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Therapeutic interventions > Week 8 > Flashcards

Week 8 Flashcards

1
Q

___ establishes direction and meaning for the activities integrated into the rehab process

A

Patient’s life outside of the clinic establishes direction and meaning for the activities integrated into the rehab process

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2
Q

__ are often very dissimilar to the functional movement demands of a patient’s life

A

Impairment based interventions are often very dissimilar to the functional movement demands of a patient’s life

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3
Q

Impairment based interventions can aide in the ___

A

Impairment based interventions can aide in the development of tissues specific physical capacities

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4
Q

What is the limitation of a strictly impairments based intervention?

A

Improvements in specific physical capacities as developed in impairment based interventions do not always translate into meaningful changes in performance

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5
Q

What do activity based interventions center upon?

A

The considerations of a patient’s activity limitations and to movement prescription and progression

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6
Q

Activity based interventions are more similar to __

A

Activity based interventions are more similar to skilled activities and foundational activities

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7
Q

Understanding a patient’s ___ is what can most directly inform a clinician’s consideration of the specific skilled activities a patient needs to be able to perform in order to maximize function

A

Understanding a patient’s participation restrictions is what can most directly inform a clinician’s consideration of the specific skilled activities a patient needs to be able to perform in order to maximize function

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8
Q

What are the characteristics of skilled activities?

A
  • Complexity
  • Variability
  • Automaticity
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9
Q

What is functional progression?

A

An ordered sequence of activities enabling the acquisition or reacquisition of skills required for the safe effective performance of athletic endeavors.

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10
Q

What are the components that make up the desired adaptation for designing a functional progression?

A
  • Demands of target activity

- Performance capabilities of patient

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11
Q

Activity demands can be progressed using ___

A

Activity demands can be progressed using the FITT principle

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12
Q

What does FITT stand for?

A
  • Frequency
  • Intensity
  • Type
  • Time
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13
Q

__ can be included in the implementation of the functional progression in patients with low functioning and highly irritable patients

A

Active rest can be included in the implementation of the functional progression in patients with low functioning and highly irritable patients

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14
Q

Functional progressions of exercise should be done in response to ___

A

Functional progressions of exercise should be done in response to patient response

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15
Q

Return to function testing may serve as ___

A

Return to function testing may serve as a pre-test and post test

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16
Q

Return to function testing can involve __

A

Return to function testing can involve having a patient attempt the targeted skill activity in a direct or simulated fashion

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17
Q

The ___ properties of non formal return to function testing are rarely known

A

The psychometric properties of non formal return to function testing are rarely known

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18
Q

The ___ properties of standardized performance based test may be known

A

The psychometric properties of standardized performance based test may be known

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19
Q

What are functional capacity evaluation?

A

Performance based assessments that involve a series of test items in an attempt to capture information regarding physical performance with respect to common occupational task

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20
Q

The functional movement screen may be used to assess ___

A

The functional movement screen may be used to assess general readiness and therefore injury risk for returning to sport activities

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21
Q

True or False

The fact that a test says that you are ready to return to work/sport safely always mean that you are

A

False

It does not always mean that

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22
Q

What are the extrinsic injury risk factors?

A
  • Playing surface
  • Foot wear
  • Level of participation
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23
Q

What are the intrinsic injury risk factors?

A
  • Gender
  • Age
  • Health status (etc)
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24
Q

What is one of the most consistent predictors of recurrent injury regarding the same site or subsequent injury involving different sites in the LE?

A

Previous history of LE injury

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25
Q

Return to function after ___ peak in training

workload is better for reducing an injury risk

A

Return to function after SUSTAINING peak in training

workload is better for reducing an injury risk

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26
Q

Movement as a result of interaction of: ____

A

Movement as a result of interaction of: Individual,

Task, Environment

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27
Q

What is motor skill acquisition?

A

Process in which performer learns to control and
integrate posture, locomotion, sensory information and muscle activations that allow individual to engage in variety of motor behaviors that are constrained by a range of
task, individual and/or environmental requirements

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28
Q

What does skilled actions equate to?

A

Consistency, flexibility, and efficiency

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29
Q

What does consistency mean?

A

A skill is repeatable

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30
Q

What does flexibility mean?

A

The ability to adapt and modify a task performance based on changing conditions

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31
Q

What does efficiency refer to?

A

A ability to be able to complete the task

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32
Q

Movement pattern emerges as a result of the interaction between ___

A

Movement pattern emerges as a result of the interaction between Individual,
Task, Environment

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33
Q

___ is the most important factor in retraining motor skills

A

Practice is the most important factor in retraining motor skills is amount of practice

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34
Q

What is performance improvement is dependent upon?

A

The amount of practice, but there are other factors in addition to the amount
of practice

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35
Q

What is task specific training?

A

The systematic and repetitive practice of functional tasks

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36
Q

What is the transfer of practice?

A

A task learned in one condition transfers to another

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37
Q

What does the transfer of task depend on?

A

Similarity between tasks or environments

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38
Q

What is the key to the transfer of practice?

A

Intensity of practice

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39
Q

Why do we need a large of amount of practice?

A

More opportunities to establish relationships among various types of info associated with each movement

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40
Q

What does a large number of trials do for a patient?

A

Enhance stability of recall and recognition schemas

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41
Q

A large number of trials gives a patient ___

A

A large number of trials gives a patient more instances of retrieval of motor programs

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42
Q

The amount of times a patient practices, it may help __

A

The amount of times a patient practices, it may help automatize activation of generalized motor patterns
for future use

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43
Q

What does the variability of practice rely on?

A

Variable practice relies on higher order motor areas

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44
Q

Wha does constant practice depend on?

A

Depends more heavily on primary motor cortex for motor-memory consolidation

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45
Q

When does variability work best?

A

When variability is within same generalized motor pattern

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46
Q

True or false

Variability of practice is applicable for everyone

A

False

May not be applicable for everyone

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47
Q

What are some practice conditions to partake in?

A
  • Massed v Distributed Practice
  • Constant v Variable Practice
  • Random v Blocked Practice
  • Whole v Part training
  • Transfer
  • Mental Practice
  • Guidance v Discovery Learning
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48
Q

What does the massed in Massed v Distributed Practice mean?

A

Amount of practice time in trial ˃ amount of rest between trials

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49
Q

What does the distributed in Massed v Distributed Practice mean?

A

Amount of rest between trials ≥ amount of time for trial

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50
Q

What does the choice whether to pick Massed v Distributed Practice depend on?

A

Depends on goal of practice session and learner’s capacity

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51
Q

What does the variable in Constant v Variable Practice mean?

A

Variable practice increases ability to adapt and generalize

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52
Q

What does the constant in Constant v Variable Practice mean?

A

Only one task, practiced the same way over and over again

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53
Q

Which form of practice out of the Constant v Variable Practice is better?

A

Most useful when learning tasks performed in variable

conditions (variable is better)

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54
Q

What happens in blocked practice in Random v Blocked Practice?

A

When all practice is completed under one condition before moving to the next

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55
Q

What happens in random practice in Random v Blocked Practice?

A

Maximize variability of practice by practicing in a random order

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56
Q

From Random v Blocked Practice, which is better for performance?

A

Blocked

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57
Q

From Random v Blocked Practice, which is better for retention and transfer?

A

Random

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58
Q

Random practice when introduced causes ___

A

Random practice when introduced causes contextual interference

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59
Q

What does contextual interference mean?

A

Increased difficulty initially of task makes learning more effective

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60
Q

When may random practice be inappropriate?

A

Random may be inappropriate until earner understands dynamics of task

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61
Q

What does practicing in parts before combining it into whole do?

A

Takes things out of context

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62
Q

Quick, discrete skills and continuous skills should be practiced ___

A

Quick, discrete skills and continuous skills should be practiced as whole

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63
Q

What kind of skills are on to do part- whole?

A

Serial skills are ok to do part-whole

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64
Q

What is mental practice?

A

A cognitive rehearsal

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65
Q

What does mental practice do?

A

Enhance learning when physical practice not possible

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66
Q

Mental practice has been shown to significantly increase ___

A

Mental practice has been shown to significantly increase efficacy of repetitive task-specific practice

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67
Q

Unguided conditions less effective during ____, but

more effective for ___

A

Unguided conditions less effective during acquisition, but more effective for retention and transfer

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68
Q

What does replacing guidance learning with discovery do for a patient?

A

Patient allowed to explore “perceptual motor workspace

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69
Q

___ of best strategies and perceptual cues

A

Trial and error discovery of best strategies and perceptual
cues

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70
Q

What is the guidance hypothesis?

A

Information provided via feedback guides learner to
correct movement, improving performance during
practice; frequent feedback has negative effect

71
Q

Properties of augmented
feedback are beneficial for motor learning when used to
____, but detrimental when relied upon

A

Properties of augmented
feedback are beneficial for motor learning when used to
reduce error, but detrimental when relied upon

72
Q

What are the categories of feedback?

A
  • Intrinsic

- Extrinsic

73
Q

Where does intrinsic feedback come from?

A
  • Comes via sensory systems

* Vision, somatosensation

74
Q

What does intrinsic feedback give a learner?

A

Is movement accurate/meeting goal?

75
Q

What is extrinsic feedback??

A

What we provide as a PT that supplements intrinsic feedback in effort to increase learning

76
Q

Extrinsic feedback is also know as ___

A

Extrinsic feedback is also know as augmented feedback

77
Q

What are some types of extrinsic feedback that we can provide?

A 
• Concurrent
• Immediate
• Verbal
• Distinct
• Knowledge of
performance (KP)
• Terminal
• Delayed
• Nonverbal
• Accumulated
• Knowledge of results (KR)
78
Q

What is concurrent extrinsic feedback?

A

Giving feedback while the patient is doing the skill

79
Q

What is concurrent extrinsic feedback good for?

A

The acquisition/performance of the movement.

80
Q

What is the downside of concurrent extrinsic feedback?

A

The patient may become reliant upon it, and will be bad for retention

81
Q

What is terminal extrinsic feedback?

A

Providing patient with feedback after they’re done with the skill

82
Q

What may terminal extrinsic feedback be more beneficial for?

A

May be more beneficial for helping the patient retain the skill

83
Q

What is immediate extrinsic feedback?

A

Giving feedback as soon as patient is done with skill

84
Q

What is delayed extrinsic feedback?

A

Waiting a while to give ac feedback

85
Q

What is distinct extrinsic feedback?

A

Giving feedback on specific aspect of the skill, can result in overload

86
Q

What is Knowledge of

performance (KP) extrinsic feedback?

A

Feedback related to the movement pattern used to achieve the goal (feedback about how they are moving)

87
Q

What is Knowledge of

results (KR) extrinsic feedback?

A

Giving terminal feedback about the outcome of the movement in terms of the movement goal

88
Q

What are the types of cuing that can be provided to a patient?

A
  • Explicit

- Implicit

89
Q

What is an explicit cue?

A

Providing learner with instructions according

to precise kinematic strategy

90
Q

What is an implicit cue?

A

Providing learner with goal oriented cues

91
Q

Explicit cues focuses on ____, because ____

A

Explicit cues focuses on internal focus of attention because they focus on a specific body movement/ how to move

92
Q

Implicit cues establish ____, because they emphasize ____

A

Implicit cues establish external focus of attention because they emphasize object movement/ the goal

93
Q

Implicit cues are based on ___

A

Implicit cues are based on outcome

94
Q

When is a high frequency of feed back ok?

A

At the beginning of learning

95
Q

When should patients be given KR?

A

Depends on complexity of task; 5-15 trial in literature

96
Q

What are the effects of erroneous feedback?

A
  • Learning incorrectly

* Unlearning what has already been learned!

97
Q

Too much feedback suppresses error detection; ___ does not do that

A

Too much feedback suppresses error detection; modeling does not do that

98
Q

Manual guidance is a type of ___ feedback

A

Manual guidance is a type of concurrent feedback

99
Q

Can we measure motor learning?

A

No, it is inferred by changes in behavior

100
Q

What is acquisition?

A

Initial practice or performance of a new skill

101
Q

What is retention?

A

Ability to demonstrate attainment of goal after time delay without practice

102
Q

What is the transfer of skills?

A

Performance of a task with similar movement yet different from original task practiced

103
Q

What is proprioceptive neuromuscular facilitation?

A

Exercise based on the principles of functional human anatomy and neurophysiology

104
Q

What is PNF used for?

A
  • To increase strength, flexibility, coordination and functional mobility
  • To facilitate the patient achieving a particular movement or posture
  • To improve functional mobility and athletic performance
105
Q

What are the PNF principles?

A
  • Patient position
  • Therapist position
  • Manual contact
  • Verbal Cues/Commands
106
Q

What should a patient position be?

A
  • Neutral position for optimal alignment

- Proper body support

107
Q

Where should a therapist be positioned?

A
  • Placing yourself in relation to technique

- Directly in line with movement performed

108
Q

Where should resistance from a therapist come from?

A

Resistance should come from a patient’s body, the hands and arms should stay relatively relaxed

109
Q

What should the hand placement for manual placement be?

A
  • Purposeful
  • Directional
  • Comfortable
110
Q

What are the types of verbal cues/ commands that we use?

A
  • Prepatory verbal cues
  • Action verbal cues
  • Corrective verbal cues
111
Q

What are prepatory verbal cues?

A

Cues telling the patient what you are about to do. Ensures the patient knows what to expect. Demonstration, guided movement, PROM

112
Q

What are action verbal cues used for?

A

Used for when you start the patient through the movement, includes the timing of the movement, changes during the movement, increased or decreased force production

113
Q

What are corrective verbal cues?

A

What we tend to give in modifying the activity. Can be done during or after the movement

114
Q

The volume with which the command is given affects the ____

A

The volume with which the command is given affects the strength of resulting muscle contraction

115
Q

When should louder commands be used?

A

Louder command when strong muscle contraction is required

116
Q

When should softer and calmer commands be used?

A

Softer and calmer tone when the goal is relaxation and pain relief

117
Q

Why are PNF patterns developed?

A

Because all normal coordinated human movement occurs in a spiral or diagonal movement and is rarely in cardinal planes

118
Q

When are muscular contractions strongest and most coordinated?

A

During diagonal patterns of movement

119
Q

What do diagonal patterns involve?

A

Rotation of the extremities and tend to require more core stability

120
Q

What does normal timing look at?

A

Proper sequence of muscle contraction

121
Q

For most functional activities, do we need stability or mobility first?

A

We tend to need more proximal stability first, before we can utilize our distal mobility

122
Q

What is approximation?

A

To bring 2 joint surfaces together

123
Q

What are the benefits of approximation?

A
  • Promotes stabilization
  • Facilitates WB and contraction of postural muscles
  • Facilitates upright reactions
124
Q

What is traction?

A

To separate two joint surfaces

125
Q

What are the effects of traction?

A
  • Relax patient
  • Reduce tone
  • Pain relief
126
Q

What is irradiation?

A

The spread of response to stimulation, from stronger to weaker motor units

127
Q

What is reinforcement?

A

To strengthen by fresh addition, make stronger

128
Q

What are the PNF strengthening techniques?

A
  • Rhythmic initiation
  • Repeated contraction
  • Slow reversal
  • Slow reversal hold
  • Rhythmic stabilization
129
Q

What are the PNF stretching techniques?

A
  • Contract- relax

- Hold relax

130
Q

What is the goal of rhythmic initiation?

A

To promote learning of a new movement, to improve intra

and inter-muscular coordination, and to promote relaxation and independent movement

131
Q

What is the goal of rhythmic rotation?

A

To promote relaxation and increased range in muscles

restricted by excess tone

132
Q

What is the goal of dynamic reversals (slow reversals)?

A

To improve intra-and inter muscular coordination, strength, and AROM

133
Q

What is the goal of rhythmic stabilization- stabilizing reversals (Alternating Isometrics)

A

Improve stability, strength, endurance, ROM and intra-and

intermuscular coordination; promote relaxation and decrease pain

134
Q

What is the goal of combination of isotonics (Agonist Reversals)?

A

Improve motor learning and improve intra-and inter muscular coordination, increase strength and ROM, promote stability, eccentric controls and endurance; improve function

135
Q

What is the goal of Hold-Relax, Contract-Relax?

A

Improve ROM through facilitating, inhibiting,

strengthening and relaxing muscle groups

136
Q

What is the goal of replication (Hold-Relax-Active Motion)

Contract-Relax Active Contraction (CRAC)?

A

Improve intra-and inter muscular coordination and agonist muscle control in the shorted range and to promote motor learning

137
Q

What is the goal of Repeated Stretch (repeated contraction)?

A

To enhance initiation of motion and motor learning, increase

agonist strength and endurance, improve intra- and intermuscular coordination and ROM, and to reduce fatigue

138
Q

How is irradiation done?

A

Applying graded resistance to larger muscle groups to enhance muscle contraction in the weaker groups

139
Q

We start rhythmic initiation with what kind of movement?

A

PROM, in order for the patient to understand the pattern of movement and once they do, they can be progressed to AAROM, then to AROM

140
Q

In what patients are rhythmic rotation seen in more?

A

Patients with neurologic conditions

141
Q

What happen in rhythmic stabilization?

A

The patient is trying to hold themselves steady, and the PT makes predictable or unpredictable movements to the body part while the patient tries to hold it steady and aligned

142
Q

What is the difference between hold relax and contract relax?

A

In hold relax the patient is holding against the PT’s resistance, while in contract relax, the patient is attempting to push the limb down and the PT is holding it, hence holding agains the patient’s resistance

143
Q

What are the goals of aquatic therapy?

A
  • Facilitate ROM
  • Initiate resistance training
  • Facilitate/inhibit WB activities
  • Enhance delivery of manual techniques
  • Facilitate cardiovascular exercise
  • Initiate functional activity replication
  • Enhance patient relaxation
144
Q

What are the precautions to take for aquatic therapy?

A
  • Fear of water
  • Neurologic disorders
    • ataxia
    • heat intolerance (MS)
    • controlled epilepsy
  • Respiratory disorders
  • Cardiac disorders
145
Q

What are the contraindications of aquatic therapy?

A
  • Unstable angina
  • Severe PVD
  • Danger of bleeding
  • Severe kidney disease
  • Uncontrolled DM
  • Wound wounds without occlusive dressing
  • Uncontrolled bowel or bladder
  • Menstruation without internal protection
  • Water and airborne infections
146
Q

What are the principles of aquatic therapy?

A
  • Buoyancy
  • Moment of force
  • Density
  • Hydrostatic pressure
  • Cohesion & viscosity
  • Drag force
147
Q

What is buoyancy?

A

Upward push equal to the weight of the flute the object displaced in water

148
Q

What are the benefits of buoyancy?

A
  • Can help to assist, or resist, patient

* Helps to promote decreased WB

149
Q

___ influences the ability of the buoyancy to assist pushing the limb to the surface

A

Position of the limb influences the ability of the buoyancy to assist pushing the limb to the surface

150
Q

The more ___ you are, the more buoyancy you have

A

The more horizontal you are, the more buoyancy you have

151
Q

What can assist with buoyancy?

A

Adding floatation devices to a limb will assist with buoyancy

152
Q

What is the moment of force?

A

Position representing the turning effect of buoyancy

153
Q

The longer the lever arm, the

___ the torque produced

A

The longer the lever arm, the

greater the torque produced

154
Q

What is density?

A

Mass per unit volume

155
Q

___ of a substance affects its ability to float

A

Relative density of a substance affects its ability to float

156
Q

What is the specific gravity of H2O?

A

1.0

157
Q

What will sink and what will float?

A

Anything less than 1.0 will float and anything greater than 1.0 will float

158
Q

What is hydrostatic pressure?

A

Fluid pressure exerted equally
on all surface areas of an
immersed body at a given
depth (Pascal’s Law)

159
Q

Hydrostatic pressure is proportional to the ___

A

Hydrostatic pressure is proportional to the *depth of

submersion*

160
Q

What is viscosity?

A

Amount of friction acting on a moving part in water

161
Q

What is cohesion?

A

Tendency of water molecules to stick together

162
Q

What is slow movement?

A

Less friction, less resistance from cohesion

163
Q

What is fast movement?

A

More friction, more resistance from cohesion

164
Q

What are the effects of hydrostatic pressure?

A
  • Leads to decreased blood pooling
  • Provides static support for unstable joints
  • Resist rib expansion
165
Q

What is drag force?

A

The force that is created from dragging an object

166
Q

Drag force is modified by ____

A

Drag force is modified by shape and speed of object

167
Q

What does increased streamline of an object equal?

A

Decreased drag

168
Q

What does increased speed of an object equal?

A

Increased drag

169
Q

What does increased drag equal?

A

Increased torque on limb

170
Q

What do you use cooler temperatures for in aquatic therapy?

A

High-intensity exercise

171
Q

What do you use warmer temperatures for in aquatic therapy?

A
  • Mobility and flexibility

* Relaxation exercise

172
Q

What temperature should the air around the pool be?

A

> 3 deg C high than water

173
Q

___ conducts temperature 25x faster than ___

A

Water conducts temperature 25x faster than air

174
Q

What are the characteristics of temperature in aquatic therapy?

A
  • Patients can perceive small changes in temperature
  • Temperature will penetrate to deeper tissues
  • Can not maintain core warmth with temp <25oC
  • Exercise at temps >37oC may be harmful if prolonged

Therapeutic interventions (8 decks)

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