therex studyguide for final

Manual Resistance Exercise

a form of active resistive exercise in which the resistance force is applied by the therapist to either a dynamic or a static muscular contraction.

intensity

defines amount of resistance or external load that is applied to the muscle and is a primary variable manipulated in resistance training.

what is volume?

total amount of work performed

Should you perform primary or linear exercises at the beginning of a workout or at the end?

Perform linear exercises at the beginning and whereas assistance or rotary exercises should be performed later in the workout

indications for stretching:

ROM is limited because soft tissues have lost their extensibility as the result of adhesions, contractures, and scar tissue formation, causing activity limitations (functional limitations) or participation restrictions (disabilities). Restricted motion may lead to structural deformities that are otherwise preventable. Muscle weakness and shortening of opposing tissue have led to limited ROM. May be a component of a total fitness or sport-specific conditioning program designed to prevent or reduce the risk of musculoskeletal injuries. May be used prior to and after vigorous exercise to potentially reduce post-exercise muscle soreness.

what are precautions and contraindications to rom exercises?

ROM should not be done when motion is disruptive to the healing process. · Carefully controlled motion within the limits of pain-free motion during early phases of healing has been shown to benefit healing and early recovery. · Signs of too much or the wrong motion include increased pain and inflammation. ROM should not be done when patient response or the condition is life-threatening. · PROM may be carefully initiated to major joints and AROM to ankles and feet to minimize venous stasis and thrombus formation. · After myocardial infarction, coronary artery bypass surgery, or percutaneous transluminal coronary angioplasty, AROM of upper extremities and limited walking are usually tolerated under careful monitoring of symptoms. Note: ROM is not synonymous with stretching. For precautions and contraindications to passive and active stretching techniques, see Chapters 4 and 5.

What is the difference between static(passive) and dynamic flexibility?

Static flexibility refers to the ROM about a joint with no emphasis on the speed of movement. Its limits are defined primarily by the extensibility of the musculotendinous unit. In other words, static flexibility is the ability to assume and maintain an extended position at one end or point in a joint's ROM (e.g., static stretch). Examples of static flexibility are holding a modified hurdler hamstrings stretch or maintaining a leg split position on the floor · Dynamic flexibility, in contrast, involves movement and is based on a joint's ability to move through its ROM without resistance. Although a clear-cut definition of dynamic flexibility has yet to be universally accepted, it can be thought of as the ability to move a joint through its ROM while performing a physical task at normal or rapid speeds. Dynamic flexibility represents the resistance encountered within a joint or series of joints to active movement.

What are the changes in collagen that impact the Stress-Strain response?

There is weakening of the tissue because of collagen turnover and weak bonding between the new, non-stressed fibers. There is also adhesion formation because of greater cross-linking between disorganized collagen fibers and because of decreased effectiveness of the ground substance maintaining space and lubrication between the fibers.45,153 The rate of return to normal tensile strength is slow.

what happens during the amoritization phase?

This transitional phase between loading and unloading is critical in plyometrics in that it needs to remain short to avoid losses of stored elastic energy created by the stretch-shortening cycle in the musculotendinous unit. This will reduce the transfer of stored elastic energy into the concentric contraction and force output as more energy is dissipated as heat.50

what are the limitations of passive rom?

True passive, relaxed ROM may be difficult to obtain when muscle is innervated and the patient is conscious. Passive motion does not: · Prevent muscle atrophy. · Increase strength or endurance. · Assist circulation to the extent that active, voluntary muscle contraction does.

multijoint movements and exercises

are those that incorporate the whole body (kinetic-chain) as opposed to single, isolated joints.

Proprioceptively enriched environments

are unstable, yet controllable situations in which exercises or movements are performed in such a manner that they place demands on the body to use its balance and stabilization mechanisms.

Elastic

can go back to original form

Plastic

cannot go back to original for

Open Chain Kinetic Exercise

completely unrestricted movement in space of a peripheral segment of the body, as in waving the hand or swinging the leg.

Repetitions define the

consecutive number of times a movement is performed before taking a rest or recovery interval.

what is stability?

controlling movement with good technique), and power (moving explosively

· What are the phases of plyometric exercises?

eccentric, amortization, concentric phases

Viscoelasticity

enables the muscle to change length when a load is applied over time (e.g., stretch) and then resume its original size and shape when the force is removed (i.e., when the stretch is removed)

Sets are defined as ·

groups of repetitions.

integration

is when an individual would participate in a program that included resistance training, but also incorporated exercises and drills to improve balance, mobility (moving joints through full ranges of motion needed for one's ADLs), stabilization (controlling movement with good technique), and power (moving explosively).

how can a therapist improve stability?

it is achieved by either positioning the joints in good postural positions followed by a series of isometric contractions (positional isometrics) or through limited ROM exercises in which load and intensity of muscle action are controlled (isolated strengthening)

what is mobility?

moving joints through full ranges of motion needed for one's ADLs

Primary or linear exercises are those that involve:

multiple joints where many segments of the body move together in a similar plane

what are the different types of rom exercises?

prom, arom, active-assistive rom

type

refers to choice of exercise to address each major muscle group in the body. Multijoint exercises are recommended for all adults engaging in resistance training.

time

refers to duration of training. No specific duration has been indicated in research related to effectiveness of the training response.

· Frequency

refers to the number of times a workout is performed within a specified time frame (e.g., two or three times a week).

Pattern refers to ·

rest intervals between sets and between exercise sessions.

Closed Chain Kinetic Exercise

restricted movement in a space of a peripheral segment of the body ---> like a squat

Basic examples by which proprioception can be challenged include:

sitting or standing on unstable surfaces like wobble boards or inflated air bladders or even performing ground-based exercises where the body's stability is challenged (e.g., single-leg squat with a reach to a target, single-leg cable press).

example of a linear or primary exercise:

squats, lunges, shoulder presses, and bench presses

Progression refers to

strategies to gradually increase intensity, frequency, and volume over the course of a training program.

Volume

the amount of work; Generally, with cardiorespiratory programs, volume refers to the frequency and duration of an exercise bout, whereas with resistance exercise, volume is defined by the number of sets × repetitions (reps), and often includes the time under tension (i.e., the amount of time spent completing a full repetition).

Intensity

the level of work performed; Intensity in cardiorespiratory programs refers to the level of work performed that is reflected through speed, grade, watts, or intensity level on cardiorespiratory equipment. With resistance training, intensity generally refers to the amount of weight lifted.

true or false: Multi-joint movements and exercises better reflect our ADLs, train the body to function as one continuous unit to create and tolerate forces, and will also help to burn additional calories as more muscle's groups work simultaneously.

true

true or false: Traditional exercise programs tend to emphasize the sagittal plane and often neglect the frontal and transverse planes that account for more injuries.

true

what is a primary variable that can be manipulated in a resistance training program?

volume

contraindications for stretching

· A bony block limits joint motion. · There was a recent fracture, and bony union is incomplete. · There is evidence of an acute inflammatory or infectious process (heat and swelling), or soft tissue healing could be disrupted in the restricted tissues and surrounding region. · There is sharp, acute pain with joint movement or muscle elongation. · A hematoma or other indication of tissue trauma is observed. · Hypermobility already exists. · Shortened soft tissues provide necessary joint stability in lieu of normal structural stability or neuromuscular control. · Shortened soft tissues enable a patient with paralysis or severe muscle weakness to perform specific functional skills otherwise not possible.

indications for prom

· In the region where there is acute, inflamed tissue, passive motion is beneficial; active motion would be detrimental to the healing process. Inflammation after injury or surgery usually lasts 2 to 6 days. · When a patient is not able to or not supposed to actively move a segment(s) of the body, as when comatose, paralyzed, or on complete bed rest, movement is provided by an external source.

what are the 3 primary ways for increasing mobility?

· Myofascial release or self-myofascial release · Stretching · Mobilizing movements

what are the guidelines with plyometric exercises?

· Perform a warm-up. To warm up, perform 3 to 5 minutes of a general warm-up, consisting of walking, jogging, or cycling. Immediately after, perform activity-specific movements and/or drills, such as dynamic balance drills shuffling, backpedaling, or sprinting 5 to 10 yards for 5 to 10 minutes. · Age: Prepubescent athletes should not perform high-intensity plyometric drills such as depth or drop jumps because of the increased stress that may be placed on the epiphyseal (growth) plates. An example of a depth or drop jump is one in which the individual starts on an elevated platform (e.g., 18- to 24-inch riser), drops to the floor, landing, and then explosively jumps upward. Plyometrics for children should initially focus on low-intensity drills used to develop neuromuscular control and be progressed to moderate-intensity drills as the athlete matures and gains more strength and training experience. · Body weight: Larger athletes (more than 220 lb) should avoid performing depth jumps from a drop greater than 18 inches because of greater amounts of stress being placed on the joints.54,55 · Strength requirements for lower-body plyometrics: For high-intensity lower-body plyometrics, the traditional recommendation has been that an athlete be capable of squatting at least 11/2 times his or her body weight before performing any drills.54,55 Given how strength (force production) differs slightly from power (rate of force production), Wathen53 provided another criteria whereby the individual should be able to perform five squats in 5 seconds or less with 60% of his or her total body weight. For example, if an athlete weights 180 lb (81.8 kg), he or she should be able to squat 96 lb (49 kg) five times in no more than 5 seconds. According to McNeely,56 for athletes performing low- to moderate-level plyometrics, as long as they land with proper form, they should be able to safely perform any drills at these levels. · Strength requirements for upper-body plyometrics: Athletes should be able to bench-press at least their body weight before performing upper-body plyometric exercises. Another recommendation suggested is that individuals perform an explosive bench-press movement using 60% of total body weight, completing five repetitions in 5 seconds or less.51 · Experience: Athletes should have a good base of strength before incorporating these drills into their training sessions. Therefore, it is recommended that athletes engage in a structured resistance training program for a minimum of 8 to 12 weeks before performing moderate- to higher-intensity drills. · Proper technique: Drills should be performed in a controlled manner with proper technique at all times. If an athlete is unable to perform a drill correctly, a basic strength assessment should be performed to determine if additional strength training may be required before performing plyometric work. Remember, it is essential that an individual know how to land before they learn how to jump. As the demands of the environment change, so too do the amplitudes, torques, and forces that these movements produce and they vary dramatically. For example, a jumping jack is performed at a much lower amplitude (height or intensity) and requires much less time on the ground between eccentric and concentric movements (amortization time) when compared with the vertical jump. Therefore, the jumping jack, although essentially using the same basic technique, is much less stressful on the body than a vertical jump. · Footwear: Footwear that provides good foot and ankle support, such as cross-training shoes, are essential for safety when performing plyometric training drills. Running shoes would not be appropriate because they typically have a narrow sole and offer poor ankle support.51 · Training surface and equipment: All plyometric drills should be performed on a nonslip, shock-absorbing surface. Grass fields, suspended wood flooring, or rubberized mats are all acceptable surfaces for plyometric training. Plyo boxes used for box and depth jumps should also have a nonslip surface on the top.51 However, the trainer or coach may also have to consider the real surface on which an individual competes if it lacks shock-absorbing properties. Training will need to ultimately mimic the true surface, without being excessive where it can result in injury. · Single-response versus multiple-response drills: Progress training drills that require only one explosive jump or throw whereas multiple-response drills require several repetitions in a row while attempting to minimize the transition time between each repetition. · Fatigue: Because of the high neural demands associated with plyometric training, these drills should be performed earlier in a training session if performed with other forms of training within the same session (e.g., cardio and resistance training), or by themselves, to allow adequate recovery to ensure best efforts during each repetition and reduction of injury risks. · Weight selection for medicine ball drills: Currently, there are no standardized recommendations on what training load should be used for medicine ball throws and tosses. However, beginning with a ball that is approximately 4% to 5% of total body weight is a good place to start. For example, a 220-lb (100-kg) athlete would use an 8- to 11-lb (3.5- to 5-kg) ball, whereas a 120-lb (54.5-kg) individual would start with a ball between 5 and 6 lb (approximately 2.5 kg).

Isokinetic Exercise

- form of dynamic exercise in which the velocity of muscle shortening or lengthening and the angular limb velocity is predetermined and held constant by a rate-limiting device known as an isokinetic dynamometer . The term isokinetic refers to movement that occurs at an equal (constant) velocity. Unlike DCER exercise in which a specific weight (amount of resistance) is selected and superimposed on the contracting muscle, in isokinetic resistance training the velocity of limb movement—not the load—is manipulated. The force encountered by the muscle depends on the extent of force applied to the equipment.5,138

Isometric Exercise

- is 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.

Eccentric Exercise

- lengthening; dynamic loading of a muscle beyond its force-producing capacity, causing physical lengthening of the muscle as it attempts to control the load, as when lowering a weight.

Concentric Exercise

- refers to a form of dynamic muscle loading in which tension in a muscle develops and physical shortening of the muscle occurs as an external force (resistance) is overcome, as when lifting a weight.

Why is rest and recovery important?

Adequate recovery between sessions is important to allow trained muscles time to restore glycogen and build or rebuild protein. Insufficient recovery does not allow the body to complete these processes, which may potentially lead to overtraining deterioration of muscle function, and injury. All of these conditions compromise an individual's ability to achieve his or her goals.

What is the important concept involving fatigue with Assistant Exercises?

Assistant exercises are isolation- or single-joint exercises (e.g., biceps curls and triceps extensions) that are often used to complement compound movements in a training session. For example, after completing barbell squats, an individual may complete a leg-extension exercise to increase the total amount of work performed by the quadriceps in a session. Because these exercises are generally less challenging in terms of complexity, they should follow compound movements to ensure that good technique and effectiveness of the movement pattern is maintained. Pre-fatiguing muscles with assistant exercises beforehand may compromise technique and the effectiveness of the compound exercises, potentially increasing the risk for injury.

what happens during the eccentric phase?

During this phase, the muscles are rapidly stretched (loaded). This rapid eccentric movement stimulates the muscle spindles located within the muscle tissue. These proprioceptors are sensitive to the amount and rate of stretch in a muscle,50 and stimulation activates the stretch reflex, facilitating a powerful concentric action of the agonist muscle group to protect the muscle from overstretching.

what happens during the concentric phase?

During this phase, the muscles contract to shorten powerfully (unload). The muscles harness the energy of the stretch-shortening cycle and stored elastic energy gained from the eccentric and amortization phases to generate a rapid, forceful contraction.

what are the guidelines for restoring muscle balance?

Homeostasis begins restoring balance through a period of adaptation (recovery, repair, and renewal) that involves changes that occur at many levels to reduce the effect of the stressor(s). Essentially the body responds by altering its physiological structures. An applicable example is with resistance training where after the initial shock phase (4-6 weeks in adults and 2-3 months in older adults), muscle adaptation becomes evident through noticeable increases in muscle size (cross-sectional area) and strength (improved motor unit synchronization and firing)

With exercise selection/sequencing, how should machine-based versus free-weight exercises be sequenced? Why?

Machine-based exercises are generally easier to perform and are probably more suitable for new exercisers, whereas free-weight exercises are more challenging and necessitate the need to stabilize the body or specific body segments while performing repetitions. Because resistance training equipment options continue to evolve and expand, and are now available in many shapes and forms (e.g., suspension trainers, kettlebells), the choices and sequences can often be confusing

goals for prom

Maintain joint and connective tissue mobility. Minimize the effects of the formation of contractures. Maintain mechanical elasticity of muscle. Assist circulation and vascular dynamics. Enhance synovial movement for cartilage nutrition and diffusion of materials in the joint. Decrease or inhibit pain. Assist with the healing process after injury or surgery. Help maintain the patient's awareness of movement.

multi-planar training

Multiplanar training creates movements in all three planes to reflect the movements of our ADLs more accurately.

Which do you need to address first regarding therapy for a pt?

Once you address motion, then address stability, then address mobility