Intro Material Flashcards
1
Q
Pathology
A
disease, disorder, or condition at cellular level
2
Q
impairment
A
abnormality in anatomical, psychological structure and/or function
3
Q
activity limitation
A
restriction to perform at level of whole person
4
Q
participation restriction
A
inability to perform actions, tasks, and activities related to self-care, home management, work, or leisure
5
Q
patient management model
A
exam
eval
diagnosis
prognosis
intervention
outcome
6
Q
purpose of exam (4)
A
1 - gather info (sub/obj)
2 - determine functional and social status (ADLs/work)
3 - identify pt goals
4 - assess performance of structure
7
Q
examination includes (3)
A
history
systems review
tests/measures
8
Q
history from exam includes…
A
demographics
occupation
general health
past medical history
9
Q
systems review from exam includes
A
cardiopulmonary
musculoskeletal
neuromuscular
integumentary
communication
10
Q
tests/measures from exam include
A
- identify specific impairments
- confirm your hypothesis
- symptoms vs signs (sub vs obj)
- provocation testing
- positive/negative signs
11
Q
evaluation is…
A
your clinical judgements based on the exam
12
Q
medical diagnosis is the ________ code
A
ICD-10
* do not give pts a medical diagnosis
13
Q
prognosis
A
process of determining the optimal level of improvement
14
Q
plan of care
A
specific interventions that will be used including duration and frequency
15
Q
how are short term goals different from long term goals?
A
- 1-2 weeks
- not really functional
- focuses on simple impairments like increasing ROM and strength
16
Q
how are long term goals different from short term?
A
- > 4 weeks
- more functional
17
Q
goals show progress to who?
A
patients, us, and insurance
18
Q
intervention
A
purposeful and skilled interaction of the PT with the patient using various techniques consistent with eval, diagnosis, and prognosis
19
Q
effects of AROM (3)
A
1 - nutrition (self-lubrication of joints)
2- motor re-education
3 - range of motion
20
Q
effects of PROM (3)
A
1 - nutrition
2- decreased swelling
3 - range of motion increase
21
Q
effects of RROM
A
1 - vascularization
2 - hypertrophy/strength
3 - neurologic changes
22
Q
T or F: you get stronger by just doing AROM
A
F - you have to stress the system
23
Q
range of motion progression
A
Passive > active-assisted > active
24
Q
what to consider when working on ROM?
A
- mobility and stability of joint
- structure of the joint
- soft tissue across the joint
25
what are some reasons you could lose ROM?
trauma
surgery
disease
inactivity
hypertrophy
26
indications for PROM
- examination
- not able or allowed to move (pathology/post surgery)
- prepare for stretching
- education
27
Does PROM increase muscle strength, size, or endurance
NO
28
what does PROM do?
gains joint ROM
stretches muscles
controls pain
29
indications for AAROM and AROM
- Pt can partially/completely move a joint
- beginning of strengthening or cardiovascular training
30
what are some limitation of AAROM and AROM
- only allows for active ROM strength
- doesn't facilitate skill development outside the motionc
31
contraindications for AAROM and AROM
- immediately after certain surgeries
- immediately after fracture/tear
- DVT
- excessive pain
- cardiovascular compromise
32
T or F: you have to have full pain free range of motion to add resistance
F: you can add resistance but only go to pain-free range
33
immobilization leads to...
- decrease soft tissue mobility
- decreased motion
- atrophy
- functional loss (neurological inactivity)
34
Do 2 or 1 joint muscles atrophy quicker if only 1 joint is immobilized?
1 joint, b/c 2nd joint still allows for some movement
35
T or F: slow twitch and fast twitch fibers atrophy at about the same rate
T
36
If you are immobilized in a shortened position there is a __________ in the number of sarcomeres and muscle is ____________.
decrease
stiffer
*opposite if muscle is immobilized in lengthened position
37
what stays the same regardless if the muscle is immobilized in a shortened or lengthened position
loss of mass, CSA, strength
38
T or F: early protected mobilization of muscle will increase results
T
39
effects of tendon immobilization
- decrease in size and number of collagen fiber bundles
- disorganization of fiber orientation
- decreased strength, elastic stiffness, and total weight
40
gentle passive mobilization of tendons does what?
- increase tensile strength
- decrease adhesions
- promotes normal soft tissue relationship
- decreases scar tissue
41
effects of ligament immobilization
- decrease collagen mass
- decrease in strength and stiffness
- increase joint stiffness
- will shorten if not exposed to stress
42
T or F: for ligaments, remobilization period is usually much longer than immobilization
T b/c low metabolic activity it takes longer for them to get stretched back out once shortened
43
ligaments can remodel for up to ________
1 year
44
effects of cartilage immobilization
- degeneration
- softening and fragmentation
- becomes vulnerable to injury
- chondrocyte deterioration leads to sclerosis
- osteophyte formation
45
after ____ weeks of immobilization, there is usually irreparable damage to cartilage
4
46
to avoid arthritic changes in cartilage it is important to obtain full ______-
AROM
47
effects of bone immobilization
- resorption
- decrease in bone mass
- possible osteoporosis
48
when does most resorption of bone typically occur during immobilization
first 6 weeks
49
with immobilization there is up to ____% increase in bone resorption and _____% decrease in formation
30, 70
50
T or F: bone responds quickest to remobilization
T: b/c increased metabolic activity
51
what does stretching do?
increase extensibility of muscle tendon unit
52
flexibility depends of what 2 things
joint ROM
soft tissue extensibility
53
3 types of stretching
static, ballistic, PNF
54
physiologically, what does static stretching do?
decrease in reflex activity of the spindle
55
how long to hold static stretch
30-60 seconds
56
ballistic stretching
repetitive bouncing motions
* may cause injury
57
process of PNF stretching
take to end range
active isometric contraction
relax
take up slack to end range
repeat
58
two types of PNF stretching
autogenic inhibition ad reciprocal inhibition
59
autogenic inhibition
contract the muscle you are trying to stretch
ex. for hamstring stretch, contract ham by having pt push down into your shoulder, then stretch
60
reciprocal inhibition
contract the antagonist of the muscle you are trying to stretch
ex: for hamstring stretch, contract quad by having pt push up into your hands
61
acute effects of stretching (3)
- elongation of musculotendinous junction
- decreased resistance to stretch
- increased tolerance to stretch
62
chronic effects of stretching
addition of sarcomeres
63
hypermobility
excessive laxity or length of tissue which can lead to instability
64
agility
ability to perform an accurate motion quickly
65
coordination
ability to produce smooth controlled motion
66
power
combo of strength, speed, and skill
67
strength
max force a muscle can develop in one contraction
68
two ways you gain strength
1 - neural changes
2 - hypertrophy
69
what kind of muscles respond well to high volume reps
posture muscles b/c they need good endurance
70
endurance exercise advantages
comfort, early rehab, less joint stress, ensures proper form before adding weight
71
why should you avoid valsalva
- decreases blood flow to heart and cardiac output
- raises HR and BP
72
how to prevent patients from holding their breath
talk to them, if they are talking then they're breathing
73
what kind of exercise should you usually start with
isometric
74
immediate muscle soreness is due to
- increased lactic acid
- decreased O2
- increase in K
- decrease in blood flow
75
DOMS
delayed-onset muscle soreness microtrauma to muscles, tendons, and connective tissue
76
symptoms of DOMS
diffuse pain, stiffness, tender to palpate
77
DOMS starts how many hours after exercise and resolves in how long?
24-48 hours
1 week
78
T or F: you should exercise when sick
F
79
you should perform strength training at least _____ times a week for maintenance
2
80
how many weeks does it take to see significant strength gains
6
81
why do you warm-up
- increase blood flow, oxygen delivery, and metabolic activity
- mental transition
82
how to warm up for strength training
12-15 reps without weight before set
83
do you need to warm up for abdominal training and isometrics
no
84
what can happen if you don't cool down
blood can pool in muscles
85
1 advantage and 1 disadvantage of manual resistance
- allows for control of ROM and resistance
- not measured quantitatively
86
3 advantages and 1 disadvantage of mechanical resistance
it is specific, quantifiable, and can be done w/o assistance but it can be dangerous
87
machine weights are more stable than free weights but may limit what?
plane of joint/muscle action
88
isometric
same length
can be performed daily but only develops strength at position held
89
isotonic
same tension (ex. dumbbell)
90
isokinetics
same speed
used mostly for objective data, often not functional
91
central activation ratio
tells us how much strength we have and if that strength loss is physiologic
92
T or F: you should review HEP at every visit
T
93
closed chain
fixed distal segment
94
open chain
distal segment not fixed
95
T or F: gait is both open and closed chain
T
96
open chain is more functional in the ________ extremity while closed chain is more functional in the ________ extremity
upper, lower
97
volume of resistance exercise =
sum of reps and sets
98
you want limb symmetry to be within ______%
10
99
ACSM guidelines for strength training
- minimum 2x per week
- 8-10 exercises targeting major muscle groups
- one set of 8-12 for healthy adults of 10-15 for older/frail
100
ACSM guidelines for cardiovascular training
30 minutes of moderate intensity physical activity 5x week or 20 mins vigorous activity 3x week
101
T or F: older adults may need to stretch longer
T: b/c the tissues are often stiffer
102
T or F: the ACSM guidelines recognize elite athletes
F
103
There is a ______% decrease in mortality rate between those with mod fitness level and those with low cardiorespiratory fitness level
60
104
How many steps are recommended per day?
10000
