Quiz 1: Exercise Progression and ROM Flashcards
What is the cumulative injury cycle? (what order does pain progress through?)
Pain
Inflammation
Muscle adhesion
Movement dysfunction
Muscle imbalance
Injury
What does R.I.C.E. stand for?
Rest, Ice, Compression, Elevation
_______ _______ is the key to optimizing results, whether it’s improving strength, endurance, flexibility, or balance.
Exercise progression
True or False:
Exercise progression prevents plateaus and keeps clients motivated by presenting new challenges.
True
What are the 4 principles of progression?
Overload
Specificity
Individuality
Reversibility
What is the overload progression principle?
(work harder to get stronger)
gradually increase the demands places on the body’s system to elicit adaptation and improvement
What is the specificity principle?
(train specific muscle area)
tailor the exercise to target specific muscle groups and movement patterns relevant to your client’s needs.
What is the individuality principle?
(unique to the client)
consider each client’s unique fitness level, limitations, and goals when designing a progression plan.
What is the reversibility principle?
(get better when you rest)
allow adequate rest and recovery periods to prevent over training and ensure sustainable progress.
What are the different way to show progression? (3)
- increasing weight/resistance
- manipulating sets/reps
- introducing variations and complexities
True or False:
When given an exercise program, all patients will progress at the same pace as the next person.
False. All patients are unique and will progress at different speeds.
How do you show progression for aerobic exercise?
gradually increase the intensity (speed, incline, difficulty, type, volume) or duration of activities like swimming, cycling, or running.
How do you show progression for resistance exercise?
progressively increase the weight/resistance, sets/reps, or exercise complexity as strength and endurance improve
What is the #1 goal of monitoring and adjusting progress?
Quality > quantity
True or False:
It is important to make sure the patient’s form is proper before letting them begin their exercise.
True, this prevents risk of injury
When monitoring and adjusting patient progression, how do you track progress data?
monitor changes in strength, endurance, flexibility, or pain levels to make proper adjustments.
Important to know variations of exercises and precursors.
Why is it important to seek feedback from your client when monitoring and adjusting patient progression?
You need to regularly communicate with your client in order to understand their perceived difficulty and adjust accordingly.
You should NEVER guess how a client is feeling.
What are the four main points to remember when addressing plateaus and challenges?
- plateaus are inevitable
- variety is key
- focus on form over weight
- consider deload weeks (reduced intensity)
What are the four main points of progression in special populations?
- adapt exercises (accommodation)
- focus on functional movements (ADLs)
- start low & progress gradually (slow and steady wins race)
- celebrate small wins
True or False:
Progress will be faster in special populations.
False, it will be slower.
What are some technology and tools for progression?
Wearable technology
Mobile apps
Software programs
What are some examples of wearable technology?
- HR monitors
- Activity trackers
- Smart scales (analyzes body comp and BMI)
What are some examples of mobile apps?
- exercise libraries (exercise instructions)
- personalized training programs
- instructional videos
- progress tracking features
What are some examples of software programs?
- data-driven program design (customized programs)
- advanced progression algorithm
- real-time monitoring and feedback
- integration with wearables and apps
What are SMART goals?
Specific, Measurable, Attainable, Results, Time
What are some motivational strategies for progression?
- SMART goals
- Positive reinforcement
- Create a supportive environment
- Focus on progress, not perfection
What is ROM?
the amount of angular motion between 2 boney levers at a joint
What are the 4 types of ROM?
RROM
PROM
AROM
AAROM
Why is ROM important?
ROM is the key that unlocks functional independence.
Improves joint health and stability
Injury prevention
What is PROM? What are the uses of it?
motion produced by an external force (manual/mechanical)
(not synonymous with passive stretching)
- decreases cartilage degeneration & adhesion
- prevents or minimizes joint contractures
- enhance synovial movement to provide cartilage nutrition
- maintain muscle elasticity
- assists healing after joint injury or surgery
What can PROM NOT do? (3)
- Does not prevent muscle atrophy
- Does not increase muscle strength or endurance
- Has only minimal impact on circulation
What is continuous passive motion (CPM)?
Passive motion that is performed by a mechanical device that moves a joint slowly and continuously through a preset, controlled ROM.
What are the advantages of CPM?
- Muscle memory (it goes only to the set degree)
- Allows the therapist to better watch the patient
When should you use PROM?
- When a joint has acutely inflamed tissue
- When a patient is not able to or not supposed to actively move the joint
- Following surgical repair of contractile tissue when AROM would compromise the repaired muscle
What is AROM?
a ROM produced entirely by a muscle action (grade 3 MMT)
What are the benefits of AROM?
- can build muscular endurance
- can help prevent muscle atrophy
- activates sensory receptors within the muscles and joints
- help prevent stiffness and pain from returning
When should you use AROM?
- When a patient can contract the muscle actively and move a segment though a ROM
- When resistance is not indicated
- During immobilization, AROM is used above and below the joint
- Can be used for aerobic conditioning
True or False:
By using AROM, it can help maintain or increase strength.
False, for strong muscles AROM won’t maintain or increase strength
What is AAROM?
a combination of both AROM and PROM, patient moves through as much AROM as possible then the rest is achieved via PROM
What are the benefits of AAROM?
combines those of PROM and AROM
What is RROM?
Resistance Range of Motion, also known as Manual Muscle Testing during the examination process.
When should you use PROM before AROM?
when there is suspect muscular weakness or tissue lesion.
What are the ways to assess (measure) AROM and PROM?
Visual and goniometry
In assessing PROM, what are the 3 normal end feels?
- Soft: muscle to muscle, fat
- Firm: capsular, tendon, or ligamentous stretch
- Hard: bone to bone
In assessing PROM, what are the 5 abnormal end feels?
- Soft: spongy = inflammation
- Firm: adhesion may be limiting motion
- Hard
- Empty: feels like it will keep going
- Spasm
Goniometry of the ankle joint:
(dorsi and plantarflexion)
Axis: inferior to lateral malleolus
Stationary arm: head of fibula
Moving arm: parallel with 5th metatarsal
Goniometry of the subtalar joint:
(inversion and eversion)
Axis: center of achilles
Stationary arm: centered in middle of calf following achilles
Moving arm: centered on calcaneus
Goniometry of the knee:
(flexion and extension)
Axis: lateral epicondyle
Stationary arm: greater trochanter
Moving arm: in line with lateral malleolus
Goniometry of the hip:
(abduct and adduct)
Axis: ASIS
Stationary arm: ASIS
Moving arm: running down to patella
Goniometry of the hip:
(flex and extend)
Axis: greater trochanter
Stationary arm: running up lateral side of trunk
Moving arm: lateral epicondyle
Goniometry of the hip:
(inversion and eversion)
Axis: center of patella
Stationary arm: aligned vertically to the ground
Moving arm: aligned with tibia
Goniometry of the shoulder:
(flexion and extension)
Axis: lateral to acromion process
Stationary arm: parallel to thorax
Moving arm: centered on lateral humerus
Goniometry of the shoulder:
(abduct and adduct)
Axis: anterior to acromion process
Stationary arm: parellel to torso
Moving arm: midline of humerus
Goniometry of the shoulder:
(internal and external rot)
Axis: centered on olecranon process
Stationary arm: parallel to table
Moving arm: center of ulna
Goniometry of the shoulder:
(horizontal abduct and adduct)
Axis: superior AC joint
Stationary arm: perpendicular to trunk
Moving arm: mid-humerus
Goniometry of the elbow and forearm:
(flexion and extension)
Axis: lateral epicondyle
Stationary arm: aligned with long axis of humerus
Moving arm: long axis of radius
Goniometry of the elbow and forearm:
(pronate and supinate)
Axis: lateral to ulnar styloid
Stationary arm: parallel to humeral midline
Moving arm: aligned with pen
Goniometry of the wrist and hand:
(flexion and extension)
Axis: lateral joint line of wrist
Stationary arm: centered on midline of ulnar shaft
Moving arm: centered on midline of 5th metacarpal
Goniometry of the wrist and hand:
(radial and ulnar deviation)
Axis: centered over distal radioulnar joint prox to capitate
Stationary arm: centered over midline of forearm
Moving arm: positioned over 3rd metacarpal
Goniometry of finger:
(flexion and extension)
Axis: dorsal aspect of joint being tested
Stationary arm: proximal midline of joint being tested
Moving arm: distal and midline of joint being tested
