Topic 5 - Progression of Exercise

Question 1

Identify the following impairment:
“Overstretching, overexertion, overuse of contractile soft tissue.”

Answer 1

Strain

Question 2

Identify the following impairment:
“Severe stress, stretch or tear of inert soft tissues.”

Answer 2

Sprain

Question 3

Identify the following impairment:
“Displacement of (usually) the boney partners in a joint that results in soft tissue damage, inflammation, pain and muscle spasm.”

Answer 3

Dislocation

Question 4

Identify the following impairment:
“An incomplete or partial dislocation that results in secondary trauma to surrounding soft tissue.”

Answer 4

Subluxation

Question 5

Identify the following impairment:
“Chronic tendon pathology.”

Answer 5

Tendinopathy

Question 6

Identify the following impairment:
“Inflammation of the synovial membrane surrounding the tendon.”

Answer 6

Tenosynovitis

Question 7

Identify the following impairment:
“Inflammation of the tendon.”

Answer 7

Tendinitis

Question 8

Identify the following impairment:
“Degeneration of the tendon.”

Answer 8

Tendinosis

Question 9

Identify the following impairment:
“Inflammation of a bursa.”

Answer 9

Bursitis

Question 10

Identify the following impairment:
“Bruising that results in capillary rupture, bleeding , edema and an inflammatory response.”

Answer 10

Contusion

Question 11

Identify the following impairment:
“Cumulative trauma disorders, repetitive strain, frictional wear to muscle or tendon that results in inflammation and pain.”

Answer 11

Overuse Syndromes

Question 12

Identify the following impairment:
“Loss of normal function of a tissue or region.”

Answer 12

Dysfunction

Question 13

Identify the following impairment:
“Mechanical loss of normal joint play in synovial joints that causes loss of function and pain.”

Answer 13

Joint Dysfunction

Question 14

Identify the following impairment:
“Adaptive shortening of skin, fascia, muscle or joint capsule that prevents mobility.”

Answer 14

Contracture

Question 15

Identify the following impairment:
“Abnormal adherence of collagen fibres to surrounding structures.”

Answer 15

Adhesion

Question 16

Identify the following impairment:
“Decrease in strength of a muscle spasm.”

Answer 16

Muscle Weakness

Question 17

Identify the following impairment:
“Increased interstitial pressure in a closed, non-expanding, __________ ___________ that results in ischemia and muscle loss.”

Answer 17

Myofascial Compartment

Question 18

Identify the following impairment:
“Prolonged contraction of a muscle in response to a painful stimulus. Primary pain causing lesion may be nearby or underlying tissue, or may be referred.”

Answer 18

Reflex Muscle Guarding

Question 19

Identify the following impairment:
“Prolonged contraction of a muscle in response to local circulatory and metabolic changes that occurs with a continued state of contraction.”

Answer 19

Intrinsic Muscle Guarding

Question 20

A grade of muscle strength on the Oxford Scale described as:
“No muscle contraction is seen or identified with palpation; paralysis.”

Answer 20

Grade 0

Question 21

A grade of muscle strength on the Oxford Scale described as:
“Muscle contraction is seen or identified with palpation, but is insufficient to produce joint motion even with elimination of gravity.”

Answer 21

Grade 1

Question 22

A grade of muscle strength on the Oxford Scale described as:
“The muscle can move the joint it crossed through a full ROM only if the part is properly positioned so that the force gravity is eliminated; limited ROM against gravity.”

Answer 22

Grade 2

Question 23

A grade of muscle strength on the Oxford Scale described as:
“The muscle can move the joint it crosses through full ROM against gravity, but without any resistance.”

Answer 23

Grade 3

Question 24

A grade of muscle strength on the Oxford Scale described as:
“The muscle can move the joint it crosses through a full range of motion against moderate resistance.”

Answer 24

Grade 4

Question 25

A grade of muscle strength on the Oxford Scale described as: "The muscle can move the joint it crosses through a full ROM, against gravity and against full resistance applied by the examiner."

Answer 25

Grade 5

Question 26

A severity grade of tissue injury described as: "Mild pain within 24 hours of injury. Mild swelling, local tenderness and pain occurs when tissue is stressed."

Answer 26

Grade 1 (First Degree)

Question 27

A severity grade of tissue injury described as: "Moderate pain requires stopping of activity. Stress and palpation of tissue increases pain. Some increase in joint mobility."

Answer 27

Grade 2 (Second Degree)

Question 28

A severity grade of tissue injury described as: "Near-complete or complete tear or avulsion of the tissue (tendon or ligament) with severe pain. There is instability of the joint."

Answer 28

Grade 3 (Third Degree)

Question 29

Which stage of healing is being described below: - Signs of inflammation are present (e.g. SHARP) - AF ROM = painful - Pain is due to altered chemical state, which irritates nerve endings; also increased tissue tension due to edema/joint effusion - Lasts 4-6 days (greater if perpetuated)

Answer 29

Acute Stage (Inflammation & Repair)

Question 30

Which stage of healing is being described below: - No inflammation - AF ROM = no pain, but pain at end-range - Muscles may test weak, therefore function is limited - Remodelling begins synthesis and deposition of collagen - Lasts 10-17 days (up to 6 weeks)

Answer 30

Subacute Stage (Proliferation, Repair & Healing)

Question 31

Which stage of healing is being described below: - No inflammation - Stretch pain is felt at end-range - Presents as contractures and/or adhesions that limit range - Connective tissue strengthens and remodels with stress - Function is limited by muscle weakness, poor endurance or poor neuromuscular control - Lasts 6 months-1 year

Answer 31

Chronic Stage (Maturation & Remodelling)

Question 32

T/F - Healing time depends on the size and severity of the injury.

Answer 32

True

Question 33

It takes __ to __ days for wound closures in muscle and skin. In comparison, it takes __ to __ weeks for tendons and ligaments to heal.

Answer 33

5-8 days 3-6 weeks

Question 34

Some signs/goals during the __________ phase include: - Control inflammation and decrease pain - Encourage healing - Maintain normal function of unaffected side/surrounding regions

Answer 34

Protection Phase (Acute Stage)

Question 35

Some signs/goals during the __________ ______ phase include: - Active exercises within pain-free ROM of the injured tissue can begin and be progressed to endurance and strength exercises - Patient feels better, decreased pain, AROM beings - "Too much too soon" vs. "not enough" - Initiate and progress non-destructive exercises and activities within tissue tolerance

Answer 35

Controlled Motion (Subacute Stage)

Question 36

T/F - Re-injury is most likely during the protection phase.

Answer 36

False - Re-injury is most likely during the CONTROLLED MOTION phase.

Question 37

Some signs/goals during the ______ to ________ phase include: - Incorporate exercises that safely stress the maturing connective tissue - Encourage patient to return to functional and work-related activities - Important to use controlled forces on the tissue to maximize the strength of the collagen as it develops - Pain is experienced only when stress is placed on restrictive contractures/adhesions or soreness from resistive exercise

Answer 37

Return to Function Phase (Chronic Stage)

Question 38

The ____ of ____ is an integral component of the prognosis, which includes: - Anticipated goals - Expected functional outcomes that are meaningful, sustainable and measurable - Extent of improvement predicted and length of time necessary to reach that level - Specific interventions

Answer 38

Plan of Care

Question 39

Goals where the primary concern is not the client's impairments.

Answer 39

Wellness Goals

Question 40

The following are examples of ________ goals: - Improve sleep quality, mood and relaxation - Injury prevention and maintenance - Improve/enhance ADLs

Answer 40

Wellness