Session 1 Flashcards
You have a new patient in an MSK clinic who is a competitive sprinter wanting to work on strength training. What sort of exercise prescription would you give them?
A - 70% max load, 8 reps, 4 sets, 90 sec rest
B - 90% max load, 5 reps, 3 sets, 3 mins rest
C - 90% max load, 8 reps, 3 sets, 2 mins rest
D - 85% max load, 6 reps, 3 sets, 30 sec rest
B - For strength training aiming load >85%, reps <6, sets 2-6, rest 2-5 mins
Which of the below are not benefits of regular exercise (multiple answers)
A - improved functional ability
B - higher BP
C - reduced HDL
D - improved angina
E - Decreased depression
F - increased serum lipid levels
H - Increased stress on joints
F - Decreased bone demineralization
Answer: B, C, F, H
B - reduces BP
C - increased HDL (healthy cholesterol)
F - reduced serum lipid levels
H - reduced stress on joints
Type of Exercise Load Reps Sets Rest
Strength >85% ????? 2-6 2-5 mins
Hypertrophy 67-85% 6-12 ???? 30-90 secs
Endurance <67% >12 ???? <30 sec
Stretching Gentle ????? 3-5 1 min rest
Strength - load >85%, reps <6, sets 2-6, rest 2-5mins
Hypertrophy - load 67-85%, reps 6-12, sets 3-6, rest 30 - 90 secs
Endurance - load <67%, reps >12, sets 2-3, rest <30 secs
Stretching - gentle stretching, hold 1 min, 3-5 sets, 1 min rest
How to calculate %1 rep max?
No indicated for at risk patients
Set load and get patient to do as many reps as possible to failure - failure is as soon as unable to achieve full range of movement. If patient gets 6 reps then you have a 6 RM - calculate all reps/sets based off of this.
Explain the three types of dynamic exercises (occurs in both concentric and eccentric movements) and give an example:
Constant load
Elastic resistance
Isokinetic
Constant load: load is consistent throughout range. Example: free weights
Elastic resistance: load varies through the range. Example: exercises with tension band
Isokinetic: speed of the limb is controlled. Example: squat or push up completed at a steady/set speed.
A patient present’s to clinic after ACL reconstruction with post-op advice of closed chain exercises for 6 weeks. Which of the below exercises would the most appropriate to start with?
A - knee extension
B - body-weight squat
C - single-leg squat
D - Straight leg raises
B
Knee extension and straight leg raises are examples of open chain exercises
Single leg squats might be too difficult immediately post op - try two leg body weight squats first
Which of the following are not contraindications of resistance exercises:
- Pain on movement
Acute inflammation
Joint effusions
CV instability
8 weeks post heart attack/myocardial infarction
New fracture
Severe osteoporosis
Acute low platelets levels
New and worsening bony metastatis
A - All are contraindications to resistance movements
Apart from not 8 weeks but 4-6 weeks post MI
If a patient’s elbow is in a cast and unable to move which sort of exercise would you prescribe to prevent muscle atrophy during this time?
Isometric
If a patient’s elbow is in a cast and unable to move which sort of exercise would you prescribe to prevent muscle atrophy during this time?
Isometric
Why is the valsalva manoeuvre associated with isometric exercises a precaution with patients with cardiovascular instability?
Valsalva manoeuvre is breath hold
Increased intrathorcic and abdominal pressure, blood pushed from heart causes temporary increase arterial blood pressure
Increased BP due to interrupted blood flow can cause complications with underlying CV instability conditions
Which movement (concentric/eccentric/isometric) is associated with improved strength gain and less absorption of oxygen and energy stores aka reduced metabolic effort?
Eccentric
What is the difference between type 2A and type 2B muscle types
both are fast twitch but 2A is moderate duration and lasts up to 30 mins. 2B is short duration, lasts less than 5 mins and is high force and high speed with short duration. 2B is large motor units, 2B is moderate motor units.
Which muscle type is associate with small motor units?
Type 1 aka slow twitch
Type 2B is opposite - large motor units
A patient comes into clinic with tight gastrocnemius - which stretch would you prescribe to get the golgi tendon organs to fire?
Slow stretch
Lean against wall - toe to wall and leg straight
A patient presents to you in clinic with chronically tight hamstring muscles - what sort of treatments could you use?
A - Slow stretch static
B- Slow stretch creep
C - PNF hold relax
D - PNF contract relax
E - dynamic
F - Hamstring strengthening
All but not hamstring strengthening alone - don’t strengthen through and reduced ROM
A patient presents with chronic tight hamstring muscles and you decide to use PNF stretching of a hold relax with agonist contraction. How would you perform this and would this be a reiprocal or Autogenic inhibition?
Patient in supine stretch leg straight then get patient to push into you for 10 secs (isometric) then relax and passively push stretch further. Add in AC by getting patient to pull their leg towards chest (quad/hip flexor) contraction (10 secs) then push further into stretch passively.
Repeat 3-5 times
Both Autogenic (muscle relaxes against high tension) and reciprocal (muscle relaxes when opposite muscle group contracts).
A patient presents with tight trapezius muscles mostly affecting the neck, what sort of treatment could you use and how would you do it?
A - Back strengthening
B - Pectorals stretching
C - PNF stretching (contract relax)
D - Trigger point latissimus dorsi
Most effectively likely to be PNF stretching
Contract relax - stretch head to shoulder (passive) then get patient to contact and push against you (allow movement - concentric) then stretch passively again
Concentric contraction for 10 secs
Repeat 3-5 times
You observe a patient stretching their pectoral muscles by lying on a foam roller - what type of stretch are they using?
Creep
