Test 1 Flashcards
Hamstring stretch
hip flexion with knee extension
Gluteus maximus stretch
hip flexion with knee flexion
Iliopsoas stretch
hip extension with knee extension
Rectus femoris
hip extension with knee flexion
Adductor stretch
hip abduction; hip flexion with knee extension
External hip rotators
hip extension and knee flexion
Internal hip rotators
hip extension and knee flexion
Gastrocnemius
knee extension
Triceps stretch
elbow flexion shoulder flexion
Soleus
dorisflex
Therapeutic exercise program should be..
individualized
Safety is a fundamental consideration
- safety of the patient
- safety of the therapist
Factors influencing patient safety during exercise:
- health history
- current health status
- tolerance to physical exertion
- medications
- environments
- accuracy in which the exercises are performed
What are the three types of motor tasks?
- discrete
- serial
- continuous
Discrete
has a recognizable being and end quad set push up kicking a ball locking a wheelchair
Serial
Made up of a series of discrete movements combined in a particular sequence
eating with a fork
wheelchair transfer
getting dressed
Continuous
Repetitive, uninterrupted movements that have no distinct beginning or ending
walking
ascending or descending stair
cycling
What are the stages of motor learning?
cognitive
associative
autonomous
What is the cognitive stage?
figuring out what to do
learning the goal or purpose & the requirements of the exercise or functional task
learning how to do the motor task safely & correctly
frequent feedback is needed
skilled therapy needed at this level
What is the associative stage?
Patient concentrates on fine-tuning the motor task
Typically makes infrequent errors
Focused on consistency and efficiency
Time and distances moved are refined
Slight variations and modification s are explored
Patient begins to use problem solving to correct errors
Infrequent feedback is required
trying to move patient to independent, but therapist is still there as safety blanket
What is the autonomous stage?
Movements are automatic
Patient does not have to pay attention to the movements of the task
Patient is able to perform tasks simultaneously
Easily adapts to variations in task demands
Little to no instruction needed
What variables affect motor learning?
Patient’s understanding of the purpose of the exercise
Patient’s interest in the exercise
Patient’s attention to the task at hand
Patient’s attention during the pre-practice verbal instructions
Patient’s observation of the task being performed by the therapist correctly
Type and timing of feedback
What is PROM?
movement of a segment within the unrestricted ROM that is produced entirely by an external force
truly passive and relaxed ROM
What is AROM
movement of a segment within the unrestricted ROM that is produced by active contraction of the muscles crossing the joint
What is AAROM?
Type of AROM in which assistance is provided manually or mechanically by an outside force because the prime mover muscles need assistance to complete the motion
What is an indication of PROM?
- In areas of acute, inflamed tissue
- Following a surgical repair of muscular or tissue
- Patients who are comatose, paralyzed or on complete bedrest
- When a therapist is examining, teaching or demonstrating
What is an indication of AAROM?
- When a patient has weak musculature and is unable to move the joint through the desired ROM
- Used in areas above and below an immobilized region to maintain ROM in the other joints
What is AROM?
- Any time the patient is able to contract muscles to actively move a segment through the desired ROM
Limitations for PROM?
- Prevent muscle atrophy
- Increase strength or endurance
- Assist circulation to the same degree active, voluntary muscle contractions do
Limitations for AROM?
- Maintain or increase strength in strong muscles
2. Develop skill or coordination except in the movement patterns used
What is a contraindication to ROM
When motion is disruptive to the healing process
Immediately after acute tears, fractures, and surgery
When patient response or condition is life-threating
When is stretching indicated?
- When limited ROM as a result of contractures, adhesions, and scar tissue formation, leading to shortening of muscles, connective tissues and skin
- When structural deformities that are otherwise preventable may result from limitations in ROM
- When contractures interfere with functional activities or care
- When muscle weakness results from opposing muscle tightness
- As part of a total fitness program designed to prevent musculoskeletal injuries
- Prior to and after vigorous exercise to minimize post-exercise muscle soreness
What are the goals of stretching?
Re-establish or regain normal ROM of joints and mobility of soft tissues that surround a joint
Prevent irreversible contractures
Increase flexibility in conjunction with strengthening exercises
Prevent or minimize the risk of musculo-tendinous injuries related to physical activities and sports
What is a contraindication for stretching?
When a bony block limits joint motion
After a recent fracture
Evidence of an acute inflammatory process
When there is sharp, acute pain with joint movement or muscle elongation
When a hematoma or other indication of tissue trauma is observed
When hypermobility already exists
When contractures are providing increased joint stability
When contractures are the basis for increased functional abilities
What is a precaution for stretching?
Do not passively force a joint beyond its normal range of motion
Recent fractures
Extra caution with patients with known or suspected osteoporosis due to disease, prolonged bed rest, age, and prolonged use of corticosteroids
Avoid vigorous stretching with tissues that have been immobilized over a long period of time
Joint pain or muscle soreness lasting more than 24 hours after stretching indicates too much force during stretching
Avoid stretching edematous tissue
Avoid overstretching weak muscles
What are the essential elements of a stretching program?
Alignment and stabilization Intensity of stretch Duration of stretch Speed of stretch Frequency of stretch Mode of stretch
What kind of stretch results in optimal rates of improved ROM
low load, low intensity
How long is the inflammatory phase for a bone?
1-7 days
When is soft callus formation?
2-3 weeks
When is hard callus formation?
3-4 months
Bone remodeling
up to one year s/p injury or surgery
What are the degrees of protection of healing tissue?
maximum (few days to 6 weeks)
moderate (usually 4-6 weeks s/p)
minimum (usually 6-12 weeks s/p)
How long is the acute stage?
4-6 days
How long is the subacute stage?
14-21 days up to 6 weeks
How long is the chronic stage?
6 weeks -one year
Energy system: ATP-PC
fuel source: PC
energy duration: short, quick burst (first 30 seconds of exercise)
anaerobic
ATP-PC replenished in muscle cell with rest
Energy system:anaerobic glycolytic
fuel source: glycogen
energy duration: moderate intensity (30 to 90 seconds of exercise)
anaerobic
ATP resynthesized in the cell; latic acid is produced
Energy system: aerobic
fuel source: glycogen long duration aerobic used after the second minute of exercise ATP is resynthesized in the mitochondria of the muscle cell
The Four Ps
Principles
Purpose
Preparation
Precautions
Karvonen’s Formua
HR = Hrrest + 60-70% (HRmax-HRrest)
Inpatient (phase I)
Self care, education, orthostatic challenge (transfers, ambulation)
Outpatient (phase II)
Starts upon d/c from hospital OR 6-8 weeks post cardiac event
Undergo symptom limited exercise stress test
Circuit-Interval Training is common; monitored with telemetry
Outpatient (phase III)
Continue to improve or maintain fitness levels
What are the goals and indications of resistance exercise?
increased strength
increased power
increased muscle endurance
Precautions for resistance exercise
Valsalva maneuver Fatigue Recovery from exercise Overwork/overtraining Substitute motions Osteoporosis Exercise induced muscle soreness
Contraindications for resistance exercise
pain, inflammation, severe cardipulmonary diseases
Programs to increase muscle strength and hypertrophy should include:
Both multiple and single joint exercises Slow to moderate lifting velocity 1 to 3 sets per exercise 60-80% of 1 RM for 8-12 repetitions 1-2 minutes of rest between sets
Programs to increase muscular strength should include:
Both multiple and single joint exercises High Repetition Velocity 1 to 3 sets per exercise Light to moderate loading (40-60% of 1 RM) for 6-10 repetitions 1-2 minutes of rest between sets
Programs to increase muscular endurance should include:
Low to moderate loads
Moderate to high repetitions (10-15 or more)
Short rest intervals
