Past Exam Qs Flashcards
Definition of hypertrophy and hyperplasia
- Increase in the size of muscle cells
* Increase in the number of muscle cells
List 6 qualifiers of strength
- Maximum strength - highest force capability of the neuromuscular system
- High-load speed-strength - >30% of 1RM highest force capability of the neuromuscular system
- Low-load speed-strength - <30% of 1RM highest force capability pf the neuromuscular system
- Rate of force development – the rate at which the neuromuscular system is able to develop force, measured by calculating the slope of the force-time curve on the rise to the maximum force of the action.
- Reactive strength – ability of the neuromuscular system to tolerate a relatively high stretch load and change movement from rapid eccentric to rapid concentric.
- Skill performance – ability of the motor control system to coordinate the muscle contraction sequences to make the greatest use of the other 5 strength qualities such that the total movement best achieves the desired outcome.
What is an open and closed chain exercise and give 2 examples (Shoulder/ knee)
- Usually a single joint movement, performed in a non-weight bearing position where the distal segment moves through space – examples knee extension machine, shoulder press
- Exercises involving multiple joints and are performed in weight bearing positions with a fixed distal extremity. They are more functional, provide more proprioceptice feedback an cause less sheer joint forces. Examples include a squat or a chin up.
List and discuss 6 stages of change
. List and discuss 6 stages of change (Long answer)
1. PRECONTEMPLATION STAGE. We enter the stages of change from a state of precontemplation– during which the idea of change is not seriously considered.
i. Denial
ii. Education/no belief or desire for the need to change
iii. May have no personally convincing reason for change as yet – it isn’t that they can’t see the solution, they can’t see the problem.
2. CONTEMPLATIVE STAGE Secondly we contemplate the need for change; but take no active steps.
i. Some researchers think that people move into this stage through a timely personal event.
ii. It is often learning what the outcomes of change will be for that person.
iii. Not generic info but specific relevant info or events
iv. Sometimes it can be a child’s comments
v. Once someone contemplates change they should take steps to act
vi. Serious thinking and charting pro’s and con’s are helpful in this stage
3. DETERMINATION STAGE Thirdly we determine to take action. eg we buy walking shoes, join a gym or discover a local swimming pool, but we take no action.
4. ACTION STAGE Then action is initiated. We walk regularly; go to that gym, have eggs instead of muesli for breakfast ……
o This is the transition stage between shifting the balance in favour of change and getting things going
o Determination can lead to action if you thoroughly consider your addictive behaviour and have begun to establish goals which meet your individual needs and values
o You need to determine exactly what you need to modify
5. MAINTENANCE STAGE Finally the action is maintained for several weeks. But most having maintained the change, whether in diet, smoking habit, exercise or whatever, will sooner or later fail and revert to the first or second stage. Then comes the verdict that is most helpful; namely
6. RELAPSE +/- TO FAIL IS NORMAL!!! Next comes the best advice I have found; we should not engage in self recrimination but instead DISCOVER WHY WE FAILED
Name 4 Cx stabilising muscles
. • Splenius cervicis
• Cervical erector spinae
• Longus colli
• Scalenes
List 10 points to consider when deciding on an appropriate rehab program.
The individual
o Who (young or old, athlete, weekend warrior)
o Injury & hx of injury (acute, subacute vs chronic)
o Comorbidities (high BP, diabetes, LBP)
o Treatment so far/surgery
Objective/goals (pain free vs play in GF)
What are the ADLs
What sports do they want to return to.
Treatment.
o Areas lacking flexibility
o Areas with excessive movement - Strengthening?
Areas of abnormal biomechanics - Kinetic chain and rest of the body
o Areas lacking in Proprioception
Available Facilities
o Gym, Pools, Pilates/ yoga studios
o Biofeedback devices and tools: theraband, weights, dura disc, firball, steps, bike
- What are the four phases of rehab?
Acute phase
- From the time of injury to almost pain free ‘normal ROM’
- PRICE is increasingly replaced by POLICE
- Treatment and management focused on soft tissue and joint mobility and pain relief
Restore ADLs
- Aim is to allow the patient to return to normal ADLs and basic sport specific technical movements.
- Progress from single joint controlled actions to complex tasks through several biomechanical planes.
- Exercises progressed by reps, increasing velocity of the movement, or the frequency (rate) of the exercises.
- Main goals are related to addressing functional limitations in activity and improving performance of semi-complex sport-specific movement patterns.
Returning to sports activities
ADL’s should produce no symptoms.
Proprioceptive, agility and functional work should all be performed without any adverse effects.
- More traditional strength and conditioning can be incorporated with increased focus on higher complexity and velocity.
- Emphasis on higher rate of force development.
- Muscle conditioning now becomes completely sport specific. ie. power/speed for sprinters, Endurance distance runners/ cyclists.
- Decisions regarding return to play are made in collaboration with all stake holders.
The following criteria can be used when deciding on a full return to sport:
- Time constraints for soft tissue healing observed
- Pain free ROM
- No persistent swelling
- Adequate strength and endurance
- Good flexibility and proprioception
- Adequate cardiovascular fitness
- Skills regained
- No biomechanical abnormality – structural or skills based
- Psychologically ready
- Coach satisfied with training form
- Rehab is not over when you return to sport/work
Return to sport focus
- Progression of activity: jog to stride to hop to agility with increasing
- complexity.
- Slow integration activities (individual to team mate , to full training)
- Assessment of athlete’s performance and structural biomechanics
- What caused the original injury? Work with skills coach - technique must be corrected here.
- Has the athlete adopted a guarding / protective mechanism?
- Has this created altered movement patterns?
- Perform 70%-90% of normal training load
- CONFIDENCE– essential to restore. Athlete maybe hesitant to perform the activity that caused the original injury, fear injury reoccurrence, lack of full return of skills.
Prevention of reinjury
- All injuries with tissue disruption will render the patient more susceptible to re-injury.
- Interventions should be aimed at impairments and functional limitations known to exist as a result of injury.
- These include altered muscle activation patterns, inadequate landing and cutting strategies.
Basic strategies
- High reps = trains strength-endurance and used with short recoveries
- Low reps – trains strength power and req longer recoveries (dependant on Pt.)
What are the types and benefits of stretching?
Static stretching
Moving the muscle or joint into an elongated positions and holding the
Be aware research consistently shows a reduction in power immediately after static stretching.
Dynamic Stretching
Muscle and joint taken through their ROM during movement. More specific to preparation for exercise and sports in particular.
- During rehab important to not ‘bounce’ muscle recovering from injury.
- Increase tendon flexibility and elasticity
- Incorporate eccentric contractions during the stretch phase position for an extended period.
Proprioceptive Neuromuscular Facilitation Stretching (PNF)
• Performed by alternating contraction of antagonist and excessively stretching
the agonist.
Aggressive but rapid increases in flexibility.
Proprioceptive neuromuscular facilitation stretching (PNF)
- Not really something you can give a patient to do at home (like MET?) but suppose you can give pec stretch with contraction
How can you measure rehabilitation progress?
Pain Outcome measures (FABQ, PCS) ROM (available before and after) Special tests Functional testing ADLs
What is the panjabi model of spinal stability?
- The control system – neural and feedback system
- The passive system – includes bones, ligaments and joint capsules
- Active subsystem – muscles and tendons
Panjabi proposed the 3 tiers of stability that is needed for each movement, they are all interrelated during movement, both static and dynamic. They are control system, passive system and active subsystems. From this, each of these are used in:
1) Local segmental control - to activate and train the local muscle system, regardless of the joint it involves. Goal is to improve kinaesthetic awareness and muscular control
2) Once that is achieved you will move into a closed chain segmental control. To reload weight bearing and unload non weight bearing m, while maintaining control.
Once this is done, you use open chain. To continue to develop segmental control whilst maintaining control of adjacent segments. Completion of this will see control of weight bearing and non weight bearing and achieve functional segmental control
What are the three main strategies of lumbopelvic control
Involves 3 main neural strategies
- Reactive control– nervous system activates a pattern of muscle activation in response to sensory input. System unexpectantly disturbed.
- Preparatory control– activation initiated in advance of the disturbance. Only used when demands are predicted.
- Ongoing tonic muscle activation–low percentage of contraction to maintain a state of preparedness.
What are the three basic principal to gain benefits
Progressive overload
- A gradual increase in the stress placed on the body during training.
- Without these additional demands, the human body has no reason to adapt any further than the current level of fitness.
Specificity
- Refers to the body’s adaptations to training. The physiological adaptations to resistance training are specific to the muscle actions involved, velocity of movement, exercise range of motion, muscle groups trained, energy systems involved, and the intensity and volume of training (Kraemer & Ratamess, 2004).
- The most effective resistance training programs are designed individually to bring about specific adaptations.
Variation
Alteration of the resistance training program over time to allow for the training stimulus to remain optimal. It has been shown that systematic program variation is very effective for long term progression (Marx et al., 2001).
Power vs strength
Strength Initially high repetitions, low resistance Progress to higher resistance with less repetitions As function and strength improve, progressions into faster, functional and eccentric exercises are performed Progression: (very important!) 1. Passive mobilisation 2. Passive exercises 3. Active exercises 4. Active resisted exercises 5. Functional/ Sports Specific 1. Progressions 1. Activation 2. Less than body weight 3. Body weight 4. Two legs 5. Single leg 6. Small reps 7. High reps 8. Plyometrics / High Weight Low Res 9. Sport Specific
Power
‘Maximum amount of work an individual can perform in a given unit of time’ B&K CSM 4th Edn
- Training for power has long been known to be critical for athletic performance.
- Emerging evidence of the importance of muscular power for all populations including the elderly.
- It is important to initiate all movements as quickly and explosively as possible.
- Volume - relatively low.
- Intensity – depends on the type of exercise eg. Jump squat and Bench Press Throw (30- 60% of 1 RM)
- Olympic Type Exercises (80- 90% of 1 RM, 3-6 RM)
- Rest Periods (5 minutes)
List 5 ways to overload a muscle
- Increasing speed of movement
- Increasing resistance
- Increasing reps
- Increasing frequency or duration
Decreasing recovery time between training
List 3 areas involved in functional capacity assessment?
- Base objective testing
- Proprioceptive test
- Strength test
- Functional Test
- Sport specific functional tests
