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Therapeutic Exercise > Midterm > Flashcards

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
Q

What is random practice order?

A

Changing the environment

Less predictable

Hand in hand with cognitive stage

Better for RETENTION

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26
Q

What is blocked/random practice order?

A

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

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27
Q

What is intrinsic feedback?

A

Comes from the learner (patient), NOT PTA

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28
Q

What is extrinsic or augmented feedback?

A

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

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29
Q

What are the various types of schedule-timing feedback?

A

Concurrent - “real time”

Immediate, postresponse - during initial learning

Delayed - after each rep

Summary - after several trials

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30
Q

What does KP stand for?

A

Knowledge of performance

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31
Q

What does KR stand for?

A

Knowledge of results

  • After they performed a task give feedback
  • Better for retention
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32
Q

What is schedule-frequency feedback?

A

“Less is more/better”

Variable over continuous to help with RETENTION

Decrease it - promote problem solving, self-monitoring and correction

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33
Q

What factors can influence adherence to an exercise program?

A
  • 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
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34
Q

What does SDOH stand for?

A

Social determinants of health

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35
Q

Where is the greatest loss in capsular pattern of the GH jt?

A

ER followed by ABD

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36
Q

Where is the greatest loss in capsular patter of the elbow?

A

Loss of flexion is greater than loss of extension

37
Q

Where is the greatest loss in capsular patter of the wrist?

A

Equal loss of flexion and extension

38
Q

Where is the greatest loss in capsular patter of the fingers?

A

Equal loss of flexion and extension

39
Q

What is the difference between ROM and stretching?

A

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
Q

When stretching a patient in pain where should your body position be?

A

Close to the patient and jt

41
Q

When performing scap mobs what position should the patient be in?

A

S/L

42
Q

When stretching forearm pronation and supination what other position should the elbow be in?

A

Perform with elbow flexion and extension

43
Q

What components does stretching do when trying to improve mobility?

A
  • Flexibility
  • Hypermobility
  • Contracture
44
Q

What is flexibility for?

A

Improve ROM - need to be flexible enough to perform a motion

Can be either static or dynamic

45
Q

Why do we stretch with contractures?

A

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
Q

What are stretching indications?

A
  • 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
Q

What are stretching contraindications?

A
  • 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
Q

What is the definition of stress?

A

Force or load per unit area.

49
Q

What is mechanical stress?

A

Internal reaction or resistance to an externally applied load

50
Q

What is strain?

A

Amount of deformation or lengthening that occurs when an external load is applied to a structure

51
Q

What are the three types of stress?

A
  • Tension
  • Compression
  • Shear
52
Q

What happens in the toe region of the stress-strain curve?

A

The wavy collagen fibers straighten

53
Q

When does deformation of the collagen fibers occur in the stress-strain curve?

A

Elastic limit

54
Q

What occurs in the plastic range of the stress-strain curve?

A

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
Q

What does X to X1 represent on the stress-strain curve?

A

New length of muscle

56
Q

What does Y to Y1 represent on the stress-strain curve?

A

Additional length added in the plastic region with more heat release

57
Q

What is the neck region of the stress-strain curve?

A

Considerable weakening of tissue

Less force needed for deformation

58
Q

When does total failure occur?

A

Quickly follows necking even with small loads

Rupture

59
Q

What is CR PNF stretch?

A

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
Q

What is AC PNF stretch?

A

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
Q

What is HR-AC PNF stretch?

A

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
Q

What are precautions of PNF stretching?

A
  • DO NOT force jt beyond normal ROM
  • Osteoporosis, prolonged bed rest, age, or prolonged steroid use
  • Newly united fracture
  • Overstretch weak muscle
63
Q

What is the Thomas test?

A

Test of hip flexors

64
Q

What muscles could be limitations in the Thomas test?

A

Iliopsoas, rectus femoris, sartorius, adductor longus and brevis, pectineus, and TFL

65
Q

What is a normal Thomas test?

A

Flat thigh and knee at about 80 degrees

66
Q

Where should the goniometer be during a Thomas test?

A

Fulcrum - greater trochanter

Proximal arm - lateral midline of pelvis

Distal arm - lateral midline of femur in line with lateral epicondyle

67
Q

What happens if the rectus femoris is the limiting factor?

A

More motion with the knee in extension

68
Q

What does it mean if the leg goes into ER and ABD?

A

Sartorius is the limiting muscle

69
Q

What does it mean if the leg goes into ABD and IR?

A

The TFL is the limiting muscle

70
Q

What does it mean if the leg is pulled into ADD?

A

The pectineus and ADD are the limiting muscles

71
Q

What are you doing in the Thomas test?

A
  • Have pt bring knees to chest
  • Lower suspected limiting side down towards the ground in a flexed position
  • Look for any compensations
72
Q

What is the Hamstring SLR test?

A
  • Have both knees extended

- Lift one in a SLR

73
Q

What compensations might you see?

A
  • Knee flexion
  • Posterior pelvic tilt
  • Lumbar flexion
74
Q

What is the normal measurement in a hamstring SLR test?

A

70-80 degrees

75
Q

Where does the goniometer go during a hamstring SLR test?

A

Fulcrum - greater trochanter

Proximal arm - lateral midline of pelvis

Distal arm - lateral midline of femur with reference to lateral epicondyle

76
Q

What is the Ober test?

A

Tests flexibility of TFL and IT band

77
Q

What position is the pt in during Ober test?

A
  • Bottom hip and knees are flexed to help stabilize
  • PTA have firm pressure on iliac crest
  • Slowly lower top leg into ADD position
78
Q

What is normal during an Ober test?

A

Thigh can lower slightly below horizontal

79
Q

When is the Ober test abnormal?

A

If pt cannot lower the leg into ADD. Gets “stuck” somewhere along the way

80
Q

Where is the goniometer placement during an Ober test?

A

Fulcrum - over ASIS

Proximal arm - horizontal line to the other ASIS

Distal arm - anterior midline of femur using midline of patella as reference

81
Q

What is the Modified Ober test?

A
  • Knee extended instead of flexed

- DON’T allow hip IR

82
Q

When do you used Modified Ober test?

A

When a tight rectus femoris is involved

83
Q

What is constant load with variable displacement?

A
  • Same tension

- Allows for some movement

84
Q

What is constant displacement with a variable load?

A
  • Tension can vary

- No movement is allowed

85
Q

How long should you stay in a stretching range?

A

30-90 seconds

86
Q

What are common compensations during cervical lateral flexion?

A
  • Rotating head to the same side

- Shoulder hike

87
Q

What are common compensations during cervical flexion?

A
  • Lateral flexion
  • Shoulder hike
  • Movement of trunk
88
Q

What is creep?

A

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
Q

What is stress-relaxation?

A

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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