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MSK 1 > 9/13 - Resistance Exercise for Impaired Muscle Performance > Flashcards

9/13 - Resistance Exercise for Impaired Muscle Performance Flashcards

1
Q

strength

A

ability of contractile tissue to produce tension

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2
Q

power

A

work produced by ms over time
(f x d/t)

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3
Q

endurance

A

ability to perform low intensity, sustained activity over a prolonged time

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4
Q

overload principle

A

progressive loading (strength)
progressive reps (endurance)

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5
Q

SAID principle

A

Specific Adaptation to Imposed Demands
- exercise prescribed specific to function
- what is the deficit and how do we address this

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6
Q

transfer of training

A

carryover of effects from one type of exercise to another
- ex: strength program also improve endurance

only limited evidence, greater support for specificity of training

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7
Q

reversibility principle / detraining

A

if you don’t use it you lose it
- detraining can happen more rapidly than building up the muscle

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8
Q

what influences the amt of tension able to be generated

A

energy stores and blood supply
fatigue
recovery from exercise

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9
Q

muscle (local) fatigue

A

diminished response of muscle

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10
Q

CP (general) fatigue

A

diminished response of person

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11
Q

threshold for fatigue

A

level of sustainable activity

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12
Q

what are other factors which influence fatigue

A

overall health
diet
sleep

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13
Q

what are general factors of fatigue that can impact the possible tension to be generated

A

muscle/local fatigue
CP/general fatigue
threshold of fatigue
other factors

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14
Q

how does age impact tension generation in normal skeletal muscle

A

childhood - linear inc in strength to puberty

adolescence - strength levels significantly differ b/w sexes

adulthood - women reach peak strength at younger age than men

late adulthood - decline of 15% or greater each year >60yo

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15
Q

what are psychological and cognitive factors which influence tension generation

A

attention
motivation
feedback

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16
Q

where do you see physiological adaptations to resistance exercise

A

neural adaptations
skeletal muscle adaptations
vascular & metabolic adaptations
adaptations of connective tissues

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17
Q

what neural adaptations are seen to resistance exercise

A

inc EMG without hypertrophy
- motor learning & improved coordination

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18
Q

what skeletal muscle adaptations are seen to resistance exercise

A

hypertrophy - inc size of ms fiber
- inc protein (actin & myosin) synthesis

hyperplasia - inc number of ms fibers
- limited evidence

muscle fiber type adaptation
- IIB converted to IIA

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19
Q

what vascular and metabolic adaptations are seen to resistance exercise

A

muscle hypertrophy
- dec capillary bed density as myofilaments inc

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20
Q

what adaptations of connective tissues are seen to resistance exercise

A

tendons, ligaments, connective tissue in ms
- tendon/ligament tensile strength inc w resistance training

bone
- ms strength correlated w bone density

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21
Q

how is alignment different from stabilization

A

alignment of muscle fibers
- changes the primary mover
alignment of gravity

stabilization in that position

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22
Q

describe how the position of the hip affects the alignment of the muscle fibers

A

if flexed&raquo_space; more TFL
if extended&raquo_space; more glut med

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23
Q

how can intensity vary and what determines this

A

submaximal vs maximal exercise loads
- considered desired goal of program

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24
Q

what about the initial level of resistance (load) should be documented to assess training effects

A

repetition maximum
- provides baseline to measure progress
- trial & error

training zone
- % of RM
- initially low for untrained patients

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25
Q

what components of volume are determinants of resistance exercise

A

reps and sets
- consider goals of exercise activity & individual patient

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26
Q

describe the impact of exercise load and reps on desired muscles

A

improve ms strength = high load/low reps

improve ms endurance = low load/high reps

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27
Q

what does the exercise order have an impact on

A

fatigue
- large ms groups before small
- multi-joint exercises before single joint

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28
Q

what should be considered when prescribing frequency of exercise

A

inc intensity and volume = inc recovery time

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29
Q

what program duration is needed for neural adaptations

A

2-3 weeks

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30
Q

what program duration is needed for hypertrophy

A

6-12weeks

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31
Q

what are components for the mode of exercise that should be considered (6)

A

type of ms contraction
position for exercise
forms of resistance
energy systems
range of movement
patient & outcome specific

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32
Q

what types of ms contractions are considered for the mode of exercise

A

concentric
eccentric
isometric

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33
Q

what about the position for exercise should be considered for mode of exercise

A

WB
non- WB

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34
Q

what about forms of resistance should be considered for the mode of exercise

A

manual
mechanical
body weight

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35
Q

what about energy systems should be considered for the mode of exercise

A

aerobic
anaerobic

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36
Q

what about range of motion could be considered for mode of exercise

A

short arc
full arc

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37
Q

what about the velocity of exercise is important for determining resistance exercise

A

function specific
force-velocity relationship
- concentric
- eccentric

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38
Q

what is periodization

A

variability of training for specific goal

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39
Q

how can you integrate function into an exercise program

A

balance of stability and active mobility
balance of strength, power, endurance

task specific movement patterns during resistance exercise

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40
Q

what are 6 types of resistance exercise

A

manual and mechanical
isometric
dynamic - concentric/eccentric
dynamic - constant / variable
isokinetic
open chain / closed chain

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41
Q

what is manual resistance exercise and what are the pros of this

A

provided by therapist

gives you real time feedback
can feel when start to fatigue
can adjust amt of force
- more in mid range, less in end range

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42
Q

what is mechanical resistance exercise

A

provided by equipment

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43
Q

what is the rationale for using isometric exercise

A

stability

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44
Q

what are types of isometric exercise (3)

A

muscle setting exercises
stabilization exercises
multiple angle isometrics

45
Q

what is an example of a muscle setting isometric exercise

A

quad set

46
Q

what is an example of a stabilization isometric exercise

A

PNF alternating isometrics

47
Q

what is an example of multiple angle isometrics

A

4-6 points in ROM
- PNF, engage ms at different angles

48
Q

what is another word for isometric in terms of exercise

A

static

49
Q

intensity of isometric training

A

60% of MVC

50
Q

duration of muscle activation

A

6-10sec

51
Q

why does isometric training have repetitive contractions

A

dec cramping

52
Q

isometric training joint angle and mode specificity

A

individualized to activity

53
Q

rationale for using concentric vs eccentric exercise

A

concentric - accelerate
eccentric - decelerate

54
Q

exercise load and concentric vs eccentric

A

inc loads are better controlled w eccentric

55
Q

energy expenditure with concentric vs eccentric exercise

A

eccentric more efficient

56
Q

mode specificity w concentric vs eccentric exercise

A

eccentric more mode specific than concentric

57
Q

what is the cross-training effect with concentric and eccentric exercise

A

opposite side (L vs R) may be stabilizing

58
Q

exercise-induced ms soreness with concentric vs eccentric exercise

A

inc DOMS w eccentric
- (delayed onset muscle soreness)

59
Q

constant vs variable resistance w dynamic exercise

A

dynamic constant external resistance exercise (DCER)
- max challenge occurs at only one point of ROM

variable-resistance exercise
- challenges ms throughout ROM
- cybex equip and/or tubing

60
Q

what are special considerations for DCER and variable resistance exercise

A

arc of motion by patient
controlled pace

61
Q

where are isokinetic machines typically seen

A

more research than clinical practice

62
Q

what is the role of velocity in isokinetic training

A

constant velocity of ms shortening / lengthening

63
Q

what is the range and selection of isokinetic training velocities

A

0-500 degrees / sec

64
Q

how can muscle groups be activated in isokinetic exercises

A

reciprocal movements with isolated muscles activated

65
Q

how is isokinetic exercise specified

A

velocity specific

66
Q

what is the role of compressive forces on joints and isokinetic exercise

A

dec at a faster velocity

67
Q

how does isokinetic training accommodate for fatigue and/or a painful arc

A

dec the force = dec resistance

68
Q

isokinetic training effects and carryover to function

A

there is limited carryover to function
- single ms or segment is isolated

69
Q

what are special considerations for isokinetic training

A

availability of equipment
appropriate setup

70
Q

open chain exercise

A

distal segment moves

independent joint movement; unpredictable pattern

segments moving are distal to moving joint

typically NWB

ex: sitting and ext knee

71
Q

closed chain exercise

A

distal segment stationary

interdependent joint movements
predictable patterns

distal & proximal segments moving

typically WBing

ex: standing and squats

72
Q

OKC or CKC: isolation of ms groups

A

OKC

73
Q

OKC or CKC: control of movements

A

OKC

74
Q

OKC or CKC: joint approximation

A

OKC & CKC

75
Q

OKC or CKC: more functional

A

CKC

76
Q

OKC or CKC: co-activation and dynamic stabilization

A

CKC ?

77
Q

OKC or CKC: proprioception, kinesthesia, NM control, and balance

A

CKC

78
Q

OKC or CKC: carry over to function and injury prevention

A

OKC and CKC

79
Q

how can you progress closed chain exercises (7)

A

% body weight (partial -> full)
BOS (wide -> narrow)
support surface (stable -> unstable)

balance
- (+) support -> (-) support
- EO -> EC

limb movement (short -> full arc)
plane of movement (uni-> multiplanar)
speed of movement (slow -> fast)

80
Q

why is placement of resistance important

A

dictates how challenging it is

81
Q

when is direction of resistance important

A

manual load
- careful of hand placement bc can impact how they activate their ms

82
Q

why do you stabilize w resistance exercises

A

prevent substitution

83
Q

how do you decide if verbal or written instructions are best for the patient

A

depends on their learning style

84
Q

what is a val salva maneuver

A

expiration w closed glottis

85
Q

what can the valsalva maneuver cause in at risk patients

A

inc BP

86
Q

how do you prevent valsalva maneuver during resistance exercise

A

avoid holding breath
exhale on lift

87
Q

what are precautions for resistance exercise

A

valsalva maneuver
substitute motions
overtraining and overwork
exercise-induced ms soreness
pathological fx

88
Q

what can encourage substitute motions which should be avoided

A

applying too much resistance

89
Q

overtraining vs overwork

A

overtraining - decline in performance
overwork - decline in strength

90
Q

what does overtraining and overwork put the patient at inc risk for

A

injury

91
Q

types of exercise induced muscle soreness

A

acute ms soreness
delayed onset ms soreness (DOMS)

92
Q

acute ms soreness

A

during or directly after exercise

93
Q

delayed onset ms soreness (DOMS)

A

12-24hrs post exercise

94
Q

how to prevent DOMS

A

gradual progression
warm up / cool down

95
Q

what patients are at inc risk for a pathological fx

A

osteoporosis
osteopenia

96
Q

what are contraindications to resistance exercise

A

pain
inflammation
severe CP dz

97
Q

appropriate exercise for a patient in pain

A

AROM w/o resistance

98
Q

appropriate exercise for patient w inflammation

A

isometric exercise

99
Q

appropriate exercise for patient w severe CP dz

A

assess parameters of activity & impact on cardiac / respiratory systems

100
Q

what are 4 advantages of manual resistance exercise

A
  1. resistance adjusted throughout ROM
  2. ms works max throughout ROM bc resistance is adjusted
  3. control ROM to protect healing tissues
    - can minimize how hard they are working in certain areas
  4. manual stabilization prevents substitution
101
Q

what are 3 disadvantages for manual resistance exercise

A
  1. resistance is subjective
  2. patient can’t perform independently
  3. labor and time intensive for PT
102
Q

resistance training guidelines for healthy adults (<50-60yo) — (8)

A
  1. begin w warmup followed by flexibility
  2. perform thru full, pain free ROM
  3. balance flex / ext exercises
  4. utilize concentric / eccentric
  5. mod intensity (60-80% 1RM)
  6. rhythmic controlled motions
  7. maintain normal breathing
  8. cool down after exercise
103
Q

resistance training guidelines for children

A

no formal resistance training under 6yo
- focus on play and body weight activity

wt training introduced in pre-pubescent years

104
Q

wt training guidelines in pre-pubescent years (5)

A
  1. close supervision w attention to proper form
  2. low loads & intensity
  3. limit frequency to 2x/wk
  4. caution w eccentric exercise
  5. ensure equipment is appropriate for child’s size
105
Q

what do you need to do resistance training in older adults (>60-65yo)

A

MD clearance

106
Q

what should be avoided with regards to resistance training in older adults & why

A

high load resistance
- tissues potentially more susceptible to overloading

flexion dominant exercise that could create postural dysfunction
- more ext bias&raquo_space; tend to be tight and weak

107
Q

what are 4 other guidelines for resistance training in older adults

A

begin w 5-10min of warm up
monitor vital signs
40-60% 1RM intensity
48hr rest interval b/w sessions

108
Q

what role does an individualized prescription play a role in

A

better outcomes and engagement

109
Q

what specific demands of the patient should be considered

A

ADL
work
sport
goals

MSK 1 (31 decks)

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