Therex Exam study guide
Differentiate 1-RM, 6-RM, HITT and circuit training programs.
- 1-RM: One Repetition Maximum - Maximum weight lifted for one repetition. - 6-RM: Six Repetition Maximum - Maximum weight for six reps. - HIIT: High-Intensity Interval Training - Short bursts of intense exercise alternated with rest periods or low-intensity exercise. - Circuit Training: Series of exercises performed one after another with minimal rest between
Name the Activities of Daily Living and Independent Activities of Daily Living.
- ADL: Basic self-care tasks like bathing, dressing, eating, toileting, and transferring. - IADL: More complex behaviors that involve an individual's ability related to their environment (managing finances and medications, cooking, shopping, housekeeping, and using transportation)
Distinguish between active, active assistive and passive range of motion and indicate the purpose and indication for each.
- AROM: what the patient can do voluntarily. It involves contractile tissue, SEC and non-contractile tissue - Active assisted ROM: Requires some form of help or assistance - Passive ROM: No patient help. Allows the therapist to assess end feel
What tests can be used to measure hamstring length?
- Active knee extension test (90-90 straight leg raise test)
What is the purpose of range of motion?
- Adequate ROM is essential for activities of daily living. - Exercises targeted at improving or maintaining ROM improves joint flexibility and muscle elasticity
Identify the factors that affect flexibility.
- Age - Gender - Genetic predispositions - hyper/hypomobile - Joint structure - Physical activity levels - Previous injury
Identify the elements that affect the application of stretching.
- Age of the patient, their goals, previous injuries, fitness level
What are the evidence-based recommendations to the application of stretching?
- Alignment: proper alignment ensure the corrrect muscle/tissue is being targeted - Stabilization: need to stabilize the joint above or below - Intensity: inverse relationship between duration and intensity (load). Low loads for increased duration is safer, increases patient comfort, and takes advantage of creep and stress relaxation effect. Low load prevents muscle guarding. - Duration: 15-30 seconds for younger people (static), 60 seconds for older adults - Speed and velocity: slow stretch prevents injury, makes the tissue more compliant, minimizes muscle activation - Frequency: minimum of 2x per week, for some population it should be daily - Mode of stretching: mechanical, manual, self - Tissue temp: static stretching after exercise when the muscle is warm
Differentiate between anaerobic and aerobic power and give an example of when each is appropriate.
- Anaerobic power: a single burst of high-intensity activity (heavy lift or long jump) - Aerobic power: repeated bursts of less intense muscle activity (climbing stairs)
Describe what makes range of motion skilled.
- Assessing a patients ROM requires clinical judgement, knowledge and skills of a PT - PROM requires adequate knowledge of anatomy, pathology and therapeutic techniques
Describe the effects of immobilization on muscle morphology.
- Atrophy: Muscle fibers shrink due to decreased protein synthesis - Reduced Capillarization: Decreased blood flow leading to a decrease in nutrient exchange - Increased Fat Infiltration: Replaces lost muscle mass
Compare the International Classification of Functioning to the Social Cognitive theory for guiding exercise prescription.
- Both the ICF model and social cognitive theory consider personal and social factors. However, the social cognitive theory places an emphasis on cognitive and social factors that influence the individual's behavior. - Combining the two allows therapists to prescribe an exercise program that is well-rounded
Describe the equipment used for self-assisted range of motion.
- Cane for ROM of the shoulder - Belts/straps can be used for ROM of the LE
Describe muscle changes that occur throughout the lifespan.
- Childhood: Rapid growth in muscle size and strength. - Adulthood: Peak muscle mass in early adulthood. Muscle mass decreases with age (sarcopenia), especially without physical activity. - Elderly: Decline in strength and power (15-20% per decade through 70s, 30% by 80s) - Muscle fiber size decreases.
Identify stages of motor learning and characteristics of each. Suggest strategies to promote progression from one stage to the next.
- Cognitive: acquisition of factual knowledge before attempting action - Associative: making fewer errors and concentrating on fine-tuning - Autonomous: Skill becomes automatic
Describe the benefits of resistance exercise across the lifespan.
- Counter process of sarcopenia - Reduce mobility loss - Decrease incidence of chronic disease, disability and premature mortality - Greater bone mineral density - Reduced risk of injury - Increase QOL - Improve balance/reduce falls
Identify the general characteristics of a useful functional test.
- Credible and valid: hard for insurance companies to refute performance - Easy to perform (minimal equipment needed to perform) - Relative to normative values: identify risk factors
What is DOMS, why does it occur?
- Delayed onset muscle soreness Seven factors that can produce DOMS 1. Minute tears in muscle tissue or damage to contractile components. 2. Osmotic pressure changes 3. Muscle spasms 4. Overstretching & tearing of portions of muscle's connective tissue harness. 5. Acute inflammation 6. Alteration in cells Ca2+ regulation 7. Combination of above factors
Discuss the basic elements of co-creating a plan according to the Patient-Centered Observation Form.
- Describing options - Discussing pros and cons - Discuss uncertainties with the decision - Assess patient understanding - Ask for patient preferences - Identifies and resolves decisional differences - Plan respects patient goals and values
What is the purpose of a functional examination, what reasons do we have for performing them?
- Establish a baseline - Quantifiable/objective results - Gain a clear picture of function and structure impairments, activity limitations, and participation restrictions - Support or refute working hypothesis regarding diagnosis
Illustrate the difference between a functional impairment and functional exam.
- Functional Impairment: Refers to limitations in performing activities of daily living due to a health condition or injury. - Functional Exam: Systematic evaluation to assess a person's ability to perform daily tasks and identify impairments
Explain the relationship of power to functional activity.
- Functional activities require power for quick, explosive movements, such as jumping, sprinting, or changing direction rapidly. - Power improves an individual's ability to perform such activities efficiently
What is the difference between a functional exercise and functional training?
- Functional exercise: is one that produces strength gains that transfer well to a particular movement - Functional training: is strength training that improves stability and involves several joints in the exercise (e.g., lunges, squats, deadlifts)
Identify likely impairments to selected functional tests (Gait speed, 30 sec sit to stand, TUG, stair climb).
- Gait Speed: Impaired balance, muscle weakness, joint stiffness. - 30 sec Sit to Stand: Lower body weakness, joint pain, reduced balance. - Timed Up and Go (TUG): Impaired balance, muscle weakness, joint pain. - Stair Climb: Leg weakness, cardiovascular issues, joint problems.
Describe skeletal muscle changes/adaptations with training.
- Hypertrophy: Enlargement of muscle fibers due to increased myofibrils, protein synthesis, and fluid retention. - Hyperplasia: Increase in the number of muscle fibers (debated in humans). - Increased Mitochondria: Enhances aerobic capacity. - Improved Neuromuscular Coordination: Better motor unit recruitment (especially in early stages).
Apply FITT-VP principles to resistance training to achieve hypertrophy, tissue tolerance, endurance, and strength.
- Hypertrophy: High volume (3-5 sets, 6-12 reps, moderate weight, short rest intervals). - Tissue Tolerance: Focus on correct form, lighter weights, slow progression. - Endurance: Moderate volume (2-3 sets, 12-20 reps, lighter weight, shorter rest periods). - Strength: High intensity (3-5 sets, 4-6 reps, heavy weight, longer rest intervals)
Describe hypomobility & hypermobility.
- Hypomobility: refers to joints that have limited or restricted movement - Hypermobility: refers to joints that can move beyond their normal ROM
Identify the factors that can reduce range of motion.
- Immobilization (casting, bracing, injury, surgery precautions) - Disuse (physical inactivity, pain inflammation, overuse, age)
Identify the structures that influence joint mobility.
- Individual joint structure and deviations from "normal" - Integrity and flexibility of the soft tissues that cross the joint + Muscle, ligaments, fascia, tendons - Joint capsule, vessels, nerves, synovial fluid
Describe types of feedback (intrinsic, extrinsic, knowledge of performance, knowledge of results, timing, frequency).
- Intrinsic: Feedback from the body's senses during the performance. - Extrinsic: Feedback from external sources like trainers. - Knowledge of Performance: Feedback about the technique. - Knowledge of Results: Feedback about the outcome. - Timing: When feedback is given during or after the movement. - Frequency: How often feedback is given during practice
Define the different modes of exercise (isometric, concentric, eccentric, open and closed chain, and isokinetic) and give examples.
- Isometric: Muscle contraction without joint movement (ex. plank). - Concentric: Muscle shortens during contraction (ex, lifting weights). - Eccentric: Muscle lengthens during contraction (ex, lowering a weight in a bicep curl). - Open Chain: Limbs move freely (ex. leg extension). - Closed Chain: Limbs fixed, movement occurs at the joint (ex. squats). - Isokinetic: Muscles contract at a constant speed regardless of resistance (ex., specialized gym equipment).
Describe the stretch-shortening cycle.
- It's the use of a rapid pre-stretch (eccentric contraction) of a muscle, followed by an immediate shortening (concentric contraction) to produce forceful movement
Describe how making errors impacts motor learning.
- Making errors and being able to correct them is an important step. - Errors can provide valuable feedback, leading to adjustments and improvements - Need to be corrected in a manner that doesn't cause the individual to lose motivation
Describe training considerations for plyometric programs.
- Mechanics of jumping and landing - Training level - Injuries (prior or current) - Specificity of training - Equipment and environment - Core strength
Recognize the factors that influence muscle tension.
- Muscle Fiber Type: Fast-twitch fibers generate more force than slow-twitch fibers. - Motor Unit Recruitment: More motor units recruited leads to greater muscle tension. - Muscle Length: Optimal tension occurs at moderate muscle lengths. - Stimulus Frequency: Rapid stimuli (tetanus) increase muscle tension.
Describe the structure of skeletal muscle including the sliding filament model/mechanism.
- Muscle Structure: Skeletal muscles are composed of muscle fibers, which are multinucleated cells. Each muscle fiber contains myofibrils, which are composed of sarcomeres, the contractile units of muscles. - Sliding Filament Mechanism: During muscle contraction, myosin (thick) filaments slide past actin (thin) filaments within sarcomeres. This sliding is powered by ATP and calcium ions. When a nerve impulse reaches a muscle, calcium ions are released, allowing myosin heads to bind to actin, forming cross-bridges. ATP provides energy for myosin heads to pull actin filaments, shortening the sarcomere and causing muscle contraction
Define muscle strength, muscle endurance and power.
- Muscle strength: the amount of force you can put out or amount of weight you can lift - Muscle endurance: how many times you can move the weight before getting fatigued - Power: how fast you can exert a force
Describe rhabdomyolysis and its implications.
- Occurs when damaged muscle tissue releases its proteins and electrolytes into the blood - It can cause damage to the heart and kidneys, resulting in permanent disability or death.
Discuss the techniques for developing exercise or physical activity goals that are 100% derived from the patient.
- PTs need to make sure the patient goals/outcomes are meaningful to the patient. - Ask open-ended questions, and use reflective listening - Goals should be Specific, Measurable, Achievable, Relevant, and Time-bound (SMART).
What makes the physical therapist's application of therapeutic exercise unique?
- PTs prescribe specific doses of exercises unique to each patient. - They must consider the patient's overall health to ensure safety and effectiveness. - The goals of therapeutic exercise include improving strength, pain-free activity, and community participation.
Describe the types of practice (part, whole, blocked, random, observation, mental).
- Part Practice: Breaking the skill into parts and practicing each separately. - Whole Practice: Practicing the skill in its entirety. - Blocked Practice: Repeatedly practicing the same task before moving to another. - Random Practice: Practicing different tasks in a random order. - Observational Practice: Learning by watching others perform the skill. - Mental Practice: Practicing mentally without physical movement.
Recommend specific exercise strategies that can influence the rate of force development.
- Plyometrics: Rapid muscle lengthening and shortening improve RFD. - Ballistic Exercises: Explosive movements against resistance. - Olympic Lifts: Clean and snatch exercises involve rapid force production
Define plyometrics and its indications (benefits and contraindications).
- Plyometrics: involves rapid muscle lengthening followed by rapid shortening, exploiting the stretch-shortening cycle for explosive movements. - Indications: Improving power and explosiveness in athletes, enhancing athletic performance. - Contraindications: Inadequate strength base, previous joint injuries, inadequate technique
Identify factors critical to motor learning.
- Repetition - Challenge - Specificity - Focus of attention - Feedback
Describe properties of soft tissue & responses to stretch.
- Soft tissue has elasticity and plasticity. Elasticity allows tissues to return to their original shape after stretching, while plasticity allows tissues to change shape permanently after prolonged stretch. - Mobility of soft tissue increases when they are stretched - The extensibility of contractile and noncontractile soft tissues increase - Soft tissue healing could be disrupted
Describe the principles of specificity, overload, adaptation, and detraining using specific examples.
- Specificity: transfer of training is minimal with/ respect to mode and speed so exercise program should be specific to goals - Overload: to improve muscle performance, the load should exceed the metabolic capacity of the muscle. Increasing the load gradually is essential for progress - Adaptation: the body adjusts to the stress that is applied through neural changes, increasing muscle fiber size, etc. - Detraining: partial or complete loss of training-induced adaptations in response to an insufficient training stimulus.
Describe and perform several tests to provide baseline data for power and plyometrics (standing long jump, vertical jump, Margaria-Kalamen Power test, 30s sit to stand, two- footed, jump).
- Standing long jump: Measures horizontal power and explosive strength. - Vertical jump: Measures vertical power and explosive strength. - Margaria-Kalamen power test: Involves running upstairs, assessing power and speed. - 30s sit to stand: Measures lower body strength and endurance. - Two-footed jump: Measures explosive power in a controlled manner.
Differentiate between static, ballistic, and dynamic stretching and indications and contraindications for each.
- Static stretching: slow stretching muscle/tendon group and holding the position- Indication: after exercise with warm muscles, contraindication: acute injury - Ballistic stretching: "bouncing", uses the momentum of moving body segment to produce stretch - Indications: athletes who will be using greater ROMs, contraindication: beginners, those with chronic contractures - Dynamic stretching: involves a gradual transition from one body position to another and progressive, controlled increase in reach/ROM as movement is repeated several times - Indications: before exercising. Contraindications: injuries
Describe the consequences of a lack of movement on connective tissue.
- Stiffness of the joint capsule (can lead to contractures) - Muscle shortening - Tendon weakening through disuse - Cartilage softening - Bone weakening - Muscle atrophy
Recognize the factors that are necessary before beginning a plyometric program.
- Strength Base: Adequate strength in lower body muscles. - Proper Technique: Athletes should have good landing and jumping mechanics. - Physical Readiness: No recent injuries or signs of fatigue. - Warm-Up: Proper warm-up to prepare muscles and joints.
What can impact the stress strain response?
- Stress-strain response is influenced by the rate and duration of stretch, tissue temperature, and the individual's age, hydration, and tissue condition. - Stress above the ultimate strength will cause fracture or rupture - The stress-strain curve demonstrates the mechanical strength of structures to understand what happens to CT under stress loads
Differentiate between stretching and range of motion exercises.
- Stretching: the goal is to increase the flexibility of the muscle or joint - Range of motion: the goal is to increase mobility at a joint, actively or passively
What is the International Classification of Functioning (ICF)?
- The ICF model is the WHO framework for measuring health and disability at both individual and population levels. - It considers Body function and structure, activities, participation, and personal and environmental factors. - The framework shifts the conceptual emphasis away from negative connotations such as disability and places it on function and the positive abilities of the individual. - Ensure therapeutic interventions are focused on patient goals
Explain the concept of specificity and its significance to an exercise plan and Rehabilitation.
- The principle of specificity of training states that the way the body responds to physical activity is very specific to the activity itself - Training effects from an exercise program are specific to the exercise performed and the muscles involved. In rehab, exercises need to be specific to the impairment. - Ex. stretching the R hamstring won't loosen the L. - Ex. Open chain exercise has limited carry-over to weight-bearing activities.
Define and discuss Social Cognitive theory for guiding exercise prescription.
- The social cognitive theory emphasizes the dynamic interaction between people, their behavior, and their environment. - Having a patient-centered goal will help give the patient the motivation needed to adhere to the exercise program. - The PT needs to consider the patient's social support. and self-efficacy when prescribing exercises.
Discuss the role of repetition and practice in achieving motor learning.
- Thousands of repetitions may be necessary to improve performance to an effective skill level. - Practice, especially distributed practice (spaced out over time), aids long-term retention and skill improvement.
Identify landmarks that a plumb line should intersect in erect posture.
- Thru ear lobe - Just in front of the shoulder joint - Thru greater trochanter - Gerdys tubercle - Tarsal joint
Describe the strength-endurance continuum.
- Training with heavier loads with less reps increases muscle strength - Training with lighter loads but more reps increases muscle endurance - Muscle endurance doesnt improve strength
Know the purpose of selected functional tests and the kinds of information they can provide (usual and fast gait speed, 30s chair rise, TUG, stair climb).
- Usual and Fast Gait Speed: Measure walking ability, reflecting mobility and balance. - 30s Chair Rise: Assesses lower body strength and endurance. - TUG: Measures mobility and balance during daily activities. - Stair Climb: Assesses lower body strength, balance, and coordination during stair negotiation.
Describe the concept of rate of force development.
- a measure of explosive strength, or simply how fast an athlete can develop force.
What are the symptoms of over-exertion during resistance exercise?
Dizziness, musculoskeletal pain, abdominal pain, chest pain, nausea
Identify the factors that affect range of motion.
Modifiable factors - Connective tissue - Muscle tightness/bulk - Activity level Non-Modificable Factors - Age/Gender - Genetics - Joint Structure
Explain the elements of SAID and FITT-VP in resistance training.
SAID: Specific Adaptations to Imposed Demands - Specificity: mode, velocity, limb position, movement pattern FITT-VP: Frequency, Intensity, Time, Type, Volume, and Progression
Describe how the Borg perceived scale of exertion is used in resistance training.
Used to calculate baseline strength, measures the individual's perception of intensity.
Recognize a progression sequence for a motor skill.
cognitive → associative → autonomous
