Musculoskeletal System - Therapeutic Exercise Flashcards
List the benefits of PROM
- Improves mobility
- Prevents joint contracture
- Improves circulation
- Improves synovial fluid movement
- Decreases pain
- Improves patient’s awareness of movement
List the benefits of AAROM
- Improves mobility
- Prevents joint contracture
- Improves circulation
- Improves synovial fluid movement
- Decreases pain
- Improves neuromuscular activity
- Improves kinesthesia and proprioception
List the benefits of AROM
- Improves mobility
- Prevents joint contracture
- Improves circulation
- Improves synovial fluid movement
- Decreases pain
- Improves neuromuscular activity
- Improves kinesthesia and proprioception
- Improves strength in very weak muscles
List the contraindications to stretching
- Acute inflammation
- Soft tissue healing (following tendon repair)
- ROM limited by bone-on-bone contact
- Recent fracture
- Hypermobility
- Hypomobility that allows for improved function (tenodesis grip)
- Acute pain with stretch
Describe elasticity, a principle of stretching
Ability of soft tissue to return to its previous length after a stretch is no longer applied
Describe viscoelasticity, a principle of stretching
- Time-dependent
- Initial resistance to stretch
- Tissue elongation as the stretch is held for longer duration
- Will return to previous length (elasticity principle)
Describe plasticity, a principle of stretching
Allows for tissue elongation, even after a stretch is no longer applied
Describe the stress-strain curve, a principle of stretching
Depicts the relationship between force (stress) and deformation (strain) of the connective tissue
Describe creep, a principle of stretching
- Soft tissue that is stretched for a sustained duration will elongate and not return to its original length after the load has been removed
- This principle is the basis of stretching!
Describe stress-relaxation, a principle of stretching
- The longer a stretching force is maintained, the more tension within the tissue decreases
- Therefore less force is required to maintain the same tissue length
Describe static stretching
- Low intensity, long duration
- Less activation of muscle spindles, thus less resistance to stretch
- 30” holds results in significant ROM gains
Describe ballistic stretching
- Quick, jerky movements
- Rapid change in muscle length
- High intensity, short duration
- Activates the muscle spindles, resulting in greater resistance to stretch
- Not nearly as effective to prepare for athletic activity
- Likely to lead to muscle soreness and injury
Describe PNF (proprioceptive neuromuscular facilitation)
- Incorporates active muscle contractions into stretching
- Effective at treating ROM limitations due to muscle spasm as opposed to connective tissue tightness
- Techniques include contract-relax, agonist contraction, and contract-relax with agonist contraction
Describe dynamic stretching
- End-range movement held only briefly and repeatedly
- Commonly used to “warm-up” to prepare for athletic activity
- Effective at preparing body for explosive movements
Describe the connective tissue layers (3) of the muscle anatomy
- Endomysium is the innermost connective tissue layer that covers individual muscle fibers
- Perimysium is the connective tissue later that groups bundles of muscle fibers (fasciclus)
- Epimysium is the outermost connective tissue layer that surrounds the entire muscle
Describe the subunits of muscle fibers in muscle anatomy
- Muscle fiber cells made up of subunits called myofibrils
- Myofibrils made up of sarcomeres (smallest unit of a muscle with contractile ability)
- Sarcomeres made up of actin an myosin (allow for muscle contraction and relaxation)
Submaximal isometric exercises are typically used in which setting?
Rehabilitation programs
List the objective findings achieved/found with isometric exercise
- Peak and average force data
- Reaction time data
- Rate of motor recruitment
- Maximal exertion data
List the objective findings found/achieved with isokinetic exercise
- Power
Describe intensity, a resistance training parameter
- Intensity of training determined by the amount of weight used
- May be expressed as individual’s 1RM
Match intensity (Very high, high, and low) with it’s appropriate repetition range and goal of treatment (Ex: Intensity — # — Endurance)
- Very high intensity — 1-3 — Power
- High intensity — 6-12 — Strength
- Low intensity — 20+ — Endurance
Describe volume, a resistance training parameter
- Total amount of work performed
- Calculation: repetitions multiplied by intensity
Describe frequency, a resistance training parameter
- Times/wk
Match frequency to intensity
- More intense exercise — 2-3x/wk
- Those in rehabilitation programs — Several times per day (if the intensity and volume is kept low)
Elaborate on exercise sequence, a resistance training parameter
- Large muscle groups before small
- Multi-joint exercises before single-joint
- High-intensity exercise before low-intensity
Elaborate on rest interval (based on intensity), a resistance training parameter
- High-intensity — 3’ or more
- Low-intensity — 1-2’
Explain the DeLorme protocol for training
- 1st set — 10 reps x 50% of 10RM
- 2nd set — 10 reps x 75% of 10RM
- 3rd set — 10 reps x 100% of 10RM
Explain the Oxford Technique protocol for training
- 1st set — 10 reps x 100% of 10RM
- 2nd set — 10 reps x 75% of 10RM
- 3rd set — 10 reps x 50% of 10RM
Describe the overload principle
Load that is placed on a muscle must be greater than what it is normally accustomed to
Describe the SAID principle
- (Specific Adaptations to Imposed Demands)
- States that the body will adapt according to the specific type of training that is utilized
Describe the transfer of training principle
- Carryover effect
- A patient who performs exercises to improve muscle strength may also see improvements in muscle endurance
Describe the reversibility principle
- Adaptations seen with resistance training are reversible if the body is not regularly challenged with the same level of resistance or greater
When does the reversibility principle take effect?
Can begin within 1-2 weeks of stopping an exercise program
Describe the length-tension relationship
- A muscle can usually produce a maximal force near its normal resting length
- If lengthened or shortened, will likely produce less force
Describe the force-velocity relationship
- Concentric contraction — as speed increases — force of contraction decreases
- Eccentric contraction — as speed increases — force of contraction increases
List the 3 components of muscle performance
- Power
- Strength
- endurance
What is the calculation for power
Work / Time
What is the calculation for work
Load x ROM (distance)
In strength and endurance training, many adaptations are found. What are the adaptations do the two have in common?
- Increased energy stores
- Increased tensile strength of tendons and ligaments
- Increased bone mineral density
- Decreased body fat percentage
Which adaptations are seen in strength training ONLY?
- Muscle fiber hypertrophy
- Fiber type remodeling from IIB to IIA
- Increased neuromuscular activity
- Increase lean body mass
- Decreased or no change in capillary bed density
- Decreased mitochondrial density
Which adaptations are seen in endurance training ONLY?
- Increased capillary bed density
- Increased mitochondrial density
Describe DOMS and it’s symptoms
- (Delayed Onset Muscle Soreness)
- Tenderness to palpation at the muscle belly or the muscle-tendon junction
- Soreness with passive stretching
- Soreness with active contraction
- Decreased ROM
- Decreased strength
Which method of exercise leads to high risk of DOMS?
- High-intensity, eccentric loading
Though the Valsalva maneuver may be useful in certain situations (listing a heavy box and stabilizing the spine during heavy exertion), when is it contraindicated? Which system is it most taxing to?
- Undesirable effects on the cardiovascular system
- HTN
- CAD
- Stroke
- Intervertebral disk pathology
- Recent eye surgery
How do you teach a patient to avoid using the Valsalva maneuver?
Breathe rhythmically and exhale during the portion of exercise that requires the most exertion
