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Midterm Flashcards

1
Q

When do you perform PROM?

A

Before MMT

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2
Q

What do you do if there is a limitation in the AROM?

A

Immediately test PROM

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3
Q

What do end feels tell you?

A

Where the individual is limited

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4
Q

What factors affect ROM?

A

Age and gender

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5
Q

Why do females tend to be more mobile?

A

Primarily due to hormones

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6
Q

What is passive insufficiency?

A

Inability to lengthen and allow full ROM across all joints it crosses

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7
Q

Which muscle group do you need enough lengthening in in order to see proper ROM?

A

Antagonist

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8
Q

What is therapeutic exercise used for?

A

Aerobic conditioning and reconditioning

Muscle performance - IE. strength, power, and endurance

Stretching

Neuromuscular control - IE. inhibition/facilitation techniques (hyper and hypotonicity)

Postural control, body mechanics, and stabilization

Balance exercises and agility

Relaxation, breathing, ventilatory muscle training

Task specific, functional training

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9
Q

What is the role of TherEx?

A

Reduce risk factors

Manage/treat pathophysiologic or pathologic condition

Manage/treat impairment

Reduce/eliminate functional limitations

Use task specific training

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10
Q

What should you not assume when intervening at the impairment level?

A

That reducing impairment generally means improvement of functional limitations and restores functional ADLs

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11
Q

What are the categories of disability prevention?

A

1st degree - health promotion, at risk population

2nd degree - early dx and reduction of severity and duration

3rd degree - use of rehab to reduce or limit progress

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12
Q

What are buffers of disability prevention?

A

Interventions aimed to reduce progression of pathology, impairment, limitation, or disability

IE. A regular exercise program/removing barriers

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13
Q

What are three important aspects of functional outcomes?

A

Must be:

  • Meaningful
  • Practical
  • Sustainable
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14
Q

What are key effective exercise instruction strategies?

A

Acquisition and retention

Measured by observation and analysis

Adherence to exercise

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15
Q

What are the three types of motor tasks?

A
  • Discrete
  • Serial
  • Continuous
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16
Q

What is a discrete task?

A

Movement that has a recognizable beginning and end

IE. Grasping an object

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17
Q

What is a serial task?

A

Task complete in a series of discrete movements

IE. Eat with a fork, WC transfers

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18
Q

What is a continuous task?

A

Repetitive uninterrupted movements and have no distinct beginning and end

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19
Q

What are the three stages of motor learning?

A
  • Cognitive
  • Associative
  • Autonomous
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20
Q

What is the cognitive stage?

A

Novice learner

Learning the what and how

Errors are common

Feeling the exercise and understanding intensity/alignment/speed

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21
Q

What is the associative stage?

A

Making few errors and concentrate on fine tuning

Understand the when/where

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22
Q

What is the autonomous stage?

A

Understand and adapt different variables

Pt is usually discharged before this stage of learning

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23
Q

What are the categories of practice order?

A
  • Blocked
  • Random
  • Block/random
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24
Q

What is blocked practice order?

A

Same conditions

Cognitive stage

More successful at ACQUIRING

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25
What is random practice order?
Changing the environment Less predictable Hand in hand with cognitive stage Better for RETENTION
26
What is blocked/random practice order?
Also helps with RETENTION and to transfer skill At least two repetitions before changing the skill IE. Sit to stand x5 at one height, sit to stand x5 a little higher, next 5x but put an unstable surface under the feet, etc
27
What is intrinsic feedback?
Comes from the learner (patient), NOT PTA
28
What is extrinsic or augmented feedback?
PTA controls type, timing and frequency of feedback Given during or after regarding knowledge of performance and/or results Start with extrinsic before intrinsic can be achieved Examples - hands on, demo, verbalize
29
What are the various types of schedule-timing feedback?
Concurrent - "real time" Immediate, postresponse - during initial learning Delayed - after each rep Summary - after several trials
30
What does KP stand for?
Knowledge of performance
31
What does KR stand for?
Knowledge of results - After they performed a task give feedback - Better for retention
32
What is schedule-frequency feedback?
"Less is more/better" Variable over continuous to help with RETENTION Decrease it - promote problem solving, self-monitoring and correction
33
What factors can influence adherence to an exercise program?
- Pt related factors - motivation, understanding, changes, time, stress, culture, age, sex, etc - Factors related to health condition or impairment - Program-related variables - program atmosphere, social support, individualized attention
34
What does SDOH stand for?
Social determinants of health
35
Where is the greatest loss in capsular pattern of the GH jt?
ER followed by ABD
36
Where is the greatest loss in capsular patter of the elbow?
Loss of flexion is greater than loss of extension
37
Where is the greatest loss in capsular patter of the wrist?
Equal loss of flexion and extension
38
Where is the greatest loss in capsular patter of the fingers?
Equal loss of flexion and extension
39
What is the difference between ROM and stretching?
Stretching is when the limiting factor of jt mobility and the goal is to lengthen that muscle. ROM is focused on moving the jt through osteokinematic motion
40
When stretching a patient in pain where should your body position be?
Close to the patient and jt
41
When performing scap mobs what position should the patient be in?
S/L
42
When stretching forearm pronation and supination what other position should the elbow be in?
Perform with elbow flexion and extension
43
What components does stretching do when trying to improve mobility?
- Flexibility - Hypermobility - Contracture
44
What is flexibility for?
Improve ROM - need to be flexible enough to perform a motion Can be either static or dynamic
45
Why do we stretch with contractures?
We stretch when we do not get any more movement from the jt because it is at a fixed angle Common in FLEXED positions Seen in pt with SCI, SVA, nerve injury, etc
46
What are stretching indications?
- Soft tissue has lost extensibility - IE. adhesions, contractures, scar tissue - Restricted motion may lead to deformity - Mm weakness and shortening can lead to limited ROM - Prevent or reduce risk of injury and potentially Mm soreness - Prior to and after exercise
47
What are stretching contraindications?
- Bony block - Recent fracture - Acute inflammatory process - Sharp, acute pain with movement or elongation - Hematoma or other trauma - Hypermobility - Shortened tissues that provide stability or function - IE. tendodesis
48
What is the definition of stress?
Force or load per unit area.
49
What is mechanical stress?
Internal reaction or resistance to an externally applied load
50
What is strain?
Amount of deformation or lengthening that occurs when an external load is applied to a structure
51
What are the three types of stress?
- Tension - Compression - Shear
52
What happens in the toe region of the stress-strain curve?
The wavy collagen fibers straighten
53
When does deformation of the collagen fibers occur in the stress-strain curve?
Elastic limit
54
What occurs in the plastic range of the stress-strain curve?
After elastic limit is reached, sequential failure of the collagen fibers and tissue occurs, which results in heat and new muscle length after stress is released
55
What does X to X1 represent on the stress-strain curve?
New length of muscle
56
What does Y to Y1 represent on the stress-strain curve?
Additional length added in the plastic region with more heat release
57
What is the neck region of the stress-strain curve?
Considerable weakening of tissue Less force needed for deformation
58
When does total failure occur?
Quickly follows necking even with small loads Rupture
59
What is CR PNF stretch?
Contract relax - Passively lengthen muscle to first point of resistance - Isometrically contract muscle submaxially for 5-10 sec - Passively lengthen for another 10 seconds
60
What is AC PNF stretch?
Agonist contraction - agonist is this sense means opposite of range limiting muscle group (antagonist) - Concentric contraction of the opposite muscle to the range limiting muscle - Hold for few seconds - Rest then repeat
61
What is HR-AC PNF stretch?
AKA slow reversal hold-relax technique - Passively move limb - Have pt perform isometric contraction for about 5 seconds followed by voluntary relaxation and concentric contraction of opposite muscle of range limiting muscle for about 5 seconds
62
What are precautions of PNF stretching?
- DO NOT force jt beyond normal ROM - Osteoporosis, prolonged bed rest, age, or prolonged steroid use - Newly united fracture - Overstretch weak muscle
63
What is the Thomas test?
Test of hip flexors
64
What muscles could be limitations in the Thomas test?
Iliopsoas, rectus femoris, sartorius, adductor longus and brevis, pectineus, and TFL
65
What is a normal Thomas test?
Flat thigh and knee at about 80 degrees
66
Where should the goniometer be during a Thomas test?
Fulcrum - greater trochanter Proximal arm - lateral midline of pelvis Distal arm - lateral midline of femur in line with lateral epicondyle
67
What happens if the rectus femoris is the limiting factor?
More motion with the knee in extension
68
What does it mean if the leg goes into ER and ABD?
Sartorius is the limiting muscle
69
What does it mean if the leg goes into ABD and IR?
The TFL is the limiting muscle
70
What does it mean if the leg is pulled into ADD?
The pectineus and ADD are the limiting muscles
71
What are you doing in the Thomas test?
- Have pt bring knees to chest - Lower suspected limiting side down towards the ground in a flexed position - Look for any compensations
72
What is the Hamstring SLR test?
- Have both knees extended | - Lift one in a SLR
73
What compensations might you see?
- Knee flexion - Posterior pelvic tilt - Lumbar flexion
74
What is the normal measurement in a hamstring SLR test?
70-80 degrees
75
Where does the goniometer go during a hamstring SLR test?
Fulcrum - greater trochanter Proximal arm - lateral midline of pelvis Distal arm - lateral midline of femur with reference to lateral epicondyle
76
What is the Ober test?
Tests flexibility of TFL and IT band
77
What position is the pt in during Ober test?
- Bottom hip and knees are flexed to help stabilize - PTA have firm pressure on iliac crest - Slowly lower top leg into ADD position
78
What is normal during an Ober test?
Thigh can lower slightly below horizontal
79
When is the Ober test abnormal?
If pt cannot lower the leg into ADD. Gets "stuck" somewhere along the way
80
Where is the goniometer placement during an Ober test?
Fulcrum - over ASIS Proximal arm - horizontal line to the other ASIS Distal arm - anterior midline of femur using midline of patella as reference
81
What is the Modified Ober test?
- Knee extended instead of flexed | - DON'T allow hip IR
82
When do you used Modified Ober test?
When a tight rectus femoris is involved
83
What is constant load with variable displacement?
- Same tension | - Allows for some movement
84
What is constant displacement with a variable load?
- Tension can vary | - No movement is allowed
85
How long should you stay in a stretching range?
30-90 seconds
86
What are common compensations during cervical lateral flexion?
- Rotating head to the same side | - Shoulder hike
87
What are common compensations during cervical flexion?
- Lateral flexion - Shoulder hike - Movement of trunk
88
What is creep?
Change in muscle tissue length dependent on load and time. Microtrauma/change in muscle length the muscle endures over time with a certain load
89
What is stress-relaxation?
Internal tension is decreased when there is a low load applied over a period of time and remains constant Keeping a low constant load over a longer duration leads to "relaxation" of muscle fibers and ultimately increase in muscle length

Therapeutic Exercise (2 decks)

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