Therapeutic Exercise Flashcards
1
Q
Term: Safely return a pt. to his or her preinjury state with as little risk of reinjury as possible with the minimum amount of pt. inconvenience
A
Intervention
2
Q
Term: Tool (object or therapist) used to restore and improve a pt.’s musculoskeletal or cardiopulmonary well being.
A
Therapeutic exercise
3
Q
Q: What is the goal of a therapeutic exercise program?
A
Optimal level of symptom free movement during basic to complex physical activities
4
Q
Q: How do you achieve symptom-free movement and function?
A
- Knowledge of basic principles
- Relationships of anatomy and kinesiology
5
Q
Content: Components of TherEx (3)
A
- Activity
- Technique
- Elements
6
Q
Term: TherEx - a posture and any movement occurring in that posture
A
Activity
7
Q
Term: TherEx - the type(s) of muscle contraction(s) i.e. concentric, eccentric, isometric
A
Technique
8
Q
Term: TherEx - sensory input used either to facilitate or inhibit a response
A
Element
9
Q
Content: Parts of the intervention definition (5)
A
- Exercise to prevent muscular atrophy
- Restoring joint and muscle function
- Increasing muscular strength
- Improving efficient cardiovascular and pulmonary function
- Neurological elements
10
Q
Content: Other bits of the TherEx puzzle (4)
A
- Understand state of the injury
- Understand surgical procedure
- Know potential rate of recovery
- Be aware of precautions, complications, and contraindications
11
Q
Content: Intervention for Bone (2)
A
- Biomechanical energy in the line of stress
- Avoid sheer forces
12
Q
Content: Intervention for Cartilage (2)
A
- Intermittent compression and decompression with gliding
- Avoid excessive overload
13
Q
Q: How can posture effect TherEx? (2)
A
- Watch for compensatory mechanism
- Can lead to other injury
14
Q
Content: Intervention for Collagen
A
Modified tension in the line of stress
15
Q
Content: Things to keep in mind when addressing the problem (4)
A
- Where is the pt. lacking function?
- What are the pt goals?
- Are they the same as your goals?
- Assess the needs
16
Q
Q: What is the PT problem solving approach?
A
Assess needs > develop a plan > implement plan > evaluate plan > ALWAYS return to ASSESS needs
17
Q
Content: Skillful Decision Making Models (4)
A
- Disablement model
- Medical model
- Clinical reasoning
- Algorithms
18
Q
Defn: Disablement model
A
Impairment, Function, Activity
19
Q
Defn: Medical model
A
Scan, Illness scripts
20
Q
Defn: Clinical reasoning
A
Reliant on experience
21
Q
Defn: Algorithms
A
If and then
22
Q
Q: What is a problem list good for?
A
Helps you develop your goals and plan
23
Q
Content: Basic Principles of TherEx (6)
A
- Bi/Unilateral
- Un/stable
- Single/multiplanar motion
- Single/multijoint motion
- Simple/complex task/exercise
- Specific to job/sport
24
Q
Content: 4 parts of specificity of training
A
- Bilateral vs. single loading exercise
- Balance
- Proporioception
- Kinesthetic
25
T/F: Balance should be progressed from simple to complex activites.
True
26
Content: Other considerations for TherEx (6)
1. Posture/position
2. Muscle type, contraction, fibers
3. Repetition
4. Rest/recovery
5. Periodization
6. Substitution
27
Q: In which phase is the area red, warm, swollen, and painful?
Acute
28
Q: In which phase is there pain present at rest and with motion of the involved area?
Acute
29
Q: In which phase is there coagulation and WBCs present?
Acute
30
Q: What are the 3 goals of the acute phase?
1. Rest
2. Relieve pain
3. Protect
31
Q: What is an illness script?
Decision making that gets right to the point and treats the problem
32
Q: In which phase does pain occur with activity or motion of involved area?
Sub-acute
33
Q: In which phase is ROM and strength limited?
Sub-acute
34
Q: In which phase is there capillary growth, granulation tissue formation, fibroblast proliferation with collagen synthesis, and increased macrophage activity?
Sub-acute
35
Q: What is another name for the sub-acute phase?
Migratory/Proliferative Phase
36
Q: What are the 3 goals of the sub-acute phase?
1. Optimal stimulus for regeneration
2. Protect
3. Gain motion
37
Q: In which phase may pain occur after activity?
Chronic
38
Q: In which phase does macrophage and fibroblast activity diminish?
Chronic
39
Q: In which phase does scar tissue density and tensile strength increase?
Chronic
40
Q: What are the 4 goals of the chronic phase?
1. Increase tissue stress
2. Full motion
3. Strengthen
4. Return to pain-free function
41
Content: Types of TherEx (7)
1. ROM
2. Strengthening
3. Flexibility
4. Coordination
5. Endurance
6. Balance/Neuromuscular control
7. Functional/specific activities
42
Content: What 3 questions can you ask for any type of TherEx
1. Does the pt. have the available ROM?
2. What motion do you need to perform this stance?
3. What exercises can you prescribe to achieve this?
43
Term: The ability of a muscle or muscle group to produce tension and a resulting force during a maximal effort, either dynamically or statically in relation to the demands placed upon it
Strength
44
Term: Relates to the ability of the neuromuscular system to produce, reduce, or control forces, contemplated or imposed, during functional activities, in a smooth, coordinated manner
Functional Strength
45
Defn: "Normal" strength
The amount or degree of strength of a muscle that allows that muscle to contract against gravity and hold against maximum resistance (one time)
46
Q: Is our definition of normal strength really a measurement of strength?
No, also need to look at endurance (a different type of strength)
47
Q: Muscle strength is a foundation for developing muscle \_\_\_\_\_\_\_\_.
Power
48
Content: 2 ways power can be enhanced
1. Increasing the work a muscle must perform in a specific period of time
2. Reducing the amount of time taken to generate the force
49
Term: The ability of a muscle to contract repeatedly against a load, generate and sustain tension, and resist fatigue over an extended period of time
Muscular endurance
50
T/F: The larger the diameter of the muscle the greater the tension-producing capacity.
True
51
Term: Increase in fiber size
Hypertrophy
52
Term: Increase in fiber number
Hyperplasia
53
Q: Which fiber type can generate large amounts of tension, but fatigue quickly?
Type 2A-B
54
Q: Which fiber type develops less tension but are resistant to fatigue?
Type 1
55
Q: Which type of contract produces the most tension?
Eccentric
56
T/F: Greater torques are produced at higher speeds.
False: lower
57
T/F: During eccentric contractions, increased speed of lengthening produces more tension.
True
58
Q: At what length is the greatest tension produced?
Near or at resting length
59
T/F: The length tension relationship can be altered by pt. position, thus positional weakness should be considered for MMT and TherEx.
True
60
Term: Advanced skill that is built on flexibility, strength, and power first, followed by coordination and balance.
Agility
61
Term: The ability to use the right muscles at the right time with appropriate sequencing and intensity
Coordination
62
Term: The ability to perform smooth, accurate, and controlled movements.
Coordination
63
Term: Ability to maintain equilibrium.
Balance
64
Q: What 3 systems are used for balance?
1. Sensory
2. Biomechanical
3. Motor
65
Term: The body's ability to transmit position sense, interpret the information and respond consciously or unconsciously to stimulation through appropriate execution of posture and movement
Proprioception
66
Q: What does functional movement allow use to do?
Gives us the ability to change direction of movement quickly and efficiently and adapt to surfaces
67
Q: What is the overload principle?
Progressive loading of the muscle by manipulating intensity or volume of the exercise
68
Q: What does the overload principle look like for strength training?
Amount of resistance applied is gradually increased
69
Q: What does the overload principle look like for endurance training?
Emphasis on increasing time muscle contraction is sustained or number of repetitions performed
70
Q: What is the acronym SAID?
Specific Adaptation to Imposed Demands
71
T/F: According to SAID, exercised should be selected to create training effects specific to pt.'s funcitonal needs and goals
True
72
Content: Progressive Resistance Exercise - DeLorme (3)
1. 3 sets of 10 RM
2. Progressive loading during each set
3. Warm up build in
73
Content: Progressive Resistance Exercise - Oxford (2)
1. Regressive loading
2. Diminished the resistance as the muscle fatigues
74
T/F: Oxford PRE results in better outcomes than DeLorme PRE.
False; same outcome
75
Q: The following example is what type of PRE? 10 reps @50%, 10 reps @75%, 10 reps @100%
DeLorme
76
Q: The following example is what type of PRE? 10 reps @ 100%, 10 reps @75%, 10 reps @50%
Oxford
77
Content: DAPRE (4)
1. Daily adjustable progressive resistive exercise
2. Based on 6RM
3. Adjusted working weight is based on the max number
4. This determines the weight for the next session
78
Content: How to calculate DAPRE (5)
- 0-2 reps decrease 5-10#
- 3-4 reps decrease 0-5#
- 5-6 reps keep same weight
- 7-10 reps increase 5-10#
- 11+ increase 10-15#
79
Diagram: Oddvar Holten Curve
80
Term: Distal portion free in space
Open Chain Exercise
81
Term: Distal protion of segment is fixed
Close chain exercise
82
Q: What are open chain exercised used for?
To isolate one joint motion
83
Q: What are closed chain exercises used for?
When you want multiple joints and muscles involved
84
Content: Periodization (4)
1. Method used to prevent overtraining
2. Helps maximize results in minimum time
3. Improves muscular endurance, strength, power, motor performance, and/or muscle hypertrophy
4. Can alter exercise variables (mode, order, frequency, intensity, volume)
85
Q: What are plyometrics good for? (3)
1. power training combined with strengthening
2. using max force in short time period
3. eccentric to concentric
86
Q: What is the plyometric theory related to series elastic components?
Stored energy created with rapid stretching, energy released immediately with concentric contraction
87
Q: What is the plyometric theory related to the neurophysiological model?
Stretch reflex occurs as a response to overstretching, reaction is to recoil spring into concentric contraction
88
Q: What are the 3 phases of plyometrics?
1. Pre-stretch
2. Amortization (time between pre-stretch and concentric contraction)
3. Muscle contraction
89
Content: TherEx Dosage (5)
1. Choose 1-2 types of exercise
2. 1-3x/wk for 6-12 wks
3. 2 sets of 10 OR 4 sets of 8
4. 48-72 hours rest per body part
5. Ample rest between sets
90
Content: Delayed Onset of Muscle Soreness (DOMS) (4)
1. can occur 48-72 hours after exercise
2. usually related to eccentric exercise or lack of preparation
3. low load and high rep will assisst in healing
4. proper hydration and nutrition are key
91
Q: What 5 things should you consider when prescribing TherEx?
1. Target Muscles
2. Adjust to activity and posture
3. Strength vs. endurance
4. Frequency
5. Pt personality
92
Q: What is the exercise prescription for an endurance training objective?
Very short rest periods, 2-3 sets, reps \> 15
93
Q: What is the exercise prescription for a hypertrophy training objective?
Rest 30-45 secs or before full recovery, 3-4 sets, reps to fatigue
94
Q: What is the exercise prescription for a strength training objective?
Rest 1-2 mins, 3-6 sets, reps 4-8
95
Q: What is the exercise prescription for a power training objective?
Rest 2-5 min, sets 2-4, reps 3-6
96
Content: Exercise selection (3)
1. Multiple exercises for the same muscle group
2. Stable and unstable surfaces
3. Incorporate interval training
97
Q: How should you structure a HEP?
So that is compliments your program in the clinic
