Theraputic Exercise Mid-Term Flashcards
6 Aspects of FUNCTION
Muscle Performance Cardiopulmonary Endurance Mobility/flexibility Neuromuscular coordination/control stability balance/Postural Equilibrium
3 Reasons for Therapeutic Exercise
improve or restore function
prevent dysfunction
4 Indications for Stretching
ROM is limited (adhesions/scar tissue/etc)
Restrictions lead to structural deformities
Muscle weakness has led to opposing tissue weakness
reduce chance of injury
5 contraindications for stretching
bony block recent fracture acute inflammation/infection tissue trauma hypermobility
Parameters for resisstance exercise by how trained
30-40% sedentary
40-70 healthy but untrained
70-80 trained
>80 highly trained
Indications for Low intensity vs high
- soft tissue healing
- articular cartilage vs heavy compression forces
- new to exercise
- children/older
- goal is muscle endurance
- warm up/cooldown
- isokinetic
8 Precautions for Resistance Exercise
1 Cardiovascular Precautions 2 Fatigue local muscle fatigue total body fatigue specific pathology 3 Recovery from Exercise lactic acid/oxygen/glycogen 4 Overwork/Overtrained 5 Substitute Motions 6 Osteoporosis post-menopausal women nutrition (calcium) certain medications gradual increase of program 7 Exercise induced Muscle Soreness acute muscle soreness (ischemia) 8 Delayed onset muscle soreness can use TENS
3 Contraindications of Resistance Exercise
Inflammation (low activity is ok if no pain)
Pain (muscle joint pain more than 24 hours)
Severe Cardiopulmonary Disease
uncontrolled hypertension, dysrhythmias etc
4 Indications for Isometric Exercises
- minimize atrophy
- re-establish neuromuscular control
- postural or joint stability
- Strength in specific ROM’s that are weak
Types of Isometric Exercise
1 Muscle-Setting
not resistance, used during acute stages of healing, prevents atrophy
2 Stabilization
dynamic stability of joint or posture, submaximal weight, trunk posture,
3 Multiple-Angle
resistance at multiple angles within available ROM, used when dynamic is painful or inadvisable.
4 Indications for PROM
1 acute inflamed, injured
2 after surgery
3 unable or unadvised active movement
4 paralized/coma, etc
Indications for Active- Assisted ROM
when patient cannot
progression from AAROM to AROM
AROM to relieve from sustained postures
Considerations for Therapeutic Exercise Pyramid
Bottom to top: Mobility joint mobs/mmstrip/pir/stretch etc Stability isometric/tapotement/muscle setting/activation Controlled Mobility synergist/agonist/antagonist - path of center of rotation kinesthetic information AAROM/AROM/Proprioception Skill Strength and Conditioning/ Functional Exercises
compensation =
functional dysfunction
Stabilization defined as these 3 things
Maintaining spine in Neutral, Pain Free, Stable position through adjustments and tension in response to functional loads
Muscular Box are how many pairs of muscles?
29
Global Muscles
Rectus Abdominis inter/exter obliques QL superficial Erectors Iliapsoas
Deep Segmental Muscles
TA
Multifidi
QL Deep
Deep hip rotators (hip girdle)
Characteristics of Global Muscles of Spine
1 superficial - further from axis
2 cross multiple segments
3 large guy wire function
4 compressive load with strong contractions
Characteristics of Deep segmental Muscles of Spine
1 closer to axis
2 attach to each vertebra
3 control segmental guy wire function
4 MORE type 1 muscle fibres for endurance
Explain “Setting the Core”
co-contraction of TRA (fingers on ASIS and bring together) and pelvic floor (holding pee), where Drawing In/Abdominal Holowing is used
Explain “Abdominal Bracing”
used to activate TRA and ext/inter obliques
Ideal timing of activation spine control muscles
Co-contraction of TRA and Pelvic Floor THEN multifidi should occur prior to other limb movement
How to train Deep segmental muscles
for endurance with low levels of isometric contractions
once CORE IS set what can be strengthened? and how?
multifidi
VIA challenging spinous processes of vertebra
progress to bird dog
How does thoracolumbar fascia involve?
TRA and Oblique activation (abdominal bracing) increase tension in TL fascia and therefor intraabdomainal pressure that stabilize.
