Week 11 Flashcards
Why do we consider muscle performance?
Strength: amount of force produced
Endurance: ability to sustain a specified output
Power: rate of force produced. Muscles with an increased % of type II fibers will generate more torque and power at a standard velocity compared to muscles with predominately type I fibers
Explain intervention ladder
1) What are the rules to initiate strengthening? 2) to initiate plyometric and complex task training?
1) The patient needs to have functional or relatively full, pain free range of motion prior to initiating strengthening at a level of > 60% MVC.
If they do not have functional pain free range of motion, we have to address these impairments first (inflammation, pain, and mobility restrictions) prior to introducing strengthening exercises.
2) You need full pain free range of motion, adequate muscle strength, and evidence of joint stability.
How to differentiate intensity, duration and frequency options for MIDF?
List individual factors that affect muscle performance
Explain 1) muscle cross sectional area, 2) muscle pennation and length, 3) fiber type and distribution
1) In general, the greater the muscle’s cross-sectional area with muscle fiber, the more force production the muscle is able to perform.
The “in general” note refers to the fact that certain muscles, in the presence of pain or dysfunction, get fatty infiltration in the muscles. Although the muscles may not loose cross-sectional area (CSA), they loose fibers within that CSA.
2) * Short fibers with increased pennation = high force production (quad, gastroc)
* Long, parallel fibers = less force production (sartorius, lumbricals), but more ROM through muscle excursion
3) * Mainly Type I fibers = low force production, slow rate of force development, high resistance of fatigue
* Mainly type IIA and IIB fibers = fast rate and large amount of force production; quickly fatiguable
Explain 1) type of muscle contraction, 2) changes in fiber type, 3) changes in the size of muscles
1) * Eccentric: The muscle is working while lengthening in a controlled manner.
* Isometric: The muscle is holding a set position.
* Concentric: Work is being done with the muscle shortening.
2) * There are various isoforms, but we’ll focus on 3 main isoforms.
* The percent of contribution of each fiber type within a muscle can theoretically be altered by exercise, inactivity, and age.
3) Hypertrophy
* An increase in cross sectional area closely correlated with increases in force production Results from accumulation of proteins through either an increased rate of synthesis or a decreased rate of degradation
Hyperplasia
* An increase in fiber number
How many MHC (myosin heavy chain) proteins can adult skeletal muscles express?
Explain reasons we lose strength
Define muscle atrophy
Explain sarcopenia
Explain forms of fatigue
(need to check when reestablishing muscle performance)
1) muscle fatigue: Considered to be a reduction in the force generating capacity of the neuromuscular system.
Involves both central and peripheral components.
* Central fatigue (inhibition) versus peripheral fatigue (metabolic)
Local muscle fatigue can include:
* Decrease in energy stores, insufficient 02, and build up of H+
* CNS inhibition
* Possible decrease in activity at the motor unit
2) cardiopulmonary fatigue: Diminished response as a result of prolonged activity
Caused by:
* Decrease in glucose levels
* Decrease in glycogen stores in the muscle and liver
* Decrease/depletion of potassium (K)
3) form fatigue: * local fatigue characterized by diminished force generating capacity of muscle
* Remember from motor control, we want to see if the patient can overcome this form fatigue. If they can’t, we pause the exercise until it can be done correctly so as not to feed into faulty movement patterns
What is the usual recovery time from a set of exercise?
What should you expect from the muscle tissue with mechanotransduction?
Why do we overload muscles?
Explain muscle strength vs endurance
Define resistance training
What do you expect to happen with resistance training?
What can the patient expect to see with gains?
Does resistance training cause tendon remodeling?
Define isometric, concentric, and eccentric contractions
isometric: The muscle contracts, but the body region does not change positions.
Strength gains are angle specific (# 10° although some studies have found a 30° transfer, and up to a 75° transfer if trained in a lengthened position) Advantage: contraction occurs without joint movement
Concentric: The muscle is producing positive work by shortening with an active muscle contraction.
In this exercise, you still have to consider where gravity is in relationship to the bony segment moving. For example, in a standing bicep curl, the biceps is contracting concentrically as the elbow is flexed, and the bicep acts eccentrically as the elbow returns to the extended position.
But what if the patient was supine? The biceps would contract concentrically until the elbow is flexed to 90 deg. Then, to complete elbow flexion, the triceps acts eccentrically through the rest of elbow flexion. When returning the elbow to the start position, the triceps acts concentrically until 90 deg of elbow flexion, then the biceps acts eccentrically for the rest of elbow extension.
Eccentric: The muscle contracts in a lengthening direction to control the load, usually to slow down the speed in the direction of gravity. This produces negative work.
Eccentric muscle contractions are characterized by greater force production an a given velocity, more neuromuscularly efficient, less metabolically demanding.
Not so good news: There is an increased incidence of delayed onset muscle soreness (DOMS).
What are the exercise volume protocols?
Explain Advantages and disadvantages
Explain Advantages and disadvantages
Explain Advantages and disadvantages
With endurance training over a 6 week period, what is the effect on mitochondrial protein content?
What are the expected results of endurance training?
Explain specificity of training for strength vs endurance
What are the steps of plyometrics?
What is exercise prescription used for?
How do you determine the appropriate amount of load?
What are the guidelines for endurance and resistance training?
List the dosage requirements for strength, power, and endurance
List precautions and contraindications of exercise
Define PNF
How does PNF generate optimal motor effort?
What should be considered when applying PNF with motor training?
Explain the diagonal line of movement in PNF
How do you optimize PNF movement?
How do PTs use their body to get the right movement during PNF?
What is the appropriate resistance in PNF?
Explain verbal commands during PNF
How can you use verbal commands for different types of contraction in PNF?
Explain UE D1 flexion PNF
Explain UE D1 extension PNF
Explain UE D2 flexion PNF
Explain UE D2 extension PNF
Explain LE D1 flexion PNF
Explain LE D1 extension PNF
Explain LE D2 flexion PNF
Explain LE D2 extension PNF
What do PNF techniques involve?
PNF, explain rhythmic initiation and slow reversal
PNF, explain hold relax and contract relax
PNF, explain alternating isometrics
PNF, explain slow reversal hold and repeated contractions
PNF, explain agonistic reversals
What aspects exist beyond resistance or weights in PNF?
What are the goals of plyometrics?
What are the components of plyometrics?
1) eccentric: This is the phase where the musculotendinous unit deforms under load created by a rapid stretch/lengthening. During this stage, kinetic energy is being used to create strain on the series elastic components of the muscle-tendon unit. During this time, the muscle will be mostly acting to stiffen the tendon with an isometric pre-contraction, then eccentrically lengthen as the joint angles change.
2) amortization: This phase is the transition between the eccentric and concentric phases. This is where kinetic energy is transferred and stored as elastic potential energy relative to the degree of tendon stiffness or compliance. You can think of this as the loaded spring ready to rapidly bounce back to its length. The quicker this phase, the more of that elastic energy will be transformed back into kinetic energy for the upcoming concentric phase. Muscles are working isometrically here to facilitate the spring like tendon.
The physiologic adaptation in plyometric performance is for this phase to achieve the fastest rate of time possible. If the Amortization phase is prolonged, the stretch reflex is inhibited and the heat generated is dissipated.
3) concentric: This is when that stored elastic potential energy converts back to kinetic energy, and combines with the associated conscious and reflex muscle contraction forces. The end result is explosively propelling the systems center of mass in the applied direction.
Label the phases
Explain the science of plyometrics
How is plyometrics progressed?
Explain force absorption phase in plyometrics
Explain force creation phase of plyometrics
Explain stretch shortening cycle phase of plyometrics
Explain maximal power demands phase in plyometrics
What should a sport specific exercise accomplish?
Explain tuck jump assessment
What tool can be used to grade the tuck jump?
Explain seated chest pass assessment
Explain agility T test
What are the interpretation of scores for the agility T test?
What are the plyometric prescription dosage guidelines in terms of intensity, volume, frequency, and contraindications
Is lower muscle strength a dependent or independent risk factor for post fracture mortality in older individuals?
Define bioenergentics
Explain rapid vs sustained energy systems
Explain the phosphagen system
Explain glycolysis
What is the difference between aerobic vs anaerobic glycolysis
Explain krebs cycle
Explain the electron transport chain
What determines the extent to which the energy systems contribute to energy produced?
Solve these for each energy system
Explain
Explain skeletal muscle hypertrophy
What effect does hypertrophy vs atrophy have on muscle protein?
Explain
Explain muscle protein turnover in an acute/single bout
Explain chronic protein turnover
What is mTORC1 used for?
What is used to accomplish mechanotransduction signaling?
Explain
What does p-mTORC1 with a net positive protein balance do?
up regulates MPS
Down regulates MPB
What to be aware of when prescribing load after an injury?
What is the difference in sets, reps, rest, load, and volume between endurance, strength, and hypertrophy?
What is the “new” hypertrophy continuum?
What is the effect of shorter vs longer rest intervals?
Explain S.A.I.D.
What is functional training?
Define progressive loading
Explain the approaches to periodization
By 50 years of age, how does muscle atrophy progress?
What is a common compensation for sarcopenia? Is it positive or negative?
Do older adults have higher metabolic resistance from the benefits of resistance training?
yes, they will experience fewer gains when compared to a younger individual in the same training program
Explain
What limits muscle adaptation to resistance training in older adults?
Assess and answer
Yes, concurrent training is important for older adults. Here’s why:
* Aerobic exercise alone improves muscle quality and strength, likely through neuromuscular adaptations and increased capillarization.
* However, resistance training is typically needed to increase muscle mass.
* Therefore, combining both (concurrent training) can optimize:
* Cardiovascular health
* Muscle strength
* Muscle mass preservation
* Functional independence
For hypertrophy, how should resistance exercises be performed?
What are APTA’s 5 recommendations for exercise prescription?
What would the outcomes be?
Prescribe exercises for 1) total hip replacement 1 week post op, 2) total knee replacement 1 week post op
Prescribe exercises for 1) hip fracture 16 days post op, 2) post op ankle fracture (immonilized for 7 weeks)
Is high intensity exercise safe for older adults?
Explain tissue capacity
What must all prescribed exercises follow?
Explain anaerobic glycolysis
What is this?
aerobic glycolysis
What is released in tricarboxylic acid (TCA) cycle?
Are heavier loads (over 60% of max) necessary during RE to activate type II hypertrophy?
What are the basic progression rules?
What should functional activities involve from muscle power, endurance, strength?
All
How does the resistance training background differ from a beginner, intermediate, and advanced lifters?
What is the exercise order?
How can exercise sessions be structured?
How do you calculate load?
What is the 1RM testing protocol?
What are the 1RM prediction equations?
At what training load is the benefit maximized for strength, power, and hypertrophy?
Explain progressive loading and rest/adaptation
Define plyometrics, speed, agility, ballistic training, and velocity based training (VBT)
What are the components of agility?
Explain stretch shortening cycle
What does the stretch shortening cycle stimulate?
For plyometrics, as intensity increase should volume decrease?
yes
What is the frequency for plyometrics?
How long should recovery time be from max effort set?
What should be considered when coming up with exercise volume?
How do you progress plyometrics?
What adjustments is made in terms of plyometrics for children?
Explain peripheral vs central fatigue
Explain the HR percentage method
Give examples of scapular strengthening exercises
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scapular strengthening exercises
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Explain the exercises: 1) forward punch and barrel hug, 2) touchdown (wall slides)
What is the rule to start strengthening and to start plyometrics?
How can you make a hip extension exercise harder/easier?
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How would you cue?
How would you cue?
How would you cue?
How would you cue?
Which of the following is NOT an accurate description of Motor Control?
A. Control of discrete movement across different joints through neural assemblies
B. Motor training can cause structural and functional adaptations within the motor areas of the CNS (basal ganglia, cerebellum, and red nucleus)
C. Interventions are prescribed at 40-60% of MVC with a target of 3 sets of 15-25 reps with a 1 minute rest break
D. Requires using the right muscles at the right time at the right intensity
C
Explanation: That’s a muscle endurance prescription, not motor control. Motor control training uses low load, high frequency.
Which of the following is NOT a neurological adaptation to motor training?
A. Alterations in cortical synapse number
B. Alterations in number of sarcomeres in series
C. Alterations in synapse strength
D. Alterations in the topography of stimulation-evoked movement representations (motor maps)
B
Explanation: Sarcomere changes are muscular, not neurological adaptations.
Which of the following observations can indicate a lack of hip-pelvic dissociation during BKFO?
A. The lumbar spine moves into sidebending
B. The lumbar spine moves into extension
C. The pelvis remains in a neutral position
D. The pelvis rotates in the same direction of hip abduction
A
Explanation: Sidebending of the lumbar spine during BKFO is a compensatory movement, indicating poor dissociation.
What is the function of the transversus abdominis in a BKFO exercise?
A. This exercise is primarily an adductor lengthening exercise, and the TA is not active
B. The TA is eccentrically lengthening
C. The TA is isometrically stabilizing the pelvis
D. The TA is concentrically shortening
C
Explanation: TA functions isometrically to stabilize the pelvis during BKFO.
Best prescription for prone plank to target motor coordination?
A. 3 sets of 30s holds, 1.5 min rest, daily
B. 3 sets of 20s holds, 30s rest, 3–5x/day
C. 3 sets of 40s holds, 3 min rest, every other day
D. 1 set of 40s hold, 5x/day
B
Explanation: High frequency, low load, moderate intensity is ideal for motor control adaptations.
Which muscle and position would you target for scapular winging in quadruped?
A. Lower trap; open kinetic chain
B. Serratus anterior; open kinetic chain
C. Lower trap; closed kinetic chain
D. Serratus anterior; closed kinetic chain
D
Explanation: Serratus anterior in CKC (for example: quadruped) improves motor control and reduces winging.
Which is NOT a theoretical mechanism through which PNF improves movement?
A. Improves motor output through improved sensory input
B. Improves motor output through repeating normal synergistic motions
C. Improves motor output by isolating specific muscles
D. Improves motor output by increasing effort in distal segment to facilitate proximal muscle activity
C
Explanation: PNF emphasizes synergies, not isolated muscles.
How much force should be used during isometric “muscle setting”?
A. Maximal to point of fatigue in 5 reps
B. Moderate to perform 10 reps
C. Minimal to barely feel the muscle
D. Varied resistance for motor learning
C
Explanation: Muscle setting uses minimal force just enough to activate the muscle gently.
Which PNF technique is primarily used to improve joint stability?
A. Slow reversals
B. Contract-relax stretching
C. Alternating isometrics
D. Repeated contractions
C
Explanation: Alternating isometrics build co-contraction for joint stability.
Which lower extremity PNF diagonal best mimics stance phase of gait?
A. D1 extension
B. D1 flexion
C. D2 extension
D. D2 flexion
A
Explanation: D1 extension mimics hip extension, adduction, and plantarflexion, key features of stance phase.
