable

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8
Q

what are the contraindications for cryotherapy

A

raynauds phenomenon, cryoglobinemia, hemoglobinuria, cold urticarial (hives) , proximal cold

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9
Q

what are the types of thermotherapy

A

hot tub, heat pack, whirlpool, paraffin wax, heat lamp

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10
Q

how long is thermotherapy done

A

20-30 minutes

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11
Q

how do you prepare a heat pack

A

from hydrocollator (7-76 degrees C), 6 layers (terrycloth) + 1 towel

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12
Q

when is thermotherapy used

A

following inflammatory stage, for pain and spasm

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13
Q

what are the temperature guides

A

neutral = 92-96, warm = 96-98, hot = 98-104, very hot = 104-110

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14
Q

what are the indications for thermotherapy

A

decrease pain, decrease muscle spasms, heat superficial joint capsules

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15
Q

what are the precautions for thermotherapy

A

medically unstable, coronary heart disease

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16
Q

what are the contraindications for thermotherapy

A

open wound, diminished sensation, poor local circulation

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17
Q

what is ultrasound

A

heating or mechanical (crystal vibrations)

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18
Q

what is the dosage for ultrasound

A

0.1-3 W/cm^2

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19
Q

what is the frequency for ultrasound

A

deep = 1 and superficial = 3 MHz

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20
Q

what is the difference between thermal and non-thermal ultrasound

A

thermal = continous, non-thermal = pulsed with a 0.2-0.8 ms duty cycle

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21
Q

what is the purpose of non-thermal ultrasound

A

increase in metabolic activity of fibroblasts

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22
Q

what are the indications for ultrasound

A

heat deep tissue, increase blood flow deep, decrease inflammatory process and speed repair

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23
Q

what are the contraindications of ultrasound

A

pregnant, over pacemaker/eyes/genitals, over growth plates, acute inflammation, cancer history in area, infection

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24
Q

what are the 2 types of electrical currents

A

IFC and NMES

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25
Q

what is IFC for

A

pain modulation, neuromuscular facilitation, and increase circulation

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26
Q

what are the parameters for IFC

A

high = 80-150pps for sensory/sub-motor, low = 2-10pps for strong muscle contraction

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27
Q

how long should IFC be done for

A

15-20 minutes

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28
Q

whta can IFC be combined with

A

ice and heat

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29
Q

what is NMES for

A

reducing atrophy/weakness, retrain neuromuscular function following injury/surgery

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29
Q

skip card

A
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30
Q

what level is NMES performed at

A

whatever they can tolerate, strong muscle contraction

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31
Q

how long is NMES performed for

A

15 max contractions to 10-15 minutes of submaximal contractions

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32
Q

how is NMES performed

A

work with machine (1:5 ratio, with 2-3 second ramp up), co-contract agonists or reciprocal antagonist/agonist

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33
Q

what are the indications for electrical currents

A

pain control, decrease/prevent atrophy, restore neuromuscular control

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34
Q

what are the contraindications for electrical current

A

pregnancy, over carotid artery, cardiac pacemakers

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35
Q

what are the two ways to write goniometer scores

A

single-motion or SFTR

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36
Q

why is ROM used

A

circulation and vascular dynamics, synovial movement for cartilage nutrition, elasticity, maintain joint and CT mobility, help maintain awareness of movement

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37
Q

what is the general benefit of remobilization

A

prevent abnormal cross-links, increase fluid content in ECM of CT

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38
Q

what is the benefit of remobilization on muscle

A

increase hematoma absorption, strength and myofiber regeneration/arrangement

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39
Q

what is the benefit of remobilization on articular cartilage

A

controlled weight bearing and loading -> repairs damaged cartilage

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40
Q

what is the benefit of remobilization on periarticular CT

A

prevents abnormal crosslinks and maintains content of matrix

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41
Q

what is periarticular CT

A

ligaments, fascia, cap, tendons

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42
Q

what are the 4 mechanical CT properties present in collagen

A

elasticity, viscosity, viscoelasticity, and plasticity

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43
Q

what is viscoelasticity

A

resist force and return to normal if stretched too far

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44
Q

what is plasticity

A

allows permanent change

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45
Q

what is the main principle of stretching

A

move tissue into plastic range for long term effects

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46
Q

what is fatigue failure

A

structural failure causes tissue failure

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47
Q

what is structural fatigue

A

failures from cumulative stress (stress fractures, tendinopathy, etc.)

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48
Q

what is hysteresis

A

the repetitive stretching heats tissues to decrease viscosity. and increase length and failure point

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49
Q

what influences stretching/ROM

A

amount (type) of collagen/elastin in structure, amount of force applied, amount of time the force is applied, timing (stage of healing), tissue temperature, relationship (healing, degree, ability to change)

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50
Q

what is duration for stretching

A

10-30 seconds, 2-6 times per week, 2-6 sets

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51
Q

what is CREEP for

A

chronic fibrotic contractures, long static, can add heat, following immobilization, do AROM after

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52
Q

what is the timing for active stretching

A

15-30 seconds, 3-5 reps

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53
Q

what is the point of passive stretching

A

past R1 and R2

54
Q

what is collagen for

A

stiffness and strength

55
Q

what is elastin for

A

elastic/stretch abilities (extensibility)

56
Q

what is ground substance for

A

reducing friction between elastin and collagen

57
Q

what is CT turnover

A

natural shortening with reorganization -> stretch to decrease

58
Q

what is the effect of immobilization in general

A

increase fibrosis (edema and immobilization, decrease ground substance and increase worms, hard/dense fibre meshwork, new cross-links, weak, wound contracture

59
Q

what is the effect of immobilization on muscle

A

structural changes, histological changes, and clinical changes

60
Q

what are the structural changes from immobilization on muscle

A

decrease size, myofibrils, oxidative capacity, capillary density, proprioception , and increase fat

61
Q

what are the histological changes of immobilization in muscle

A

decrease in ATP, ACP, CP,and mitochondria, and an increase in lactic acid

62
Q

what are the clinical changes of immobilization in muscle

A

weak/atrophy, decrease reflex, and decrease endurance and recovery

63
Q

what are the effects of immobilization on articular cartilage

A

less matrix orgaization, necrosis, irreversible damage, increase i fibrofatty tissue which becomes scar tisue

64
Q

what is the effects of immobilization on periarticular CT

A

CT thickens and fibrotic, decrease mobility (sticky), and decrease GAG and water in ground substance

65
Q

what is hookes law

A

stress strain curve, deformation caused when stress is applied

66
Q

what is a static muscle contraction

A

isometric = tension produced in muscle without a change in the muscles length

67
Q

what are the advantages of static muscle contractions

A

strength without stress, can start early, muscle too weak for other exercises

68
Q

what are the disadvantages of static muscle contractions

A

only gains around 20-30 degrees around isometric angle, valsalva maneuver

69
Q

what is the prescription for static muscle contractions

A

2-6-2, 66-100% MVC, rep dependent

70
Q

what are the benefits of OKC strengthening

A

more stabilizers, more shear force, start earlier, increased velocity, decreased force, easier to isolate joints

71
Q

what is the benefit of CKC strengthening

A

weight bearing, all components are healed, decreased shear, increased force/resistance

72
Q

what are the general strengthening principles

A
  • endurance -> hypertrophy -> strength -> power (increase with intensity, decrease velocity), timeline = endurance -> power -> strength, start ASAP (phase 2), have a purpose and individualize everything
73
Q

what happens with recovery after fatigue

A

initial = decrease lactic acid and other wastes, later = metabolites restored, final = > 40 mins

74
Q

what is sets/reps prescription for hypertrophy

A

65-85%, 6-12 reps, 3-6 sets, 30-90 second

75
Q

what is the sets/res prescription for power

A

80-90%, 1-3 reps, 1-3 sets, 2-5 minutes

76
Q

what is the strength timeframe

A

initial 6-10 weeks = neural
6+ = hypertrophy
12-16 = strength
16+ = power (needs coordination)

77
Q

what is the SNAP progression principle

A

S = specific exercise (mimic sport/occupation and timing)
N = no pain
A = attainable goals
P = progressive overload

78
Q

what are the 3 progressive overload methods

A

delorme, oxford, and DAPRE

79
Q

what are the 2 bottom lines for strengthening

A
  1. strengthening requires progressive overload
  2. regularly evaluate strength to determine if increase is warranted
80
Q

what is proprioception

A

the body’s ability to correctly transmit and interpret position information and respond to a stimulus

81
Q

what is proprioception dependent on

A

flexibility and strength

82
Q

what is balance

A

ability to maintain equilibrium by controlling C of M

83
Q

what is balance influenced by

A

strength and CNS input

84
Q

what are the 3 components systems of balance

A

oculomotor, vestibular, somatosensory

85
Q

what are the balance evaluation tests

A

romberg, single-leg stand, BESS, berg, foam and dome

86
Q

what are the progressions of balance

A

static -> dynamic
simple -> complex

87
Q

what is coordination

A

appropriate intensity and timing

88
Q

what are the neuro requirements of coordination

A

activity and position perception, repetition and adjustments, inhibition

89
Q

what are the progressions for coordination

A

simple -> complex
slow -> fast
static -> dynamic
low load -> high load
coordination -> agility

90
Q

what is agility

A

ability to control body during rapid, complex, and skillful activities

91
Q

what are the 5 components of agility

A

flexibility, power, strength, speed, and coordination

92
Q

what is the most important part about agility prescription

A

making it sport specific

93
Q

what are the effects of body misalignment

A

slow changes over time, and shortening of some structures with lengthening of others

94
Q

what goes with medial tibial torsion

A

varum

95
Q

what are the major problems with back pain (percentages)

A
  1. affects 70-85% of population
  2. 90% improve, but 50% recurrence
  3. 85% cannot get a diagnosis
  4. small # of definitive diagnoses
96
Q

what is the clinical management of compression fractures

A

bed rest, pain management, bracing, extension, education on proper lifting, fix posture and stabilization

97
Q

what is the MOI of spondylolysis

A

hyperextension sports with rotation (injury to contra side) -> scotty dog fracture

98
Q

what is the clinical management of spondylolysis

A

stretch hams and glutes, keep in flexion and strengthen abs

99
Q

what is the MOI/history of spondylolisthesis

A

15-16 yrs (family predisposition), slipped disk, “bilateral spony”

100
Q

what is the clinical management of spondylilosthesis

A

keep in flexion, posure, rest, brace, surgeon if > 6 months

101
Q

what questions do you ask before you attempt to treat low back pain

A
  1. serious systemic disease
  2. neurological compromise
  3. social/psychosocial distress
102
Q

what are the systemic disease/ cancer red flags

A
  • over 50
  • history of cancer
  • night pain
  • bladder incontinence/ bowel
  • nerve pain/damage (change in sensation/paralysis, reflexes and myotomes)
  • weight loss
103
Q

what is the evidence of neurological compromise

A

bladder/bowel incontinence, saddle region/leg numbness, tingling, pain, or weakness, and pain radiates distally

104
Q

what is the history of acute nerve compression

A

disk prolapse, 20-55 at L5/S1 or L4/L5

105
Q

what are the triggers for social/psychological distress

A

previous failed treatments, substance abuse, disability compensation

106
Q

what are the deep c-spine muscles

A

flexion = rec cap, long coli, and long capi
extension = sub occ, multifidis, interspinlis

107
Q

what are the global c-spine muscles

A

flexion = SCM, scalene, suprahyoid
extension = erect spin, semispin, longissimus

108
Q

what are the neck c-spine recruitment tests

A
  1. craniocervicular fleixon test (nod)
  2. with cuff
  3. wall slide
  4. endurance test
109
Q

what needs to be considered about c-spine recruitment vs strength

A

big neutral zone and low reps and sets to high reps and sets

110
Q

what are the global and local muscles of the core

A

global = rectus, bliques, lats, glutes, sup paraspinals, GL
local = transverse, multifidis

111
Q

what is the neutral zone

A

glass vs bowl, tight ligaments = more stable and vice verse -> dyanmic stabilizers have to do less

112
Q

what are core dysfunctions

A

alongside back pain, multifidis or TA

113
Q

what is the core cannister

A

diaphragm (top) pelvic floor (bottom) and multifidis and TA (sides)

114
Q

what are the 5 components of CORE exercise design

A
  1. type of contraction
  2. body position
  3. level. ofresistance
  4. repetition
  5. progression
115
Q

what are the reps and mehods of core stability

A

increase time then increase reps, static to dynamic, low loads to functional movements

116
Q

how do you turn off global core muscles

A

4 point stance, then turn on local with 30-40% MVC

117
Q

what is aquatic exercise

A

how water affects the body’s ability to move and exercise

118
Q

what is specific gravity

A

the density of an object relative to water

119
Q

what is the specific gravity of a person

A

0.95, 0.93 = fat and 1.10 = muscle

120
Q

what is buoyancy

A

upward force equal to water it displaces (opposite to gravity)

121
Q

what is the significance of buoyancy

A

relative weightlessness and movement resistance

122
Q

what is viscosity

A

friction between liquid molecules -> resistance to flow

123
Q

what is drag

A

resistance of water to body -> frictional, wave (speed) and form (size)

124
Q

why is the water having higher pressure than the atmosphere a good thing

A

reduces swelling because with increased pressure = increased compression

125
Q

what is ideal water temp for aquatic exercise

A

warm/body temp, water conducts heat 25x faster than air, and heat transfer is increased with movement

126
Q

what are the equipment types for aquatic therapy

A

water dumbbells, vest/belt, floatation cuffs, boots and bells (surface area)

127
Q

what are the indications for aquatic exercise

A

spasm, non-weight bearing, pain, inflammation/edema, weakness, decreased endurance, loss of motion, CVS maintenance

128
Q

what are the precautions of aquatic exercise

A

ear infection, fear of water, medications, special conditions like CVD, seizures, diabetes, etc.

129
Q

what are the contraindications of aquatic exercise

A

fever/illness, open wound, medical conditions such as kidney disease, urinary/bowel incontinence, tracheostomy/NG tube, radiation treatment in past 3 months (decreased immune system)

130
Q

what are the mechanics of assistive devices

A

to increase stability, reduce weight bearing

131
Q

how do you fit for canadian crutches (lofstrand)

A

hand grip at greater troch and cuff just below elbow, 20-30 degree elbow bend

132
Q

how do you use a cane

A

contra side, 25% weight bearing, 2nd class lever