Mrs. T TherEx II Final Study Guide

Question 1

Understand the Nagi Model and how to apply it

Answer 1

◦Pathology – health cond., disease, disorder, injury
◦Impairment – consequences of pathology (s/s) pain, impaired balance or circulation
◦Functional Limitation – reduced ability of performing actions(reaching, grasping, lifting, pushing)
◦Disability- loss of independence (self-care, Mobility in the community, Occupational task, socialize)

Question 2

What is Stretch weakness and Tight weakness?

Answer 2

a.Stretch weakness: Muscles that are habitually kept in a stretched position tend to test weaker because of a shift in the length-tension curve.

b. Tight weakness: Muscles kept in a habitually shortened position tend to lose their elasticity; these
p. 424 k/c

Question 3

Scoliosis what’s tight / weak?

Structural vs. Nonstructural

Answer 3

Concave – stretch (mm tight) / Convex- strengthen (mm weak) p.338 skank

Structural scoliosis: involves an irreversible lateral curvature with fixed rotation of the vertebrae.

Nonstructural scoliosis: is reversible and can be changed with forward or side bending and with positional changes
p.427 k/c

Question 4

Affects of the muscle length/tension relationship in the wrist?

Answer 4

Position of the wrist controls the length of the extrinsic muscles of the hand. p.655 k/c

Question 5

stages of motor learning

Answer 5

a. Cognitive – must attend only to task at hand
b. Associative – performs movements more consistently with fewer errors
c. Autonomous – performs the exercises or functional task consistently, automatically & while doing other task

Question 6

Knowledge of Performance vs. Knowledge of Results

Answer 6

◦ Knowledge of Performance – Intrinsic feedback sensed during a task about the quality or nature of the performance of a motor task
◦ Knowledge of Results – Immediate, post task augments feedback about the outcome of a motor task
K /C Box 1.19 p.33

Question 7

Extrinsic vs. Intrinsic feedback

Answer 7

◦ Extrinsic – (external source)Verbal cueing and physical prompting from therapist
◦ Intrinsic – (within)Typically involves proprioceptive kinesthetic cues

Question 8

Adhesive Capsulitis (Stages)
A.K.A
Frozen Shoulder

Answer 8

Stage I – gradual onset of pain that increase with movement & is present at night
(less than 3 months)

Stage II  (Freezing)- persistent and more intense pain even at rest motion is limited in all directions                     
(between 3-9 months)

Stage III (Frozen) - pain only with movement, significant adhesions and limited GH motion (9-15 months)

Stage IV (Thawing) – minimal pain and no synovitis but significant capsular restrictions form adhesions motion may improve 
(15-24 months or longer)

Question 9

Capsular restriction pattern (Shoulder)

Answer 9

Max loss of ER
Mod loss of Abd
Elbow complex
Flexion loss in greater than ext. loss

Question 10

What are the motions (MOI) that cause anterior and posterior shoulder dislocations

Answer 10

Anterior MOI:
ER, Abd

Posterior MOI:
IR, Add, Flex

Question 11

Describe the carrying angle and normal values for men and women.

Answer 11

a. Men – 10° of valgus
b. Women - 13° of valgus
p. 377 shank

Question 12

Lateral Epicondylitis - “TENNIS ELBOW” what mm are affected.

Answer 12

extensor mm are affected

p.636-8 k/c

Question 13

Medial Epicondylitis -“Golfers Elbow” what mm are affected.

Answer 13

flexor mm are affected

p.636-8 k/c

Question 14

Describe resistance precautions associated with total shoulder arthroplasty and how to treat. p.557-9k/c

Answer 14

a. Phase 1 - Postpone light NWB ISOM of ST(scapula thoracic) and deltoid mm 4-6 wks. post-surgery
b. Phase 2 – Improve function of Rotator cuff & ST mm, sub-max ISOM of GH mm combined with light WB through UE/ delay resisted rotation several weeks to protect rotator cuff / progress to low-resistance dynamic strengthening of elbow & wrist
c. Phase 3 – Progress PRE in functional patterns / progress closed-chain stabilization exercises

Question 15

Describe what dysfunctions/diseases may increase the risk of developing myositis ossificans and how to appropriately treat. p.635-6 k/c

Answer 15

myositis ossificans – is abnormal bone growth
Most often occurs in TBI, SCI or burn patients

Cause: Aggressive stretching post injury/immobilization

Brachialis mm is the most affected

Treatment:

i. Rest
ii. Periodic AROM in pain-free range
iii. Occasionally, surgical excision is necessary rare

Question 16

Describe the specific deformities that may affect the hand in a patient diagnosed with RA

Answer 16

RA deformities affecting the hand –
Boutonniere(PIP√, DIP/) 
Swan Neck (hyper PIP/, DIP √)

Question 17

Describe the convex on concave rule and understand how it applies to the different joints with application of joint mobilizations

Answer 17

Basis for determining the motion of mobilizing force when joint mobilization gliding techniques are used
Convex–> Concave = opposite
Concave–> Convex = same
Apply the pressure in the direction that the bone is moving. p.122k/c

Hand joints (concave)wrist (convex)
elbow  (concave) shoulder (convex)

Foot joints (concave)ankle (convex)
knee (concave) hip (convex)

Question 18

Normal vs. abnormal responses to exercise.

Answer 18

Normal response
I. ↑ in HR
ii.↑ in respiration depth and rate (VO2, CO, systolic)

Abnormal response
I. Immediate: persistent dyspnea(SOB), dizziness, pain, leg claudication(legs are limp) excessive fatigue, pallor(pale), cold sweat, ataxia(loss of full body control), pulmonary rales(crackle sounds)

ii. Delayed: prolonged fatigue, insomnia, sudden weight gain or fluid retention

P3 cardiovascular notes / p.26 shank