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Therex final
| Question | Answer |
|---|---|
| Components of TherEx | Balance, Coordination, cardiopulmonary control, flexibility + mobility, muscle performance, neuromuscular control, stability, posture |
| model of disablement | pathology --> impairment --> dysfunction --> disability |
| Pathology | disruption in body's homeostasis. e.g. inflammatory process, change in LT curve of muscle, wound healing + scar formation |
| impairments | the consequences of pathologic conditions. musculoskeletal, neuromuscular, cardiovascular/pulmonary, endurance, integumentary |
| Functional limitations | inability for a person to perform functionally as a whole (ADLs) |
| Disbaility | individual functioning within the social realm. |
| risk factors | biological, behavioral, physical environment, socioeconomic. |
| functional excursion | the distance a muscle can shorten after its been elongated to its max |
| active insufficiency | false manual muscle test reading |
| passive insufficiency | effects goniometric reading |
| Active assisted ROM | assistance provided by outside force either manually or mechanically because the prime movers need help to complete the motion |
| indications for PROM | acute/inflamed tissue 2-6 days post injury or surgery, also when AROM is contraindicated |
| PROM WILL NOT: | prevent muscle atrophy, increase strength or endurance, assist circulation as well as AROM/voluntary contraction |
| types of contractures | Myostatic (stretch gently) + pseudomyostatic (arthrogenic + periarticular): fibrotic and irreversable |
| Determinants of Stretching | Alignment + stabilization, intensity, duration, speed, frequency, mode, neuromuscular inhibition. |
| How long to hold stretched position | 15-30 secs add 10 secs for every 10 yrs increase in age |
| CI's to stretching | Advanced age, fracture, osteoporosis, acute local inflammation, hematoma, myositis ossificans, integrity of jt. hypermobility, functional contractures, sharp acute pain with movement, if shortened tissue provides jt. stability |
| Stretch around the elbow? | watch out for heterotrophic ossification, edema, weak muscles |
| NM inhibition | hold relax, contract relax, distraction, contraction of contralateral extremity |
| functional strength | ability of the nm system to produce, reduce, or control forces during functional activities in a smooth coordinated manner |
| benefits of resistance exercise | enhance muscle performance, increased CT strength, greater bone density, reduced risk of soft tissue injury, enhanced physical performance, enhanced physical well being |
| principles of training | overload principle, SAID principle, Reversibility principle |
| What are some signs of muscle fatigue?` | tremulousness, jerky movements, unable to complete ROM, substitute motions, decline in peak torque |
| What are the determinants of resistance exercise? | Alignment, stabilization, intensity, volume, exercise order, frequency, rest interval, duration, mode of exercise, velocity, periodization, integration with functional activities, |
| what are the CI's to resistive exercise? | inflammation, pain, cardiac/resp disease |
| Training zone | after established baseline RM, amount of res. used when starting percent of RM. start out with 30-40% --> 60-70% |
| types of isometric contractions | muscle setting (e.g. quad set), stabilization exercise (PNF, Rhythmic stabilization), resisted isometric exercise |
| how long to hold isometric contraction | 6-10 secs |
| Brime isometric regime | 20 max contractions held 6 secs daily with 20 sec rest |
| davies rule of 10 | 10 sets, 10 reps everyday, `10 deg for every 10 secs. hold for 10 secs go up 10 degrees and repeat |
| CI's for isometric exercise? | cardiac or vascular disease |
| What kind of exercise is theraband? | high velocity variable dynamic resistance |
| isokinetic exercise | velocity is manipulated, not the load. accomodates to fatigue. short arc b4 long arc` |
| Progression of closed chain exercise | % body weight, BOS, support surface, balance, exclusion of limb movement, plane/direction of movement, speed of movement |
| What is PRE? | system of dynamic resistance when constant external load is applied. rom is used for baseline and progressed. |
| What is delorme? | use of 3 sets of 10 of a 10 rep max with progressive loading each set. builds warm up into program... 50%-75-100% |
| what is oxford method? | uses 10 RM ... 100-75-50 |
| plyometric training | high intensity high velocity eccentric to concentric exercises to develop coordination and muscle power |
| precautions of resistance training | valsava, substitutions, overtraining, overwork |
| what are the signs of DOMS? | 1. muscle soreness starting 12-24 hrs peaking 48-72 hrs post exercise 2. tenderness with palpation 3. increased soreness with passive lengthening 4. local edema/warmth 5. muscle stiffness 6. decreased ROM + muscle strength |
| H20 + temp | water retains 1000 X more heat than air and conducts temp 25 X faster increases with velocity |
| temp for water exercise | 26-33 C. 33C for acute MS injuries to relax, elevate pain threshold, and decrease spasm. |
| what about swimming strokes? | elicits higher elevation of HR, BP, v02 max than anything else |
| % jt. loading and ambulation: | c7=10%, xiphoid = 33%, ASIS = 50% |
| what are the types of tendinopathies?> | tenosynovitis (synovial), tendonitis (inflamm of tendon), tenovaginitis (thickening), tendinosis (overuse) |
| What is the protection phase ? | 4-6 days, PROM of affected tissue, AROM above and below, massage, muscle setting, control inflammation. |
| what is controlled-motion phase? | up to 6 weeks .Nondestructive exercise, promote healing and scar formation, isometrics + NM control, muscular endurance + LATER low intensity with high reps with light resistance |
| what is the chronic stage? | up to 6 months or year, progressive stretching, strengthening, endurance + return to function |
| myofascial pain syndrome | chronic regional pains syndrome, trigger point release |
| What to do for FM? | increase aerobic exercise |
| what is a functional capacity eval? | battery of performance tests to determine ability to work, perform ADLs or leisure |
| tests of function | gait performance, functional mobility, body mechanics, UE functional performance, agility and skill, adaptability to environment |
| When to return a pt to full part of activity? | 1. acute signs and symptoms resolved, no pain or edema 2. demonstrated ROM, strength, endurance, proprioception, agility, coordination. 3. activity performed as pre-injury 4. confidence to perform the task |
| when to start working on NMC? | acute stage |
| best position to train balance | QUADRIPED |
| how should speed + accuracy be addressed | TOGETHER, miss mary mack. inversely related |
| how to test proprioception | WB exercise!! anything that stimulates those jt. mechanoreceptors |
| android obesity | abdominal fat --> more risk of disease |
| gynoid obesity | fat around hips + thighs ---> less risk of disease |
| Waist Hip Ratio (WHR) | > ,95 + .86 is high risk |
| Sub Q fat norms? | 10-22 % men 20-32% women |
| BMI | kg/m^2 >25 overweight >30 obese |
| pilates is important for... | kinesthetic awareness, spinal stabilization ex/core strength, |
| what are the symptoms of Myositis Ossificans? | passive extension more limited than flexion, resisted elbow flexion causes pain, heterotopic bone formation, distal brachialis tender. |
| frozen shoulder | dense adhesions and capsular restrictions in dependant fold of capsule. freezing stage (pain)--> frozen stage (atrophy) ---> thawing stage (loss of ROM) |
| Complex Regional Pain syndrome stage I | acute reversible stage characterized by vasodilation lasting 3 weeks - 6 months. major pain, hyperhidrosis, warmth, erythrema, nail growth, and edema in hand |
| RSD stage II | dystrophic vasconstrictive phase lasts 3-6 months. characterized by burning hyperesthesia, intolerance to cold, mottling, brittle nails + osteoporosis |
| RSD stage III | known as atrophic stage characterized by severe osteoporosis, muscle wasting + contractures, can last for months or years with possible spontaneous recovery after 18-24 months. |
| whats the diff between type I + II? | type II has a known nerve injury |
| common impairments w RSD | outrageous pain in shoulder or hand, decrease motion of shoulder w capsular pattern, dec. flex + ext of hand, edema of hand, trophic changes in skin, nail growth or brittleness, atrophy of intrinsic hand muscles, osteoporosis |
| when is surgery indicated for RTC tear? | FULL thickness tears after trial of non-operative management |
| what are 3 types of rtc repair? | arthroscopic, mini approach (split deltoid), traditional open approach ( deltopectoral) |
| indications for THA | severe hip pain, marked limitations in movement, fracture, bone tumors, failure of conservative Tx |
| THA approaches | 1. posterolateral approach - glut max split, highest jt. instability. 2. direct lateral - post op weakness + positive trendelenberg's 3. anterolateral - for ppl with muscle imbalances, hip flexion + IR |
| goals of acute THA | prevent vascular + pulmonary complications + post-op dislocation, achieve functional mobility, maintain strength in UE + unaffected side, prevent reflex inhibition + muscle atrophy of affected side, prevent flexion contracture |
| Whats the **** is a Q angle? | line from ASIS to patella and then from patella to Tib Tub. may be a cause of PFPS. |
| Where does L3 refer to? | anterior knee pain |
| How to injure the ACL? | valgus force to knee OR ER of tibia with forced hyperextension |
| what is the goal of ACL exercise? | restore 90 deg of flexion, and full passive extension by first week. in acute phase, begin muscle setting of quads, hamstrings, hip ABD, ADD |
| what are the prehension patterns? | power grip, precision patterns, combined grips., pinch |
| whats the closed packed position of the foot? | full dorsiflexion |
| What are the risk factors for FALLS? | Balance deficit, muscle weakness, gait deficit, visual deficits, previous history of falls |
| what are the consequences of inactivity? | deconditioning, loss of muscle strength, functional decline, heightened risk of falls, hospitalization |
| How to correct back pain? | first self correct the lateral shift then standing backbend --> prone extension on hard surface |
| How to fix increased lumbar lordosis dueing gait>? | increase abdominal strength, stretch anterior hip flexors, strengthen pelvic floor and hip ADD, stretch + strengthen TFL/ITB |
| what are the functional leg length discrepancies? | circumduction, hip hiking, steppage, vaulting |
| What can cause long leg during gait? | spasticity of extensors, weakness of flexors, locking of knee, foot drop, SI problems |
| whats the normal walking base>? | 50-130 MM |
| anteroposterior sway limit | 12 degrees |
| lateral sway? | standing 4 inches apart, 16 degrees |
| What is the ankle strategy? | functions in anteroposterior plane to restore small perterbations. muscle activation proceeds distal to proximal. |
| weight shift strategy | functions in lateral plane, hips move in lateral plane through abductors and adductors |
| Hip strategy (IE balance beam) | utilized for large or rapid external perterbations. uses rapid hip flexion or extension to move the COM over the BOS. activation is proximal to distal. |
| stepping strategy (IE stumble) | if large force displaces COM beyond the limits of stability --> enlarge BOS by stepping forward. |
| Whats the best way to stretch? | low load long duration yields most significant plastic changes |
| delorme method | use of 3 sets of 10 of a 10 RM with progressive loading each set. builds warm up into exercise ... 50-75-100% |
| What to do about hip hiking>? | strengthen hamstrings |
| what to do about steppage?` | strengthen ankle dorsiflexors |
| what is vaulting? | raising up on toes of opposite limb to clear ground for affected limb |
| when should you emphasize exhalation? | during contraction |
| Diagnosis Criteria PPS | 1. history of paralytic polio 2. partial to complete muscle functional recovery 3. 15 years of stability 4. onset of greater than 2 new health problems 5. no other condition explains symptoms |
Created by:
llacorte
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