Other

Question 1

List the components of the musculoskeletal screening

Answer 1

1. Posture
   
   2. Active shoulder ROM
   3. Anterior shoulder flexility
   4. Cervical ROM
   5. Resisted internal/external rotation
   6. Full knee extension
   7. Resisted knee extension and flexion
   8. Knee to chest
   9. Hamstring flexibility
   10. Balance

Question 2

List the MET insurance reimbursement criteria.

Answer 2

• Client has sustained major trauma, undergone surgery, or has a chronic condition
  
  • Client is not covered by Medicare, Medicaid, or any gov-based insurance
  • Client has a referral from MD or DO
  • Client has received max benefit from PT/DC
  • Client has residual functional deficits

Question 3

List the three major MET service options.

Answer 3

1 on 1
condition-based group training
medical memberships

Question 4

Describe what

to do once a referral is received.

Answer 4

1. Schedule the client
   
   2. Communicate with the medical professional
   3. Review the condition of the clients
   4. Assess the client
   5. Send a thank you fax within 24 hours
   6. Establish goals
   7. Design the program
   8. Send assessment summary within 72 hours to Dr.

Question 5

Describe three written reports you must submit to referral sources.

Answer 5

Progress report
Assessment report
Discharge report

Question 6

List the four responsibilities of medical exercise professionals.

Answer 6

• Manage the client effectively
• Communicate with med pros
• Document each session
• Outcome based

Question 7

List the components of a MET marketing packet.

Answer 7

• Brochure
• Introductory letter
• Business cards
• Sample flowchart
• Sample exercise sheet
• Referral pad
• Programming solutions

Question 8

List the pillars of a strong and successful MET practice.

Answer 8

• Practice management systems
• Multiple streams of income
• Medical referrals
• Marketing plan

Question 9

List the “Functional Assessment Scales” and the indications for each.

Answer 9

• Cervical Oswestry Scale-cervical disc herniation
  
  • Functional Scale for Ankle Assessment-ankle sprain
  • Functional Status Index- Parkinson’s
  • Harris Hip Function Scale-hip replacement
  • Lysholm’s Knee Scale-ACL repair
  • Oswestry Lumbar Scale-lumbar disc herniation
  • Functional Shoulder Strength Scale-total shoulder replacement
  • Tinetti Gait/Balance Scale-Seniors

Question 10

List the 7 keys to building a successful MET practice.

Answer 10

1. A passion for medical exercise sciences and working with medical exercise clients
   
   2. Seek out medical exercise education
   3. Establish a marketing plan
   4. Become a part of the local medical community
   5. Establish referral relationships
   6. Become the go-to fitness expert
   7. Establish multiple streams of income

Question 11

Describe the medical exercise professional’s scope of practice and role.

Answer 11

The role of the medical exercise professional is to develop and implement safe and effective exercise and conditioning programs for client’s with medical conditions.
The scope of practice of the MET includes fitness assessments, strength training, flexibility training, cardiovascular training, functional conditioning, speciality training, aquatic exercise, weight reduction programming, wellness/fitness education, and group training.

Question 12

Define the term “pathology”

Answer 12

The science of the causes and effects of diseases.

Question 13

List and describe the medical exercise red flags

Answer 13

Radiating pain-pain that travels a length of the body

Numbness/tingling-numbness or tingling sensations in any area of the body

Loss of range of motion-a joint or joints that no longer have the degree of motion they once had Loss of function-no longer being able to do something you once could

Swelling-increase of size and inflation of an area

Nite pain-pain experienced at night within the torso or pelvis

Chest pain/shortness of breath-pain in the chest area and difficulty breathing

Open wounds-wounds that are still healing

Abnormal vital signs- changes in blood pressure or heart rate

Question 14

List and describe the five medical exercise sciences.

Answer 14

1. Anatomy-the foundation of all MET
2. Pathology-necessary to understand the application of MET to conditions
3. Exercise Physiology-the reaction to exercise
4. Kinesiology-selection of exercise
5. Biomechanics-understanding the distribution and result of forces generated during exercise

Question 15

List the 6 keys to MET program design.

Answer 15

1. Clear understanding of anatomy and pathology.
2. Immediately recognize contraindicated exercise and activities
3. Assess key areas using key techniques
4. Incorporate indicated exercise and activities into the program
5. Understand progression guidelines and functional goals leading to a positive outcome
6. Use a protocol-based approach

Question 16

What are the 4 joint receptors and where are they found?

Answer 16

Type I-found in joint capsule. Postural reactions, slow adapting.

Type II-located deep in capsule, mid range of movement

Type III-found in ligaments. fire at the end ROM.

Type IV-found in capsule, fat pad, and ligaments. These are the nociceptors

Question 17

Explain the side effects of prolonged NSAID usage.

Answer 17

The side effects of prolonged NSAID usage includes GI problems, renal failure, hemorrhage, and nausea. They cause GI problems because of the fact that they reduce all type of inflammation, even the good types. One of these good types is involved with lining the GI with mucus. Without that, the GI can form ulcers. This is why it is important to take NSAIDS on a full stomach.

The renal failure can occur because the large molecules can get lodged in your kidneys and liver.
Hemorrhage and nausea can occur because of the damage that occurs from the loss of mucus in the GI.

Question 18

Explain Wolff’s Law and how is pertains to post rehab training

Answer 18

Wolff’s Law states that an application of stress to connective tissue will result in an increase of strength, an elimination of that stress reduces strength, and every tissue has a physiologic limit. This pertains to post rehab training because this is exactly what we are doing with exercise. We are subjecting the body to a form of stress, so that it can adapt and become stronger (or better). This is also important for the post rehab professional as we want to be mindful of the physiologic limit of the tissues so we do not exceed that can cause injury.

Question 19

What are the different types of connective tissue? Please describe each one

Answer 19

Fascia-fibrous tissue that encloses muscles or organs

Cartilage-smooth rubber-like elastic tissue

Ligaments-tough, flexible tissue that connects two bones or cartilage

Adipose tissue-fat tissue

Tendon-attaches a muscle to a bone

Blood vessels-carries blood through tissues and organs

Dermis-thick layer of tissue below epidermis that forms the true skin

Bone-hard tissue forming the skeleton of the body

Joint capsule-a ligamentous sac that surrounds the articular cavity of a moveable joint

Question 20

Please explain the concept of joint inflammation and the order of related events after injury.

Answer 20

It starts with trauma or degeneration. The trauma causes vessel damage resulting in hemorrhaging of those vessels. This increases the permeability of the blood vessels which causes protein to be released into the interstitial space. This protein brings GAG molecules which cause an increase in water brought to the area. This water is what causes edema or swelling. Histamine, prostaglandins, and bradykinin are released and this causes a quick vasoconstriction followed by vasodilation, triggering the inflammatory response. White blood cells are brought in to help clean up the area. The interstitial edema causes pain. By day 3, the primary and secondary connective tissue begin to heal and there is a reduction in white blood cells. By days 3-5, fibrin, a precursor to collagen fibers, appears. By day 3 or 4, light exercise can be introduced to help collagen lay in a uniform manor into dense connective tissue. If no movement occurs, the connective tissue can become mobile due to scarring by day 5.

Question 21

What are the 9 components of function?

Answer 21

ROM/Flexibility

Power

Muscle Recruitment

Strength

Coordination

Joint Stability

Endurance

Proprioception

Balance

Question 22

List the 3 components of joint stability from the inside out.

Answer 22

1. Boney congruency
2. Ligamentous integrity
3. Muscle recruitment/strength

Question 23

What is the hierarchy of conditions in MET?

Answer 23

1. Cardiovascular disorders
2. Surgical procedures
3. Neurological disorders
4. Soft tissue disorders with radiating pain
5. Soft tissue disorders with no radiating pain

Question 24

What are the 5 principles of assessment?

Answer 24

1. Understand anatomy and pathology
2. Get a good history
3. Think and assess function
4. Select appropriate activities
5. Listen-they will tell you whats wrong and needs attention

Question 25

What are the 3 joint forces for injury?

Answer 25

1. Shear force-one surface sliding over another
2. Compression force-force coming down (knee menisci)
3. Rotational/Torsion force-ACL

Question 26

What are the 3 degrees of sprain?

Answer 26

1. Frist degree-ligament stretching, mild pain, no instability, little swelling. Micro.
2. Second degree-mild ligament tearing, moderate pain, instability, swelling, macro.
3. Third degree-complete rupture, gross instability, severe pain and swelling