Basic Exercise

Question 1

2 types of basic exercise

Answer 1

-passive
-active

Question 2

3 types of active exercise

Answer 2

-active assisted (AA)
-active
-resisted

Question 3

passive exercise

Answer 3

produced entirely by an external force (manual or mechanical; aka machine or us)
-no volitional muscle contraction
-applied in anatomical planes or diagonals or combination
-perform rhythmically + through entire ROM
-usually not used if pt is able to assist
-involves an end feel

Question 4

soft end feel

Answer 4

soft tissue approximation

Question 5

soft end feel example

Answer 5

knee flexion
(contact between soft tissue of posterior leg + posterior thigh)

Question 6

firm end feel

Answer 6

-muscular stretch
-capsular stretch
-ligamentous stretch

Question 7

firm end feel example-
muscular stretch

Answer 7

hip flexion with the knee straight
(passive elastic tension of hamstring muscles)

Question 8

firm end feel example-
capsular stretch

Answer 8

extension of metacarpophalangeal joints of fingers
(tension in the anterior capsule)

Question 9

firm end feel example-
ligamentous stretch

Answer 9

forearm supination
(tension in the palmar radioulnar ligament of the inferior radioulnar joint, interosseous membrane, oblique cord)

Question 10

hard end feel

Answer 10

bone contacting bone

Question 11

hard end feel example

Answer 11

elbow extension
(contact between the olecranon process of the ulna + the olecranon fossa of the humerus)

Question 12

benefits of passive exercise

Answer 12

-maintain existing joint range
-minimize contracture development
-maintain elasticity of muscle
-assist LOCAL circulation/regulation of blood flow
-decrease edema
-enhance cartilage nutrition/lubrication
-inhibit/reduce pain
-awareness of joint motion; sensory stimulation
-assess limits of joint motion; joint integrity (assess + modify treatment each day; assessment followed by 3-5 reps)

Question 13

how frequently should passive exercise be performed

Answer 13

10 min 2/day

Question 14

limitations of passive exercise

Answer 14

-will not prevent atrophy
-will not maintain or increase strength, tone, or endurance
-will not improve GENERAL circulation

Question 15

is passive exercise the same as flexibility exercise

Answer 15

no- because these go past the end feel

Question 16

ROM exercises constitute skilled physical therapy only if…

Answer 16

they are part of an active treatment for a specific disease state, illness, or injury that has resulted in a loss or restriction of mobility (as evidenced by physical therapy notes showing the degree of motion lost + the degree to be restored)

Question 17

who may perform ROM tests

Answer 17

only a qualified physical therapist
-therefore, such tests are skilled physical therapy

Question 18

can nonskilled individuals provide ROM exercises

Answer 18

yes- but only if unrelated to the restoration of a specific loss of function
-often safely + effectively

Question 19

T/F- passive exercises to maintain ROM in paralyzed extremities that can be carried out by nonskilled persons do not constitute skilled physical therapy

Answer 19

true

Question 20

active exercise

Answer 20

any exercise where movement of the body or segment is accomplished by, or in conjunction with, active voluntary muscle contraction with or without assistance from an external source

Question 21

types of active exercise

Answer 21

-progressive (correlates with strength)
-active assist
-active “free” (no assist)
-active resistive (manual or external)

Question 22

progressive active exercise

Answer 22

correlates with strength

Question 23

active “free” exercise

Answer 23

no assist

Question 24

active resistive exercise

Answer 24

manual or external

Question 25

benefits of active exercise

Answer 25

-maintain or increase muscle strength -prevent atrophy -increase endurance -maintain physiological elasticity of muscle -increase local circulation -sensory stimulation, proprioception

Question 26

exercise selection- isometrics

Answer 26

-little or no observable joint motion -little change in muscle length -when there is pain with movement -when joint movement is contraindicated (s/p Sx) -maintain tone, increased strength (if resistance is applied) -can use various joint angles

Question 27

exercise selection- isotonics

Answer 27

CONCENTRIC -shortening of muscle -against gravity ECCENTRIC -lengthening of muscle -against gravity -maybe easier than concentric -develops more tension (may develop strength more rapidly; stand to sit vs sit to stand) -large part of functioning

Question 28

basic principles/procedures of exercise

Answer 28

-identify segments with precautions (fx, stroke, THR) -informed consent; risks, benefits, alternatives -begin at level of pt ability based on your evaluation- P, AA, A -stabilize, support, + control the body segments -pt position (for their comfort + ease of movement) -therapist position (provide assist, pt safety) -TEACH (pt +/or caregivier) -demonstrate the desired motion (pt needs to see) -give v/c prior + during exercise -balance your assistance WITH pt ability to assist -watch for substitutions + uncoordinated movements -adjust assistance/resistance throughout the ROM to perform maximally without substitutions -modify the exercise according to the normal/abnormal end feel determined during the eval

Question 29

muscle grades + exercise selection- 0/5

Answer 29

pt unable to assist -assistance: full support PROM

Question 30

muscle grades + exercise selection- 1/5

Answer 30

palpable contraction; no movement -assistance: full support PROM, encourage pt to try to assist, "help me if you can", palpate muscle tendon

Question 31

muscle grades + exercise selection- 2/5

Answer 31

50% of ROM against gravity; full ROM no gravity -assistance: PROM if fatigued, gravity eliminated, ex: AAROM

Question 32

muscle grades + exercise selection- 3/5

Answer 32

full ROM against gravity -assistance: AROM, give v/c, encouragement, watch for fatigue, reps

Question 33

muscle grades + exercise selection- 3+/5

Answer 33

minimal resistance -assistance: slight manual resistance OR lightweight theraband/weight

Question 34

muscle grades + exercise selection- 4/5

Answer 34

moderate resistance -assistance: weight or elastic band

Question 35

muscle grades + exercise selection- 5/5

Answer 35

maximal resistance -assistance: weight or elastic band

Question 36

precautions

Answer 36

-ID areas of injury/contusions/fractures -avoid trauma when applying resistance -avoid excessive stress after immobilization -avoid Valsalva maneuver, may increase BP monitor pt response