Ther ex test 3
This is a 14 item balance test with a score of <45 putting pts at risk for falls; perfect score is 56
Berg balance test
What system estimates the amount of momentum necessary for lifting an object?
CNS
This is the vertical projection of COM to the ground; typically slightly anterior to S2
COG
This is the point in a persons body that is at perfect equilibrium; its the point that corresponds to the center of the total body mass
COM
What are the two type of dynamic exercises?
Concentric and eccentric
This term is a form of resistance training in which a limb moves through a ROM against constant external load, provided by free weights, weight machines, or weight pulleys
DCER (dynamic constant external resistance)
What grade can be described as manual vibrations that are used at the BEGINNING OF THE RANGE
Grade I
This type of lift is often recommended for patients with balance deficits by clinicians because it imposes less compression on the spine
Leg lifting style
This type of resistive program allows for progressive fatigue
Oxford
what are three contraindications of Resistance exercises?
Pain, inflammation, severe cardiopulmonary disease; additionally cancer that has metastasized to the bone
Gliding techniques are applied in what direction?
Parallel
what does DCER stand for?
dynamic constant external resistance
when pts with balance problems go to pick up a object and it weighs far more than they expect what direction do they fall?
forward, underestimated pts fall forward
This principle states that if muscle performance is to improve, a resistance load that exceed the metabolic capacity of the muscle must be applied
Overload Principle
Joint traction application should be applied in what direction? (the entire bone is moved so that joint surfaces separate)
Perpendicular
This term refers to a patients ability to create movement voluntarily
Physiological movements
This term relates to the strength and speed of movement/ work produced by muscle in a timely manner
Power
When conducting joint mob PT/PTA should always firmly and comfortably stabilize one joint segment. in most cases where should that be?
Proximally
The Otago home exercises program is targeted to what patient load?
Pts who are at risk for falls; frail older adults
This normally occurs along with sliding or spinning; its like a ball rolling on the ground; occurs on incongruent surfaces
Roll
What are the motions of arthrokinematics?
Roll, slide, spin, compression, distractions
What are the three components of motion in joint mob?
Roll, spin, slide
If joints are more incongruent then more _____ is occurring rather than sliding where there is more congruency
Roll= incongruent Sliding= Congruency
This test a patients ability to stand with the feet parallel and together with the eyes open and then closed for 30 seconds
Romberg test
Concave is same or opposite direction of movement?
Same- concave- same- concave- same
Refers to self stretching that use joint traction or glides that direct stretch force to the joint capsule
Self mobilization
Grade II distraction is used to determine what?
Sensitivity of the joint
D1 flexion UE
Shoulder flexion, adduction, external rotation; elbow flexion, supination, wrist and finger flexion
If the convex surface is stable then the concave surface will ______ in the same direction
Slide
This principle states that to improve a specific muscle performance that resistance program should match that element construct
Specific adaptation to imposed demands (SAID) Principle
occurs when one bone rotates around a stationary longitudinal mechanical axis; example is radial head at humeroradial head during pronation
Spin
in the use of Joint mob one surface is always _______ & and one surface is always __________
Stable, and Mobile
These type of test asses pts ability to maintain different postures
Static balance test
What type of test is the Romberg test?
Static balance test
this is when a perturbation is to large and the pt takes at step to maintain balance
Stepping Strategies
This is a strategy used to maintain balance where the pt lowers COM by flexing knees which then causes ankle and hip flexion
Suspension strategy
This test request pts to rise from a chair, walk 3 meters and return to the chair and sit back down.
TUG Test (Functional test)
This is a traditional Chinese exercise program consisting of a sequence of whole body movements that are performed in a slow, relaxed manner with an emphasis on posture alignment and synchronized breathing
Tai Chi
The objective for lift training according to page 271 is to reduce the load on what?
The lumbar spine
This is used to snap adhesions or is applied to a dislocated structure to reposition the joint surfaces also known as HVT
Thrust manipulation (grade V)
This is a Balance and gait test that is focused on determining wether a pt is at risk for falls; with a maximum score of 28
Tinetti mobility test
Grade III and Grade IV of the non thrust techniques push a pt into what?
Tissue resistance
This system maintains balance during head rotation, acceleration/ deceleration, and stabilization during gait
Vestibular System
When is a persons balance the best?
When COM or COG is maintained over BOS
using hip strategy if there is a backward sway the pt compensates in what direction
anterior
This is the motions of the bone surfaces within the joint
arthrokinematics
This type of balance control allows you to maintain when a bus begins to move
automatic postural reactions
This type of balance control is used to maintain balance in response to unexpected external perturbations
automatic postural reactions
when pts with balance issues go to lift something and it weighs far less than what they expect they tend to fall in what direction
back, overestimated pts fall back
What should joint mob treatments begin and end with?
begin and end with Grade 1 and 2 oscillations
Internal factors that put pts at risk for a fall are?
cardiovascular, neuromuscular, orthopedic, perceptual, and psychiatric or cognitive impairments
This type of dynamic muscle activation occurs when tension develops and physical shortening of the muscle occurs
concentric
How can a PT/PTA prevent a pt from having a valsalva maneuver
have the pt exhale during the most difficult part of exercise
External factors that put pts at risk for a fall are?
medications, appliances, assistive devices, environmental hazards, and level of care.
What is Mass times velocity?
momentum
Osteo______ is a contraindication of Joint mob while OA is only a precaution
porosis
using hip strategy if there is a forward sway the pt compensates in what direction
posterior
This system maintains balance even in change of terrain, body sway and space.
somatosensory system
A person with vestibular damage is at risk of what disease
vertigo
What time on the TUG test puts pts at high risk for falls?
14 seconds or more
What is one dynamic balance test?
5x sit to stand
Isometric contractions should be held at least but no more than how many seconds?
6-10 seconds
These motions are necessary for normal ROM but can not be actively performed by a pt.
Accessory Movements
This strategy is a small perturbation in which the pt maintain balance at the ankles, if the pt loses balance forward the gastroc stabilizes and loss of balance backwards anterior tib stabilizes
Ankle strategy
Using the ankle strategy what three muscle groups would help maintain balance when balance is lost backwards?
Anterior tib, then quads, then abs
The functional reach is what type of test?
Anticipatory postural control test.
This is the ability to maintain equilibrium with gravity both statically and dynamically
Balance
Incoming sensory information is integrated and processed by what structures...
Cerebellum, basal ganglia, and supplementary motor area
D1 extension of LE is in internal or external rotation of the hip?
D1 EXTENSION IS INTERNAL ROTATION OF THE HIP however it is ankle eversion
LE D2 extension ankle and hip rotation?
D2 extension ER of hip and ankle inversion
This resistive exercise program has daily adjustable progressive resistive exercise; it starts with a 6 rep max
Dapre
This resistive program builds in warm up into its protocol
Delorme
This joint motion means that two joint surfaces are pulled apart
Distraction
Sensory input is sent to the brain via AFFERENT nerve fibers in the
Dorsal column/ medial tract
The functional reach test is ______ rather than a static test and measures a patients margin of stability. it measures a patients ability maintain balance during functional task
Dynamic
This type of balance control is essential to maintain balance when moving on stable surfaces, such as sit to stand transfers and walking
Dynamic balance control
These type of test asses pts ability to transition from sitting to standing, standing on uneven surfaces, or moving around such as jumping, walking, hipping, and skipping
Dynamic balance test
This term refers to the ability to perform receptive or sustained activities of a period of time
Endurance
LE D1 Flexion is internal or external rotation of the hip?
External rotation of the hip but its in ankle Inversion
This test requires a pt to reach out as far as possible while maintaining a fixed BOS in the standing position
Functional reach test
Using the ankle strategy what three muscles would help maintain balance when its lost forwards?
Gastroc, then hamstrings, and then paraspinals
If the motion is applied passively it is referred to as what?
Glide
What two motions does self mobilization accomplish specifically?
Glide, and traction
These 2 grades on the Maitland grading scale are used to manage pain and spasms, normally used before and after treatment
Grade I and Grade II
With joint Effusions what two grades of Joint mob are allowed?
Grade I and Grade II are ok if used with caution
this is rapid oscillations like manual vibrations however it is tissue resistance at the VERY END RANGE
Grade IV
D1 Extension LE
Hip Ext, abd, IR- Knee extension; plantar flexion and eversion; toe flexion
Using the weight shift strategy what are the main MM
Hip abd. and add. w/ some help from ankle investors and evertors
This strategy includes large or rapid perturbations, with COG near LOS; uses rapid hip flex/ext to move COM with BOS
Hip strategy
According to the book the only 3 true contraindications of joint mob and manipulation is?
Hypermobility, joint effusion, and inflammation
Grade II and III are what type of rhythmic oscillations
II and III are LARGE rhythmic oscillations
This is a type of contraction that is controlled by a rate limiting device that allows Max load with near max tension throughout ROM.
Isokinetic
This type of static exercise is best in low level pts, can be found most effective 5 weeks onset, helps develop postural and joint stability
Isometric
This technique involves moving joint surfaces away from one another, performed in the perpendicular plane, Used to decrease joint hypo mobility or pain
Joint Traction
What determines the amount of joint play available?
Joint capsule laxity
What determines joint play?
Joint capsules laxity
TB, osteoporosis, ligament rupture, vascular disorder, malignancy, and inflammatory arthritis are all contraindications of?
Joint mobilization
These type of motions can be demonstrated passively but not actively by a pt
Joint play
What position will allow for the most joint play?
Loose packed, open packed, or resting position
There are two phases of the Otago home exercise program what are they?
Management phase and self management phase
this is a concurrent application of sustained accessory mobilization applied by PT and a active physiological movement to end range applied by pt
Mobilization w/ movement
Grade III and IV are used to gain what?
Motion within the joint
These type of chain exercises are particularly difficult post op
Open
This at home exercise program was created to reduce the risk of fall, it includes 17 stretch and balance exercises
Otego Home Exercise program