week 4

Question 1

Explain and demonstrate MMT to the patient  Assess unaffected side  Test position- either gravity eliminated or against gravity  Stabilized the site of attachment of the origin of the muscle (proximal to the joint being tested)  Prevent substitutions  Gradual resistance is applied in the opposite direction of movement

Answer 1

MMT process

Question 2

Moves through full ROM against gravity and takes max resistance

Answer 2

5 Normal

Question 3

Moves through full ROM against gravity and takes mod resistance

Answer 3

4 good

Question 4

Moves through full ROM against gravity and takes less than mod resistance

Answer 4

4- good minus

Question 5

Moves through full ROM against gravity and takes min resistance

Answer 5

3+ fair plus

Question 6

Moves through full ROM against gravity, unable to take resistance

Answer 6

3 fair

Question 7

Moves less than full ROM against gravity

Answer 7

3- fair minus

Question 8

Moves through full ROM in gravity-eliminated plane, takes min resistance

Answer 8

2+ poor plus

Question 9

Moves through full ROM in gravity-eliminated plane, takes no added resistance

Answer 9

2 poor

Question 10

Moves through less than full ROM in gravity-eliminated plane, takes no added resistance

Answer 10

2- poor minus

Question 11

Tension is palpated, no motion occurs

Answer 11

1 trace

Question 12

No tension is palpated, no motion occurs

Answer 12

0

Question 13

Contraindications of grip and pinch test

Answer 13

healing fracture, ligament repair, tendon laceration, tendon transfer of forearm, wrist, hand

Question 14

precautions of grip and pinch test

Answer 14

grip/pinch testing is not appropriate in an acute joint, ligament, or tendon injury until resistive exercises are appropriate. Must be sure structures are healed enough for maximal load

Question 15

grip testing procedure

Answer 15

Measures the extrinsic and intrinsic muscles of the hand.  Used to measures hand dysfunction and recovery  Should be measured with a calibrated dynamometer Average of 3 trials should be scored (unless painful)  Grip held for 3 seconds  15 second intervals between trails  Compare to uninvolved side (however correct for dominance)  Compare to established norms

Question 16

rung for standard testing

Answer 16

second

Question 17

grip testing position

Answer 17

Patient seated with arm adducted at side  Elbow flexed to 90, forearm in neutral, wrist at 15-30* of extension and 0-15* of ulnar deviation  Patient instructed to squeeze as hard as possible  Therapist gently supports the base of the dynamometer

Question 18

Five-rung grip test

Answer 18

to determine bell curve

Question 19

Rapid exchange grip test

Answer 19

In the past been thought to limit less than maximal effort

Question 20

Place pinch meter between the radial side of the IF and thumb

Answer 20

lateral pinch

Question 21

Place pinch meter between the pulp of the thumb and pulp of the IF and MF

Answer 21

three point pinch

Question 22

Place pinch meter between the tip of the thumb and tip of the IF

Answer 22

two point pinch

Question 23

components of grip and pinch

Answer 23

Strength  ROM  Tendon glide  Lymphatic Function  Motor Control  Stable base (wrist, thumb)  Load Transfer (80% transferred to radius, 20% through ulna)  Innervation

Question 24

example of Activity method is altered

Answer 24

One handed techniques

Question 25

example of Object can be adapted

Answer 25

built up utensil

Question 26

example of Environment is modified

Answer 26

wheelchair ramp

Question 27

example of Alter Method

Answer 27

Learn to dress the affected side first to compensate for hemiplegia

Question 28

example Alter Task Object

Answer 28

use of sock aid for dressing lower body

Question 29

example of Modify the Task Environment

Answer 29

Lower clothing racks to increase access to clothes

Question 30

Remediation for Weakness

Answer 30

Always link interventions to impairments  Educate patient/caregiver how interventions will lead to improvement  Provide opportunity to transfer gains into functional tasks  Good for patients with few impairments or who’s impairments are expected to improve  Interventions include  Strengthening, ROM, endurance, aerobic exercise etc.

Question 31

Contraindications/Precautions for ther ex

Answer 31

poor health, inflamed joints, recent surgeries, permanent contractures, lack of voluntary control over motion

Question 32

Isotonic: concentric and eccentric

Answer 32

muscles move joint through ROM  Concentric: muscle shortens as it develops tension  Eccentric: Muscle lengthens as it develops tension

Question 33

Isometric

Answer 33

static muscle contraction with no change in muscle length

Question 34

Increasing muscle endurance

Answer 34

lower resistance, higher reps

Question 35

“During continuous physical activity both the circulatory and respiratory systems must supply adequate oxygen to continue the task”

Answer 35

cardiovascular endurance

Question 36

“Muscles engaged during the task can continue to work without fatigue.”

Answer 36

muscular endurance

Question 37

the signs of exceeded cardiopulmonary capacity

Answer 37

Dyspnea, weakness, angina, cognitive changes, changes in BP, decreased HR, pallor or cyanosis

Question 38

what MET level is this? Dusting, bathing (sitting),waking at slow pack, light office work (sitting), making bed

Answer 38

1.0-2.5 METs

Question 39

what MET level is this? Moderate (walk, run, play), raking lawn, walking downstairs, motorcycle riding, water aerobics, very light stationary biking

Answer 39

2.6-4.0 METs

Question 40

Major house cleaning, weeding, carpentry on house, dance aerobics, walk/jog (jogging less than 10 min), Elliptical (mod effort) MET level?

Answer 40

greater than 4.0-6.0 METs

Question 41

Shoveling, carrying object 50-74 lbs, carrying groceries upstairs, running 10-12 min mile, moving furniture, high-impact aerobics MET level?

Answer 41

6.0-10 METs

Question 42

Metabolic equivalent level (MET)

Answer 42

One MET = basal metabolic rate (amt of O2 consumption necessary to maintain metabolic process of the body at rest (3.5mL of O2 per kilogram of body weight/min)

Question 43

a reflection of cardiovascular state and fitness level (physiological)

Answer 43

Endurance

Question 44

a subjective feeling of being exhausted.

Answer 44

fatigue