TherEx Chapter 6

You are having a patient perform manual resistance exercise in a PNF pattern, specifically the D2 flexion pattern for the upper extremity. As the patient flexes his shoulder and brings his arm overhead against your resistance, what other muscle groups at the shoulder are being strengthened? A) Abductors and external rotators B) Adductors and external rotators C) Abductors and internal rotators D) Adductors and internal rotators

A) Abductors and external rotators

Each of the following is a true statement about muscle strength and resistance training through the life-span except: A) Although muscle strength tends to gradually decrease in middle-age and older adults, weight training has been shown to be ineffective (does not lead to adaptive strength gains or functional improvement) after the seventh decade of life B) During the early and middle childhood years prior to puberty, muscle strength increases linearly and is reasonably similar (as little as a 10% difference) in boys and girls C) During puberty, although greater muscle hypertrophy occurs in boys than girls as the result of resistance training, relative training-induced strength gains are comparable between the sexes D) During late adulthood muscle atrophy occurs to a greater extent in type II than type I muscle fibers

A) Although muscle strength tends to gradually decrease in middle-age and older adults, weight training has been shown to be ineffective (does not lead to adaptive strength gains or functional improvement) after the seventh decade of life

To strengthen the posterior tibialis using manual resistance, have the patient assume a long sitting position on a table or mat. Support and hold the lower leg with one hand and: A) Apply resistance to the plantar and medial surfaces of the foot at the first metatarsal as the patient plantarflexes and inverts the ankle and foot B) Apply resistance to the plantar and lateral surfaces of the foot at the fifth metatarsal as the patient plantarflexes and everts the ankle and foot C) Apply resistance to the dorsal and medial surfaces of the foot at the first metatarsal as the patient dorsiflexes and inverts the ankle and foot D) Apply resistance to the dorsal and lateral surfaces of the foot at the fifth metatarsal as the patient dorsiflexes and everts the ankle and foot

A) Apply resistance to the plantar and medial surfaces of the foot at the first metatarsal as the patient plantarflexes and inverts the ankle and foot

Each of the following is a true statement about isokinetic exercise except: A) Current technology provides resistance only to concentric muscle contractions B) It accommodates for a painful arc C) It provides maximal resistance throughout the available ROM D) It accommodates for muscle fatigue

A) Current technology provides resistance only to concentric muscle contractions

The PNF pattern of the upper extremity that ends with the shoulder in flexion, adduction, and external rotation is: A) D1 flexion B) D1 extension C) D2 flexion D) D2 extension

A) D1 flexion

You are having a patient throw and catch a weighted ball in a stretch-shortening drill. Which of the following is a true statement about this type of training? The most appropriate way to progress this drill is to: A) Decrease the amoritization phase before increasing the weight of the ball B) Increase the amoritization phase before increasing the weight of the ball C) Increase the weight of the ball to slow down the speed of the drill D) Throw and receive the ball from a longer distance

A) Decrease the amoritization phase before increasing the weight of the ball

Your goal is to improve lower extremity proprioception, balance, and strength. Which of the following closed-chain exercises is the most challenging? A) Have the patient stand on one foot on a piece of foam and maintain his balance B) Have the patient kneel in an upright position on a piece of foam and shift his weight from side to side C) Have the patient stand on the floor on one leg and maintain his balance D) Have the patient stand on the floor with weight equally distributed on both feet and throw and catch a ball

A) Have the patient stand on one foot on a piece of foam and maintain his balance

Within 1 week of beginning resistance exercise of the shoulder external rotators as a component of a rehabilitation program after a shoulder injury, your patient, Mr. K., is able to increase the level of resistance by using a heavier grade of elastic tubing. This improvement in muscle performance is due primarily to which of the following adaptive changes? A) Increased recruitment of motor units B) Increased oxygen to the muscle C) Hypertrophy of muscle fibers D) Fiber-type transformation from slow twitch to fast twitch

A) Increased recruitment of motor units

a patient, who has an inflammatory muscle disease such as polymyositis engages in a vigorous resistance training program, it is possible that progressive deterioration, rather than improvement, in muscle strength that is irreversible can occur. The term that best describes this phenomenon is: A) Overwork weakness B) Progressive muscle fatigue caused by overtraining C) Muscle overload D) Delayed-onset myopathy

A) Overwork weakness

Mrs. B. is an 87-year-old resident of Western Hills Skilled Nursing Facility. She sustained a compression fracture of the T12 vertebra several weeks ago when she inadvertently sat down forcefully on a hard chair. Incorporating resistance training that focuses on eccentric exercises of her quadriceps and gluteal muscles in weight-bearing positions (e.g., controlled squatting and partial lunges) represents what principle of therapeutic exercise? A) Specificity of training B) Reversibility of training C) Overflow principle D) Overload principle

A) Specificity of training

Examples of plyometric activities for the upper extremities could include any of the following except: A) Wall push-ups B) Clap push-ups C) Catching and throwing a weighted ball D) Dribbling a ball against the wall

A) Wall push-ups

An ideal ISOM muscle contraction should be held for how long? A) 3 seconds B) 6 seconds C) 10 seconds D) 12 seconds

B) 6 seconds

To improve upper extremity strength, stability, and proprioception, during which of the following variations of push-ups does body weight provide the greatest resistance? A) Bilateral wall push-ups while in a standing position and leaning into and pushing away from the wall B) Bilateral push-ups while in a fully prone position on the floor with weight on the hands and toes C) Bilateral push-ups while standing and leaning on the hands on a kitchen countertop D) Bilateral push-ups in a prone position with weight on the hands and knees

B) Bilateral push-ups while in a fully prone position on the floor with weight on the hands and toes

You are coaching a patient doing resistance exercises to avoid a Valsalva maneuver. Any of the following are good strategies except: A) Have patient exhale with each resisted effort B) Have patient inhale with each resisted effort C) Have patient talk during the exercises D) Caution patient to avoid breath holding

B) Have patient inhale with each resisted effort

Of the following, which is the most effective way to improve muscle endurance? A) Have the patient train on an isokinetic dynamometer at fast speeds only B) Have the patient train using dynamic exercise against submaximal loads over progressively longer time periods C) Have the patient exercise against maximal resistance for a limited number of repetitions D) Have the patient train by using isometric exercises against resistance

B) Have the patient train using dynamic exercise against submaximal loads over progressively longer time periods

You are designing an exercise program for a patient with a history of hypertension. Which of the following types of exercise is associated with the highest risk of causing an increase in blood pressure during exercise? A) Isokinetic exercise at medium to fast velocities B) High-effort isometric exercise C) Setting exercises D) High-effort dynamic resistance exercise

B) High-effort isometric exercise

Which of the following is true regarding isokinetic exercise? A) Joint compressive forces increase with increased velocity of exercise B) Load is dependent on the velocity of limb movement through the arc of motion C) Slow-velocity training is more appropriate for carryover to functional activities than medium and fast velocities D) Depending on the type of isokinetic dynamometer used, the rate of limb movement may range from 0° to 500° per minute

B) Load is dependent on the velocity of limb movement through the arc of motion

Mr. Z is a 68-year-old gentleman who underwent abdominal surgery 3 months ago. Since his surgery he has had difficulty walking. You determine that during the period of bed rest and modified activity his legs have become quite weak, contributing to his difficulty walking. The ROM of his lower extremities is within normal limits. You determine that the 10 RM for the hip extensors and quadriceps bilaterally (measured on a bilateral leg press unit) is only 20 lb. After a brief warm-up on a stationary bicycle, you have Mr. Z. perform the following PRE regimen: 10 repetitions of hip and knee extension against 20 lb; 10 repetitions against 15 lb; and 10 repetitions against 10 lb with a rest between each set of 10 repetitions. This approach to PRE is known as: A) Circuit weight training B) Oxford regimen C) DeLorme regimen D) DAPRE regimen

B) Oxford regimen

Plyometric training drills are an example of an intervention to develop primarily which of the following? A) Strength B) Power C) Balance D) Endurance

B) Power

Which of the following is a correct description of plyometric exercise? A) Slow, controlled, eccentric loading of a muscle performed in functional positions B) Quick, forceful eccentric muscle contraction against resistance, rapidly followed by a resisted concentric muscle contraction C) Series of resisted isometric muscle contractions in functional positions D) Forceful and rapid concentric contraction followed by an isometric hold

B) Quick, forceful eccentric muscle contraction against resistance, rapidly followed by a resisted concentric muscle contraction

The principle of resistance training that suggests that adaptive changes are transient unless a person participates in a maintenance program is which of the following? A) Overload principle B) Reversibility principle C) SAID principle D) Wolff's principle

B) Reversibility principle

ou have a patient assume a prone-lying position and prop symmetrically on his forearms. You apply manual resistance in several directions at the shoulder girdles as you ask the patient to hold (maintain) the symmetrical position. This technique is known as: A) Agonist-contraction B) Rhythmic stabilization C) Recurrent facilitation D) Repeated contractions

B) Rhythmic stabilization

To selectively strengthen the flexor digitorum superficialis using manual resistance exercise, position the patient's forearm in supination and wrist in neutral on a table; then: A) Stabilize the MCP and PIP joints in neutral, then apply resistance to the distal phalanx as the patient flexes the DIP joint B) Stabilize the MCP and DIP joints in neutral, then apply resistance to the middle phalanx as the patient flexes the PIP joint C) Stabilize the PIP and DIP joints in neutral, then apply resistance to the proximal phalanx as the patient flexes the MCP joint D) Without additional stabilization, apply resistance to the distal phalanx and ask the patient to flex the MCP, PIP, and DIP joints simultaneously

B) Stabilize the MCP and DIP joints in neutral, then apply resistance to the middle phalanx as the patient flexes the PIP joint

Each of the following is an indication that muscle fatigue is occurring when a patient is exercising against resistance except: A) Muscular tremor occurs during the exercise B) Temporary loss of sensation in the exercising muscles C) The patient may not be able to complete the available ROM against the initial level of resistance applied D) The patient may attempt to use a substitute motion and muscle group to perform the exercise

B) Temporary loss of sensation in the exercising muscles

If a patient, who is in a prone-lying position with a cuff weight around his ankle, flexes his knee from a fully extended (0°) position to a fully flexed (150°) position, what type(s) of contraction will occur in which muscle group(s)? A) The knee flexors contract concentrically through the full ROM B) The knee flexors contract concentrically from 0° to 90°, and the knee extensors contract eccentrically from 90° to 150° of flexion C) The knee flexors contract eccentrically from 0° to 90°, and the knee extensors contract concentrically from 90° to 150° of flexion D) The knee flexors contract eccentrically throughout the full ROM

B) The knee flexors contract concentrically from 0° to 90°, and the knee extensors contract eccentrically from 90° to 150° of flexion

When an exercise involves using the same muscle group to lift and lower a constant load, such as flexing and extending the elbow while standing and holding a weight, which of the following is correct about the effect of this exercise on the tension generated by the musculature? A) Greater muscle tension develops when the weight is lowered (controlled by an eccentric contraction) than when it is lifted and controlled by a concentric contraction B) When the weight is lowered (controlled by an eccentric contraction), fewer motor units are recruited, and thus less tension is generated, than when the weight is lifted (controlled by a concentric contraction) C) The same tension is generated in the muscle during the lifting and lowering phases of the exercise because the greatest resistance (load) is imposed by the weight at the same point in the ROM D) Greater energy expenditure is necessary during the eccentric phase of the exercise than during the concentric phase

B) When the weight is lowered (controlled by an eccentric contraction), fewer motor units are recruited, and thus less tension is generated, than when the weight is lifted (controlled by a concentric contraction)

You are trying to decide if it is time to increase resistance while strength training your patient. Current recommendations are to increase if they can do which of the following volumes without fatigue? A) 1-2 repetitions, 2-3 sets B) 2-6 repetitions, 2-3 sets C) 6-12 repetitions, 2-3 sets D) 12-15 repetitions, 2-3 sets

C) 6-12 repetitions, 2-3 sets

Which of the following is a contraindication to implementing resistance exercise? A) Risk of pathological fracture due to osteoporosis B) Joint instability C) Acute pain or inflammation D) If muscle soreness occurs after a bout of exercise

C) Acute pain or inflammation

You are having a patient perform manual resistance exercise of the lower extremity using a PNF diagonal pattern. In which of the following lower extremity patterns is ankle dorsiflexion coupled with eversion resisted? A) D1 flexion B) D1 extension C) D2 flexion D) D2 extension

C) D2 flexion

You are asked to develop a home exercise program aimed at improving strength of a particular muscle group. You set your parameters using which of the following? A) Low load, low repetitions B) Low load, high repetitions C) High load, low repetitions D) High load, high repetitions

C) High load, low repetitions

A patient doing hip abduction exercise with a cuff weight in the supine position is primarily applying a resistance force to which of the following muscle groups? A) Hip adductors B) Hip abductors C) Hip flexors D) Hip extensors

C) Hip flexors

Following surgery and 8 weeks of rehabilitation for carpal tunnel syndrome, you notice that the patient's thenar eminence is almost the same size as that of the uninvolved hand. This change is due to which of the following adaptive changes? A) Increased recruitment of motor units B) Hyperplasia of muscle fibers C) Hypertrophy of muscle fibers D) Fiber type transformation

C) Hypertrophy of muscle fibers

If the strength of a muscle is "good" (grade 4/5) and active ROM cannot be done, repetitive setting exercises will accomplish each of the following except: A) Maintain mobility between muscle fibers B) Develop or maintain an awareness of the sensation of a muscle contraction C) Increase the strength in the muscle D) Enhance circulation within the muscle

C) Increase the strength in the muscle

Which components of a resistance exercise program should be modified (manipulated) during the program to produce training-induced improvement in muscle endurance? A) Position of the patient and load B) Sets and mode of exercise C) Load and repetitions D) Repetitions and mode of exercise

C) Load and repetitions

A patient has mild joint swelling and pain during active ROM, but resisted tests of the muscles that cross the swollen joints do not cause pain. Your goal is to maintain or possibly increase strength through the available ROM. The most appropriate choice of exercise is: A) Setting exercises at the end of the ROM B) High-velocity isokinetic exercise C) Multiple-angle isometric exercise against resistance D) Eccentric/concentric, closed-chain exercise against body weight throughout the ROM

C) Multiple-angle isometric exercise against resistance

A condition characterized by progressive deterioration of strength in muscles already weakened by a nonprogressive neuromuscular disease is called: A) Overtraining B) Delayed-onset muscle soreness C) Overwork D) Ischemia

C) Overwork

Research has shown that the most effective way to relieve the symptoms of DOMS once it has developed is to: A) Passively stretch the muscle until the DOMS subsides B) Apply cold before starting to exercise again C) Perform gentle active exercises for a few minutes before starting to exercise again D) Apply topical heat and rest until the DOMS subsides

C) Perform gentle active exercises for a few minutes before starting to exercise again

You test the muscle strength of the middle deltoid and determine it to be 2/5. The goal of an exercise you are having a patient do is to increase muscular endurance of the middle deltoid. Of the exercises described, which is most appropriate to meet the goal at this point in the exercise program? A) Place the patient in a side-lying position and have him actively abduct the arm without your assistance as many times as possible B) Place the patient in a sitting position with the elbow flexed and have him abduct the arm through the full ROM 8 to 10 times against light resistance C) Place the patient in a supine position on a large mat. As you support the weight of the arm, have the patient abduct the arm through full ROM as many times as possible against a minimal amount of manual resistance. D) Have the patient assume the supine position. Provide as much assistance as needed to enable the patient to flex the shoulder from 0° to 90° for as many repetitions as possible.

C) Place the patient in a supine position on a large mat. As you support the weight of the arm, have the patient abduct the arm through full ROM as many times as possible against a minimal amount of manual resistance.

Each of the following exercises could be considered closed-chain work of the lower extremities except: A) Lunges B) Step-ups C) Seated long arc quads D) Squats

C) Seated long arc quads

our patient is lying supine and you are strengthening the iliopsoas on the (R) using manual resistance. The main reason you would want to place the patient's (L) hip and knee in flexion (foot planted on the table) is to: A) Stretch the erector spinae muscles in the lumbar region of the back B) Improve the mechanical efficiency of the iliopsoas on the (R) C) Stabilize the pelvis in a neutral to posteriorly rotated position to lessen the possibility of an anterior pelvic tilt occurring, placing stress on the low back D) Place the pelvis in a slight anterior tilt so the trunk is more stable and the iliopsoas can generate greater tension

C) Stabilize the pelvis in a neutral to posteriorly rotated position to lessen the possibility of an anterior pelvic tilt occurring, placing stress on the low back

Which factors affect the amount of resistance provided by elastic resistance bands during exercise? A) Length of the muscle and stretch of the band B) Stretch of the band and speed of movement C) Stretch of the band and angle of the band in relation to the moving bone D) Angle of the band in relation to the moving bone and length of the muscle

C) Stretch of the band and angle of the band in relation to the moving bone

It has been shown that after resistance exercise to exhaustion, recovery from exercise (recovery from fatigue) occurs most efficiently if: A) The fatigued muscle rests completely during recovery B) Cold is applied to the fatigued muscle C) The patient performs low-intensity, active exercise using the fatigued muscle D) The muscle is passively stretched during recovery

C) The patient performs low-intensity, active exercise using the fatigued muscle

In addition to an isokinetic dynamometer, which of the following types of resistance equipment can be used safely and effectively to improve muscle strength at fast velocities of limb movement? A) Free weights B) Variable resistance equipment made up of a weight-cable and cam system C) Variable resistance equipment that employs pneumatic or hydraulic resistance D) Simple weight-pulley system

C) Variable resistance equipment that employs pneumatic or hydraulic resistance

Which of the following best describes contralateral or cross-exercise, a phenomenon that has been observed as a result of resistance training? A) When resistance exercise is carried out by a muscle, the antagonist to that muscle also shows an increase in strength B) When exercise is carried out concentrically against resistance, an increase in eccentric muscle strength in the same leg also occurs C) When resistance exercise is carried out by a muscle group on the right side of the body, small gains in strength occur in the same unexercised muscle on the opposite side of the body D) When training is carried out for the purpose of developing strength, muscular endurance also develops in that same muscle

C) When resistance exercise is carried out by a muscle group on the right side of the body, small gains in strength occur in the same unexercised muscle on the opposite side of the body

Submaximal exercise loads are recommended for each of the following patients except: A) 30-year-old patient with an acute rotator cuff strain B) 65-year-old sedentary patient following a period of prolonged bed rest C) 8-year-old child with a subacute quadriceps strain D) 40-year-old client who wants a conditioning program

D) 40-year-old client who wants a conditioning program

When applying manual resistance to the upper extremity using the D1 extension pattern (PNF), the muscle groups being facilitated (strengthened) are the shoulder extensors and the: A) Adductors, internal rotators, and wrist and finger flexors B) Abductors, external rotators, and wrist and finger extensors C) Adductors, external rotators, and wrist and finger flexors D) Abductors, internal rotators, and wrist and finger extensors

D) Abductors, internal rotators, and wrist and finger extensors

Which of the following is true regarding closed-chain exercise? A) It is less effective for developing co-activation of muscle groups and dynamic stability than open-chain training B) Muscles develop strength more quickly than with open-chain exercise C) It is a better choice than open-chain exercise to isolate and train weak muscle groups D) Against similar exercise loads, it causes lower levels of shear in the joint than open-chain exercise

D) Against similar exercise loads, it causes lower levels of shear in the joint than open-chain exercise

The type of resistance exercise best suited to prevent reinjury is: A) ISOM B) ISOK C) Concentric D) Eccentric

D) Eccentric

A patient is holding a piece of elastic tubing with both hands in front of his body. Both elbows are flexed to 90°, and both upper arms are held gently against the sides of the patient's chest. You instruct the patient to internally and externally rotate both shoulders simultaneously in this position. This activity strengthens the: A) Internal rotators concentrically and eccentrically B) External rotators concentrically and the internal rotators eccentrically C) Internal rotators concentrically and the external rotators eccentrically D) External rotators concentrically and eccentrically

D) External rotators concentrically and eccentrically

Which of the following best defines muscle strength? A) Ability of muscle to contract repeatedly against a load B) Work produced by a muscle per unit of time C) Produce or control forces imposed during functional activities D) Force generated during a single maximum effort

D) Force generated during a single maximum effort

In terms of exercise order, if you are doing a strength program to the lower extremities, which muscle group should be exercised first? A) Ankle dorsiflexors B) Knee extensors C) Hip flexors D) Hip extensors

D) Hip extensors

Each of the following is characteristic of delayed-onset muscle soreness except: A) Tends to peak 24 to 72 hours after the conclusion of high-intensity exercise B) Increased soreness during passive lengthening of the involved muscle groups C) Occurs more frequently after eccentric exercise than isometric exercise D) Is believed to be caused by postexercise muscle spasm

D) Is believed to be caused by postexercise muscle spasm

When putting together effective dosage for exercise, you must consider all of the following except: A) Intensity B) Volume C) Frequency D) Position

D) Position

Of the following, which is the best definition of an "8 RM"? A) The number of repetitions of a particular exercise a patient can perform in 8 seconds against a specific load (amount of resistance) B) The number of sets (bouts) of a specific exercise a patient can perform for 8 repetitions C) The greatest amount of resistance (load) a patient can lift or lower through the available ROM in 8 seconds D) The greatest amount of resistance (load) a patient can lift or lower through the available ROM for 8 repetitions (no more, no less).

D) The greatest amount of resistance (load) a patient can lift or lower through the available ROM for 8 repetitions (no more, no less).

Which of the following forms of resistance training is most appropriate for a 9-year-old child with weakness of the elbow musculature as the result of an elbow sprain, followed by several weeks of elbow immobilization combined with daily active (nonresisted) ROM? A) High-load, low-repetition biceps curls on equipment specifically designed to adjust to a child's body proportions B) Low-load, high-repetition biceps curls on equipment usually used by the adult patient population C) Supervised exercise by unlicensed support personnel D) Underhand bilateral toss of a weighted ball

D) Underhand bilateral toss of a weighted ball