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Foundations > Exam 2 > Flashcards

Exam 2 Flashcards

1
Q

Joints and Muscles

A
  • we just motion to screen for and assess joint impairment
  • we use force to screen for and assess muscle impairment
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2
Q

Categories of Physiologic Motion Assessment

A

1) Active
2) Active Assistive
3) Passive

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3
Q

Considerations for Categories of Motion Assessment

A

1) Quality
2) Quantity
3) Subjective Response

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4
Q

Active Range of Motion (AROM)

A
  • movement of a joint provided entirely by the individual performing the exercise
  • other than gravity, there is no outside force aiding in the movement
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5
Q

Passive Range of Motion (PROM)

A
  • movement applied to a joint solely by an external force (something other than the muscles around the joint)
  • Gravity assited
  • Self ROM utilizing other parts of the patient’s body to generate force
  • another person
  • an outside assistive device: Dynamic splint or passive motion machine
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6
Q

Active-Assistive ROM

A
  • the handler directs and guides the motion, asking the patient to assist
  • the safest place to begin in learning to handle joints and assess physiologic motion
  • a powerful tool of assessment and treatment
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7
Q

Motion Assessment - Quality

A
  • terms indicating healthy finding: smooth, with ease, without substitution
  • terms indicating presence of dysfunction: guarded, slow, with effort, wincing, substitution
  • quality may be different at mid range
  • end of ranges into overpressures - known as assessing the end feel
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8
Q

Motion Assessment - Subjective Response

A
  • a continuous dialogue with your patient
  • subjective response may be totally different at mid range and end of ranges
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9
Q

Quantity of Motion

A
  • This is where we start documenting
  • not enough: stiff, hypomobile, limited
  • just right: within normal limits (WNL), within functional limits (WFL), clears, unrestricted, unimpaired
  • too much!: hypermobile, unstable
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10
Q

Approaches to quantify motion

A
  • estimate a percentage of normal
  • measure linear displacement between two points with ruler or tape measure
  • measure angular displacement (in degrees) using principles of goniometry
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11
Q

Goniometry

A
  • most often used to quantify joint ROM
  • 0-180 system of describing joint position and motion
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12
Q

End Feels

A
  • sensing and describing the feel of the movement at the end of a joint’s physiologic range
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13
Q

Normal End Feels

A

Soft tissue approximation: soft and spongy
Muscular: elastic like
Ligamentous: firm arrest of movement, slight give
Cartilaginous: Sudden stop but not hard
Capsular: Firm arrest of movement with slight creep

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14
Q

Abnormal End Feels

A
  • painful/guarded/spasm
  • edematous: a watery give
  • bony block: a sudden hard stop
  • empty: no resistance
  • spastic/clonus
  • bony grate: a grating, rough sensation
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15
Q

Normal Range of Motion

A
  • requires tissue excursion of:
    • the joint
    • surrounding muscles
    • surrounding soft tissues
  • no adverse
    • pain or guarding
    • abnormally increased tone
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16
Q

Active motion

A
  • place to start
  • usually the safest screening test
  • a non diagnostic test
  • tells you:
    • willingness to move
    • presence or absence of gross motor
    • strength and function
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17
Q

Passive motion, resistive tests

A
  • both carry risk
  • be sure:
    • no obvious contraindications
    • severity and irritability of condition is assessed
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18
Q

Muscle Performance

A
  • the ability of a muscle to do work
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19
Q

Muscle strength

A
  • force exerted by a muscle or a group of muscles to overcome a resistance in one maximal effort
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20
Q

muscle power

A
  • work produced per unit of time
  • strength x speed
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21
Q

muscle endurance

A
  • ability to muscle to contract repeatedly over time
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22
Q

factors affecting muscle performance

A

1) Muscle Fiber Type and Size
2) Force-Velocity Relationships
3) Length-tension relationships
4) Muscle architecture
5) Neural Control
6) Age
7) Fatigue
8) Cognitive Training
9) Corticosteroids
10) Muscle Pathology
11) Disuse atrophy
12) Disease or condition

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23
Q

Muscle Fiber Type and Size

A
  • larger cross-sectional area = greater force
  • slow twitch (Type 1)
    • fatigue resistant, recruited first
    • small muscles across small lever arm; postural muscles
  • fast twitch (Type 2a and 2b)
    • large force over short time, explosive movements
    • fatigue more quickly, recruited last
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24
Q

Force-Velocity Relationship

A
  • increased speed generally decreases forces (concentric)
  • opposite with eccentric contractions (more force to control)
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25
Q

Length-Tension Relationship

A
  • optimal force is at normal resting length
  • largest number of ross bridge dysfunction
    • passive insufficiency = muscle length increased so that can no longer produce maximal force
    • active insufficiency = muscle length shortened excessively so that can no loner produce maximal force
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26
Q

Muscle architecture

A
  • pennate (feather shaped muscles) more force
  • use length-tension relationship better
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27
Q

Neural control

A

brain to neuromuscular junction

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28
Q

Age

A
  • muscle mass peaks in mid 20’s (earlier for women)
  • after the 30’s there is a 10% decrease in muscle mass per decade; more in 60’s
  • not symmetrical, LE’s > UE’s
  • exercise minimizes these changes
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29
Q

Cognitive training

A
  • mental rehearsal/preparation
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30
Q

corticosteroids

A
  • catabolic effects > muscle atrophy and weakness
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31
Q

Muscle pathology

A
  • muscle strain
    • overstretch or tear of a muscle, esp. at musculotendinous junction
    • Grade I: minimal, strong and painful (tender), some swelling, minimal discoloration, tender to palpation
    • Grade II: Partial tear, weak and painful, mild swelling, sometimes bruising and noticeable loss of strength (active and painless)
    • Grade III: Full tear, profoundly weak (or absent) and painless, muscle deformity, swelling, discoloration
      • weak and painless can also be a neurological disorder
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32
Q

Disuse atrphy

A
  • “use it or lose it”
  • associated with prolonged period of immobility
  • rapid and dramatic
  • initially due to neural changes, then actual atrophy
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33
Q

Disease or condition

A
  • muscular dystrophy, myesthenia gravis, cerebral palsy
  • ALS, MS, Polio, Stroke, SCI
  • Nerve root and peripheral nerve injury
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34
Q

Overview of Approaches to Clinically Assess Muscle Performance

A

1) Gross Functional Check
2) Manual Resistive Assessment - A Manual Muscle Test
3) Manual Isometric Resistive strength with hand held dynamometer
4) Isokinetic Testing

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35
Q

Functional Strength Testing

A
  • “Screening” of muscular strength through observation of movement
    • “WFL”/”WNL”
    • “No focal weakness”
  • a gross screen of key muscle groups
    • LE: quads, hip flexors, dorsiflexors
  • an assumption of strength made through key functional movements
    • e.g. sit to stand, sit up, squat, pull up, push up
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36
Q

Five Times Sit to Stand

A
  • The amount of time it takes an individual to rise from a chain 5 times (armless chair, 43 cm height, subject’s arms cross)
  • A FTSST time of <13 seconds had the best Sn/Sp
  • Reliability: intraclass correlation coefficient of .89 for in community-living adults
  • Performance is associated with LE strength and with balance impairment
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37
Q

Manual Muscle Testing (MMT)

A
  • an attempt to determine a patient’s ability to voluntarily contract a specific muscle
  • patients are asked to move against and hold a position against gravity and/or a therapist’s manual resistance
  • grades the relative magnitude or strength loss, to document the presence of impairments in strength
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38
Q

History of MMT

A
  • developed after Polio epidemic to assess which muscles were still working
  • designed to assess weakness in the presence of a lower motor neuron disease
  • presence of pain invalidates any test attempting to quantify maximal strength
  • MMT assesses strength over isolated joint motions - better ways to assess muscle performance in the presence of abnormal tone or motor control
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39
Q

Manual Muscle Testing Indications

A
  • indicated in any patient with suspected impairment of muscle performance (strength, power, or endurance)
  • provides information for proper treatment
  • provides an objective baseline to monitor
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40
Q

Precautions/Considerations

A
  • it is important to determine the patient’s ability to withstand the force to be applied
  • is there adequate stability of surrounding area for ability to sustain muscle test
    • in the case of a recent fracture, post-surgical, or other tissue healing, consider postponing muscle test
  • proper breathing techniques (avoiding Valsalva)
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41
Q

Testing considerations

A
  • know base anatomy, physiology and function
    • remember origins, insertions and lines of pull
  • proper positioning so the test muscle is the prime mover
    • test muscle is placed against gravity
  • adequate stabilization of proximal/regional anatomy
    • avoid substitutions by other muscles
  • observation of how patient performs AROM
    • alter position based upon performance
    • muscle test <3 (less than full ROM against gravity) is then placed in a gravity minimized testing position
  • consistent timing, pressure, and position enhances reliability
  • comparison of one side to the other is a better indicator of loss
  • avoidance of preconceived impressions regarding the test outcome
  • do no harm - caution with painful motions
  • contraindications due to debilitative disease, acute pain, and local pathology or inflammation
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42
Q

Make vs break test

A
  • make: meeting patient’s muscle force
  • break: overcoming patient’s muscle force
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43
Q

Gravity vs. gravity minimized (gravity eliminated)

A
  • gravity: against gravity, muscle placed so that it must overcome the force of gravity and your resistance
  • gravity eliminated: muscle placed so that the effects of gravity are neutralized
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44
Q

Grading Muscle Strength

A

1) 5 - normal
- subject completes ROM against gravity with maximal resistance
2) 4+ - good plus
- completes ROM against gravity with moderate-maximal resistance
3) 4 - good
- completes ROM against gravity with moderate resistance
4) 4- - good minus
- completes ROM against gravity with minimal-moderate resistance
5) 3+ - Fair Plus
- completes ROM against gravity with only minimal resistance
6) 3 - Fair
- completes ROM against gravity without manual resistance
7) 3- - Fair Minus
- does not complete the range of motion against gravity, but does complete more than half of the range
8) 2+ - Poor plus
- is able to initiate movement against gravity
9) 2 - poor
- completes range of motion with gravity eliminated
10) 2- - poor minus
- does not complete ROM in a gravity eliminated position
11) 1 - trace
- muscle contraction can be palpated, but there is no joint movement
12) 0 - zero
- patient demonstrates no palpable muscle contraction

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45
Q

Interpretation

A
  • reliability is dependent upon consistent test positions, accurate joint placement and avoiding use of compensatory muscle use
  • variability of +/- 1-2 full muscle grades under clinical conditions
  • be conservative in your grading!
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46
Q

Application of Resistance

A
  • assessing for a grade 4 or 5 strength
  • must be opposite to direction of movement
  • given near shortened range, but not end range
  • involve a gradual build up and release of resistance
  • a make test
  • always two hands involved - one to provide resistance, other to stabilize proximally
47
Q

The art of clinical practice

A

combining active, passive, and resistive motion testing in a clinical decision making model

48
Q

Selective tissue tension (STT) testing

A
  • a systematic series of specific active, passive, and resistive movement tests, designed to assess the status of each major soft tissue component of a joint complex
  • used, in conjunction with the history, to develop a diagnostic approach to soft tissue lesions
49
Q

What are we testing in STT?

A
  • soft tissue
    • muscle, tendon, fascia, ligament, joint capsule, bursa, ligament, joint capsule, bursa, nerves and nerve roots, dura mater
    • not bone
  • contractile tissue
    • muscle tendon, bony insertions
  • non contractile tissue
    • joint capsule, ligament, bursa, dura and nerve roots
50
Q

Key components of the STT Exam

A

1) Active Movements
2) Passive Movements
3) Isometric Tests
- confirm site of tissue involvement by palpatory findings

51
Q

Resistive Tests

A
  • performed as a mid range isometric test
  • outcomes:
    1) strong and painless
    2) strong and painful
    3) weak and painful
    4) weak and painless
52
Q

Passive Movement Limitations

A
  • capsular pattern
    • multi directional movement restrictions, with or without pain
  • non-capsular pattern
    • a non characteristic pattern of limited movement - not capsular
53
Q

Movement - motor skills

A

activities or tasks that require voluntary control over movements of the joints and body segments to achieve a goal

54
Q

Movement - motor learning

A
  • the acquisition of motor skills, the performance enhancement of learned or highly experienced motor skills
  • learning a skilled task and then practicing with a goal in mind until the skill is executed automatically
55
Q

Motor learning stages

A

1) Cognitive phase
2) associative phase
3) autonomous phase

56
Q

cognitive phase

A

movements are slow, inconsistent, and inefficient, and large parts of the movement are controlled consciously; thinking

57
Q

associative phase

A

movements become more fluid, reliable, and efficient, and some parts of the movement are controlled automatically

58
Q

autonomous phase

A

movements are accurate, consistent, and efficient, and movement is largely controlled automatically

59
Q

motor function training - stages

A
  • cognitive stage
    • thinking, trial and error, mistakes
    • what to do
  • associative stage
    • continued practice results in refinement of motor program
      -how to do
  • autonomous stage
    • much practice results in automaticity of movement
    • how to succeed
60
Q

Motor function training - cognitive stage

A
  • purpose and context of skill
  • steps of the skill/plan
  • learner’s style
  • demonstration and return of demonstration
  • feedback
61
Q

motor function training - associative stage

A
  • continued deliberate practice and feedback results in refinement of skill
  • able to identify and correct errors
  • skill variation: how we go from the mat to function
  • reduction of dependence on therapist
62
Q

motor function training - autonomous stage

A
  • wide variation of skill performance
  • success measures
  • independence
63
Q

movement - motor control

A
  • how our neuromuscular system functions to activate and coordinate the muscles and limbs involved in the performance of a motor skill
  • the process of initiating, directing, and grading purposeful voluntary movement
64
Q

movement - motor development

A
  • combination of motor learning and motor control and development from infancy to old age
  • growth and maturation influence changes in motor behavior
65
Q

movement - motor program

A
  • a series of mini-routines organized into the correct sequence to perform a movement
  • a stored representation, resulting from motor planning and refined through practice, that is used to produce a coordinated movement
  • stored in LTM (long term memory), starting in utero
66
Q

motor function - motor plan

A

complex series of motor programs to execute a desired movement or series of movements, the steps and organization needed to execute that movement

67
Q

motor function - motor memory

A
  • recall of motor programs
  • conditions, sensory input, parameters, outcome
68
Q

motor function - motor learning

A
  • actual internalization
  • permanent changes in capability
69
Q

Motor control and motor learning

A
  • prioritized through skills (action), movements and neuromotor processes
    1) understand the action goal and to explore strategies to achieve it
    2) discover the best movement to accomplish the action goal given the unique characteristics of learner and environment
    3) refine the movement and make it more efficient by modifying neuromotor processes
70
Q

motor learning

A
  • teaching/patient education to allow for motor learning to occur in our patients
  • what we do!
  • requires:
    • practice
    • feedback
    • transfer of learning
    • generalizability
    • outcomes
71
Q

motor function training

A

1) stability - must come first
- “can’t shoot a canon out of a row boat”
2) mobility on stability
- distal mobility requires proximal stability
3) mobility (dynamic stability)
4) motor skill (appropriate movement)
5) feedback
- knowledge of results
- outcomes oriented
- quantity of movement
- knowledge of performance
- quality oriented
6) concurrent or terminal feedback
7) functional mobility skills
- bed mobility
- rolling, scooting in supine, bridging, supine to sit, sitting skills
- transfers
- level and unlevel surfaces, standing skills
- locomotion
- ambulation, wheelchair, level and uneven, smooth and compliant surfaces
8) ADL and/or IADL

72
Q

Motor function training ultimate objective

A
  • of any rehabilitation program is to return individual to a lifestyle that is as close to the premorbid level of function as possible or, alternatively, to maximize the current potential for function and maintain it
73
Q

What is an intervention?

A

the act of interfering with the outcome or course especially of a condition or process (as to prevent harm or improve function)

74
Q

Intervention - Step One

A

identify the problem and its underlying cause

75
Q

Goals of Exercise Prescription

A
  • What are you trying to achieve and why?
  • How are you going to achieve the established goals?
  • What modifications or progressions need to be made?
  • How will you decide this?
  • tie your interventions to the impairments and functional limitations identified in your examination
76
Q

Therapeutic exercise

A
  • the systematic, planned performance of bodily movements, postures or physical activities designed to provide a patient/client with the means to:
    • remediate or prevent impairments
    • improve, restore, or enhance physical function
    • prevent or reduce health-related risk factors
    • optimize overall health status, fitness or sense of well-being
77
Q

Passive Range of Motion/Mobility

A
  • muscle length
  • passive exercise is the movement of a joint or body segment by a force external to the body
    • no voluntary muscle contraction by the patient
78
Q

Indications for Passive Exercise

A
  • when a patient is unable to perform any form of active contraction/exercise
    • paralysis
    • comatose
    • recovery from surgery or trauma/precautions/protocols
    • healing fractures
  • contraindicated when passive movement significantly increases the patient’s symptoms
79
Q

Benefits of passive exercise

A
  • preserves and maintains range of motion
  • minimizes contracture formation
  • minimizes adhesion formation
  • maintains mechanical elasticity of muscle
  • promotes and maintains local circulation
  • promotes awareness of joint motion
  • evaluates joint integrity and motion
  • enhances cartilage nutrition
  • inhibits or reduces pain
80
Q

PROM does not…

A
  • prevent muscle atrophy
  • increase muscle strength or endurance
  • assist in circulation as well as AROM/AAROM
81
Q

PROM does

A
  • qualify as skilled physical therapy service if there is a therapeutic (functional) goal - otherwise it is considered maintenance
  • maintenance is not always denied
82
Q

Active ROM (AROM)

A

a movement of a segment within the unrestricted ROM that is produced by active contraction of the muscles crossing the joint

83
Q

Active-Assistive ROM (AAROM)

A

a type of AROM in which assistance is provided manually or mechanically by an outside force because the prime mover muscles need assistance to complete the motion

84
Q

Goals of AROM and AAROM

A
  • maintain physiological elasticity and contractility of the participating muscles
  • provide sensory feedback from the contracting muscles
  • provide a stimulus for bone and joint tissue integrity
  • increase circulation and prevent thrombus (clot) formation
  • develop coordination and motor skills for functional activities
85
Q

Application of AROM

A
  • demonstrate the motion to the patient using PROM or visual cues, and then ask the patient to perform the motion
  • provide assistance only as needed for smooth motion - less is more
  • verbal or tactile cues are appropriate feedback
  • motion is performed within the available range
86
Q

Self-Assisted ROM

A
  • protect healing tissue
  • HEP
  • Manual vs. Equipment based
  • pulleys, wands/bars, finger ladders, foam rollers, straps
87
Q

Stretching/Muscle Length

A
  • exercises designed to elongate the contractile and noncontractile components of muscle-tendon units and periarticular structures
  • know your anatomy to provide appropriate alignment and stabilization
88
Q

Stretching

A
  • mode: static, dynamic, ballistic
  • intensity:
    • slow, low load, prolonged stretch should make a change in the underlying tissue
    • nervous system controls this
  • duration:
    • lack of ideal combo of duration to repetitions
    • generally, 15-60 seconds, for 2-5 reps have been frequently cited in the literature
  • frequency: many variables affect this decision: age, chronicity, pathology, meds
    • 3-5 times per week is most commonly cited
89
Q

Stretching Cont’d

A
  • two joint muscles should be stretched one joint at a time progressing to full length
  • release stretch gradually
  • allow for a few seconds rest between repetitions
  • if patient does not tolerate full static stretch for 30-60 seconds, use several slow intermittent stretches with muscle in elongated position
  • ACSM recommends stretching after exercise to reduce the effect of delayed onset muscle soreness
    • not enough evidence to recommend discontinuing before exercise
    • for overall conditioning and health, stretch right after warm up
    • for programs designed to enhance muscular power, strength or endurance, ACSM recommends after activity, not after warm up
  • stretching improves ROM not strength
    • some inconclusive evidence that may hinder strength
90
Q

Types of muscle contraction and exercise

A

1) isotonic
2) isometric
3) isokinetic

91
Q

isotonic contractions

A
  • visible joint motion when the muscle contracts
  • can use eccentric and/or concentric contractions or exercise
  • can perform in an open chain or closed chain manner/method
  • used to maintain or increase strength, power, and endurance
  • promote local circulation
  • enhance cardiovascular efficiency
  • create hypertrophy of muscle fibers
  • maintain physiological elasticity of a muscle
  • maintain joint motion
  • maintain or enhance coordination
92
Q

Concentric contraction

A

results in the muscle fibers producing a relative shortening of the muscle
- example: contraction of the biceps to produce elbow flexion (from 0 degrees to 90 degrees)

93
Q

Eccentric contraction

A

muscle fibers allow a relative lengthening of the muscle
- example: contraction of the biceps to control elbow extension (from 90 degrees to 0 degrees)

94
Q

Open chain

A

unrestricted movement in space of the distal segment during exercise
- e.g.: seated long arc quadriceps exercises

95
Q

Closed chain

A

the distal segment is fixed meeting external resistance
- e.g.: forward or side step up strengthening of the quadriceps

96
Q

Isometric contraction

A
  • produces little or no observable joint motion and no significant change in the length of the muscle
  • with or without external resistance
    • ex: quad set is an isometric contraction without resistance applied
  • useful as a means to avoid pain associated with joint motion but still want to work on strength
  • useful when initiating muscle activity in a very weak muscle (or one that has shut down)
    • after surgery, CVA or other neurologic insults, with stable fractures
97
Q

Isokinetic

A
  • specific equipment
  • equipment controls the speed of the patient’s contractions and produces a variable resistance to the muscle as it contracts through its arc or ROM
98
Q

Resistance Exercise

A
  • any form of active exercise in which a dynamic or static muscular contraction is resisted by an outside force
    • applied either manually or mechanically
  • if resistance is applied to a muscle as it contracts, the muscle will adapt and become stronger over time
  • the therapeutic use of resistance is an integral part of a patient’s plan of care
99
Q

Mechanical Resistance Exercise

A
  • resistance is applied through the use of equipment or mechanical apparatus
    • free weights, weight machines, theraband
  • can measure the amount of resistance quantitatively and incrementally progress
  • useful when amounts of resistance greater than the therapist can apply manually are necessary or as part of an independent program
100
Q

Goals of Resistance Exercise

A
  • overall goal: improve function!
  • specific goals:
    1) increase strength
    2) increase muscular endurance
    3) increase power
101
Q

Increase strength

A
  • strength = force output of a contracting muscle
  • directly related to the amount of tension a contracting muscle can produce
  • to increase strength, the muscle contraction must be loaded or resisted so that the increasing levels of tension will develop
102
Q

strength training

A
  • muscle or muscle group lifting, lowering, or controlled heavy loads for a relatively low number of reps or over a short period of time
  • results in increased muscle strength due to increase in muscle fiber size
103
Q

Increase Muscle Endurance

A
  • endurance = ability to perform low-intensity repetitive exercise over a prolonged period of time
  • muscle endurance = ability of a muscle to contract repeatedly against a load, generate and sustain tension, and resist fatigue over an extended period of time
  • strength and muscle endurance do not always correlate well with each other
  • the key elements are always low intensity contraction, high reps and prolonged time
104
Q

Increase power

A
  • related to strength and speed
  • work per unit of time; i.e., the “rate of performing work”
  • either a single burst of high-intensity activity, or by repeated bursts of less intense muscle activity (climbing flight of stairs)
  • the greater the intensity of the exercise and the shorter the time period taken to generate force, the greater is the muscle power
105
Q

Overload Principle

A
  • if muscle performance is to improve, a load that exceeds the metabolic capacity of the muscle must be applied
    • muscle must be challenged to perform at a level greater than that to which it is accustomed
  • progressive loading of muscle achieved by altering the weight (resistance) or repetitions and sets
    • in strength training the amount of resistance is progressively increased
    • in endurance training, emphasis is on the reps/sets
106
Q

Contraindications to Resistance Exercise

A
  • pain with resistance
    • full understanding of the pain origin must be determined
  • inflammation
    • precipitation of greater joint of muscle damage
    • low-low level isometrics may be indicated if they do not increase pain or other cardinal signs of inflammation
  • severe cardiopulmonary disease
    • resistance training should be postponed up to 12 weeks post myocardial infarction or CABG
107
Q

Precautions for Resistance Exercise

A

1) avoid valsalva maneuver
- patient holds their breath during an exericse, resulting in increased intro-abdominal and intrathoracic pressures which cause an abrupt increase in arterial blood pressure
2) avoid substitute motions
- ex: if deltoid or supraspinatus are weak or abduction of the arm is paiful, a patient elevates the scapula (shrugs the shoulder) and laterally flexes the trunk to the opposite side to elevate the arm

108
Q

determinants of resistance exercise

A
  • alignment
  • stabilization
  • intensity
  • volume
  • exercise order
  • frequency
  • rest interval
  • duration
  • mode of exercise
  • velocity
  • periodization
  • integration of exercises into functional activities
109
Q

Alignment

A
  • of segments of the body during exercise; avoid substitute movements
  • see when load is too heavy, when muscle is fatigued, when O2 demands too high
110
Q

stabilization

A

of proximal or distal joints to prevent substitution

111
Q

Intensity

A
  • the extent to which the muscle is loaded or how much weight is lifted, lowered or held
  • in general, the level of resistance is often lower in rehab programs for persons with impairments than in conditioning programs for health individuals
112
Q

Components of Exercise Prescription

A
  • mode-type of exercise
  • intensity - how hard or at what level the exercise occurs (how do you monitor?)
  • frequency - how often
  • duration - how long
  • progression/modification
113
Q

Progression/Modification

A

non-weight bearing –> no resistance/pattern assist
quadruped –> no resistance/independent
kneeling –> + resistance/pattern assist
standing –> + resistance/independent

Foundations (16 decks)

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