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Therapeutic Exercise > Resistance Exercise > Flashcards

Resistance Exercise Flashcards

1
Q

What is the equation for work?

A

W = F x d

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2
Q

Define strength vs. endurance.

A 
strength = ability of muscle to generate tension
endurance = ability of muscle to generate tension over time
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3
Q

What is the equation for power?

A

P = W / t

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4
Q

Does connective tissue benefit with strength training?

A

yes

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5
Q

What is the SAID principle?

A

SAID = specific training adaptations to impose demands

  • if you need to get better at walking, you need to actually do that activity
  • think training specificity
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6
Q

What’s the reversibility principle?

A

if you stop training, you’ll start to see losses in performance in only two weeks

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7
Q

How is cross training the opposite of the SAID principle?

A

cross training makes you use different modes of exercise to get benefits, which helps avoid overuse

  • SAID says you need to train in the area you want to perform in to get best results
  • but you can’t do that 100% of the time due to overuse
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8
Q

When thinking about the specificity of training, what components of your therapy program do you need to think about?

A
  • the velocity the pt needs to get to
  • the ROM the pt needs to get to
  • the muscle group the pt needs to get stronger
  • the muscle actions needed (con vs eccentric)
  • intensity of the job demands (slow and controlled or fast)
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9
Q

What’s especially important for enhancing muscle recovery?

A

having a cool down that’s at 30-40% VO2 max

  • hydration, carbs/protein are all important also
  • recovery occurs within 3-4 minutes post exercise
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10
Q

What comes first, muscle fiber hypertrophy OR neural adaptation? When do each occur?

A

neural adaptation first, then muscle hypertrophy

  • neural occurs at 4 weeks
  • stretch gains you see at 8 weeks
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11
Q

T/F: Muscle fiber type distribution and total number of muscle fibers are determined by age 3.

A

false, age 1

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12
Q

T/F: When you increase speed with a concentric contraction, tension can also increase.

A

false, has to be eccentric

- increased speed with eccentric contractions can increase tension

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13
Q

Which muscle fiber type is the quickest to fatigue?

A

type IIb (type I has the longest time till fatigue)

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14
Q

What are ways that we can enhance muscle recovery?

A
  • “active muscle recovery” aka cool down at 30-40% VO2max
  • CHO/protein
  • hydration
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15
Q

What are some factors that influence fatigue?

A

age, medications, decreased food/hydration, decreased training, pain, posture, body mechanics

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16
Q

A 78 yo female with gait difficulties wants to return to her two story home independently. According to the SAID principle, what needs to be included in your training?

A

SAID = specific adaptations to impose demands

- need to include walking and stair climbing in POC, as well as balance exercises

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17
Q

A 45 yo truck driver tore his rotator cuff, and his goal is to return to truck driving with some lifting. According to the SAID principle, what needs to be included in your training regimen?

A
  • lifting/squatting weights with proper mechanics, arm ROM and strengthening
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18
Q

What are some ways that a muscle can grow weaker? Why would we want to fix this? (aka benefits?)

A
  • muscle gets weaker from disuse (physical inactivity), age, trauma, pathology, pain, immobilization, swelling, nerve deinnervation
  • we want to fix this to improve/maintain muscle strength, bone density, balance, independence, improve QOL
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19
Q

How much time does it take for a muscle to begin to hypertrophy?

A
  • 4-8 wks of regular training, 2-3 wks of high intensity

- 8 sessions are needed to increase contractile proteins

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20
Q

What musculoskeletal adaptations occur during training?

A
  • hypertrophy: muscle fibrils increase in size, acquire more contractile proteins
  • proteins remodel
  • potentially hyperplasia as well, but that’s controversial
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21
Q

How do the motor units adapt to increased resistance exercise?

A

they respond to neural adaptation first (more recruitment of MUs and more firing), then muscle fiber changes in size
- neuromuscular change at 4 wks, strength at 8

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22
Q

Describe what generally happens when participating in resistance training exercise.

A
  • your neural motor units that control your muscle contractions recruit more MUs to complete a contraction thus making it more powerful
  • the number of MUs as well as the firing rate increase = neural adaptation
  • the muscle cells in your body grow larger due to gaining more contractile proteins, allowing you to make a stronger contraction

THUS you get stronger

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23
Q

Can fiber types convert from one type to another?

A

yes, via plasticity

  • type IIb can go to IIa with endurance training
  • type IIa can go to IIb with detraining
  • old age causes type II fibers to convert to type I (slower)
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24
Q

T/F: Strength training increases Pcr and ATP.

A

true for both

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25
Q

What does strength training do for our energy substrates?

A
  • increases muscle glycogen levels and mobilization

- increases PCr and ATP

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26
Q

When would it be appropriate to have more rest between sets, vs. not much time?

A
  • if you’re focusing on building endurance, there shouldn’t be much rest between sets
  • if you’re trying to build strength alone, a few minutes of rest between sets works
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27
Q

Of your 1RM, what is the typical % of RM that we train in?

A

40-70%

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28
Q

How many reps and at what intensity would we train to increase endurance?

A

high reps (20+) and low intensity

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29
Q

To increase MU recruitment, how much intensity and reps should we aim for?

A

high intensity, low reps (

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30
Q

To solely focus on increasing muscle hypertrophy, how many reps and what kind of intensity should we try for?

A

moderate intensity, moderate reps (12-15)

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31
Q

If a patient tells you they’re at about a 6/10 of exertion, what system are they mostly working in? (cardiovas, endurance, strengthening)

A

endurance, close to strengthening

32
Q

Pt. tells you that she is at a level 5 of exertion while doing her exercises, which are meant to strengthen her shoulder girdle. What is your assessment here?

A

she’s not working her muscles with enough weight to increase muscle strength, she’s only really increasing muscle endurance
- bump up weights until she can only do like 12-15 with a higher exertion level

33
Q

What does the Borg scale tell you?

A

patient’s perceived level of exertion

34
Q

If you want a patient to work at 90% of their 1RM, how many reps should they be doing at a certain weight?

A

4-5 reps

35
Q

Your patient is able to do 10 reps of an exercise at a certain weight before they fatigue. What % of their 1RM do you think they’re working at?

A

75%

36
Q

If a patient is able to do 15 reps to exhaustion, the weight they’re using is at what % of their 1RM?

A

60% 1RM

37
Q

Describe how many reps a patient should be able to do when exercising at:

- 60% 1RM
- 75% 1RM
- 90% 1RM
A 
60% = 15 reps, working on muscle hypertrophy/endurance
75% = 10 reps, working on muscle hypertrophy
90% = 4-5 reps, working on MU recruitment
38
Q

What is the typical strength dosage prescription?

A

DeLorme: 3 sets of 10 reps

  • do 40-60% of max effort at 60-80% 1RM
  • 8-12 reps for 2-3 sets
39
Q

What is a typical endurance exercise dosage?

A

3-5 sets of 40-50 reps, low weight

40
Q

T/F: You get greater strength gains by resting longer, like 2-3 minutes vs 30-40 sec.

A

true, taking longer rest periods is advantageous to strength gain

41
Q

When is it appropriate to do a short-arc exercise vs. a long arc?

A

short-arc can be used when patient is in pain, or if they’re just starting out and needed to do a smaller range
- but the goal is to strengthen throughout the entire ROM, so if you need to lessen the weight for them to get full ROM, you need to do so

42
Q

Why would we start with a high power or high skill exercise in our treatment before doing a low power or low skill exercise with a patient?

A

these high power/skill activities easily fatigue the patient, so you want to start with those first to ensure they’ll still be able to do them

43
Q

What do you need to think about, as far as pt. needs, when prescribing exercise dosage?

A
  • what will be most feasible for patient compliance
  • velocity: what velocity the patient works/performs at, you need to build to match that
  • progression: need to continually overload muscle
44
Q

How does a muscle physiologically become better at endurance training?

A

by increasing capillary density and number of mitochondria, over a period of 6-12 weeks

45
Q

T/F: Endurance training can sometimes be more beneficial for increasing function with pts vs strength training.

A

true, these pts benefit from an increased oxygen capacities, which help them more with functions that muscle hypertrophy may alone
- this also minimizes forces on joints, which these pts may need

46
Q

How do you overload an endurance muscle?

A

you increase the time of contraction, or increase number of contractions
- instead of increasing the weight like you would a strength muscle

47
Q

When does detraining occur? What happens?

A

detraining = 1-2 weeks without resistance exercise

- you’ll see loss in strength gains that you worked toward

48
Q

Training-induced strength gains in pre-pubescent children are likely the result of what physiological happenings?

A

mostly neural adaptation, vs increase in muscle mass

49
Q

What connective tissue benefits occur from training?

A
  • ligaments and tendons become stronger
  • hyaline cartilage becomes thicker
  • sheath of connective tissue becomes stronger
50
Q

How much does strength decline each year after peaking in 20s?

A

1% decline each year

  • 15-20% decline in 60-70yo
  • > 30% decline in each decade after 70
51
Q

Give some examples of ways to train the muscle isometrically.

A
  • pushing into a wall for IR of GH
  • muscle sets
  • rhythmic stabilization, dynamic stabilization, and alternating isometrics
  • multiple angle isometrics
52
Q

How long should you hold an isometric contraction?

A

from 6-10 seconds only

53
Q

When do we use isometric exercise? (i.e. when is it indicated)

A

OVERALL: to stabilize joint and start to activate surrounding muscles, not really for strength gains

  • use when dynamic exercise could cause pain
  • use when joint integrity can be compromised from dynamic exercise
  • to re-establish neuromuscular control when joint movement isn’t allowed (post-op, soft-tissue injury)
  • to minimize muscle atrophy when joint cannot be moved
  • to develop static strength at points in ROM that are needed for specific functional needs
54
Q

What should you be sure to watch for in your pt when they’re doing isometric exercise?

A

BREATHING, no valsalva

- breathe out during contraction

55
Q

T/F: In severe muscle weakness, it may be easier to control the lowering of a limb against gravity vs. lifting it.

A

true, eccentric muscle contractions are stronger (lowering limb)

56
Q

If you want to improve the speed of a concentric contraction, what must you as a therapist do?

A

decrease the weight pt is using

57
Q

How do you know if you’ve overtrained?

A
  • soreness persists for longer than 3 days
  • if pain becomes sharp and shooting
  • if pain doesn’t get better as you work through the range
58
Q

What do you consider as you think about prescribing an exercise dosage for a patient? What 3 questions do you have to answer?

A

frequency: how many times/wk
duration: how long they need to exercise each time
intensity: how hard they need to exercise

  • this all depends on patient age, their goals, any comorbidities, compliance and barriers to compliance, previous level of functioning, what stage of recovery they’re in
59
Q

What are the contraindications to exercise?

A
  • sharp pain
  • swelling/inflammation
  • severe cardiopulm disease
60
Q

When a patient is exercising, what are you looking at/monitoring to make sure they’re exercising properly and safely?

A

look at:

  • patient breathing (valsalva)
  • if they’re substituting (explain proper use or lower weight)
  • overtraining
  • prolonged muscle soreness
61
Q

What does a slow reversal entail?

A

concentric resistance in one agonistic direction, then concentric resistance in the opposite antagonistic direction

- can do in PNF patterns or in single plane
- ex: resist elbow flexion (concentric bicep) through range, then switch hand position and resist elbow extension (tricep concentric)
62
Q

What’s the difference between a slow reversal and a slow reversal hold?

A

Both are concentric contractions against resistance across both motions of the joint, but the hold just implies that pt does an isometric contraction at a certain spot in the range
- maybe on a spot where pt seems to be struggling in range

63
Q

T/F: Patients with COPD, CP, arthritis, HTN, etc. should not do progressive resistance exercise because their condition is too dangerous to incorporate fatiguing exercise.

A

false, PRE has shown to be safe and effective for these pops

- just make sure you allow potentially more rest breaks, as well as only 8-10 reps until fatigue

64
Q

Your patient is an athlete doing high-level plyometrics every day at practice, and comes in with achilles tendonopathy. What might you tell them, first off?

A

you’re doing too much eccentric exercise: you need a day break in between high-level eccentric exercise sessions

  • if it’s not high level, it’s okay to do every day for increased tendon microcirculation and higher strength gains
65
Q

Decelerating the body is done by what kind of contractions?

A

eccentric

- accelerating is concentric

66
Q

What needs to be documented when doing exercise with a theraband?

A

patient position, color of band, joint position

67
Q

List the increasing levels of theraband resistance by color.

A

yellow -> red -> green -> blue -> black -> silver -> gold

68
Q

Describe the advantages and disadvantages of resistance machines.

A
  • adv: less work for PT, gives weight value for documentation, good when you alone can’t overload muscle
  • disadv: not a consistant resistance throughout entire range, not in functional patterns b/c usually only in single plane
69
Q

Are proprioceptors more stimulated in OKC or CKC activities?

A

closed kinetic chain

70
Q

T/F: OKC activity increases acceleration forces and resistance forces.

A

false

  • OKC increases acceleration, DECREASES resistance forces
  • also increases rotational and distraction forces
71
Q

T/F: OKC promotes functional activity.

A

yes because we don’t do EVERYTHING in a closed kinetic fashion

72
Q

What kind of kinetic chain activity allows for specific joint assessment?

A

open KC

73
Q

In which kind of kinetic chain activity do you get co-contraction and co-activation?

A

closed KC

74
Q

You want to work on weight shifting to increase scapular stability. Where would you start with exercise, and how could you progress? Why would weight shifting help with stability?

A

weight shifting allows for dynamic stabilization through axial compression

  • start with patient standing and put hands on mat table at high height, weight shift through hands
  • work up to quadruped, where you have more weight at your hands, do rhythmic stabilization at shoulder girdle here
  • make it harder by closing eyes
  • make it harder by making surface unstable (rockerboard)
75
Q

What is a push up plus?

A

push up with protraction at the end to work the serratus anterior

76
Q

How do you maximize hamstring recruitment on an elliptical? (think position)

A

maintain erect body position to max hamstrings

77
Q

What should your average step height be so that it’s functional?

A

8in

Therapeutic Exercise (6 decks)

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