Rehab Final Exam
Loads/Reps for Power
-80-90% of their max -Low Reps (1-2)
Identify what the acronym ATC IS IT represents.
-A: Avoid aggravation -T: Timing -C: Compliance -I: Individualization -S: Specific Sequences -I: Intensity -T: Total Patient
What are some possible benefits of massaging scar tissue?
-Breaking up the scar tissue -Increase flexibility -Decrease Pain -Increase ROM
Compression
-Compressing skin together -Pinching
What might an athlete c/o if he has "crimped" nerves and what may cause this?
-Crimped nerve-tightness/stiff feeling of nerve -This could be from an entrapped nerve, overuse/stress injury, stress type of activity.
Grade 1 joint mobilization
-Decrease pain -Light ossulations -Light/beginning ROM
Grade 2 joint mobilization
-Derease pain -Beginning/mid ROM
Discuss the difference between Flexibility and ROM.
-Flexibility- the extensibility of a muscle or tendon. -ROM- movement that can fully occur at a joint (full movement of a joint)
Vibration
-Friction type movement on skin
How does functional exercise differ from functional examination?
-Functional Exercise- one specific exercise performed in functional assessment -Functional Examination- combination of all exercises performed
Percussion
-Hacking/Hitting type motion like drums -Tapping
Grade 4 joint mobilization
-Increase ROM -maximal ROM light ossulations
Grade 3 joint mobilization
-Increase ROM -mid to close to end ROM
Loads/Reps for Endurance
-Low Loads (less than 67% of their max) -High Reps (12 or more)
Grade 5 joint mobilization
-Manipulation -Surpassing maximal ROM -More chiropractic technique
Loads/Reps for Hypertrophy
-Moderate loads, 67-85% their max -High Reps (6-12)
Loads/Reps for Strength Exercises
-More than 85% of their max -Low reps (<6)
What should we tell our athletes to expect during a neural flossing treatment?
-Neural flossing is supposed to help increase ROM and joint mobilization. -Athletes may expect a tightness feeling when exercises are performed but should feel looser after treatment.
What type of functional testing could you use for a football receiver who has sustained a second degree MCL sprain?
-Open-Chain Skills: short arc quads, SLR -Closed Chain Skills: TKE's, heel taps, squats -Sport-Specific skills: catching a football, short sprints, cutting, tackling, blocking Position Specific Skills: Running routes, cutting, catching a pass from different directions, blocking
If a swimmer has strong abdominals and weak spine muscles, what posture will the swimmer display and what other imbalances may be seen?
-Posterior tilt; kyphosis -Weak back, weak quads -Strong/stretched hamstrings, gluteus maximus, and iliopsoas -Strong abdominals, rectus abdominus
Petrissage
-Rolling/Kneading technique
Define the SAID principle.
-S: Specific -A: Adaptations to -I: Imposed -D: Demands
Effleurage
-Standard massage -Rubbing type motion -Introduce yourself to the patient
Use three types of orthodics and give an example of the use of each.
-Steel/Hard: turf toe injury -Semi-Rigid: help with arch support -Custom Made: specific injury for specific athlete
What is meant when it is said that the body is a tensegrity unit?
-The body all works together
Osteokinematics
-What the bone is doing -What we can physically see
Arthrokinesmatics
-What the joint is doing -What is going on inside the joint/body
The loose packed position for the patellofemoral joint is what?
0 degrees knee extension
If you were performing an FCE on a car mechanic what are five job-specific activities you would have them perform? How would you determine reps/sets/weights/time?
1. Changing oil- pronation and supination 2. Changing tire- flexion, extension, rotation of shoulder 3. Fixing a battery- wrist flexion, pronation, supination, wrist extension, etc. 4. Changing brake lights/head lights- shoulder extension, shoulder flexion, wrist flexion and extension 5. Fixing/changing windshield/windshield wipers- shoulder flexion, shoulder extension, shoulder rotation. -Do more than just stationary arm exercises. -YOu would want to base reps/sets/weights/time on the employees actual activity. You wan to base it on how long, how much, and things along those lines that are apart of the persons actual job. They should be similar to real life. You want life like stimulations.
Name the two primary indications for joint mobilizations
1. Decrease swelling/Pain 2. Increase ROM/Mobilization
List a progression of five mini-squats within a rehabilitation program.
1. Double leg mini squat holding on for balance (even surface) 2. Double leg mini squat not holding on (even surface) 3. Double leg mini squat eyes closed (even surface) 4. Double leg mini squat holding on (uneven surface) 5. Double leg mini squat not holding on (uneven surface)
What are at least 3 contraindications for stretching?
1. Fracture 2. Bony Block 3. Infection
8 Major categories of testing starting after history? Give an example of one way to test the client within each category.
1. Girth- measure with tape measurer different parts 2. Flexibility/ROM- goniometer measurements 3. Manual Muscle Testing- strength testing of muscles 4. Strength- lifting weights 5. Force Grip- dynamometer; different lifting techniques 6. Vitals- HR, BP with and without activity 7. ADLS- simple everyday activities 8. Job Specific Activities- specific activities related to the person's job
How might you break up scar tissue 6 months post-op?
1. Myofascial Release 2. Lymphatic Drainage 3. Deep Tissue Friction 4. Compression 5. Heat 6. Lubrication -Compressing together around scar -Pushing together around scar -Moving away from scar -Light Ossolations on scar, etc.
Name a minimum of 5 ABSOLUTE contraindications of joint mobilizations.
1. Osteoporosis 2. Fracture 3. Hypermobility
Give an example of two exercises to relieve extensor lag of the quadriceps.
1. Patellar mobilizations 2. Heel slides 3. Wall slides being supine
Special tests need what four things to be valuable to our profession?
1. Reliability 2. Sensitivity 3. Validity 4. Specificity
List at least 5 different pieces of equipment that can be used as part of the lower extremity neuromuscular and rehabilitation exercise
1. Theraband 2. Bosu Ball 3. Swiss Ball 4. BAPS Board 5. Airex Pad
List 10 shoulder complex exercises that research has shown to be "optimal" according to our Houglum textbook.
1. Theraband ER 2. Theraband IR 3. Theraband Extension 4. Theraband ER at 90 dgrees 5. Seated Rows
List three reasons FCE's are performed.
1. Workers Comp 2. Insurance Claims 3. Employer for return to work/limitations for returning to work
4 Main factors of a joint in an open packed position
1. decrease space between joint/bones that make up joint 2. tissue is relaxed
The normal angle of the femoral head is _______ degrees anterior to the long axis of the shaft of the femur and femoral condyles
15
Which class of levers tends to have the greatest mechanics advantage?
2nd
When measuring ROM, one should expect to accurate within how many degrees?
3 to 5 degrees
Loose packed position of the hip is what?
30 degrees abduction and 30 degrees flexion
Scapular plane position is approximately what position of the shoulder?
30 degrees horizontal flexion
How long does the history portion of an FCE generally take?
45 minutes
What percentage of diagnosis comes from history portion of exam?
80%
In which phase of rehabilitation is rest and pain control most important?
Acute Phase
Which of the following is an indication for use of manual therapy?
Adhesion
Tensile strength of a wound is directly related to what?
Amount of collagen present
An athlete is performing a hamstring curl as an exercise for a hamstring strain. This exercise is considered to be what?
An open kinetic chain exercise
List two open chain exercises and three closed chain exercises that can be performed for the knee
CC: Supine TKE's -Single leg heel taps -Squats OC: short arch quads -SLR
When incorporating neuromuscular training into a rehabilitation protocol, which of he following exercises would be considered a multiplanar exercise for the lower extremity?
Carioca drill through the agility ladder
Connective tissue obtains its strength primarily from what?
Collagen
Macrophages are responsible for what?
Debridement, Recruitment of other macrophages, Release of growth factors
The first priority of a rehabilitation program should be what?
Decrease pain and swelling
Which of the following types of drills is generally considered the most intense?
Depth jumps
Complete this definition of the stretch-shortening cycle of plyometrics: A rapid ___________ muscle action stimulates the stretch reflex and storage of elastic energy, which increases the forces produce during the subsequent ______________ action.
Eccentric, Concntric
If the heel counter and medial heel are collapsed to the medial side, the patient does what?
Excessively pronates
Flexion during the D1 and D2 upper extremity PNF pattern is always associated with what motion?
External rotation
A grade 3 anterior glide of the humerus on the glenoid will increase shoulder flexion.
False
A hypermobile tibiofemoral joint is an indication for joint mobilization techniques.
False
An object is most stable when the line of gravity falls outside the base of support.
False
At the time an injury occurs, there is a brief period of vasodilation followed by vasoconstriction.
False
Contracture of the hip extensors are a major cause of lordosis.
False
Mobilization techniques are performed perpendicular to the treatment plane and traction is performed parallel to the treatment plane.
False
Phases of the healing process are clearly defined and have definite start and ending points.
False
Proprioceptors are important for body movement and athletic activity but not for static functions such as standing.
False
Retroversion typically results in a toe in gait.
False
Since functional activities are multiplanar, therapeutic exercises should begin with diagonal pattern exercises.
False
Strength does not play a role in balance.
False
Strengthening exercises should begin above 90 degrees to maximize scapular muscle activity.
False
The extensor hallicus longus is housed deep in the posterior compartment.
False
The rehabilitation progress for a stress fracture and a slipped capital femoral epiphysis are the same.
False
The shortest healing phase is the remodeling phase.
False
The way a shoe is laced has little impact on the support the shoe can provide.
False
Training plyometrics daily is considered essential in power/explosive sports.
False
When an athlete walks into the athletic training room you notice that he/she is walking toe-in. This could be a result of what?
Femoral anteversion
A therapeutic exercise program progression is sequentially organized in the following order of sequence:
Flexibility, Endurance and Strength, Proprioception and Coordination, and Functional Activities
For the previous question, what would return to play protocol look like for an athlete returning from a grade 2 MCL sprain?
Full ROM, no swelling, no pain, 75% or greater strength, able to complete functional activities for sport with no pain
During ankle rehabilitation the final phase includes what?
Functional Exercises
The ___________ cause a reflex inhibition in the antagonist muscle and protects the musculotendinous unit for excessive tensile forces.
Golgi Tendon Organs
A hamstring muscle that can go through a full range of motion and resist light manual resistance while side lying, but no manual resistance in prone is graded what?
Grade 3
A quadriceps muscle that can go through a full ROM against gravity and resist light manual resistance but not heavy resistance is given what grade?
Grade 4
An athlete who sustains a severe or career-ending injury may go through a progression of emotional reactions, which are frequently seen with an individual who has experienced a significant loss. All of the following are included in this series of reactions except what?
Guilt
Which muscle group provides the most dynamic stability for patients with an ACL injury?
Hamstrings
Selection of a swiss ball size is based on what?
Height of the patient
What motion of the hip is greatly reduced in most (if not all) ankle sprains even through the running RTP.
Hip extension
Which of the following is not an indicator of being too aggressive with exercise?
Increased Flexibility
Rhythmic Stabilization
Isometric contraction of agonist followed by an isometric contraction of antagonist
Repeated Contractions
Isometric contraction of antagonist followed by isotonic contraction of agonist followed by isometric contraction of agonist
Hold-Relax
Isometric contraction of antagonist followed by relaxation
Slow-Reversal-Hold
Isotonic contraction of antagonist followed by an isometric contraction of antagonist followed by the same sequence of the agonist
Contract-Relax
Isotonic contraction of antagonist followed by relaxation
Slow-Reversal-Hold-Relax
Isotonic movement, followed by isometric movement of antagonist, relaxation, followed isotonic of agonist
Muscle Endurance is improved primarily through a therapeutic exercise program that emphasizes what?
Low resistance, high repetitions
Posterior glides of the hip help to increase which motion?
Medial rotation and flexion
If the scapula is unstable the glenohumeral joint tends to?
Migrate superiorly
Stationary contractions that are performed every 20 degrees throughout the available ROM are called what?
Multiple-Angled Isometric Exercises
It takes less force to move a limb fast through its ROM than it does to move it more slowly due to which of Newton's laws?
Newton's law of momentum
A ___________ stretching technique is most likely to require the aid of an exercise partner?
PNF stretch
What was one way to measure pain that is more accurate than the standard 1-10 scale?
PROMIS
Which of the following massage techniques are methods of petrissage?
Pinching, Rolling, Kneading
During the healing process, when do you see the formation of granulation tissue and the migration of phagocytes and fibers to the injured area?
Proliferation Phase
What conditioning component is needed to perceive the position of the knee as the foot lands on the ground?
Proprioception
Short term goals should be what?
Reasonable and attainable, challenging, discussed with the patient in advance
Which of the following are recommended on the treadmill?
Retrowalking, Carioca, ROM exercises, Gait Analysis
What occurs when one point on an articular surface comes in contact with different points on a second articular surface?
Slide
In which technique does the athlete move through a complete ROM against a maximal resistance in a smooth and rhythmic pattern?
Slow Reversal
Balance is a function of what?
Somatosensory system, Vestibular system, and Oculomotor
What is a functional deficit?
Something that can be seen on a functional exam as still lacking/having problems with/limited
Dynamic stretching is most similar to which of the following?
Specific Warm-up
With an anterior tilt what is happening in the spine and hip?
Spine- Extension Hip- Flexion
With a posterior tilt what is happening in the spine and hip?
Spine-Flexion Hip Extension
The stretch method that uses a stretch that is held for a long period of time is what?
Static stretch
Which of the following surfaces is most appropriate for plyometric activities?
Suspended floors
Dorsiflexion-plantar flexion motion occurs at which joint?
Talocrural
When training to develop agility, which of the following should be done first?
Teach proper exercise technique
Agonist Reversal
Technique that employs movement at the end range-eccentric, concentric, and eccentric contraction of the same muscle
Proprioceptors are located throughout the body in muscles, tendons, and joints to provide sensory awareness of what?
The Position of the Joint
In the human body, the point of attachment of the muscle causing the motion is always closer to the joint axis than the resisting motion. Which type of lever system most commonly exists in the body?
Third
A heavy athlete places more stress on his/her body than a light athlete while performing plyometrics.
True
A long-term goal of a therapeutic exercise program is its final desired outcome.
True
A medial glide mobilization technique for the hip increases hip extension and lateral rotation.
True
A meniscal repair has a much slower rehabilitation progression than a meniscectomy, but is generally considered more advantageous than a meniscectomy.
True
A patient with a piriformis syndrome can have pain into the leg that mimics S1 nerve root irritation.
True
A shoulder rehabilitation program should be designed to restore shoulder stability through inclusion of the neuromuscular re-education and muscle balance.
True
An athlete's center of gravity changes during motion.
True
Collagen is the structure targeted with stretching exercises to increase motion.
True
Corman's exercises are performed with passive movement of the shoulder muscles to increase shoulder motion.
True
Creep time is time dependent , so a load that is applied for a longer time is more effective in causing a change in tissue length that a quickly applied load.
True
Double support in the gait cycle occurs during heel strike of one leg and just before toe off of the other leg.
True
Force couples are two equal forces acting in opposite but parallel directions to create a rotary motion.
True
Full ROM of an affected body part is a major criterion before the athlete can return to participation.
True
Growth of new blood vessels is called angiogenesis.
True
Hip anteversion and retroversion are conditions that alter knee alignment.
True
Hip sprains are relatively uncommon in athletic injuries.
True
If the athlete;s hip flexors are tight, the hip extensors are probably weak.
True
It can take more than a year for an injured part to regain maximal tensile strength.
True
It is best to teach PNF patterns prior to adding weight or resistance.
True
Joint mobilization is usually initiated in an open-packed position to obtain the most effective results.
True
Low resistance, high repetition strengthening exercises are commonly used in early phases of rehab to reduce excessive stresses on the joint.
True
More shear stress is placed on the knee in open chain terminal extension than in closed chain terminal extension.
True
Muscle Strength imbalances can be increased by myofascial pathology.
True
Patella alignment should be assessed in both static and dynamic activities and in open and closed kinetic chain conditions.
True
Poor posture can reduce the body's efficiency during movement.
True
Rhythmic initiation involves voluntary relaxation, passive movement and repeated isotonic contractions of the agonist pattern.
True
Shortening the stride length will reduce stress applied to the hip during ambulation.
True
The athlete can perform neural mobes themselves with bands, but they won't be as effective as if they were performed by a clinician.
True
The primary goal of the advanced phase of rehabilitation exercises is to fully restore power, flexibility, endurance, speed, and agility of the injured part as well as the entire body.
True
The purpose of plyometrics is to increase the power of subsequent movements by using natural elastic components of muscle and tendon and the stretch reflex.
True
The recommended height of a box jump is 16 to 42 inches tall.
True
The sacroiliac joint can refer pain to the back or hip.
True
The shortest phase in plyometric exercises is the amortization phase.
True
The volume of plyometrics is usually expressed in terms od contacts per session (foot contacts, throws, or catches).
True
When deciding the order of exercises, multi joint exercises are performed before single joint, and large muscle group before small muscle group exercise in training.
True
When the concave surface is stationary and the convex surface is moving, mobilization should be performed in the opposite direction as the bone.
True
When the weight bearing knee is in flexion, the posterior aspect of the joint receives the majority of its compressive forces.
True
An athlete with a functionally unstable knee is completing a neuromuscular control rehabilitation program. The athlete has completed the bilateral balancing exercises on an unstable surface with visual input. Which of the following is most appropriate to follow this exercise in progression?
Two-foot balance on a foam pad with eyes closed
When initiating a lower extremity plyometric training program during the rehabilitation of an athlete with patellar tendonitis, which of the following exercises should be completed in the first week of the program?
Two-legged side-to-side line jump
Which of the following are precautions/contraindications of therapeutic massage?
Varicose Veins, Thrombophlebitis, Arteriosclerosis, Abscesses
For which of the following player positions is the shoulder press most sport specific upper body exercise?
Volleyball setter
Which of the following would be specific functional test for dorsiflexion?
Walk on heels
What kind of joint mobilization would we utilize on a gymnast with hypermobile shoulders?
You would not want to use joint mobilizations on this athlete because hypermobility is a contraindication
What is the concave-on-convex rule?
if concave is moving around a convex then the roll and glide happen in the same direction
An extensor lag is defined as a condition with full ___________ motion, but ____________ extension is incomplete.
passive, active