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ICP > Spring ICP Exam 1 > Flashcards

Spring ICP Exam 1 Flashcards

1
Q

Prospective study on Eccentric Hamstring Strength and BFIh Fascicle length demonstrated that athletes with a shorter BFIH, were how much times more likely to sustain a HSI than those with longer fascicle lengths?

A

4.1 times

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2
Q

Athletes with lower eccentric hamstring strength were at how much greater risk of a HSI than stronger players?

A

4.4 times

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3
Q

What is the progression for eccentric knee flexor exercises?

A

Bilateral Slider -> Unilateral Slider/Nordic Hamstring -> Unilateral Slider + Load/Nordic Hamstring + Load

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4
Q

What is the progression for long hip extensor exercises?

A

Asking Diver/Bilateral 45 degrees hip extension -> Asking Diver + Load/Unilateral 45 degrees hip extension/Bilateral hamstring bridge -> Romanian Deadlift + Load/45 degrees hip extension + Load/Unilateral hamstring bridge

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5
Q

What is the progression for short hip extensor exercises?

A

Bilateral hip thrust -> Unilateral hip thrust -> Unilateral hip thrust + speed/Bilateral hip thrust + load

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6
Q

What is the progression requirements for the Hip extensor and eccentric knee flexor exercises?

A

When full ROM completed with pain rated less than or equal to 4/10

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7
Q

What is the percentage associated with Stage 1 of a progressive running protocol

A

Stage 1 = 0 - 50% of maximal velocity

Low -> Medium -> Decel back to Low.

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8
Q

What is the percentage associated with Stage 2 of a progressive running protocol

A

Stage 2 = 50 - 80% of maximal velocity

Low aceler to medium -> Med/High -> Decel back to Low

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9
Q

What is the percentage associated with Stage 3 of a progressive running protocol?

A

Stage 3 = 80 - 100% of maximal velocity

Low aceler to High -> High -> Decel back to low

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10
Q

Askling Protocol

A

Hamstring Rehab Protocol

Exercise 1 - Lengthening
Exercise 2 - Strength and stabilization
Exercise 3 - Eccentric Strengthening

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11
Q

Pain Threshold Protocol

A

Protocol used for RTP

Criteria:
1. No TTP (tender to palpation) pain
2. No pain with active knee extension and SLR within 90% of contralateral limb
3. No pain during maximal effort isometric @ 0/0 and 90/90 degrees of hip/knee flexion

No pain or apprehension during spring @ 100% max effort

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12
Q

Pincer Lesion (FAI)

A

Extra bone extends out over the normal rim of the acetabulum. Labrum can be crushed under the rim of the acetabulum

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13
Q

Cam Lesion (FAI)

A

Femoral head is not round and cannot rotate smoothly inside the acetabulum. Bump forms on the edge of the femoral head that grinds the cartilage inside the acetabulum

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14
Q

Combined Lesion (FAI)

A

Both a pincer and cam lesion are present

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15
Q

FAI syndrome

A

Motion-related clinical disorder of the hip with a triad of symptoms, clinical signs and imaging findings. Represents symptomatic premature contact between the proximal femur and the acetabulum.

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16
Q

Primary symptom of FAI syndrome

A

Motion-related or position-related pain in the hip or groin. Pain may also be felt in the back, buttock or thigh. Pt may also describe clicking, catching, locking, stiffness, restricted ROM, or giving way.

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17
Q

When determining a surgeon for a Hip procedure, what criteria should be accounted for?

A

Number of surgeries. training, expertise

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18
Q

Phase 1 Characteristics

A

Weight-Bearing as tolerated (WBAT) with crutches for 3 weeks (limit to 20 pds with flat floot)

See ROM restrictions

Avoid Open-Kinetic Chain hip flexor activation + no SLRs in flexion

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19
Q

Phase 2 Characteristics

A

Gait Progression
Soft Tissue Work
Begin mobs at Week 5 (posterior and inferior)
WB exercises and strengthening

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20
Q

Phase 3 Characteristics

A

Return to function phase
More WB functional strengthening
Avoid WB rotation until Week 10 and agility until Week 16

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21
Q

Phase 4 Characteristics

A

Return to sport phase
Running program, agility, plyos initiated and used here
Return to Sport within 6-8 months

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22
Q

Problem Solving Approach

A

7 step process

  1. Understand patient’s participation restrictions and activity limitations
  2. Establish movement dysfunctions (global) - determine overuse/non-acute
  3. Establish impairments, tissues and joints involved, (local) identify diffs
  4. Establish stage of healing, irritability of tissues, problem lists
  5. Establish goals and plan -> pick tools in toolbox
  6. Establish baseline measures
  7. Treat and Reassess
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23
Q

The body is a natural cheater, what does this mean?

A

It will sacrifice quality for quantity

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24
Q

What does Sahrmann argue when it comes to Biomechanical muscle imbalance

A

Repeated movements and sustained postures can lead to adaptations in muscle length, strength, and stiffness

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25
Q

What do joints develop in the case of biomechanical muscle imbalance

A

Directional Preference

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26
Q

Changes in muscle length does what when it comes to biomechanical muscle imbalance?

A

Affects length-tension curve leading to stretch weakness and active insufficiency

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27
Q

What does Janda believe about Neurological muscle imbalance?

A

CNS and musculoskeletal system are interdependent

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28
Q

The muscular system is at a functional crossroads, True or False?

A

True

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29
Q

Characteristic patterns of muscle tightness and weakness lead to what in neurological muscle imbalance?

A

Pain and pathology of peripheral joints

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30
Q

Note to Kadin for Review

A

Look at Slide 9 of the Movement and Function Quality powerpoint because I can’t put the pic in the notecards

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31
Q

Janda’s Chronic Musculoskeletal Pain Cycle

A

Pain and inflammation -> Muscle imbalances -> Impaired movement patterns and posture -> Faulty motor programming -> Altered joint forces and proprioception -> Joint changes -> Repeat

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32
Q

Stable Joints of the body

A

Foot, Knee, Low Back, Scapula, and Elbow

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33
Q

Mobile Joints of the body

A

Ankle, Hips, T-spine, Neck, Shoulder, and Wrist

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34
Q

Mobility dysfunction can be broken down to 2 unique subcategories:

A

Tissue Extensibility Dysfunction and Joint Mobility Dysfunction

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35
Q

Tissue Extensibility Dysfunction

A

Involves tissues that are extraarticular.

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36
Q

Joint Mobility Dysfunction

A

Involved structures that are articular or intraarticular

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37
Q

Active or Passive Muscle Insufficiency

A

Tissue Extensibility Dysfunction

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38
Q

Osteoarthritis

A

Joint Mobility Dysfunction

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39
Q

Neural Tension

A

Tissue Extensibility Dysfunction

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40
Q

Subluxation

A

Joint Mobility Dysfunction

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41
Q

Fascial tension

A

Tissue Extensibility Dysfunction

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42
Q

Adhesive capsulitis

A

Joint Mobility Dysfunction

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43
Q

Muscle Shortening

A

Tissue Extensibility Dysfunction

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44
Q

Intraarticular loose bodies

A

Joint Mobility Dysfunction

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45
Q

Scarring

A

Tissue Extensibility Dysfunction

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46
Q

Fibrosis

A

Tissue Extensibility Dysfunction

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47
Q

Order of Evaluation

A

Dynamic to Static and Global to Local

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48
Q

Dynamic to Static Evaluation

A

Functional Movement Assessment
Gait
Static Posture Assessment

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49
Q

Global to Local Evaluation

A

Use Dynamic to Static assessments to identify joint specific assessments

Length/Tension/Strength of Tissues
Joint Motion and end feels of joints

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50
Q

Janda’s Approach

A

Normalize the Periphery
Restore Muscle balance
Increase afferent input to facilitate reflexive stabilization
Increase endurance in coordinated movement patterns

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51
Q

Athletes with an FMS composite score at 14 or below combined with a self-reported past history were at what risk of injury?

A

15 times increased risk

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52
Q

Before starting an FMS, what are steps to complete?

A

Measure tibia length, floor to top center of tib turberosity
Measure the hand length, distance from the distal wrist crease to the tip of the longest digit

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53
Q

How to score the FMS

A

Completed perfectly as verbally described, score of 3

Completed with compensation(s), score of 2

Unable to perform the pattern as described, score of 1

If there is pain with the movement pattern, score of 0

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54
Q

FMS steps

A

Squatting -> Stepping -> Lunging -> Reaching -> Leg Raising -> Push-Up -> Rotary Stability

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55
Q

Limitations with FMS

A

Not developed to be predictive (Causation versus association)

Limitations with reliability

More specific than sensitive (Better at ruling in than out)

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56
Q

Step Down Task

A

Have the patient step down from a 20 cm step and lightly touch the heel to the ground. Maneuver is repeated for 5 reps

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57
Q

Pt positioning for Step Down Task

A

Pt stands SL support with the hands on the waist, the knee straight and the foot positioned close to the edge of the step. Pt bends the tested knee until the contralateral leg gently contacts the floor and then re-extends the knee to the starting position.

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58
Q

Heel Raise

A

Testing for Forefoot Control

Normal - Some Varus
Abnormal - Excessive varus

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59
Q

Articular Chain Reactions

A

Biomechanical interactions of different joints

60
Q

Postural Chain Reactions

A

Structural and Functional interactions of different joints

61
Q

Brugger’s Cogwheel

A

Placeholder answer

62
Q

Notable keystone postural positions

A

Pelvis, Ribs, Scapula

63
Q

Muscles that have stabilizing functions (postural/tonic) will do what when stressed

A

Shorten

64
Q

Active muscles will do what when stressed

A

Will not shorten but will become weak

65
Q

Upper Crossed Syndrome

A

Inhibited Muscles: Deep Cervical flexors, Lower neck flexors, Middle and Lower trap, Serratus Ant, Rhomboids

Facilitated Muscles: SCM, Pectoralis, Upper Trap, Levator Scap, Suboccipitals

66
Q

Lower Crossed Syndrome

A

Inhibited Muscles: Rectus Abdominals, Gluteus Min/Med/Max

Facilitated Muscles: Rectus Femoris/iliopsoas, Hip Adductors, Hamstrings, TFL, Piriformis, Thoracolumbar Extensors, Quad Lumborum

67
Q

What leads to subtalar pronation

A

Tibial IR leading to a flattening of the arch

68
Q

What leads to subtalar supination?

A

Tibial ER leading to a raising of the arch

69
Q

Leg Length Discrepancy Compensation

A

Pronation/Supination, Knee Ext., ER of hip, Lateral curve of the spine

70
Q

What to lengthen and strengthen for UCS

A

Lengthen: Pec Major, Upper Trap, Lev Scap, SCM

Strengthen: Deep Cervical Flexors, Scap Stabilizers (Rhomboids, Traps, Serratus Anterior)

71
Q

What are the two strength assessments for UCS

A

Cervical Flexion Test and DNS test for scapular stabilization

72
Q

What to Lengthen and Strengthen for LCS

A

Lengthen: Hip Flexors (Thomas Test), Hamstrings, Hip Adductors, QL

Strengthen: Abdominal Muscles, Glute Max and Min

73
Q

Low Back Pain Characteristics

A

Prevalent concern across age groups and activity levels. Finding the structural cause is difficult, Testing is inconsistent, Presence of other factors such as fear avoidance and depression make exam difficult

74
Q

Up to how many individuals experience one episode of LBP?

A

80%

65% of patients still experience LBP one year after initial onset

10-15% of athletic injuries occur to lower back

75
Q

The lumbar spine forms what kind of curve anteriorly?

A

Convex curve (Lordosis)

76
Q

Lumbar lordosis is good at what and needs what?

A

Structurally strong for dissipating forces

Needs stability

77
Q

How many Lumbar, fused sacral, and fused coccygeal vertebrae are there?

A

5,5,4

78
Q

The sacrum articulates with what? What does this form?

A

Articulates with the ilium, forms the sacroiliac joint

79
Q

What are the 4 kinds of ligaments responsible for articulation with sacrum?

A

Iliolumbar ligaments, Posterior sacroiliac ligaments, Sacrospinous ligaments, and Sacrotuberous ligaments

80
Q

What do the multifidi do?

A

Contract bilaterally to cause extension
Contract unilaterally to cause ipsilateral side flexion and contralateral rotation

81
Q

Inner Core Muscles

A

Local Muscles, Deep Muscles, Stabilizers, Trunk Stabilizers

82
Q

Outer Core Muscles

A

Global muscles, superficial muscles, movers, trunk movers

83
Q

Outer Core of the Trunk

A

Erector Spinae (Iliocostalis, longissimus, spinalis), Rectus abdominis, External oblique, Gluteal muscles, Thoracolumbar fascia

84
Q

Inner core of the trunk

A

Transverse abdominis, Diaphragm, Pelvic Floor Muscles, Internal Oblique, Multifidus

85
Q

Lumbopelvic-Hip Stability

A

Stable pelvis serves as a platform for lumbopelvic-hip stability and extremity performance

86
Q

When is the pelvis stable?

A

When pelvis is in pelvic neutral

87
Q

Abdominal Hollowing

A

Abdomen drawn in to facilitate transverse abdominis and multifidus. Does not activate core muscles.

88
Q

Abdominal Bracing

A

Abdominal and back muscles activate to co-contract. Activates outer core muscles.

89
Q

While both abdominal bracing and hollowing are used during core exercises, abdominal bracing provides what better than hollowing?

A

Provides greater pelvic and spinal stability. Progress from hollowing to bracing

90
Q

Core Activation and Stabilization Steps

A

Find and Maintain pelvic neutral
Abdominal hollowing exercises to recruit transverse abdominis
Activation exercises to recruit multifidus
Abdominal bracing to activate local and global muscles
- Engage abdominal bracing while performing simple ADLs and sport/work related activities

91
Q

The facet joint assists the vertebral body in bearing how much of the compressive loads, especially during what form of motion

A

30%, hyperextension

92
Q

The facet joints with the intervertebral discs aid the spinal column to resist what with about how much contribution from the facet joints

A

Shear and rotational torsion, 40%

93
Q

Fryette’s Laws

A

Created by Harrison Fryette and describes spinal motion

94
Q

Fryette’s Laws 1 and 2 pertain to

A

Thoracic and Lumbar Spine movement

95
Q

Fryette’s 3rd Law pertains to

A

The entire spine

96
Q

Fryette’s Law 1

A

When the spine is in neutral, sidebending to one side will be accompanied by horizontal abduction to the OPPOSITE side

97
Q

Fryette’s Law 2

A

When the spine is in a flexed/extended position (non-neutral) sidebending to one side will be accompanied by rotation to the SAME side

98
Q

Fryette’s Law 3

A

When motion is introduced in one plane, it will modify (reduce) motion in the other two planes.

Frontal - Sidebending
Sagittal - Flex/Ext
Transverse - Rotation

99
Q

Pelvis

A

2 bones, sacrum, and 3 joints (R/L SI and Pubic symphysis)

100
Q

How many muscles attach to the pelvis?

A

45

101
Q

Form Closure

A

Pelvic ring stability provided by joint shape and structure

Reduced with ligament or bone injury/closure

102
Q

Force Closure

A

Stability provided by dynamic forces on pelvis

Reduced with muscle (core) injury

103
Q

Neuromotor control

A

Proper activation and sequential recruitment of muscles

Dysfunctional recruitment following injury

104
Q

Components of the Lumbopelvic-Hip Complex

A

Pelvis, Sacrum, Lumbar Vertebrae, Hip Joints

105
Q

Nutation

A

Anterior movement of the sacrum base (forward and downward). Happens with posterior pelvic tilt (sacrum takes a drink). Iliac crests move closer together. Isch Tubes move father apart.

106
Q

Counternutation

A

Posterior movement of the sacrum base (backward and upward). Happens with anterior pelvic tilt (sacrum leans back to take a nap). Iliac crests move farther apart. Isch tubes move closer together.

107
Q

During Lumbar flexion

A

Sacrum counternutates. Isch Tubes move closer together. Iliac Crests move apart.

108
Q

During Lumbar extension

A

Sacrum nutates. Isch tubes move apart. Iliac crests move closer together.

109
Q

Neutral to forward flexion:

A

During the first degrees of the flexion, the lumbar spine flexes until lumbar lordosis is neutral then the pelvis starts to rotate anteriorly.

Total Motion:
Lumbar Spine = 45 degrees
Pelvis = 60 degrees

110
Q

Forward flexion to neutral:

A

When returning to extension, the pelvis will rotate posteriorly first, then the lumbar extends to normal lordotic curve

111
Q

Pelvis rotates on a diagonal axis:

A

If one hip moves into flexion while the other maintains an extended position, the sacral base on the flexed-hip side rotates posteriorly (counternutation) while the extended-leg sacral base rotates anteriorly (nutation)

112
Q

Stabilization for Sacroiliac Joint Motion

A

Important in relieving pain and in transmitting forces

113
Q

Dysfunction for Sacroiliac Joint Motion

A

A lack of stabilization, cause of back and pelvic pain

114
Q

Sacroiliac dysfunction results from one of two conditions

A

SI dysfunction or IS dysfunction

115
Q

SI dysfunction

A

Sacrum motion restricted on the ilium

116
Q

IS dysfunction

A

ilium motion restricted on the sacrum

117
Q

Regional mechanical LBP

A

Non-specific mechanical LBP, Facet dysfunction, or deformity leading to spondy or spondylolisthesis. More than 90% of all cases

118
Q

Initial onset of LBP or subsequent acute episodes create a

A

One-sided, one level atrophy of the multifidus muscle

119
Q

Facet Joint Pathology may involve?

A

Subluxation/Dislocation of the facet (rare)
Facet Joint syndrome
Degeneration of the facet

Exact patho is unclear

120
Q

Facet Joint Syndrome presents as?

A

Pain, Spasm, Swelling, Altered posture, decreased ROM

121
Q

Facet Joint Syndrome management

A

Modalities, Manual therapies to restore normal motion, Pain control (injections), aggressive rehab

122
Q

Specific Concerns of Facet Joint Syndrome

A

Avoid painful motions early
Alleviate spasm if present
Increase mobility of hypomobile segment

123
Q

Facet Joint OA is also known as?

A

DJD - Degenerative Joint Disease

124
Q

Pathology of Facet Joint OA

A

Localized breakdown of one or more of the synovial joints of the spine.

ALWAYS ASK AGE OF PATIENT

125
Q

Spondylolysis

A

Present in 4-6% of gen pop.
Unilateral lesion (fx) of the pars interarticularis
Need multiple pain film views to diagnose
“Scotty dog has a collar”

126
Q

Spondy Treatment

A

Early stage = high chance of healing
Later stage = lower rate of healing

Osseous healing is not necessary to achieve good clinical outcome with full RTP.

127
Q

Spondy Treatment in athlete

A

No sig diff in brace or rest
No sig diff in rigid or soft brace
No sig diff in 3 vs 6 months of rest

Relative rest is essential in treatment and should continue for at least 3 months after resolution of symptoms in earlier-stage lesions with potential for healing

128
Q

Spondylolisthesis

A

Forward translation of one vertebral body on another
Requires the bilateral fracture or non-union of the R and L pars interarticularis

129
Q

Most common location of Spondylolisthesis

A

L5-S1 = Most common site
L4-5 = 2nd most common and so on, up the spine

130
Q

5 types of Spondylolisthesis

A

Isthmic, Dysplastic, Degenerative, Pathologic, Traumatic

131
Q

Isthmic Spondylolisthesis

A

Primary lesion is in the pars interarticularis

Fatigue fracture of the pars (pre-teen gymnast)

132
Q

Dysplastic Spondylolisthesis

A

Congenital abnormality at the lumbosacral junction due to a deficiency of the upper sacrum OR dysplasia of the posterior arch of L5

133
Q

Degenerative Spondylolisthesis

A

Degenerative arthritis of the facet joints associated with long-standing intersegmental instability

Much more common in females and more common at the L4-5 level than L5-S1 level

134
Q

Pathologic Spondylolisthesis

A

Due to metabolic bone disease, tumor, or after surgery

135
Q

Meyerding Scale for Grading of Spondylolisthesis Severity

A

Grade 1-5
1: Less than 25%
2: 25-50%
3: 50-75%
4: 75-100%
5: Greater than 100%

136
Q

Mechanical LBP with neurogenic leg pain

A

Spinal Stenosis, Intervertebral disc herniation, Spinal stenosis associated with dengen spondylolisthesis

7-10% of all cases

137
Q

Lumbar stenosis

A

Symptomatic narrowing of the spinal canal or intervertebral foramen in the lumbosacral region

Produces either unilateral (nerve root) or bilateral (spinal cord) symptoms

138
Q

4 types of disc lesions

A

1: Normal
2: Disk bulge
3: Foraminal disk herniation
4: Extruded disk fragment

139
Q

Non-mechanical spine disorders

A

Neoplasia -> Metastases, Lymphoid tumors, spinal cord tumors

Infection -> infective spondylitis, epidural abscess, endocarditis, herpes zoster, Lyme disease

Other spondyarthritides
-> ankylosing spondylitis

Less than 1% of all cases

140
Q

Treatments for Acute LBP

A

Manipulation/Manual Therapy
Stabilization exercises
Motion and Activity (NOT REST)
Medication (Pain = )

141
Q

Clinical Prediction Rule

A

Pts with 4/5 criteria increased the probability of success from 45% to 95%

Criteria : Duration of more than 16 days of LBP, No symptoms distal to knee, Higher than 19 on FABQ, Greater or equal to 1 hypomobile segment in the lumbar spine, greater or equal to 1 hip with greater than 35 degrees of IR

142
Q

Stabilization Exercises

A

Core stability: Facilitation of deep muscles of the spine. There are usually neuromuscular deficits in these muscles from LBP. Morphologic changes can be present. Stabilization programs usually focus on low-loads and high reps.

143
Q

Specific Concerns of LBP

A

Centralize pt pain
Improve posture, body mechanics, and general fitness
Teach pt to move into and maintain pelvic neutral position
Restore muscle balance, flexibility, endurance, and strength of the trunk, pelvis, and hip muscles
Relieve pain and muscle spasm

144
Q

3 parts of Local Mobility

A

Neural mobility
Joint mobility
Soft Tissue mobility

145
Q

3 parts of Global Stability

A

Activation
Acquisition
Assimilation

ICP (3 decks)

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