Week 8 Flashcards
(174 cards)
1
Q
___ establishes direction and meaning for the activities integrated into the rehab process
A
Patient’s life outside of the clinic establishes direction and meaning for the activities integrated into the rehab process
2
Q
__ are often very dissimilar to the functional movement demands of a patient’s life
A
Impairment based interventions are often very dissimilar to the functional movement demands of a patient’s life
3
Q
Impairment based interventions can aide in the ___
A
Impairment based interventions can aide in the development of tissues specific physical capacities
4
Q
What is the limitation of a strictly impairments based intervention?
A
Improvements in specific physical capacities as developed in impairment based interventions do not always translate into meaningful changes in performance
5
Q
What do activity based interventions center upon?
A
The considerations of a patient’s activity limitations and to movement prescription and progression
6
Q
Activity based interventions are more similar to __
A
Activity based interventions are more similar to skilled activities and foundational activities
7
Q
Understanding a patient’s ___ is what can most directly inform a clinician’s consideration of the specific skilled activities a patient needs to be able to perform in order to maximize function
A
Understanding a patient’s participation restrictions is what can most directly inform a clinician’s consideration of the specific skilled activities a patient needs to be able to perform in order to maximize function
8
Q
What are the characteristics of skilled activities?
A
- Complexity
- Variability
- Automaticity
9
Q
What is functional progression?
A
An ordered sequence of activities enabling the acquisition or reacquisition of skills required for the safe effective performance of athletic endeavors.
10
Q
What are the components that make up the desired adaptation for designing a functional progression?
A
- Demands of target activity
- Performance capabilities of patient
11
Q
Activity demands can be progressed using ___
A
Activity demands can be progressed using the FITT principle
12
Q
What does FITT stand for?
A
- Frequency
- Intensity
- Type
- Time
13
Q
__ can be included in the implementation of the functional progression in patients with low functioning and highly irritable patients
A
Active rest can be included in the implementation of the functional progression in patients with low functioning and highly irritable patients
14
Q
Functional progressions of exercise should be done in response to ___
A
Functional progressions of exercise should be done in response to patient response
15
Q
Return to function testing may serve as ___
A
Return to function testing may serve as a pre-test and post test
16
Q
Return to function testing can involve __
A
Return to function testing can involve having a patient attempt the targeted skill activity in a direct or simulated fashion
17
Q
The ___ properties of non formal return to function testing are rarely known
A
The psychometric properties of non formal return to function testing are rarely known
18
Q
The ___ properties of standardized performance based test may be known
A
The psychometric properties of standardized performance based test may be known
19
Q
What are functional capacity evaluation?
A
Performance based assessments that involve a series of test items in an attempt to capture information regarding physical performance with respect to common occupational task
20
Q
The functional movement screen may be used to assess ___
A
The functional movement screen may be used to assess general readiness and therefore injury risk for returning to sport activities
21
Q
True or False
The fact that a test says that you are ready to return to work/sport safely always mean that you are
A
False
It does not always mean that
22
Q
What are the extrinsic injury risk factors?
A
- Playing surface
- Foot wear
- Level of participation
23
Q
What are the intrinsic injury risk factors?
A
- Gender
- Age
- Health status (etc)
24
Q
What is one of the most consistent predictors of recurrent injury regarding the same site or subsequent injury involving different sites in the LE?
A
Previous history of LE injury
25
Return to function after ___ peak in training
| workload is better for reducing an injury risk
Return to function after *SUSTAINING* peak in training
| workload is better for reducing an injury risk
26
Movement as a result of interaction of: ____
Movement as a result of interaction of: Individual,
| Task, Environment
27
What is motor skill acquisition?
Process in which performer learns to control and
integrate posture, locomotion, sensory information and muscle activations that allow individual to engage in variety of motor behaviors that are constrained by a range of
task, individual and/or environmental requirements
28
What does skilled actions equate to?
Consistency, flexibility, and efficiency
29
What does consistency mean?
A skill is repeatable
30
What does flexibility mean?
The ability to adapt and modify a task performance based on changing conditions
31
What does efficiency refer to?
A ability to be able to complete the task
32
Movement pattern emerges as a result of the interaction between ___
Movement pattern emerges as a result of the interaction between *Individual,
Task, Environment*
33
___ is the most important factor in retraining motor skills
*Practice* is the most important factor in retraining motor skills is amount of practice
34
What is performance improvement is dependent upon?
The amount of practice, but there are other factors in addition to the amount
of practice
35
What is task specific training?
The systematic and repetitive practice of functional tasks
36
What is the transfer of practice?
A task learned in one condition transfers to another
37
What does the transfer of task depend on?
Similarity between tasks or environments
38
What is the key to the transfer of practice?
Intensity of practice
39
Why do we need a large of amount of practice?
More opportunities to establish relationships among various types of info associated with each movement
40
What does a large number of trials do for a patient?
Enhance stability of recall and recognition schemas
41
A large number of trials gives a patient ___
A large number of trials gives a patient *more instances of retrieval of motor programs*
42
The amount of times a patient practices, it may help __
The amount of times a patient practices, it may help *automatize activation of generalized motor patterns
for future use*
43
What does the variability of practice rely on?
Variable practice relies on higher order motor areas
44
Wha does constant practice depend on?
Depends more heavily on primary motor cortex for motor-memory consolidation
45
When does variability work best?
When variability is within same generalized motor pattern
46
True or false
Variability of practice is applicable for everyone
False
May not be applicable for everyone
47
What are some practice conditions to partake in?
* Massed v Distributed Practice
* Constant v Variable Practice
* Random v Blocked Practice
* Whole v Part training
* Transfer
* Mental Practice
* Guidance v Discovery Learning
48
What does the massed in Massed v Distributed Practice mean?
Amount of practice time in trial ˃ amount of rest between trials
49
What does the distributed in Massed v Distributed Practice mean?
Amount of rest between trials ≥ amount of time for trial
50
What does the choice whether to pick Massed v Distributed Practice depend on?
Depends on goal of practice session and learner’s capacity
51
What does the variable in Constant v Variable Practice mean?
Variable practice increases ability to adapt and generalize
52
What does the constant in Constant v Variable Practice mean?
Only one task, practiced the same way over and over again
53
Which form of practice out of the Constant v Variable Practice is better?
Most useful when learning tasks performed in variable
| conditions (variable is better)
54
What happens in blocked practice in Random v Blocked Practice?
When all practice is completed under one condition before moving to the next
55
What happens in random practice in Random v Blocked Practice?
Maximize variability of practice by practicing in a random order
56
From Random v Blocked Practice, which is better for performance?
Blocked
57
From Random v Blocked Practice, which is better for retention and transfer?
Random
58
Random practice when introduced causes ___
Random practice when introduced causes *contextual interference*
59
What does contextual interference mean?
Increased difficulty initially of task makes learning more effective
60
When may random practice be inappropriate?
Random may be inappropriate until earner understands dynamics of task
61
What does practicing in parts before combining it into whole do?
Takes things out of context
62
Quick, discrete skills and continuous skills should be practiced ___
Quick, discrete skills and continuous skills should be practiced *as whole*
63
What kind of skills are on to do part- whole?
Serial skills are ok to do part-whole
64
What is mental practice?
A cognitive rehearsal
65
What does mental practice do?
Enhance learning when physical practice not possible
66
Mental practice has been shown to significantly increase ___
Mental practice has been shown to significantly increase *efficacy of repetitive task-specific practice*
67
Unguided conditions less effective during ____, but
| more effective for ___
Unguided conditions less effective during *acquisition*, but more effective for *retention and transfer*
68
What does replacing guidance learning with discovery do for a patient?
Patient allowed to explore “perceptual motor workspace
69
___ of best strategies and perceptual cues
*Trial and error discovery* of best strategies and perceptual
cues
70
What is the guidance hypothesis?
Information provided via feedback guides learner to
correct movement, improving performance during
practice; frequent feedback has negative effect
71
Properties of augmented
feedback are beneficial for motor learning when used to
____, but detrimental when relied upon
Properties of augmented
feedback are beneficial for motor learning when used to
*reduce error*, but detrimental when relied upon
72
What are the categories of feedback?
- Intrinsic
| - Extrinsic
73
Where does intrinsic feedback come from?
* Comes via sensory systems
| * Vision, somatosensation
74
What does intrinsic feedback give a learner?
Is movement accurate/meeting goal?
75
What is extrinsic feedback??
What we provide as a PT that supplements intrinsic feedback in effort to increase learning
76
Extrinsic feedback is also know as ___
Extrinsic feedback is also know as *augmented feedback*
77
What are some types of extrinsic feedback that we can provide?
```
• Concurrent
• Immediate
• Verbal
• Distinct
• Knowledge of
performance (KP)
• Terminal
• Delayed
• Nonverbal
• Accumulated
• Knowledge of results (KR)
```
78
What is concurrent extrinsic feedback?
Giving feedback while the patient is doing the skill
79
What is concurrent extrinsic feedback good for?
The acquisition/performance of the movement.
80
What is the downside of concurrent extrinsic feedback?
The patient may become reliant upon it, and will be bad for retention
81
What is terminal extrinsic feedback?
Providing patient with feedback after they're done with the skill
82
What may terminal extrinsic feedback be more beneficial for?
May be more beneficial for helping the patient retain the skill
83
What is immediate extrinsic feedback?
Giving feedback as soon as patient is done with skill
84
What is delayed extrinsic feedback?
Waiting a while to give ac feedback
85
What is distinct extrinsic feedback?
Giving feedback on specific aspect of the skill, can result in overload
86
What is Knowledge of
| performance (KP) extrinsic feedback?
Feedback related to the movement pattern used to achieve the goal (feedback about how they are moving)
87
What is Knowledge of
| results (KR) extrinsic feedback?
Giving terminal feedback about the outcome of the movement in terms of the movement goal
88
What are the types of cuing that can be provided to a patient?
- Explicit
| - Implicit
89
What is an explicit cue?
Providing learner with instructions according
| to precise kinematic strategy
90
What is an implicit cue?
Providing learner with goal oriented cues
91
Explicit cues focuses on ____, because ____
Explicit cues focuses on *internal focus of attention* because *they focus on a specific body movement/ how to move*
92
Implicit cues establish ____, because they emphasize ____
Implicit cues establish *external focus of attention* because they emphasize *object movement/ the goal*
93
Implicit cues are based on ___
Implicit cues are based on *outcome*
94
When is a high frequency of feed back ok?
At the beginning of learning
95
When should patients be given KR?
Depends on complexity of task; 5-15 trial in literature
96
What are the effects of erroneous feedback?
* Learning incorrectly
| * Unlearning what has already been learned!
97
Too much feedback suppresses error detection; ___ does not do that
Too much feedback suppresses error detection; *modeling* does not do that
98
Manual guidance is a type of ___ feedback
Manual guidance is a type of *concurrent* feedback
99
Can we measure motor learning?
No, it is inferred by changes in behavior
100
What is acquisition?
Initial practice or performance of a new skill
101
What is retention?
Ability to demonstrate attainment of goal after time delay without practice
102
What is the transfer of skills?
Performance of a task with similar movement yet different from original task practiced
103
What is proprioceptive neuromuscular facilitation?
Exercise based on the principles of functional human anatomy and neurophysiology
104
What is PNF used for?
* To increase strength, flexibility, coordination and functional mobility
* To facilitate the patient achieving a particular movement or posture
* To improve functional mobility and athletic performance
105
What are the PNF principles?
- Patient position
- Therapist position
- Manual contact
- Verbal Cues/Commands
106
What should a patient position be?
- Neutral position for optimal alignment
| - Proper body support
107
Where should a therapist be positioned?
- Placing yourself in relation to technique
| - Directly in line with movement performed
108
Where should resistance from a therapist come from?
Resistance should come from a patient's body, the hands and arms should stay relatively relaxed
109
What should the hand placement for manual placement be?
* Purposeful
* Directional
* Comfortable
110
What are the types of verbal cues/ commands that we use?
- Prepatory verbal cues
- Action verbal cues
- Corrective verbal cues
111
What are prepatory verbal cues?
Cues telling the patient what you are about to do. Ensures the patient knows what to expect. Demonstration, guided movement, PROM
112
What are action verbal cues used for?
Used for when you start the patient through the movement, includes the timing of the movement, changes during the movement, increased or decreased force production
113
What are corrective verbal cues?
What we tend to give in modifying the activity. Can be done during or after the movement
114
The volume with which the command is given affects the ____
The volume with which the command is given affects the *strength of resulting muscle contraction*
115
When should louder commands be used?
Louder command when strong muscle contraction is required
116
When should softer and calmer commands be used?
Softer and calmer tone when the goal is relaxation and pain relief
117
Why are PNF patterns developed?
Because all normal coordinated human movement occurs in a spiral or diagonal movement and is rarely in cardinal planes
118
When are muscular contractions strongest and most coordinated?
During diagonal patterns of movement
119
What do diagonal patterns involve?
Rotation of the extremities and tend to require more core stability
120
What does normal timing look at?
Proper sequence of muscle contraction
121
For most functional activities, do we need stability or mobility first?
We tend to need more proximal stability first, before we can utilize our distal mobility
122
What is approximation?
To bring 2 joint surfaces together
123
What are the benefits of approximation?
* Promotes stabilization
* Facilitates WB and contraction of postural muscles
* Facilitates upright reactions
124
What is traction?
To separate two joint surfaces
125
What are the effects of traction?
* Relax patient
* Reduce tone
* Pain relief
126
What is irradiation?
The spread of response to stimulation, from stronger to weaker motor units
127
What is reinforcement?
To strengthen by fresh addition, make stronger
128
What are the PNF strengthening techniques?
- Rhythmic initiation
- Repeated contraction
- Slow reversal
- Slow reversal hold
- Rhythmic stabilization
129
What are the PNF stretching techniques?
- Contract- relax
| - Hold relax
130
What is the goal of rhythmic initiation?
To promote learning of a new movement, to improve intra
| and inter-muscular coordination, and to promote relaxation and independent movement
131
What is the goal of rhythmic rotation?
To promote relaxation and increased range in muscles
| restricted by excess tone
132
What is the goal of dynamic reversals (slow reversals)?
To improve intra-and inter muscular coordination, strength, and AROM
133
What is the goal of rhythmic stabilization- stabilizing reversals (Alternating Isometrics)
Improve stability, strength, endurance, ROM and intra-and
| intermuscular coordination; promote relaxation and decrease pain
134
What is the goal of combination of isotonics (Agonist Reversals)?
Improve motor learning and improve intra-and inter muscular coordination, increase strength and ROM, promote stability, eccentric controls and endurance; improve function
135
What is the goal of Hold-Relax, Contract-Relax?
Improve ROM through facilitating, inhibiting,
| strengthening and relaxing muscle groups
136
What is the goal of replication (Hold-Relax-Active Motion)
| Contract-Relax Active Contraction (CRAC)?
Improve intra-and inter muscular coordination and agonist muscle control in the shorted range and to promote motor learning
137
What is the goal of Repeated Stretch (repeated contraction)?
To enhance initiation of motion and motor learning, increase
| agonist strength and endurance, improve intra- and intermuscular coordination and ROM, and to reduce fatigue
138
How is irradiation done?
Applying graded resistance to larger muscle groups to enhance muscle contraction in the weaker groups
139
We start rhythmic initiation with what kind of movement?
PROM, in order for the patient to understand the pattern of movement and once they do, they can be progressed to AAROM, then to AROM
140
In what patients are rhythmic rotation seen in more?
Patients with neurologic conditions
141
What happen in rhythmic stabilization?
The patient is trying to hold themselves steady, and the PT makes predictable or unpredictable movements to the body part while the patient tries to hold it steady and aligned
142
What is the difference between hold relax and contract relax?
In hold relax the patient is holding against the PT's resistance, while in contract relax, the patient is attempting to push the limb down and the PT is holding it, hence holding agains the patient's resistance
143
What are the goals of aquatic therapy?
- Facilitate ROM
- Initiate resistance training
- Facilitate/inhibit WB activities
- Enhance delivery of manual techniques
- Facilitate cardiovascular exercise
- Initiate functional activity replication
- Enhance patient relaxation
144
What are the precautions to take for aquatic therapy?
* Fear of water
* Neurologic disorders
* ataxia
* heat intolerance (MS)
* controlled epilepsy
* Respiratory disorders
* Cardiac disorders
145
What are the contraindications of aquatic therapy?
- Unstable angina
- Severe PVD
- Danger of bleeding
- Severe kidney disease
- Uncontrolled DM
- Wound wounds without occlusive dressing
- Uncontrolled bowel or bladder
- Menstruation without internal protection
- Water and airborne infections
146
What are the principles of aquatic therapy?
- Buoyancy
- Moment of force
- Density
- Hydrostatic pressure
- Cohesion & viscosity
- Drag force
147
What is buoyancy?
Upward push equal to the weight of the flute the object displaced in water
148
What are the benefits of buoyancy?
* Can help to assist, or resist, patient
| * Helps to promote decreased WB
149
___ influences the ability of the buoyancy to assist pushing the limb to the surface
*Position of the limb* influences the ability of the buoyancy to assist pushing the limb to the surface
150
The more ___ you are, the more buoyancy you have
The more *horizontal* you are, the more buoyancy you have
151
What can assist with buoyancy?
Adding floatation devices to a limb will assist with buoyancy
152
What is the moment of force?
Position representing the turning effect of buoyancy
153
The longer the lever arm, the
| ___ the torque produced
The longer the lever arm, the
| *greater* the torque produced
154
What is density?
Mass per unit volume
155
___ of a substance affects its ability to float
*Relative density* of a substance affects its ability to float
156
What is the specific gravity of H2O?
1.0
157
What will sink and what will float?
Anything less than 1.0 will float and anything greater than 1.0 will float
158
What is hydrostatic pressure?
Fluid pressure exerted equally
on all surface areas of an
immersed body at a given
depth (Pascal’s Law)
159
Hydrostatic pressure is proportional to the ___
Hydrostatic pressure is proportional to the *depth of
| submersion*
160
What is viscosity?
Amount of friction acting on a moving part in water
161
What is cohesion?
Tendency of water molecules to stick together
162
What is slow movement?
Less friction, less resistance from cohesion
163
What is fast movement?
More friction, more resistance from cohesion
164
What are the effects of hydrostatic pressure?
- Leads to decreased blood pooling
- Provides static support for unstable joints
- Resist rib expansion
165
What is drag force?
The force that is created from dragging an object
166
Drag force is modified by ____
Drag force is modified by *shape and speed of object*
167
What does increased streamline of an object equal?
Decreased drag
168
What does increased speed of an object equal?
Increased drag
169
What does increased drag equal?
Increased torque on limb
170
What do you use cooler temperatures for in aquatic therapy?
High-intensity exercise
171
What do you use warmer temperatures for in aquatic therapy?
* Mobility and flexibility
| * Relaxation exercise
172
What temperature should the air around the pool be?
>3 deg C high than water
173
___ conducts temperature 25x faster than ___
*Water* conducts temperature 25x faster than *air*
174
What are the characteristics of temperature in aquatic therapy?
- Patients can perceive small changes in temperature
- Temperature will penetrate to deeper tissues
- Can not maintain core warmth with temp <25oC
- Exercise at temps >37oC may be harmful if prolonged
