Ther-Ex Exam 1

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  1. physical fitness requires what three things?
    • proper cardiovascular functioning
    • muscle strength and endurance
    • muslce and joint flexability
  2. what is vo2 max?
    when an individual reaches max effort, the max amont of oxygen consumed per minute
  3. what is the oxygen consumed by the myocardial tissue?
    myocardial 02 consumption/ mV02
  4. what 4 things affect the mV02?
    • heart rate
    • blood pressure
    • myocardial contractiity
    • afterload
  5. what is afterload?
    ventricular force reqired to open the aortic valve
  6. what the the to types of endurance?
    • muscle endurance
    • ardovasuclar endurance
  7. waht is the ability to perform large muscle dynamic exercise for long period of time?
    cardiovascular endurance
  8. what is augmentation of energy uitlization of muscle or muscle groups by means of an exercise program?
  9. what are the three major energy systems?
    • ATP-CP
    • anarobic glyolytic
    • aerobic
  10. energy is released when the atp becomes ADP by breaking down the bond of one phosphate. does this process require oxygen?
    no, it requires water.
  11. what is the primary energy source for short, quick bursts of activity, typically in the first 30 seconds of intense exercise?
  12. is there a higher cellular concentration of atp or cp?
    cp-3-5x the amount
  13. what is the primary energy source for ativity of moderate intenity and short duration, from 30-90 seconds?
    anaerobic glyolytic
  14. glycolosis breaks down to form pyruvic acid and atop. how much of each are produced in the process?
    2 pyruvic acid, 2 atp (net 4 gross)
  15. what occurs to pyrubi acid if there is not enough oxygen available to cells?
    converted to lactic acid
  16. what is predominant energy system after the 1st to 2nd minutes of exercise?
  17. how many molecues of atp are created by the krebs cycle?
  18. required rest to replenish energy stores?
    2. glycogen in muscle
    3. glycogen in liver
    4. oxygen 
    5. lactic acid removal
    • 1. 2-5 min
    • 2. 10-46 hrs
    • 3. 12-24 hrs
    • 4. 10sec-1min
    • 5. 30min-2hrs
  19. what are kilocalories and MET's?
    measurements of energy expenditure while engaging in physical activity
  20. what do all the different settings have in common?
    • they're a human
    • central motor control
    • target tissue
    • specific functional goals
  21. overview of the individual session
    • warm up
    • remedy  for ROM limitation
    • motor control learning in the new ROM
    • functional movements
  22. how do you know when to make a specfic exercise easier?
    • unable to maintain form
    • causes or increases pain
    • true muscle fatigue
  23. how do you know when to make a specific exercise more challenging?
    • patient performs with ease and no fatigue
    • patient has mastered form
  24. what are the four stages in the develpment of motor control?
    • initial mobility
    • stability
    • controlled mobility
    • skill
  25. in which stage of motor control are postural and antigravity control typically lacking?
    initial mobility
  26. in which stage of motor control is the patient able to maintain a steady position in weight bearing antigravity posture?
  27. explain the controled mobility stage of motor control?
    ability to change position or move in weight bearing while maintaing postural stability
  28. what is sensory information that results from movement?
  29. what is information sent in advance of an anticipated motor command to ready for the incoming sensory input?
  30. what are 3 things to consider when creating a prescription?
    • tissue involved
    • stage of healing
    • goal
  31. what is defined as seemingly unrelated impairment in remote anatomical regions of the body that may contribute to and  be associated with patients primary report of symptoms?
    regional interdependance
  32. what is the primary goal for inpatient settings?
    get them up and moving!
  33. what is the main priority when treating a patient post-op? why?
    reduce pain and swelling

    because it interfers with motor control
  34. true or false: you will always have a problem with motor control when pain is present?
  35. true or false: treating the uninvolved side can help the involved side?
    false! there is no uninvolved side!
  36. how ccan orthopedic injury impact motor control?
    • proprioception is damaged when tissue is damaged
    • increase in muscle tone at rest
    • decrease of muscle tone when activated
  37. what stage of tissue repair does nueromuscular reeduation start?
  38. where do patients goals go in soap notes?
  39. what can occur of only the pain generator are addressed?
    chronic reinjury because you have to treat the causitive factors also. If movement dysfunctions are not corrected then the injury will just keep happening.
  40. how do you know if you can progress to the next phase when treating a patient?
    by a combo of the target tissue timeline and how the patient is responding to treatment
  41. if a muscle imbalance occurs, what can happen to a joint?
    a shift in the axis of rotation tht can iltimately lead to break down over time.
  42. what is the overall goal of ther-ex?
    to achieve symptom free movement and function
  43. what are the componets of physical function? (9)
    • neuromuscular control
    • coordination
    • stability
    • mobility
    • postural control, stabillity and equilibrium
    • cardiopulm fitness
    • flexability
    • muslce performance
  44. what are the areas of fitness?
    • strength
    • endurance
    • flexibility
    • balance
    • cardiopulm fitness
  45. POC implementation inclues what 3 steps?
    • carry out the POC
    • assess the treatment
    • modify
  46. how can we assess the treatment effectiveness
    • outcome measures
    • comparable signs
  47. who can put together a POC?
    • PT
    • PTA
  48. what is muscle endurance?
    ability of a muscle to contract repeatedly over a period of time.
  49. what is the ability of an individual to sustain low intensity exerise over a period of time called?
    total body endurance
  50. what is the ability of soft tissues to elongate and or shorten durning movement?
  51. what is the ability of a muslce to relax and yield to a stretch?
  52. what is the conscious effort to relieve tension in muslces?
  53. what is the ability to perform muscle contraction in appropriate sequence and at appropriate intensity to accomplish a task smoothly?
  54. what is the an ability that is learned through repetion and requires reciprocal movements and approprate stability?
  55. what are the 3 stages of adaptation syndrome?
    • depletion
    • replenish
    • supercompensaton
  56. failed adaptation over time can result in what type of inury?
    overuse injury
  57. what are 3 types of contraction?
    • eccentric
    • concentric
    • isometric
  58. 3 types of muscle fibers?
    • slow oxidative
    • fast oxidative gycolytic
    • fast glycolytic
  59. describe the velocity-tension relationship that is present in a concentric contraction. what about eccentric?
    • concentric: the relationship is inverse
    • eccentric: tension and velocity increase together
  60. what factors affect velocity of contraction?
    • motor unit recrutment
    • type of muscle fibers
    • length of fier (longer fibers have higher shortening velocities)
  61. name the muscles by function
    • postural
    • force generators
    • stabilizers
    • neurtalizers
    • agonist
    • antagonist
  62. what is co-contraction?
    activation of all muscles arond the joint
  63. how many weeks does it take to truly increase strength? 

    improvements prior to that time are due to changes in what?

    muscle recruitment
  64. what are the 4 signs of fatigue
    • shaking
    • burning
    • unable to complete ROM
    • substitution patterns
  65. according to cyriaxs rules of resisted movement what does wak and painful motion indicate?

    weak and painless?

    painful on reptiton?
    major lesion

    neurological lesion

  66. if passive and active ROM are limited in the same direction what does that indicate?
    capsular restriction or bony changes
  67. if there is a difference of greater than 5* from active and passive ROM what does that indicate?
    muscle recruitment
  68. what are the functions of reinforcing ligaments?
    • support the joint
    • assist in giuding motion passively
    • proprioception
  69. is it normal to have an increase in temperature locally and initally?
  70. what is normal body temp?
  71. what can affect temp?
    • age
    • time of day 
    • immune system function
    • drug use
  72. what are the characteristics of pain? (6)
    • location
    • descriptors
    • intensity
    • frequency and duration
    • pattern of pain (cyclic or waves)
    • aggravating and easing factors
  73. what are typical desriptors for musculoskeletal issues?
    aching, sore, deep, dull, cramping, heavy, hurting
  74. pain descriptors for neurogenic?
    sharp, shooting, burning, pulling, stinging, electriacl, prickly, pinching, gnawing
  75. vascular pain descriptors?
    throbbing, pulsing, beating, pounding
  76. and emotional pain desriptors?
    cruel, punishing, torturing, miserable, dreadful, tiring, exhausting
  77. what are the pain descriptors that increase suspicion of systemic issues?
    boring, deep aching, knifelike, stabbing (from the inside out) comes in waves
  78. behavior of s/s during ther ex where pain spreads to areas outside or distant from the immediate are of involvement is called?
  79. what is centriliazation?
    increasing s/s in immediate area of lesion.
  80. would centralization or peripheralization indicate a worsening or progressive condition?
  81. what is the normal 02 range?
  82. what 02 range indicates that activity should be haulted?
    if it drops below 90 in acutely ill, 86 in COPD pt's.
  83. what are the 2 catorgies of fatigue?
    localized and generalized
  84. what are the 3 catogories of the effects of joint mobilizations?
    • mechanical
    • neurophysiological effects
    • psychological effects
  85. what are the 3 normal joint end feels?
    • bone on bone
    • soft tissue
    • hard/springy tissue stretch
  86. what are the 4 abnormal joint end feels?
    • empty
    • springy block
    • muscle spasm
    • capsular
  87. what is defined by decrease in joint spae between bones?
  88. what is defined by separation of joint spaces?
  89. what is the difference between traction and distraction?
    distaction occurs perpendicularly between joints, traction doesnt always distract the joint surfaces perpendicular from on another
  90. how many stages of traction are there?
  91. briefly describe the stages of traction using one word.
    • 1. loosen
    • 2. tighten
    • 3. stretch
  92. does a stage 1 traction create a force strong enough to separate joint surfaces?
    no, but it can relive some pressure
  93. name some non contractile tissue
    fasica, tendon, ligaments, skin, capsule
  94. does stretching prior to an athleti activity decrease risk of injury?
    no, it can cause damage!
  95. what is the ability of a muscle to relax and yield to a stretch?
  96. what are the two types of flexibility?
    passive and dynamic
  97. what is defined as therapeutic techniques that lengthen shortend tissue and increase ROM?
  98. what are the causes of hypomobile joints?
    • chronic postural mal alignment
    • prolonged immobilization
    • sedentary lifestyle
    • muscle weakness or poor recruitment
    • tissue trauma
    • deformities
  99. what are indicators for hpermobility?
    • excessive rom
    • aberrant motion
    • hinging of spine
    • compression and movement feels better
  100. what are the three general types of ROM exercises?
    passive, active, and active assistive
  101. when you would you use PROM?
    • if the patient is unable to move the body part
    • if the patient is not allowed to move the body part on their own
    • if doing it activly causes pain due to inflammation
  102. which componet of connective tissue provides strength to withstand high leels of tensiona nd force during movement?
  103. which compnet of connective tissue assists in the recovery of tissue after stess?
  104. what is the proportional degree of elongation that occurs during stress?
  105. if there is crosslinking in soft tissue, what is the goal according to the stress strain curve?
    to apply enough stress and stain upon the tissue  to cause microfiber tears in the plastic zone. this will prevent the tissue from going back to its previous size.
  106. what is defined as a non-specific term sed to desrive mild restricted motion>
  107. how do adhesion occur?
    results from healing or union of two injured or torn parts as a result of the inflammatory process
  108. what are the 5 types of contractures
    • myostatic
    • pseudomyostatic 
    • arthogenic (perarticular)
    • fibrotic
    • irreversible
  109. which contracture occurs in patients with CNS issues?
  110. which type of contractue usually occurs as a result of chronic inflammation and is very difficult to regain normal ROM
  111. how long do you stretch contractures?
    20-60 minutes
  112. how can you make the stretching of a contracture more effective?
    thermal agents
  113. what are the two types of passive stretching?
    • mechanical
    • manual
  114. what is a stretching technique that require and active contraction of a muscle to elicit relaxation?
    active-inhibition stretch
  115. precautions for stretching?
    • osteoporosis
    • fx
    • force applies should not cause pain
    • immobilized tissue
    • cortiocosteroid use in 15 mts
    • edema
    • dont exceed normal limits of ROM
    • balance strength in new ROM with stretching
    • age
    • muscle weakness
  116. what are the contraindications for stretching?
    • hematoma
    • inflammation or acute infection
    • sharp pain with movement
    • after recent fx
    • bony block
  117. what sensroy nerve receptors located in the muscle belly are sensitive to velocty and change?
    muscle spindles
  118. are GTO's sensitive to passive stretch?
  119. what happens to ligaments during immobilization?
    ligaments lose stiffness and become weaker
  120. what happens to the other structures of the joint due to immobilization?
    • connective tissue becomes stiffer
    • adesions from
    • crosslinking between collagen fibers
  121. what changes occur to a muscle that is immobilized in a shortended state?
    sarcomere numbers and sarcomere length are decreased.
  122. what happens to muscles that are immobilized in the lengthened state?
    increase in the number of sarcomeres
  123. what affect does temp have on the plastic range of the stress strain curve?
    as temp increases the force reqired to attain the plastic range is decreased
  124. what are some potential uses for PNF?
    • facilitate neuromuscular control
    • develop musclular endurance
    • facilitate stability
    • facilitate mobility
    • coordinated movements
    • increase flixibility
    • lays a foundation for the resotration of function
  125. at what point during rehab is pnf approprate?
    its aailable throught he entirety of the rehab process. it just depends on how it is modified.
  126. what are the PNF techniques used to increase flexibilty?
    • CR
    • CRAC
  127. what PNF techniques works on both concentric and eccentric motor control of a specific muslce/movement?
    agonist reversals
  128. during agonist reversals PNF do you change handholds?
  129. what are the 5 steps to the progession of stabilizaton activites?
    • kinesthetic awareness training
    • proper activation of deep stabilizers
    • superimpse exremity motion onto core stabilzation
    • increase muscle strength and endurance stabilizers
    • transitional stabilization training exercise
  130. list the progression of  stabilzation positions
    • supine
    • seated
    • standing
    • transitional moements
    • specific functional movement training
  131. what are the locacl/segmental muscles involved with spine stability?
    • mulitfidi
    • TA's 
    • IO's
    • pelvic floor and diaphragm
  132. voluntary contraction of the pelvic floor leads to contraction of which muscles?
    all the abs
  133. the global muscles involved with spine stability are?
    • erector spinae
    • external obliques
    • rectus abdominus
  134. what occurs with LBP?
    • decreased recruitment of segmental muscles
    • increased recruitment of global muscles
    • changes in neuromotor control
    • fat inflitrates the paraspinal muscles and atrohy occurs
  135. What are some other muscles that are commonly trained with spine stabilization?
    • deep c- flexors
    • SA
    • LT, MT
    • Lats
    • Glutes
  136. what are some stabilization exercises that help with transitional movements?
    • hand heel rocks- quadruped
    • supine heel slides
    • squatting and reaching
    • weight shifts and turning
  137. what are some early functional training movements?
    • rolling
    • supine to sit
    • sit to stand
    • in and out of car
    • walking
  138. what must you always address with cervical and shoulder patients?
    • c-t junction segmental mobility
    • upper rib mobility
    • upper thoracic mobility
  139. what are some outcome measures for L-spine?
    • oswestry
    • GROC
    • FABQ
  140. what is an open loop system and a closed loop system?
    • open loop: a programmed system that does not use feedback to error correct. 
    • closed loop: a control system that does use feedback to reference for correctness and formulate a correction to achieve the goal.
  141. How are open skills different from closed skills?
    open skills are performed in an unstable and often rapidly changing environment. Closed skills are performed in a stable predictable environment.
  142. what is knowledge of performance and knowledge of results?
    • performance: related to the nature of movement. 
    • results: related to the nature of the result produced in  relationship to the goal.
  143. what variable would you manipulate to improve:
    • strength: load/intensity
    • endurance: reps/duration & frequency
    • power: plyometrics; strength & speed
  144. what are the grades of mobilizations?
    • I- small amp. oss. at very beginning of jt. play
    • II- lg. amp. oss. in mid range of jt play
    • III- lg. amp. oss into restriction
    • IV- sm. amp. oss into jt. capsule
    • V- HVLAT-manipulation
  145. What are the healing times for these tissues?
    1. muscles
    2. tendons
    3. ligament
    4. bone
    5. cartilage
    6. peripheral nerves
    • 1. 2-4 weeks
    • 2. 15-18 months
    • 3. 8-9 weeks
    • 4. 6-12 weeks (depends on age)
    • 5. months; 1000's of reps
    • 6. 3x as long as it was damaged!
  146. What does De Lorme regimen say?
    • set 1: 10 R @ 50% 10rm
    • set 2: 10 R @ 75% 10RM
    • set 3: 10 R @ 100% 10RM
  147. what does oxford regimen say?
    • set 1: 10R @ 100% 10RM
    • set 2: 10R @ 75% 10RM
    • set 3: 10R @ 50% 10RM
  148. what are the exercise guidelines for the proliferation phase?
    AROM, isometrics, controlled isotonics, soft tissue mobilization, light pain free stretching
  149. what are the exercise guidelines for acute inflammation?
    PROM, AROM, (pain freee!!!)
  150. What are the exercise guidelines for remodeling phase?
    specificity, eccentric, plyometrics.
  151. what are some things that all synovial joints have?
    • articular cartilage
    • joint cavity and capsule
    • synovial fluid
    • reinforcing ligaments 
    • bursa
    • fatty pads
  152. what is convex-concave rule?
    convexities roll and glide in the opposite direction whereas concavities roll and glide in the same direction.
  153. How is referred pain different from radicular pain?
    Referred pain is a misinterpritation of where the pain is actually coming from because many tissues share the same neural pathway. Radicular pain however follows a specific neural pathway and the pt. will almost trace a specific never exactly.
  154. what is radiating pain?
    pain that moves out or spreads as if to travel from one area to another.
  155. what are some interventions to increase mobility?
    • joint mobes
    • soft tissue mobilization
    • manual/mechanical stretching
    • self stretching
    • PNF
  156. what is the intervention sequence?
    • warm up
    • joint mobe
    • stretching
    • neuro re-ed
    • address movement dysfunction
  157. What are isometrics?
    static exercise with muscle contraction without joint movement
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Ther-Ex Exam 1
ther-ex exam 1
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