TherEx Poll and Async Question Unit 1-5

Match the following patient findings with the related element of a physical therapy exam. 1. 155 deg knee flexion 2. unable to train with cross-country team 3. pain with descending one step a. Subjective exam: participation restriction b. Objective exam: performance test c. Objective exam: discrete measure

1 -- c 2 -- a 3 -- b

PLAY Match Gravity List 3 detractors for participating in therapeutic exercise. -Pain-Fear-Time demands-Anxiety Match the following patient findings with the related element of a physical therapy exam. 1. R anterior knee pain 2. 5/5 quad strength 3. Painfree with left single-leg squat to 60-degree knee flexion; painful right knee single-leg squat at 35-degree knee flexion 4. Unable to run >5 minutes without knee pain a. Objective exam: discrete measure b. Subjective exam: activity limitation c. Subjective exam: chief complaint d. Objective exam: performance test

1 -- c 2 -- a 3 -- d 4 -- b

When working with patients we seek to determine performance deficits by selecting tests that mimic the patient-specific activity demands. Match each of these tests to an activity which the test mimics any part of 1. vertical jump height 2. S/L balance on a foam 3. T-test 4. time to walk 10m a. hiking b. ability to cross street in timely manner c. volleyball spike or block d. playing soccer

1 -- c 2 -- a 3 -- d 4 -- b

Match each photo A-H from Slide 2, Physical Capacity, with the corresponding primary attribute of physical capacity-enabling performance. 1. lifting refrigerator 2. cyclists 3. Hussain Bolt sprinting 4. dancing on the beach 5. trunk side hold on incline a. aerobic endurance b. balance c. muscle endurance d. strength e. speed

1 -- d 2 -- a 3 -- e 4 -- b 5 -- c

Match each photo A-H from Slide 2, Physical Capacity, with the corresponding primary attribute of physical capacity-enabling performance. 1. dumbbell biceps curl 2. football player leaping over opponents 3. overhead reach in exercise 4. walking on tight rope 5. running to get out of the rain 6. walking group a. balance b. power c. speed d. strength e. aerobic endurance f. flexibility

1 -- d 2 -- b 3 -- f 4 -- a 5 -- c 6 -- e

Your patient is found to have atrophy of the right quads following right knee arthroscopic surgery with meniscectomy. The difference in quad girth is 2 cm between the right and left sides. How would dose your exercise if your treatment goal is to increase muscle fiber size (hypertrophy)? a. 3-8 RM, 4 sets, 4-minute rest b. 8-12 RM, 3 sets, 4-minute rest between sets c. 15+ RM, 2 sets, 1-minute rest between sets d. 8-12 RM, 3 sets, 1-minute rest between sets

d. 8-12 RM, 3 sets, 1-minute rest between sets

List 3 motivators for participating in therapeutic exercise.

-Enjoyment -Physical appearance -Mastery -Social connectedness

List 3 detractors for participating in therapeutic exercise.

-Pain -Fear -Time demands -Anxiety

Part 2 - Reflect on the origin, insertion, and function of the following muscles. Match each muscle as an inner unit/deep/intrinsic muscle or an outer unit/superficial/extrinsic muscle. 1. Longissmus thoracis 2. Medial fibers of quadratus lumborum a. Outer unit/superficial/extrinsic muscle b. Inner unit/deep/intrinsic muscle

1-a 2-b

Part I - Reflect on the origin, insertion, and function of the following muscles. Match each muscle as an inner unit/deep/intrinsic muscle or an outer unit/superficial/extrinsic muscle. 1. Rectus abdominus 2. Multifidus and rotatores a. Outer unit/superficial/extrinsic muscle b. Inner unit/deep/intrinsic muscle

1-a 2-b

Part I - Link each intervention to a rehabilitation approach. 1. Lumbo-sacral manipulation 2. Hook-lying transversus abdominis contraction and hold 10 counts 3. Squat training with feedback of dowel along spine a. Movement control: local mobility b. Movement control: global stability - activation c. Movement control: global stability - assimilation

1-a 2-b 3-c

Part II - Link each intervention to a rehabilitation approach. 1. Soft tissue mobilization to the right quadratus lumborum 2. Islolated hip extension independent of lumbar spine movement in quadruped 3. Repeated extension exercise in prone a. Movement control: local mobility b. Symptom modulation c. Movement control: global stability - acquisition

1-a 2-c 3-b

Part II - Link the following exercise objective with the appropriate clinical reasoning statement. (Refer to videos and worksheet for exercise names.) 1. Abdominal crunches 2. Supine selective activation of transversus abdominus a. Movement control b. Muscle conditioning

1-b 2-a

Match the following physical therapist statements (as if speaking to a patient) to each step of a therapeutic exercise intervention. 1. Exercise selection 2. Rationale for exercise selection 3. Instruction of exercise 4. Prescription of exercise parameters 5. Outcome measures a. "I chose this stretch because the lack of flexibility in front of your hip may contribute to the pain you have while walking." b. "Today we are going to teach you a stretch to increase flexibility of the front of your hip." c. "I'd like you to hold the stretch position for 30 seconds, rest 10 seconds, and repeat for a total of 3 repetitions on each leg. Try the stretches before and after you go out for your walk." d. "Let's measure your hip range of motion now that you have finished the stretch. When you get home, note if there is any change in your walking tolerance time when you stretch before your walks." e. "Watch as I demonstrate this stretch: You will lie on your back and keep your affected leg straight while holding the opposite knee toward your chest."

1-b 2-a 3-e 4- c 5- d

Part I - Link the following exercise objective with the appropriate clinical reasoning statement. (Refer to videos and worksheet for exercise names.) 1. Quadruped hip/lumbar dissociation 2. Single-leg Romanian dead lift 3. Resisted trunk rotation a. Muscle conditioning b. Movement control c. Functional optimization

1-b 2-c 3-a

You decide to prescribe a stretch to increase ankle dorsiflexion based upon a patient's subjective and objective examination findings. Match each relative examination finding with the appropriate level of the ICF model. Each match serves as a form of clinical reasoning for the selected exercise. 1. Dorsiflexion range of motion is +10 degrees. 2. Walking limited to 2 blocks. 3. Unable to participate with family in local 5k charity walk. a. Participation b. Body structure and function limitation c. Activity

1-b 2-c 3-a

Match each muscle with its action on the lumbar spine. Note some muscles have more than one function. Pick the best (most specific) choice available. 1. Transversus abdominis 2. Left multifidus 3. Bilateral iliocostalis lumborum 4. Right internal oblique 5. Right quadratus lumborum a. Lumbar extension b. Left side bend and right rotation c. Right trunk rotation d. Right side bend e. Increased intra-abdominal pressure; no torque produced on spine

1-e 2-b 3-a 4-c 5-d

The movement control phase of trunk training has 5 steps outlined in the preceding lecture segment. Match each step with the order in which training occurs. -Dissociation of the lumbar spine and hip motion -Demonstration of movement control in various postures -Selective activation of the transverse abdominus and lumbar mulitifidi -Technique training for muscle-conditioning exercise -Identification of neutral, midrange lumbar spine posture

1. Dissociation of the lumbar spine and hip motion 2. Identification of neutral, midrange lumbar spine posture 3. Selective activation of the transverse abdominus and lumbar mulitifidi 4. Demonstration of movement control in various postures 5. Technique training for muscle-conditioning exercise

Match the exercise with the number to make the correct order for exercises with the greatest to least Gluteal-to-TFL Activation Index. Unilateral bridge Sidestep Quadruped hip extension, knee extending Clam

Clam Sidestep Unilateral bridge Quadruped hip extension, knee extending

T/F: When a patient is in the mid and later stages of motor learning, a PT should increase the amount and frequency of feedback.

False

Resistance training load is set based upon the concept of repetition maximum and the training adaptation goals. A physical therapist has established the goal of improving strength of a patient's right tibialis posterior. The physical therapist teaches the exercise technique and selects a moderate tension resistance band for the exercise. The patient is able to perform a maximum of 14 repetitions with good form and through full available range of motion. Given the patient's repetition maximum with this resistance what will the primary muscle conditioning training adaptation be?

Muscular endurance

T/F: For novice trainers or individuals initiating a muscle conditioning program, the majority of gains in muscular force production during the first few weeks are attributed to neural adaptations rather than contractile element adaptations.

True

T/F: The early stage of motor learning requires more cognitive effort than later stages of motor learning.

True

J, a 17-year-old Caucasian female volleyball player, presenting to PT 1 week status-post R ACL reconstruction. Patient is weight-bearing as tolerated in extension-locked brace with bilateral axillary crutches. • Observation: Incisions clean and healing normally. Global knee effusion and proportionate redness. Visible quadriceps atrophy. • PROM: R knee = 12° - 80° with firm end-feel and pain at either end-range • Strength: o Straight Leg Raise: NT (Not Tested) due to graft precautions (no open chain knee extension 5°-60° for 8 weeks) o Quad set: delayed/diminished activation o MMT: § Quadriceps: NT R, 5/5 L § Hamstring: NT R, 5/5 L § Gluteus medius: 4-/5 R, 4+/5 L § Gluteus maximus: 4-/5 R, 4+/5 L What dosage/parameters would be appropriate for J's exercises? a) 5-10s holds, x10 reps, 4x/day b) 3 sets of 8 reps at 80% of her 1-RM, 3-4x per week c) 2 sets of 30s holds for a total time of 60s, once daily d) 2-3 sets of 2-6 reps at max effort, 3-4x per week

a) 5-10s holds, x10 reps, 4x/day

Your patient is now 12 weeks post-op. ROM, MMT's, and gait are normalized. Single leg wall sit test reveals RLE time is 60% of the LLE. Single leg squat analysis reveals decreased knee flexion and increased ipsilateral trunk lean and femoral adduction/IR on the RLE after 10 repetitions. She has just initiated lower level plyometrics and a running interval program of 1min run:2min walk for 15min. Which of these training strategies would apply the principles of motor learning in order to help J improve her kinematics during SL squats? a) Allow J to use a mirror for constant visual feedback on her single leg squats and then slowly remove that feedback as her performance improves. b) Provide verbal encouragement as she practices single leg squats c) Have J perform cognitive tasks like counting backwards by 7s while she practices her single leg squats d) Prescribe weighted double limb squats, since she is not functionally strong enough to perform single leg squats correctly.

a) Allow J to use a mirror for constant visual feedback on her single leg squats and then slowly remove that feedback as her performance improves.

When assessing Jim's performance on their squats, which of the following observations suggest that this exercise needs to be progressed? a) Good form/technique without pain and reports of "light" effort b) Good form/technique with reports of slight pain and "moderate" effort c) Compensatory form without pain and reports of "light" effort d) Compensatory form with reports of slight pain and "moderate" effort

a) Good form/technique without pain and reports of "light" effort

A physical therapist uses motor imagery cues "try to pull your hip bones together" in an effort to help a patient selectively activate their transvsersus abdominis. Which exercise strategy is this activity? a) Movement Control-Activation: training to activate hypoactive muscles or isolated movement patterns b) Movement Control-Acquisition: training to acquire the skill of dissociating or coordinating movements of the lumbar spine and adjacent regions (single plane co-contraction exercises, balance and coordination exercises, etc.) c) Movement Control-Assimilation: training to assimilate loaded multi-planar movements into ADLS step up/down progression, sit-to-stand progression, multi-planar movement progression, and so on d) Functional optimization: training to develop fitness including strength, power, endurance, aerobic capacity, sport specific training

a) Movement Control-Activation: training to activate hypoactive muscles or isolated movement patterns

Tam is reporting back pain during yoga, particularly with poses that require bending forward or sitting. You are interested in initiating multifidus movement activation training. Which exercise might be a good start? a) Standing activation with arm lift b) Supine bracing with exhale emphasis c) Hooklying hip abduction d) Bird-dog (quadruped arm & leg raise)

a) Standing activation with arm lift

What does it mean for therapeutic exercise to be "outcome-driven"? a) The ther ex is prescribed with a specific body structure/function impairment, activity limitation, or participation restriction in mind. b) The ther ex prescribed is billable to insurance. c) Specific health conditions have specific ther ex to treat it. d) The ther ex is prescribed to be done only under supervision by a licensed PT.

a) The ther ex is prescribed with a specific body structure/function impairment, activity limitation, or participation restriction in mind.

J, a 17-year-old Caucasian female volleyball player, presenting to PT 1 week status-post R ACL reconstruction. Patient is weight-bearing as tolerated in extension-locked brace with bilateral axillary crutches. • Observation: Incisions clean and healing normally. Global knee effusion and proportionate redness. Visible quadriceps atrophy. • PROM: R knee = 12° - 80° with firm end-feel and pain at either end-range • Strength: o Straight Leg Raise: NT (Not Tested) due to graft precautions (no open chain knee extension 5°-60° for 8 weeks) o Quad set: delayed/diminished activation o MMT: § Quadriceps: NT R, 5/5 L § Hamstring: NT R, 5/5 L § Gluteus medius: 4-/5 R, 4+/5 L § Gluteus maximus: 4-/5 R, 4+/5 L What is the purpose of initiating exercises this early in J's post-op recovery? a) To activate the muscles in order to mitigate the negative effects of post-operative neuromuscular inhibition b) To promote muscle hypertrophy and strengthening c) To stabilize the joint(s) involved, in J's case, the knee d) To normalize J's gait mechanics.

a) To activate the muscles in order to mitigate the negative effects of post-operative neuromuscular inhibition

EM's primary activity limitation is cross country skiing. Which of the following would be the most functional way to improve the length of her hip flexors? a) Walking forward lunge dynamic stretch b) Kneeling 2-joint hip flexor static stretch c) Supine Thomas test position static stretch d) Quad/TFL self-mobilization with foam roller

a) Walking forward lunge dynamic stretch

Resistance training load is set based upon the concept of repetition maximum and the training adaptation goals. A physical therapist has established the goal of improving strength of a patient's right tibialis posterior. The physical therapist teaches the exercise technique and selects a moderate tension resistance band for the exercise. The patient is able to perform a maximum of 14 repetitions with good form and through full available range of motion. How should the physical therapist change the exercise to maximize the target training adaptation? a. Choose a resistance band with greater resistance b. Choose a resistance band with less resistance c. Decrease repetitions d. Increase repetitions

a. Choose a resistance band with greater resistance

Which aspect of the definition of therapeutic exercise distinguishes a physical therapist from exercise professionals (coaches and trainers)? a. Remediate impairments associated with health conditions b. Reduce health-related risk factors c. Enhance physical function d. Optimize fitness

a. Remediate impairments associated with health conditions

Your patient has performed a standing right hip flexor stretch with good form in the sagittal plane. You wish to enhance the stretch by adding a frontal plane motion to the exercise. Which cue will you use? a. While maintaining your posterior pelvic tilt and forward lean from the hips, reach your arms overhead and to the left. b. While maintaining your posterior pelvic tilt and forward lean from the hips, reach your arms across the body to the right at waist height. c. Release the posterior pelvic tilt, and substitute with arms reaching overhead and to the right. d. While maintaining your posterior pelvic tilt and forward lean from the hips, reach your arms overhead and to the right.

a. While maintaining your posterior pelvic tilt and forward lean from the hips, reach your arms overhead and to the left.

You are working with an 88-yr old patient in an acute care setting who has been hospitalized for the past 2 days due to sepsis from a UTI. When you enter her room, she states that she does not want to do exercise and needs to rest. How do you respond? a) "It's the doctor's orders. You have to do it." b) "Exercising can get your circulation going and help you heal, so you can go home sooner." c) "It'll be fun and good for you." d) "You're right, we shouldn't exercise. Let's try to walk instead."

b) "Exercising can get your circulation going and help you heal, so you can go home sooner."

What is the most direct way that you can progress Jim's squat exercise? a) Have Jim perform the leg press machine b) Have Jim perform single limb squats c) Have Jim perform squat jumps d) Have Jim perform squats on a foam pad

b) Have Jim perform single limb squats

TY is an 18-year old recreational basketball player with anterior knee pain. You observe excessive femoral IR during gait. What DISTAL kinetic chain effects might you expect with this movement deviation? a) Inadequate hip extension during late stance b) Inadequate re-supination of the foot during late stance phase c) Excessive contralateral pelvic drop (i.e. Trendelenberg) during midstance d) Excessive rearfoot inversion during midstance

b) Inadequate re-supination of the foot during late stance

Your patient is now 12 weeks post-op. ROM, MMT's, and gait are normalized. Single leg wall sit test reveals RLE time is 60% of the LLE. Single leg squat analysis reveals decreased knee flexion and increased ipsilateral trunk lean and femoral adduction/IR on the RLE after 10 repetitions. She has just initiated lower level plyometrics and a running interval program of 1min run:2min walk for 15min. What would be the most appropriate dosage of J's power training? a) 3 sets of 15 reps at maximum intensity, 1 min rest breaks between sets, 4x per week b) Maximum effort, to fatigue (i.e. stop when J starts to compensate), 3x per week c) Moderate intensity, 1:1 work:rest ratio, daily d) 3 sets of 4 reps at moderate intensity, 72-hour recovery between workouts

b) Maximum effort, to fatigue (i.e. stop when J starts to compensate), 3x per week

A physical therapist uses tactile cueing to teach their patient to abduct the hip without sidebending at the lumbar spine. Which exercise strategy is this activity? a) Movement Control-Activation: training to activate hypoactive muscles or isolated movement patterns b) Movement Control-Acquisition: training to acquire the skill of dissociating or coordinating movements of the lumbar spine and adjacent regions (single plane co-contraction exercises, balance and coordination exercises, etc.) c) Movement Control-Assimilation: training to assimilate loaded multi-planar movements into ADLS step up/down progression, sit-to-stand progression, multi-planar movement progression, and so on d) Functional optimization: training to develop fitness including strength, power, endurance, aerobic capacity, sport specific training

b) Movement Control-Acquisition: training to acquire the skill of dissociating or coordinating movements of the lumbar spine and adjacent regions (single plane co-contraction exercises, balance and coordination exercises, etc.)

J is now 6 weeks post-op, is no longer using the extension brace, and is ambulating with single axillary crutch. • Gait: decreased L step length, decreased R terminal knee extension at initial contact, L weight shift/trunk lean into crutch • PROM: R knee = 0° - 130° with firm end-feel at either range (L knee = 5°- 155°) • Strength o Quad set = activation WNL (within normal limits) o Straight Leg Raise = 5 reps before quad lag o MMT § Hamstring: 4/5 R, 5/5 L § Gluteus medius: 4-/5 R, 4+/5 L § Gluteus maximus: 4-/5 R, 4+/5 L J has been working on her SLR exercise as part of her HEP, per her surgeon's recommendation. She states that she has been doing 3 sets of 10 reps. Are these optimal parameters for her? a) No - J should be doing higher reps per set to target muscle endurance adaptation. b) No - J has an extensor lag after 5 reps, so she should be only doing 5 reps per set. c) Yes - these are hypertrophy parameters, which is the target muscle adaptation. d) Yes - the surgeon prescribed these parameters for a reason.

b) No - J has an extensor lag after 5 reps, so she should be only doing 5 reps per set.

Why is incorporating performance testing in your objective examination useful? a) Physical performance testing has high reliability and has good test validity for the general patient population b) Physical performance testing combines motor control with physical capacity assessment and can highlight weak links in movement performance. c) Physical performance testing is easier to perform for the novice clinician and therefore produces more reliable results. d) Physical performance testing can be used to replace MMTs and ROM goniometry, so makes the objective exam more efficient.

b) Physical performance testing combines motor control with physical capacity assessment and can highlight weak links in movement performance.

After demonstrating and verbally instructing your patient to pick up her backpack from the floor with optimal lifting mechanics, she performs the motor skill with ideal form. At the end of the session you see her pick up the backpack from the floor with poor mechanics. This scenario is an example of a. Motor learning, not motor performance b. Motor performance, not motor learning

b. Motor performance, not motor learning

Which statement is most accurate based upon the lecture? a. Evidence is strong for stretching's effect on decreasing injury risk. b. Physical therapists select and prescribe ROM exercises linked to their patients' activity and participation limitations. c. Numerous studies suggest that stretching results in prolonged loss of force production in the muscle being stretched.

b. Physical therapists select and prescribe ROM exercises linked to their patients' activity and participation limitations.

A 48 y/o male presents to PT postgrade I right lateral ankle sprain while playing basketball with his son. His MD recommended PT for instruction of exercise to prevent re-sprain. You notice during his single leg heel raise that his right foot inverts greater than the left and demonstrates increased weight-bearing over the 4th and 5th metatarsal. MMT reveals 4/5 peroneous longus strength. Which exercise would be most appropriate to target his altered movement pattern and weakness? a. Resisted dorsiflexion and inversion with Theraband b. Resisted plantar flexion and eversion with Theraband c. Resisted dorsiflexion and eversion with Theraband d. Resisted plantar flexion and inversion with Theraband

b. Resisted plantar flexion and eversion with Theraband

Given the available evidence about stretching agonists, stretching antagonists, and muscle force production, which of the following stretching exercises might be useful to perform immediately prior to squatting to improve the force production of the gluteus maximus muscle? a. Stretching of the gluteus maximus b. Stretching of the iliopsoas c. Stretching of the hamstrings

b. Stretching of the iliopsoas

Activities like jumping and throwing require the ability to develop force rapidly. Which type of training most specifically enhances this aspect of muscle performance? a. strength b. power c. endurance

b. power

What dosage/parameters would be the most appropriate for a patient who is experiencing significant ROM restrictions after a long period of immobilization? a) 5-10s holds, x10 reps, 4x/day b) 3 sets of 8 reps at 80% of her 1-RM, 3-4x per week c) 2 sets of 30s holds for a total time of 60s, 4x/day d) Variable parameters can be used, but focus on high training volume, ideally throughout the day, with emphasis on practice to promote motor learning

c) 2 sets of 30s holds for a total time of 60s, 4x/day

Why is dosing of a particular exercise a critical component to safe and effective "exercise prescription"? a) A clinically appropriate exercise can be overdosed and produce an adverse effect on the patient. b) A clinically appropriate exercise can be underdosed and produce no effect on the patient. c) Both A & B

c) Both A & B

Which of the following concepts IS NOT part of the "Move Well" model? a) Skill b) Capacity c) Effort d) Motivation

c) Effort

Your patient has been immobilized at the L foot/ankle for 6 weeks due to a L ankle fracture after falling. They report difficulty descending stairs. "My leg feels weak & sore." Which attributes of physical capacity are likely impaired at the L foot/ankle? a) Aerobic endurance and strength b) Power and balance c) Flexibility and strength d) Muscular endurance and aerobic endurance

c) Flexibility and strength

A patient performs split squats (body weight only) in front of a mirror to ensure performance with a level pelvis in the frontal plane. Which exercise strategy is this activity? a) Movement Control-Activation: training to activate hypoactive muscles or isolated movement patterns b) Movement Control-Acquisition: training to acquire the skill of dissociating or coordinating movements of the lumbar spine and adjacent regions (single plane co-contraction exercises, balance and coordination exercises, etc.) c) Movement Control-Assimilation: training to assimilate loaded multi-planar movements into ADLS step up/down progression, sit-to-stand progression, multi-planar movement progression, and so on d) Functional optimization: training to develop fitness including strength, power, endurance, aerobic capacity, sport specific training

c) Movement Control-Assimilation: training to assimilate loaded multi-planar movements into ADLS step up/down progression, sit-to-stand progression, multi-planar movement progression, and so on

Jim returns to PT the next week reporting increased knee irritability during weight-bearing after falling over the weekend. They had to stop doing their squats due to pain. Which exercise may be more appropriate today to safely train their quadriceps? a) Clams b) Bridging c) Seated knee extensions d) Step Ups

c) Seated knee extensions

Which choice best describes the mechanism of AUTOGENIC INHIBITION when using a foam roller to perform self-STM? a) The friction of the roller on the skin increases blood flow and heat to the region, allowing for more relaxation. b) The painful stimulus of the foam roller on the muscle inhibits muscle contraction, allowing the muscle tension to release. c) The pressure of the foam roller onto the muscle creates tension on the golgi tendon organ and inhibits the muscle spindle, causing the muscle to relax d) The stretch on the muscle spindles by the foam roller inhibits muscle contraction and therefore allows the muscle to relax.

c) The pressure of the foam roller onto the muscle creates tension on the golgi tendon organ and inhibits the muscle spindle, causing the muscle to relax

J is now 6 weeks post-op, is no longer using the extension brace, and is ambulating with single axillary crutch. • Gait: decreased L step length, decreased R terminal knee extension at initial contact, L weight shift/trunk lean into crutch • PROM: R knee = 0° - 130° with firm end-feel at either range (L knee = 5°- 155°) • Strength o Quad set = activation WNL (within normal limits) o Straight Leg Raise = 5 reps before quad lag o MMT § Hamstring: 4/5 R, 5/5 L § Gluteus medius: 4-/5 R, 4+/5 L § Gluteus maximus: 4-/5 R, 4+/5 L You want to conduct a performance test in order to assess J's quadriceps endurance. Which of the following tests would be most appropriate? a) Side hop test b) Y-balance and reach c) Wall sit d) Modified Sorensen test

c) Wall sit

Your patient has been performing static calf stretching, and you wish to introduce dynamic calf stretching. Which of the following is the most appropriate prescription of repetition and duration for the dynamic calf stretch? a. 10-second hold per leg, 3 reps each leg b. 30-second hold per leg, 2 reps each leg c. 3-second hold per leg, 10 reps each leg d. 30-second hold per leg, 1 rep each leg

c. 3-second hold per leg, 10 reps each leg

When is the most optimal time to perform stretching exercises? a. When a patient first wakes up in the morning b. When combined with balance and muscle conditioning exercises c. After a physiological warm-up

c. After a physiological warm-up

Training volume is defined as the product of exercise, repetitions, and sets. High volume training most specifically targets which muscular adaptation? a. hypertrophy b. strength c. endurance d. power

c. endurance

Jim has been performing 3 sets of 15 squats as part of their quadriceps conditioning program since undergoing knee surgery 3 months ago. What muscular adaptation goals are these parameters targeting? a) Strength b) Power c) Hypertrophy d) Endurance

d) Endurance

A patient performs a resisted trunk rotation on a cable machine while the physical therapist provides intermittent verbal feedback on the patient's performance. Which exercise strategy is this activity? a) Movement Control-Activation: training to activate hypoactive muscles or isolated movement patterns b) Movement Control-Acquisition: training to acquire the skill of dissociating or coordinating movements of the lumbar spine and adjacent regions (single plane co-contraction exercises, balance and coordination exercises, etc.) c) Movement Control-Assimilation: training to assimilate loaded multi-planar movements into ADLS step up/down progression, sit-to-stand progression, multi-planar movement progression, and so on d) Functional optimization: training to develop fitness including strength, power, endurance, aerobic capacity, sport specific training

d) Functional optimization: training to develop fitness including strength, power, endurance, aerobic capacity, sport specific training

EM is an active and healthy 70-year old female s/p R ORIF of the femur 4 months ago. She is (+) on Thomas test with knee extended by approx 15deg. You plan to prescribe a dynamic hip flexor stretch. What is the ANTAGONIST muscle group in this scenario? a) Lumbar extensors b) Lumbar flexors c) Hip abductors d) Hip extensors

d) Hip extensors

After explaining the benefits of exercise to your patient, she is agreeable to exercise. She has a 20deg extensor lag during a straight leg raise and is unable to perform a sit-to-stand without using her UE. What muscle groups should be targeted? a) Hip flexors and hip abductors b) Trunk extensors and trunk flexors c) Knee flexors and plantar flexors d) Knee extensors and hip extensors

d) Knee extensors and hip extensors

Red is s/p R knee MCL sprain 2 months ago. He still reports instability when hiking > 3 miles. MMT R gluteus medius is 4/5. Which muscle conditioning exercise would you select based on his level of function, activity of interest, and symptom irritability? a) Clamshells with resistance band b) Bridging with resistance band c) Seated hip abduction (with weight machine or with resistance band) d) Lateral step down with resistance band

d) Lateral step down with resistance band

J, a 17-year-old Caucasian female volleyball player, presenting to PT 1 week status-post R ACL reconstruction. Patient is weight-bearing as tolerated in extension-locked brace with bilateral axillary crutches. • Observation: Incisions clean and healing normally. Global knee effusion and proportionate redness. Visible quadriceps atrophy. • PROM: R knee = 12° - 80° with firm end-feel and pain at either end-range • Strength: o Straight Leg Raise: NT (Not Tested) due to graft precautions (no open chain knee extension 5°-60° for 8 weeks) o Quad set: delayed/diminished activation o MMT: § Quadriceps: NT R, 5/5 L § Hamstring: NT R, 5/5 L § Gluteus medius: 4-/5 R, 4+/5 L § Gluteus maximus: 4-/5 R, 4+/5 L Which of the following exercises would be appropriate for J to initiate today? a) Straight leg raise b) Seated knee extension c) Bridges d) Quad sets

d) Quad sets

J is now 6 weeks post-op, is no longer using the extension brace, and is ambulating with single axillary crutch. • Gait: decreased L step length, decreased R terminal knee extension at initial contact, L weight shift/trunk lean into crutch • PROM: R knee = 0° - 130° with firm end-feel at either range (L knee = 5°- 155°) • Strength o Quad set = activation WNL (within normal limits) o Straight Leg Raise = 5 reps before quad lag o MMT § Hamstring: 4/5 R, 5/5 L § Gluteus medius: 4-/5 R, 4+/5 L § Gluteus maximus: 4-/5 R, 4+/5 L You decide that J would benefit from muscle conditioning in functional positions that help to improve her R stance phase of gait. Which of these exercises would most directly target impaired R stance? a) Bridging b) Sit-to-stands c) Wall sit d) Standing isometric closed kinetic chain hip abduction

d) Standing isometric closed kinetic chain hip abduction

Which statement best differentiates prescription of stretching exercises between a healthy structure and structures in which ROM is impaired? a. Stretching volume (reps x hold times) should be greater for healthy structures while stretching frequency should be greater for structures with ROM impairments. b. Both stretching volume (reps x hold times) and frequency of performing stretching exercises is greater for healthy structures compared to those with ROM impairments. c. Stretching volume (reps x hold times) should be greater for structures with ROM impairments while stretching frequency should be greater for healthy structures. d. Both stretching volume (reps x hold times) and frequency of performing stretching exercises is greater for structures with ROM impairments compared to healthy structures.

d. Both stretching volume (reps x hold times) and frequency of performing stretching exercises is greater for structures with ROM impairments compared to healthy structures.

Choose the most logical exercise progression to allow a patient to ultimately and safely perform a single-leg squat following ACL reconstruction. a. Step-downs, decline step-downs, then single-leg squats b. Anterior lunges, decline step-downs, then single-leg squats c. Bench split squats, split squats, then single-leg squats d. Split squats, bench split squats, then single-leg squats

d. Split squats, bench split squats, then single-leg squats

Which of the following is NOT a proposed mechanism of foam rolling to increase muscle length? a. Altered viscoelastic properties of the fascia b. Increased blood flow c. Changes in muscle spindle length or stretch perception d. Mechanical disruption of scar tissue e. Adding sarcomeres to muscle fibers

e. Adding sarcomeres to muscle fibers