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CHI442: Physical Rehab 1 > Week 1 Intro > Flashcards

Flashcards in Week 1 Intro Deck (35):

According to a meta-analysis of RCT what is more beneficial stretching or excercise programs?

Strength training reduced sports injuries to less than 1/3 and overuse injuries could be almost halved. 



What is one way moderate levels of physical activity can effect the brain?

 It can enhance neuroplasticity in the visual cortex of adult humans 


According to David Progue what are the 5 science backed habits that lead to long term happiness?

  1. Companionship. people surrounded by friends and fam are happier. Being isolated lets feelings of insecurity and self-doubt blossom.
  2. Control. A sense that you have no control over your circumstances. Find things you can control, even if they’re little things. Clean the desk. Do small things that you chose to do.
  3. New things. it releases dopamine
  4. Do-gooding. Volunteering, giving a gift, sending a note of praise to someone — all of these selfless gestures give you a connection to other people and make you feel good about yourself.
  5. Exercise. Physical activity releases endorphins and serotonin in your brain


What are some examples of Soft Tissue Lesions: Musculoskeletal Disorders?

  • Strain 
  • Sprain 
  • Dislocation 
  • Muscle/Tendon Rupture or Tear 
  • Tendinopathy, Tendinous Lesions 
  • Synovitis 
  • Hemarthrosis 
  • Ganglion 
  • Bursitis 
  • Contusion 
  • Overuse Syndromes, Cumulative Trauma Disorders, Repetitive Strain Injuries 


What are some Clinical Conditions Resulting From Trauma or Pathology?

  • Dysfunction - a result of adaptive shortening of a soft tissues, adhesions, weakness muscle, ROM 
  • Joint Dysfunction 
  • Contracture 
  • Adhesions 
  • Reflex Muscle Guarding 
  • Intrinsic Muscle Spasm 
  • Muscle Weakness 
  • Myofascial Compartment Syndrome 


Describe the classification of a connective tissure injury?

Grade 1 (First-Degree) 

–Mild swelling, local tenderness, pain with tissue stress, microscopic strtching, minimal/no loss integrity [full recovery 10-14days

Grade 2 (Second-Degree) 

–Moderate tearing, stop activity, pain on palpation & stress, some fibers are torn with some increased ROM, some loss of structural integrity [2-3wks activity mod. + rahab with up to 3 months for full recovey]

Grade 3 (Third-Degree) 

–Near or complete avulsion of tissue with severe pain and joint instabilty [up to 6 mths full recovery with adequate intervention]


What are the Stages of Inflammation and Repair in a tissue?

  1. Acute Stage –Inflammatory reaction (4-6days) 
  2. Subacute Stage –Repair and healing (4-24days)
  3. Chronic Stage –Maturation and remodeling (21days-2yrs) 

>>Chronic Inflammation 

>>Chronic Pain Syndrome 


Stages of Tissue Healing

Acute stage: Inflammarory reaction


Clinical Signs



  • vascular changes, exudayion of cells/chemicals, clot formation, phagocytosis, neutralisation of irritants, early ibroblastic activity

Clinical Signs

  • inflammation, pain before tissue resistance


  • control effects of inflam: RICE
  • prevent deleterious effects of rest: dondestructive movement, passive ROM, massage, muscle setting with caution


Stages of Tissue Healing

Subacute Stage: proliferation, repair


Clinical Signs



  • removal of noxious stimuli, growth of capillary beds to area, collagen formation, granulation tissue, very fragile easily injured tissue

Clinical Signs

  • decreasing inflammation, pain synchronous with tissue resistance


  • develop mobile scar: selective stretching, mobilisation/manipulation of restrictions
  • promote healing: open/closed chain stabilisation, muscular endurance and cardiopulmonary endurance exercises, progressing in intensity+range


Stages of Tissue Healing

Chronic Stage: maturation and remodelling


Clinical Signs



  • maturation of connective tissue, contracture of scar tissue, remodellong of scar, collagen aligns to stress

Clinical Signs

  • abscence of inflammation, pain after tissue resistance 


  • increase tensile quality of scar: progressive strengthening and endurance exercises 
  • develop functional independance: functional exercises and specificity drills


Describe the tissue response to inflammation from the time of injury toward healing

  • homeostasis: platelets, fibrin, proteoglycans
  • inflammation: neutrophils, macrophages , lymphocytes
  • proliferation: fibroblasts, collagen, epithelial cells, endothelial cells
  • remodelling: collagen fibril crosslinking, scar maturation


what are the 5 steps to effective plan of care for a patient with an acute stage injury?

  1. Educate the patient
  2. Control pain, edema, spasm
  3. Maintain soft tissue and joint integrity and mobility
  4. Reduce joint swelling if symptoms are present
  5. Maintain integrity and function of associated areas


what are some precautions and contraindications when managing a patient in the acute stage of injury?

Precautions- proper dose of rest and movement during inflam. stage, dont want to decondition or increase pain or increase inflamm.

Contraindications- stretching and resistance exercise should not be performed at the site of swollen tissue


 What are the specific interventions and dosages for the management of tissue injury in the acute phase?

–Passive range of motion

–Low-dosage joint mobilization techniques

–Muscle setting



What are some interventions that will help a patient with an acute injury to maintain a normal physiological state?

Range of motion- active or passive

Resistance exercise- not to directly affected tissue but surrounding

–Functional activities-


What is the tissue response diring the subacute stage of tissue injury?

  • 2-4 days post injury inflamm. decreases>>clot starts resolving>> repair
  • 10 to 17 days (14 to 21 days after onset of injury); but may last up to 6 weeks
  • Synthesis and deposition of collagen


what are the 5 steps to effective plan of care for a patient with an subacute stage injury?

  1. Educate the patient
  2. Promote healing of injured Tissues
  3. Restore soft tissue, muscle and/or joint mobility
  4. Develop neuromuscular control, muscle endurance and strength
  5. Maintain integrity and function of associated areas


what are some precautions when managing a patient in a subacute stage of injury?

  • joint swelling should normally decrease early in this stage
  • so be aware of over use signs include
    • resting pain
    • fatigue
    • increased weakness
    • spasm lasting > 24hrs


What is the tissue response diring the chronic stage of tissue injury?

  • maturation of tissue
    • improved quality of collagen (orientation tensile strength)
    • reduction in wound size
    • quantity of collagen stabilises to equal synthesis and degradation
  • remodelling of tissue
    • immature collagen molecules = H bonds easily remodeled
    • possible for up to 10 wks
    • if not properly stressed = restricting scar
    • approx. 14 weeks tissue unresponsive to tissue remodelling as collagen is held by covalend bonds


what are the 5 steps to effective plan of care for a patient with an chronic stage injury?


  1. Educate the patient
  2. Increase soft tissue, muscle and/or joint mobility
  3. Improve neuromuscular control, muscle endurance and strength
  4. Improve cardiopulmonary endurance
  5. Progress functional activities


what are some precautions when managing a patient in a Chronic stage of injury?

  • should be no signs of inflamm.
  • some discomfort expected but no longet than a couple of hours
  • signs of excessive activity dosage
    • joint swelling
    • pain lasting > 4hrs
    • pain requiring medical relief
    • decreased strength
    • fatigue more easily


What are some contributing factors to cummulative trauma with chronic reccuring pain?

  • Imbalance between the length and strength of the muscles
  • Rapid or excessive repeated eccentric demand
  • Muscle weakness
  • Bone malalignment or weak structural support
  • Change in the usual intensity or demands
  • Returning to an activity too soon after an injury
  • Sustained awkward postures or motions
  • Environmental factors
  • Age-related factors
  • Training errors


What are the 4 steps to a rehabilitation plan?

Where to start?

  1. Restore Biomechanical Integrity / Mobilization (Mobility) 
  2. Stabilization (Neuromuscular adaptation/control)
  3. Strength and Endurance 
  4. Power and/or Functional Integration 



Describe the first step of a Rehab program

(Mobilization Phase)

Restore Biomechanical Integrity Mobilization (Mobility)

  1. Myofascial and connective tissue length and flexibility 
  2. Arthrokinematic deficits 
  3. ROM 
  4. Promote increased vascularity 
  5. Manipulation and mobilization; IASTM, dry needling, electrical physiological therapeutics, soft tissue and stretching techniques; manual resistance techniques (e.g. PIR, PNF, PFS, MEP). 


What are the classifications of muscle tightness?

0 = no tightness, normal end feel at end PROM 

1= slight tightness, Lack of springy end feel end PROM 

2=tightness, Lack of end feel very early in within PROM, weaker?


Describe the second step of a Rehab program

(stabilisation Phase)

Stabilization Neuromuscular adaptation/control

  • exercises to enhance conscious awareness of specific regions, movements and/or musculature requiring activation. 
  • The patient cognitively performs these corrective exercises (e.g. activation of the TA or VMO independently of the superficial muscles as part of the first stage of motor learning. (muscle setting)
  • These are rehearsed until they become automated 


Describe the third step of a Rehab program

Strength and Endurance Phase

  • Exercises address specific needs of patient
  • Exercise intensity; sets; repetitions; and exercise technique are purposely defined in order to achieve appropriate functional gains 
  • Decide what is needed – strength, endurance, neuromuscular efficiency, motor control ? 


Describe the fourth and final step of a rehab program


Power and/or Functional Integration

  • address specific functional requirements of the patient 
  • Design the exercises to improve the rate of force production, and/or include functional performance components that mimic as closely as possible the actual ADL, work or sport requirements of the patient 


What are the established stages of learing motor control?

First Stage – Conscious awareness 

patient must learns how to become “aware” of specific muscle activation or how to move anarticulation/region. 

Second Stage – Associative 

patient has developed the “awareness” to appropriately perform more complex exercises using specific musculature or a specific region. 

Third Stage – Autonomous control 

patient does not have to think about the exercise in order to perform it correctly. 


What are some general doseage amounts for rehab exercises?

  • Approximately 30-40% intensity; 
  • 1 set twice daily or 2 sets once daily; 
  • 6-15 repetitions per set; 
  • Isometric holds of 5-10 seconds per repetition, and/or movements occurring over 5-10 seconds per repetition. 


When progressing rehabilitation exercises, how can you train endurance or strength?

  • Lower intensity (<50%), higher repetitions (12-15) and slower movements and/or isometric holds typically trains endurance
  • Higher intensity (>70%) and lower repetitions (6-8) typically trains strength.


What does 1RM mean?

1 Repetition Maximum - maximum amount of force that can be generated in one maximal contraction. 

  • Start with a weight that the individual can lift comfortably (50‐60% BW). 
  • Have the individual perform 1 rep. slowly and with perfect form. 
  • If they can not perform one more rep with good form, this is their 1RM. 
  • If they can perform another rep with good form, increase the weight depending on how easy it was to lift the initial weight (generally 2‐10 Kgs).
  • Wait 1‐2 minutes between each testing and 
  • repeat process until 1RM is determined.


When creating a rehab brogram for an individual what are some hindering or encouraging factors for them sticking with the plan?

  • interferes with everyday life 
  • appears to be ineffective
  • too difficult to implement
  • patients prefer programs that are designed with consideration of their preferences, circumstances, fitness levels, and exercise experiences


What are some general facts for patient education on rehab programs?

  • Muscle strength is lost at a rate of 1 - 3% per day with rest 
  • Muscle strength improves at a rate of 0.5 - 1% per day with training 
  • Approximately 6 weeks to 3 months are necessary to re-educate motor control in patients 
  • Treatment with manipulation, medication, injection, or surgery will not rehabilitate or condition the muscles needed to either improve stability or enhance performance