Musculoskeletal Exercise Assessment and Prescription 3

Question 1

WHY USE OUTCOMES MEASURES FOR MSK EXERCISE?

Answer 1

• To measure changes in performance
• Quantitative and qualitative measures
• To establish a baseline measure; gives the clinician and client a starting point
• To determine whether an exercise program is effective
• To know when to progress an exercise
• To demonstrate changes to the client
• To know when the programme is ineffective

Question 2

HOW DO WE SELECT THE BEST OUTCOME MEASURE TO USE?

Answer 2

Be specific to what (and the position) we are trying to measure Parameter of physical capacity
strength vs power vs endurance vs agility
Type of contraction
isometric vs isotonic vs isokinetic
Type of exercise
single vs multi-joint, OKC vs CKC

Question 3

outcome measure: HOW DO WE MAXIMISE REPEATABILITY?

Answer 3

• Keep velocity constant
• Be specific to contraction type
• Keep joint angle/muscle length or ROM constant

Question 4

outcome measure: HOW DO WE COMPARE SIDES?

Answer 4

• Comparisons: – Left vs right
– Affected vs unaffected
• Calculation of symmetry index
– Symmetry index = (Affected side/unaffected) x 100
* no symmetry due to dominant side

Question 5

WHEN DO I ADD RESISTANCE?

Answer 5

Be careful adding resistance if your client has:
• Extreme joint and muscle pain during active unresisted movements
• Joint or muscle inflammation
• Severe cardiopulmonary disease
• Acute or delayed muscle soreness
• Unstable joint or unhealed fracture site
• Takes medications that can alter acute and chronic response to exercise
• Pain, shortness of breath or dizziness
• Is a child or elderly adult
• You are going to perform uncontrolled ballistic movements
• Substitution strategies due to inappropriate resistance or lack of stability

Question 6

WHAT IF GRAVITY IS TOO MUCH?

Answer 6

What are your options when your client is unable to generate movement against gravity?
• Isometrics
• Gravity eliminated exercises
• Active assisted - powder board, pulleys, poles

Question 7

HOW DO I QUANTIFY LOAD

Answer 7

• Repetition Maximum (RM)
– The maximum amount of weight that can be lifted with correct technique for a specified number of repetitions
- HAVE TO HAVE BALANCE OF SOMEONE BEING EFFECTIVELY WARMED UP, CORRECT WEIGHT
• %of1RM
– % of the maximum amount of weight that can be lifted with correct technique for a single repetition

Question 8

SOME STANDARDISED ASSESSMENTS - STRENGTH

Answer 8

Repetition maximum testing Grip strength (Norms available) Abdominal muscle strength test

Question 9

SOME STANDARDISED ASSESSMENTS - POWER

Answer 9

Vertical jump (norms available) 
Standing long jump (norms available) 
Shuttle run

Question 10

SOME STANDARDISED ASSESSMENTS - ENDURANCE

Answer 10

Repetition maximum testing
Timed wall squat
Upper body endurance test (norms available)

Question 11

SOME STANDARDISED ASSESSMENTS - AGILITY

Answer 11

Cross-over hop for distance
Cross-over hop for time
Figure 8 run