TE Exam review
Substitutions by the patient during resistance exercise usually can be avoided by which of the following: a. applying alignment and stabilization principles used for MMT b. increasing the load c. increasing the speed of repititions d. using open-chain techniques
A
Describe part practice for motor learning
A task is broken down into separate dimensions where individual and usually the more difficult components of the task are practiced
Which type of exercise is described as a form of dynamic exercise in which the velocity of the joint angular velocity is predetermined and held constant by a rate-limiting device - refers to movement that occurs at a constant velocity
Isokinetic exercise
The principle of resistance training that suggests in order to increase muscle performance, the load MUST be greater than the metabolic capacity of the muscle is which principle?
Overload principle
Describe the major goals during the acute stage of tissue healing
Prevent harm or damage and control inflammation
How can DOMS be prevented?
Progressing the intensity and volume of an exercise program gradually
Which should come first in a progression of neuromuscular control, proximal or distal control?
Proximal
Define continuous task
Repetitive, uninterrupted movements that have no distinct beginning and ending
The principle of resistance training that suggests adaptive changes in the body's systems in response to a resistance exercise program are transient unless train-induced improvements are regularly used for functional activities or unless an individual participates in a maintenance program is which principle?
Reversibility principle
Which should come first in a progression for range of motion, short arc or full arc?
Short arc
A supine lying patient slowly lowers their arm from 90* (straight up in the air) to lying on the table above their head, reaching 180* flexion. Which muscle group is working and how are the muscles contracting?
Shoulder extensors are eccentrically contracting
A supine lying patient lifts their shoulder straight up from hip to 90*, so that it is pointing straight up at the ceiling. Which muscle group was primarily working and how were the muscles contracting
Shoulder flexors concentrically contracting
Which should come first in a progression of functional movement patterns, multi or single joint movments?
Single joint
Describe random-order practice
Slight variations of the same task are carried out in an unpredictable order
The principle of resistance training that suggests the adaptive effects of training, such as improvement of strength, power, and endurance, are highly specific to the training method employed is which principle?
Specificity of training principle
Which should come first in a progression, exercising in the unstable portion of range or the stable portion of range?
Stable
Is a patient after surgery more likely to start with dynamic or static muscle contractions?
Static
In which stage of tissue healing is the therapists role critical due to their understanding of the healing process and tissue response to stresses?
Subacute
In which stage of tissue healing is there growth of capillary beds in the area, collagen formation, and granulation tissue, but the area is still fragile and easily injured
Subacute
Which stage of healing is characterized by decreased inflammation and pain that is synchronous with tissue resistance
Subacute
Which intensity is a patient most likely to start with, a near-maximal or a submaximal load?
Submaximal
Describe whole practice for motor learning
The entire task is performed from beginning to end and is not practiced in separate segments
Describe a grade 3 MMT
The muscle can complete full ROM against gravity but cannot withstand any resistance
Describe a grade 2 MMT
The muscle completes available ROM in the gravity-lessened position, but no ROM in the against gravity position
Describe a grade 1 MMT
The muscle or tendon has a palpable contraction but no movement of the joint is detected
Describe a grade 4 MMT
The muscle takes resistance but gives at end range
Describe a grade 5 MMT
The muscle withstands maximal resistance
What is the associative stage of learning?
The patient makes infrequent errors and concentrates on fine-tuning the motor task during this stage. The patient explores slight variations and modifications and requires infrequent feedback - the 2nd stage
Describe blocked-order practice
The same task or series of exercises or tasks is performed repeatedly under the same conditions and in a predictable order
True or false: Step ups to a curb to improve stair-climbing ability is an example of task-specific functional training?
True
True or false: carrying a tray of food from the kitchen to the living room, using the same tray and route each time is an example of body transport with manipulation?
True
True or false: following unaccustomed, high-intensity eccentric exercise, there is greater incidence and severity of delayed-onset muscle soreness than there is after concentric exercise
True
True or false: most patients are discharged before reaching the autonomous stage of learning?
True
True or false: muscle activation occurs in multiple muscle groups, both distal and proximal to the moving joint in closed chain exercises
True
True or false: plyometric training is an example of power training?
True
True or false: random/blocked-order practice results in faster skill acquisition than random-order practice
True
Which should come first in a progression, uniplanar or multiplanar movements?
Uniplanar
Describe random/blocked-order practice
Variations of the same task are performed in random order, but each variation of the task is performed more than once
What is the cognitive stage of learning?
When learning a skilled movement, a patient first must figure out what to do - that is, the patient must learn the goal or purpose and the requirements of the exercise or functional task. The patient is focused on correct performance and required frequent feedback - the 1st stage
What would be the the appropriate progression for the width of base of support in closed chain exercises
Wide before narrow
In terms of exercise order, should lower-intensity or higher-intensity exercises be performed first?
higher intensity before lower intensity
Define discrete task
involves an action or movement with a recognizable beginning and end - grasping an object
In terms of exercise order, should you exercise small or large muscle groups first?
large before small
Describe physical practice for motor learning
the movements of an exercise or functional task are actually performed
At how many weeks post-injury is scar tissue unresponsive to remodeling?
14 weeks
In sitting, a patient is able to flex the hip through 75% of the available ROM without manual resistance. In side-lying, the patient is able to flex the hip through the full ROM. What should the PTA record as the patients hip flexor muscle grade?
3-/5
At which MMT grade for the LE should the patient be before discontinuing the use of supportive or assistive devices with ambulation?
4/5
In order to achieve adaptive changes, an isometric muscle contraction should be held for how long?
6-10 seconds
When testing the iliopsoas for a grade 3 or greater, the PTA should place the muscle in: a. a gravity-lessened position b. a position where the muscle is maximally elongated and against gravity c. a position where the muscle works with gravity d. a position against gravity
A
Which of the following is a correct wat to reduce the risk of a pathological fracture? a. avoid trunk flexion with rotation b. initially perform 2-3 sets of 15-20 reps of 1-2 different exercises for the first 1-2 weeks c. avoid any weight bearing exercises all together d. perform resistance exercises 5-7 times per week with intensity to a minimum of 80% 1RM
A
Which of the following is the soft tissue lesion characterized by repeated submaximal overload or frictional wear? a. cumulative trauma disorder/overuse syndrome b. bursitis c. tendinopathy d. synovitis
A
Which of the following is true regarding type 1 (slow twitch) muscle fibers? a. they have a small diameter b. they have a low capillary density c. they are anaerobic d. they have low resistance to fatigue
A
Describe mental practice for motor learning
A cognitive rehearsal of how a motor task is to be performed occurs prior to actually executing the task - the terms visualization and motor imagery practice are used synonymously with mental practice
Define serial task
A series of discrete movements that are combined in a particular sequence - to eat with a fork (grasp, position, hold, scoop, lift)
Stretching and resistive exercise at the site of inflamed or swollen tissue is contraindicated in which stage of recovery?
Acute
Which stage of healing is characterized by inflammation, painful and guarded ROM before tissue resistance
Acute
Your patient has pain before tissue resistance with shoulder flexion. Which stage of recovery is MOST likely present?
Acute
When trying to palpate a muscle, what can you do to better feel the contraction?
Add resistance to the action of the muscle
What term is described by abnormal adherence of collagen fibers to surrounding structures during immobilization, after trauma, or as a complication of surgery, which restricts normal elasticity and gliding of the structures involved
Adhesion
Which of the following is a precaution to reduce the risk of a pathological fracture for a patient with osteoporosis? a. perform high intensity, high-volume weight training b. perform standing LE exercises while holding a countertop c. perform weight lift exercises daily d. integrate weight-bearing activities such as jumping or hopping
B
Which of the following is appropriate during the acute stage of an ankle ligament sprain a. endurance exercises to the ankle joint b. AROM to the hip joint c. stretching to the ankle joint d. near-maximal isometrics to the ankle joint
B
Which of the following is correct? a. the force during eccentric contraction increases steadily with increased velocity of contraction b. the force during concentric contraction decreases steadily with increased velocity of contraction c. the force during concentric contraction increases initially and then quickly levels off with increased velocity of contraction d. the force during eccentric contraction decreases initially and then quickly levels off as the velocity increases
B
Which of the following refers to the amount of external resistance imposed on the contracting muscle during each repetition of an exercise? a. volume b. intenisty c. mode d. frequency
B
Which type of exercise should be considered in order to vary the resistance across the active ROM to accommodate for the internal torque produced due to changes in muscle length and internal moment arms? a. isotonic exercise b. isokinetic exercise c. isometric exercise
B
Which type of feedback is an effective strategy to reduce the total amount of feedback given during the associate stage of learning? a. minimal to no feedback b. infrequent feedback c. no feedback/total independence d. frequent feedback
B
Your patient is in the associative motor learning stage. Which of the following would be true? a. the movements are automatic and the patient does not need to pay attention to the risks b. the patient would start to explore inter-trial variability c. the patient performs the motor task with frequent errors d. the patient requires frequent feedback from the PTA
B
Near-maximal exercise loads would be recommended for which of the following patients? a. 8 y.o. child with a subacute quadriceps strain b. 65 y.o. pt that has been on prolonged bedrest c. 40 y.o. client without known pathology who wants a conditioning program d. 30 y.o. pt with acute rotator cuff strain
C
What is the most important intervention that cannot be overemphasized at the end of the chronic stage to return to high demand activities? a. trunk stabilization b. progress open to closed chain activities c. proper education to teach a safe progression of exercise and how to avoid damaging stresses d. rest, ice, compression, elevation
C
When testing the iliopsoas for a grade 3 or greater, the PTA should place the muscle in: a. a position where the muscle works with gravity b. a gravity-lessened position c. a position against gravity
C
Which of the following is a general precaution during resistance training? a. have the patient hold breath during resisted exercise b. pain during exercise is normal c. prevent incorrect or substitute motions by adequate stabilization d. Resistance at the distal tibia/fibula region is permitted with a hip fracture that is not completely healed
C
Which of the following is a sign of excessive stress with exercise during the subacute stage? a. increased ROM over several exercise sessions b. decreasing feelings of stiffness c. progressive weakness over several exercise sessions d. temporary soreness that decreases within 2 hours of exercise
C
Which of the following is considered a serial task? a. lifting a weight b. performing a self-stretch c. performing a wheelchair transfer d. walking
C
Which of the following is the criteria to initiate active exercises in the early controlled motion phase? a. pain with ROM b. increased fatigue after 24 hours c. decreased swelling d. constant pain
C
Which stage of healing is characterized by absence of inflammation and pain after tissue resistance
Chronic
Your patient with a shoulder problem presents with no inflammation and only has stretch pain after tissue resistance. Which stage of recovery is this?
Chronic
What term is described as adaptive shortening of skin, fascia, muscle, or a joint capsule that prevents normal mobility or flexibility of that structure?
Contracture
Early gains in muscle strength associated with the initiation of a resistance training program are the result of which of the following factors? a. neuromuscular recruitment and muscle fiber hyperplasia b. muscle fiber hypertrophy and hyperplasia c. muscle fiber-type conversion and muscle fiber hypertrophy d. neuromuscular recruitment and muscle fiber hypertrophy
D
Which best describes a grade 2 soft tissue injury? a. instability of the joint b. mild pain at the time of injury c. complete tear of the tissue d. pain that requires stopping the activity
D
Which of the following is a contraindication to resistance exercise: a. absence of pain b. diabetes mellitus II c. mild/controlled hypertension d. post op day 10 status post CABG (post-operative day 10 status post coronary artery bypass graft; 10 days after open heart surgery)
D
Which of the following refers to the number of sessions per day or week? a. mode b. volume c. intensity d. frequency
D
What term is described by loss of normal function of a tissue or region?
Dysfunction
The type of resistance exercise considered an essential component of rehabilitation programs for musculoskeletal injuries to reduce the risk of re-injury associated with high intensity deceleration or quick changes of direction focuses on what type of muscle contraction
Eccentric
What is the word that describes a grade 3 MMT
Fair
True or false: It is thought that open chain training elicits greater proprioceptive and kinesthetic feedback than closed chain training
False
True or false: open chain exercises are typically performed in weight bearing positions
False
True or false: strength training is the systematic practice of using muscle force to raise, lower, or control heavy external loads over a long period of time
False
The PTA should use which part of the hand to palpate during a MMT
Finger pads
What degree of tissue injury is characterized by mild pain at the time of injury or within the first 24 hours, mild swelling, local tenderness, and pain when the tissue is stretched?
Grade 1
What degree of tissue injury is characterized by moderate pain that requires stopping activity, stress and palpation of the tissue greatly increases pain, and torn fibers that result in some increased joint mobility
Grade 2
What degree of tissue injury is characterized by near-complete or complete tearing or avulsion with sever pain. Stress to the torn tissue is usually painless and palpation may reveal a defect. A torn ligament will result in instability of the joint
Grade 3
What type of load/repetitions would you use to develop a strengthening program?
High load, low reps
Which type of exercise is described as a static form of exercise in which a muscle contracts and produces force without an appreciable change in the length of the muscle and without visible joint motion
Isometric (static) exercise
Which type of exercise is described as resistance training in which a limb moved through a ROM against a constant external load?
Isotonic exercise
What is the autonomous stage of learning?
Movements are automatic in this final stage of learning. The patient does not have to pay attention to the movements in the task, making it possible to do other things simultaneously. The patient requires little, if any, instruction
In terms of exercise order, if you are exercising multiple muscle groups in a single session, should you exercise multi or single joint muscles first?
Multi joint muscles should be before single joint muscles
