Lecture 3 - Strength in rehabilitation

Question 1

Describe anti-gravity movement (GD)

Answer 1

Body part is lifted against the force of gravity
Type of resistance training

Question 2

Describe gravity assisted movement (GA)

Answer 2

Movement of body part is assisted or helped by gravity
Less work required by the muscle
Muscle in question is moving perpendicular to the floor in downward motion

Question 3

Describe gravity eliminated movement (GL)

Answer 3

Movement of the body part is neither hindered or assisted by gravity
Muscle in question is parallel to the floor, perpendicular to gravity

Question 4

Bodies muscles must be able to do 3 things to carry out physical demands of the body in ADL and sport

Answer 4

Produce
Sustain
Regulate muscle tension

Question 5

If one of these components is impaired, the person will have activity limitations, or increased risk of injury (3)

Answer 5

Strength
Power
Endurance

Question 6

Types of contraction - movement stays the same (hold)

Answer 6

Isometric contraction

Question 7

Type of contraction - muscle is shortening (produce the force against something)

Answer 7

Concentric contraction

Question 8

Type of contraction - muscle is lengthening (often against gravity because they are slowing our body down)

Answer 8

Eccentric contraction

Question 9

Term to say you create a force against something

Answer 9

Strength

Question 10

Why isometric exercise? (5)

Answer 10

1. Minimize muscle atrophy when joint movement is not possible
2. Activate muscles to begin to re-establish neuromuscular control
3. Develop postural and joint stability
4. Improve muscular strength when dynamic RT could compromise joint integrity or cause pain
5. Develop static muscular strength at particular points of ROM (work on the gap where injuries occur)

Question 11

What is muscle setting?

Answer 11

Involve low intensity isometric contractions performed against little or no resistance

Question 12

What is muscle setting used for?

Answer 12

Decrease muscle pain and spasm
Promote relaxation and circulation after injury

Question 13

When is muscle setting used?

Answer 13

In acute stages of healing

Question 14

What is stabilization exercise?

Answer 14

Form of isometric exercise where you use rhythmic stabilizations and alternating isometrics to facilitate sequential muscle activation

Question 15

What is stabilization exercise used for?

Answer 15

Improve postural stability or dynamic stability of a joint

Question 16

What is multi-angle isometrics?

Answer 16

Manual or mechanical resistance is applied at multiple joint positions within available ROM

Question 17

What is the goal of multi-angle isometrics?

Answer 17

Improve strength through ROM

Question 18

When is multi-angle isometrics used?

Answer 18

When dynamic resistance exercise is painful or inadvisable

Question 19

2 benefits of repetitive isometric contractions

Answer 19

• Decrease muscle cramping
• Increases effectiveness of isometric goals

Question 20

T or F: for isometrics, the resistance must be progressively increased to overload the muscle apply and release the tension gradually

Answer 20

TRUE

Question 21

Intensity of muscle contraction - isometrics

Answer 21

Sufficient to use 66-100% of a muscles voluntary contraction to improve strength

Question 22

Isometrics - at 5 sec, 75% of the tension exerted at beginning, and __ by 10 sec

Answer 22

50%

Question 23

Shortening of muscle with contraction
Accelerate body segments or objects

Answer 23

Concentric

Question 24

Lengthening of muscle while controlling against a resistance/force
Decelerates body segments
Shock absorber

Answer 24

Eccentric

Question 25

T or F: more injuries occur at concentric motions

Answer 25

FALSE Eccentric motions

Question 26

- Involves change in muscle length - Constant resistance throughout the exercises - Speed of movement will change

Answer 26

Isotonic activity

Question 27

- Involves change in muscle length - Velocity is controlled and maintained at a specific speed of movement - Amount of resistance provided to the muscle varies as the muscle goes through a range

Answer 27

Isokinetic activity

Question 28

Characteristics of isokinetic exercises (5)

Answer 28

Can train reciprocal muscles Compressive forces on the joint are LESS with faster velocities than at slow velocities Patient can still perform exercise even if fatigued Patient is able to eliminate painful arc Speeds available in sport is more than in machine

Question 29

Type of resistance exercise is chosen dependent on what? (5)

Answer 29

- Extent of impairments - Stage of tissue healing - Condition of joints and their tolerance to compression and movement - General physical and cognitive abilities of the patient - Patient's goals

Question 30

What happens if you put the patient into combination movement too earl in rehab process?

Answer 30

Compensation from muscles around it so not strengthening the muscle targeted

Question 31

Positioning for RT : Weight bearing/CKC

Answer 31

Typically weight bearing position Less shear forces at joint (more compression at the joint) Generally safer in rehab program

Question 32

Positioning for RT: Non-weight bearing/OKC

Answer 32

Typically NWB More shear force at joint Can better isolate muscle High velocity movements (throw, kick, etc.)

Question 33

Distal end of the joint working is fixed on something

Answer 33

Closed kinetic chain

Question 34

Distal end of the joint working is free to move in space

Answer 34

Open kinetic chain

Question 35

Which of OKC or CKC would you use in early-mid rehab program?

Answer 35

OCK to make sure you don't use other muscles to compensate

Question 36

When to use open kinetic chain? (4)

Answer 36

- When WB is contraindicated - Soft tissue pain and swelling or restricted ROM of any segment in the chain, may require OKC exercises at adjacent joints - First to develop isolated control and strength of weak musculature - Sport/activity requires it

Question 37

When to use closed kinetic chain? (4)

Answer 37

- Promote dynamic stabilization and co-activation - Provides greater proprioceptive and kinesthetic feedback - Provides more joint stability - Sport/activity requires it

Question 38

Parameters and progression of CKC exercises - % BW

Answer 38

PWB to FWB to FWB + add weight

Question 39

Parameters and progression of CKC exercises - base of support

Answer 39

Wide to narrow Bilateral to unilateral Fixed on support surface to sliding on support surface

Question 40

Parameters and progression of CKC exercises - Support surface

Answer 40

Stable to unstable/moving Rigid to soft Height: ground level to increasing height

Question 41

Parameters and progression of CKC exercises - Balance

Answer 41

With external support to no external support Eyes open to eyes closed

Question 42

Parameters and progression of CKC exercises - Exclusion of limb movement

Answer 42

Small to large ranges (full depth vs 1/4 squat) Short arc to full arc (if appropriate)

Question 43

Parameters and progression of CKC exercises - Plane or direction of movement

Answer 43

Uniplanar to multiplanar (ex: lunge to curtsey lunge) Anterior to posterior to diagonal

Question 44

Parameters and progression of CKC exercises - Speed of movement or directional change

Answer 44

Slow to fast

Question 45

Rapid gains in strength are seen in a debilitated or deconditioned muscle during the first __

Answer 45

3-5 weeks

Question 46

Choosing our sets and reps - Strength of injured part should be within ___ of strength of uninjured counterpart

Answer 46

10%

Question 47

Recommendations for early rehabilitation (sets and reps)

Answer 47

6-15 reps for 2 sets Continue until able to perform 3 sets of 20-25 reps

Question 48

Common guideline for increasing weight

Answer 48

Increase weight 5-10% when all prescribed repetitions and sets can be completed easily without significant fatigue (5-10 for UE, 10-20 for LE)

Question 49

Training goal : strength What is goal rep & sets?

Answer 49

Less than 6 reps for 2-6 sets

Question 50

Training goal : power, single effort or multiple effort What is goal rep & sets?

Answer 50

Single effort 1-2 reps for 3-5 sets Multiple effort 3-5 reps for 3-5 sets

Question 51

Training goal : hypertrophy What is goal rep & sets?

Answer 51

6-12 reps for 3-6 sets

Question 52

Training goal : muscular endurance What is goal rep & sets?

Answer 52

More than 12 reps for 2-3 sets

Question 53

When you had an ustable surface, your primary goal becomes neuromuscular and not strength (neuromuscular requirements increase – accessory muscles and brain connections for balance will increase when unstable)

Answer 53

If you want true strength gains, you need to stay on a stable surface Can include both stable and unstable in the same training session

Question 54

Contributions of stabilizing muscles increases ___ when the handle changed from stable to unstable during pushing motions in squat

Answer 54

~40%

Question 55

Guidelines for progression of strength training (4)

Answer 55

1. Change 1 parameter at a time (FIIT) 2. Begin with isometrics if required (i.e. high pain level, ROM deficiencies, post-op, activation of muscles) 3. Begin concentric/eccentric RT as soon as possible 4. Begin plyometric exercises ONCE the patient has met the appropriate requirements

Question 56

Fundamental movements required before going into plyometrics (4)

Answer 56

1. Stand in proper posture (DL and SL) 2. Squatting (DL and SL) 3. Lunging 4. Step up/down

Question 57

Return to play requirements (2)

Answer 57

1/4 SL squats for 3x15 or step down controlled SL calf raises 3x15

Question 58

What makes up the quick stretch-shortening cycle for plyometrics?

Answer 58

- Eccentric phase - Amortization phase - Concentric phase