Exercise Physiology Final
ACSM recommends, frame of inactivity in which cardiorespiratory begins to decline
1 week
What is MET for light stroll at 1.0 mph?
1.6‐3.9 METs
Once aerobic exercise begins, how quickly does the gas exchange across the alveolar‐capillary membrane improve?
1‐2 Breaths
To increase bone mineral density with >6 months of resistance training
3‐6 sets 1-10 rep max for multi joint exercises 1-4 minutes rest between sets
Heart rate intensity for people at risk for CAD or elderly
40‐60% max HR
What is the optimal duration per day on a CPM for maximal patient compliance and most gained overall benefit?
4‐8 hours
Center of mass is located at what percentage of a person's height?
55% of height or S2 vertebrae
Which of the following exercises is the most effective way to improve muscle endurance?
60% 1RM x 30 reps open chain exercise 75% 1RM x 15‐20 reps dynamic exercise
Threshold intensity for active healthy adult for carido adaptations to occur
60-90% max HR
According to ACSM, how many weeks of inactivity lead to return of physiological function to pretraining levels?
8‐10 weeks
According to ACSM, what blood glucose level contraindicates starting an exercise program in clients taking insulin for diabetes?
<100 and >300 mg/dL
A patient who is most appropriate for use of an arm ergometer
A 55 yo female with bilateral osteoarthritis
Detraining upon cessation of exercise is most likely due to:
A decrease in blood volume
Elbow strain and no full extension, 45 degrees, best ROM?
AAROM
The most appropriate exercise parameters for the subacute phase
AAROM in pain-free range
A 24yo dude who was in an ATV accident fractured his R femur 2 weeks ago. In the hospital he had an ORIF. He be starting PT today and needs an exercise program. Eval. and treat, WBAT and progress to FWB as tolerated frame Here are his deficits: ‐AROM R hip flex 0‐90, ABD 10 ‐AROM R knee flex 75, PROM 90 What's the most appropriate to increase his ROM deficits?
AAROM supine knee and hip flexion
Client suffered right hamstring strain about 5 days ago. She presents with skin discoloration, tenderness, and lacks full hamstring excursion. Which is most effective physical therapy intervention to increase ROM?
AROM
For an exercise program for 65 year old client s/p TKR yesterday
AROM ankle dorsiflexion/plantar flexion, quadriceps and glutes isometrics, and AAROM knee flexion/extension heel slides
Energy system for high intensity exercise lasting 1-2 minutes
ATP via phosphagen and anaerobic glycolysis
Weak muscles with lower crossed syndrome
Abdominals and glutes
When flexing the arm during D2 flexion what actions are you performing (server position)
Abduction and external rotation
When applying manual resistance to LE D1 extension pattern, muscle groups being facilitated (strengthened) are shoulder extensors and what?
Abductors, Internal rotators, Wrist and finger extensors
When applying manual resistance using D1 extension, the muscle groups being facilitated (strengthened) are the shoulder extensors and the:
Abductors, internal rotators, wrist & finger extensors
Which is a contraindication for resistance exercise?
Acute pain or inflammation
Exercise pescription for a client with Multiple Sclerosis emphasize which parameter?
Aerobic exercise in the morning to minimize motor fatigue
Which is true regarding Closed Chain Exercise?
Against similar exercise loads, it causes lower levels of shear in the joint than open chain
Which of the following BEST describes what is occurring with the stretch in this image? (Guy laying on floor with hands behind thigh stretching hamstring, arrow indicating that he is extending his knee)
Antagonist hamstrings, Active stretch, dynamic flexibility
Which muscles in order of activity react when the body sustains a backward/ posterior sway when using the ankle strategy for balance control?
Anterior Tibialis‐ Quadriceps - Abdominal
During several physical therapy sessions a patient you have been treating for low back pain learned how to perform pelvic tilt exercises in several positions (sitting, supine, standing) with continued practice at home. Your patient is now able to perform extremity movements while maintaining a stable pelvic position. What stage is the patient in?
Autonomous
To increase UE strength, stability, and proprioception, which provides greatest resistance
Bilateral wall pushups, prone with head down, on incline board, and weight on hands and knees
A patient's goal is to walk his dog but states his neighborhood has gradual hills and is full of kids riding their bikes and skateboarding. What sequence BEST describes the difficulty of this task?
Body transport, open environment, without intertrial variability, with manipulation
Why is it important to test and address strength impairments of infraspinatus and teres minor rotor cuff muscles?
Both muscles are needed for external rotation of the glenohumeral joint to clear the greater tubercle with shoulder elevation >90 degrees
A patient 8 weeks s/p R shoulder rotator cuff repair can start strengthening but has a 5 pound lift limit. Exercises that can be done:
CRITERIA: Variable or constant resistance, less than 5 lbs, strengthen rotator cuff or scapular muscles, endurance parameters, and put position in regards to gravity
Which term is synonymous with aerobic fitness and is associated with aspects of physical function that can be modified by therapeutic exercise?
Cardiopulmonary Endurance
Which one of the following is the most appropriate benefit of using a CPM machine?
Cartilage regeneration
How do you keep DM patient from experiencing exercise induced hypoglycemia
Check blood glucose just before exercise
Why is cardiac output lower in children compared to adults during similar sub-max work load?
Children have a lower stroke volume
Which of the following stages of motor learning does augmented and extrinsic feedback have the most positive feedback on acquisition of a motor skill?
Cognitive
Stage of motor learning described as time where frequent errors are made/ requires persons full attention?
Cognitive Stage
What is considered an EMERGENCY?
Compartment Syndrome
PT helping pt acquire ability to shift weight side-to-side standing, giving manual guidance. The type of feedback is
Concurrent feedback
1st minute of recovery after exercise - vital sign independent of poor prognosis
Decrease in heart rate <12 bpm
Which of the following changes in Vital Signs provides independent confirmation of poor prognosis during the first minute of recovery?
Decrease of HR in first minute is < 12 beats per minute
Golfer with medial epicondylitis asks PT for stretches to do. She has no pain but some stiffness after playing. What position would you prescribe for the best stretch
Elbow ext, Wrist ext, Forearm supination
Stretch for medial epicondylitis
Elbow extension, supination, wrist extension
Most common sub for shoulder IR/ER while supine is
Elbow flexion/extension
What is a stretch to do while playing golf? Patient has medial epicondylitis, no pain, only stiffness after playing golf:
Elbow in extension, forearm supinated, wrist in extension
To help reduce post-stretch soreness after stretching the biceps, where should cold be applied?
End-range elbow extension with shoulder extension (want it in the most lengthened position)
True or False? A client's clinical signs and symptoms are more reliable in diagnosis with a DVT as compared to Well's DVT Clinical Probability Score.
False
A 35-year old healthy Female client who is 30lbs overweight has set her goal on running a 10k race in about 6 months. Which is the BEST method to help her achieve her goal?
Fast walking progressing to running 5‐6x/week.
Which of the following best defines muscle strength?
Force generated during a single max effort
Without compensation, self-feeding with a fork would require functional ROM of the following motions except:
Forearm pronation
20 yo power lifter in gym, eccentric bicep training unable to hold a weight that his handed to him
GTO, autogenic inhibition
55 year old female with RA has wrist pain and "bump" on dorsal surface of wrist (picture of hand), bump is most likely
Ganglion
Energy for long duration aerobic activity yields which of the following ATP #s based upon the substrate?
Glucose 38, Glycogen39, fatty acid 129
Patient tossing a med ball noticed pain at medial elbow but continued to work out with a lighter medicine ball. She had a little bit of pain after, and some tenderness at palpation. There was no limit on activities, and she did not have pain after a couple of days. What Grade is this tissue injury?
Grade 1 tissue injury
Football player tore a few MCL fibers
Grade 2
17 yo HS football player in gym, 2‐3 days ago with swelling, ecchymosis and tenderness
Grade 3
Of the following scenarios, which will develop most muscle tension
Greatest force production occurs with greatest number of motor units.
Most common site for Ulnar nerve compression
Guyon's tunnel or cubital tunnel
When seated upright clients unable to fully extend knee, which muscle is agonist and what type of flexibility? (She's sitting and extending her knees)
Hamstrings, dynamic flex
Goal is to improve LE proprioception, balance and strength. Which closed chain exercise is most challenging?
Have patient stand on one foot on piece of foam and maintain balance.
What are determinants of myocardial oxygen consumption (MVO2)?
Heart Rate, Blood Pressure, Myocardial contractility, Afterload
Significance of Exertional Angina with mVO2
Heart is unable to take enough O2 because heart rate increases and diastolic filling is decreased, which sacrifices coronary blood flow
Safe and effective stretching to increase ROM requires all of the except
High intensity to minimize muscle guarding
Safe and effective stretching to increase ROM requires all of the following except:
High intensity to minimize muscle guarding
Which exercise poses the highest risk for increasing BP in a pt. with Hx of HTN
High‐Effort Isometrics
With the picture of the client stepping down off of something the PT would expect the patient to have weak
Hip Extensors, Abductors, and External Rotators
Person on extended bed rest has hip contracture in the position of external rotation. What is this position called?
Hip External Rotation Contracture
Hip is in position of external rotation
Hip external rotation contracture
True regarding anterior pelvic tilt
Hip joint in flexion
What is true about anterior pelvic tilt?
Hip joint is in position of FLEXION
Which is a condition in a client that would be a contraindication to resistance exercise training (think about the heart)
Hypertrophic cardiomyopathy
Patient had surgery and 8 weeks of rehab for carpal tunnel. You notice the patient's thenar eminence is almost the same size as that of the uninvolved hand. This is due to what adaptive change?
Hypertrophy of muscle fibers
Blurred vision, pallor, shakiness, headache are signs of...
Hypoglycemia
Name 2 patient education strategies for lateral elbow pain with gripping activities
Ice and counter-pressure band
Within 1 week of resistance training shoulder ER, Mr. K. can increase resistance by using heavier elastic tubing. Improvement in muscle performance can be due to
Increase recruitment of motor units
If the strength of a muscle is "good" or and active ROM cannot be done, repetitive isometric exercise will accomplish each of the following except:
Increase strength in the muscle
Your patient has limitations in right shoulder ER ROM. As you perform stretch interventions to improve PROM, you also need to develop strength in what agonist?
Infraspinatus
Which of the following terms best describes a loss of passive extension ROM at knee joint?
Knee flexion contracture
25-year-old tennis player has had anterior shoulder pain for 4 weeks. S/he cannot play due to pain. Patient has no pain at rest and can sleep on affected shoulder with no problems. Only hurts when they attempt to play. Pt has full AROM and PROM. RT shoulder MMT subscapularis 3+/5, teres minor and infraspinatus. Best to address?
Left sidelying RT shoulder external rotation with 2 pound weight standing RT shoulder internal rotation with light theraband resistance.
Tight in upper crossed syndrome
Levator scapulae, sternocleidomastoid, pectoralis minor
Which is NOT a benefit of a CPM?
Long-term functional goals
Consistent with the taxonomy of motor tasks, which of the following activities is the BEST example of body stability in an open environment with intertrial variability without manipulation?
Maintaining sitting balance while riding a bus from school to home
Variation in VO2max resulting from aging is due to change in...
Max cardiac output
Which of the following muscles are weak in upper cross syndrome?
Middle trapezius, lower trapezius and serratus anterior
If patient has mild joint swelling, pain at ROM, but resistive MMT has no pain, what would we have them do to increase strength through the available ROM?
Multiple angle isometrics against resistance
Pt has mild joint swelling and pain during AROM, but resisted tests muscles that cross swollen joints show no pain. Your goal is to maintain or increase strength through the available ROM:
Multiple angle isometrics against resistance
A client who sustained a supracondylar humerus fracture in unable to fully extend the right elbow after the cast is removed. Which BEST describes the condition?
Myostatic Elbow Flexion Contracture
Right shoulder strain, pain at rest, limited AROM, PROM of shoulder. During this stage of healing...(sling or no sling)
NO SLING
Unique s/s of a complete muscle/tendon rupture
NO pain with stretching or contraction
75 year old 3 days s/p TKA is ready to go home, but feels like he overdid it‐‐has alot of pain and swelling. He asks the PT what he can do at home
No pillow or towel under knee, Quadriceps isometrics, gentle AAROM heel slides with ice after
35-year-old female with with acute RT shoulder rotator cuff impingement has pain at rest, pain while sleeping and pain before and after activity. Pt has full PROM, full AROM is painful, strength test is 4+/5 in all planes with pain. What is the next step towards treatment?
No sling, activity modification, pendulums, postural education.
65 y/o golfer osteoarthritis R hip, full PROM and AROM in R and L hip joint. Strengthen these deficits R hip flexion 4+/5 R hip abduction 4+/5 R hip extension 4/5 R hip adduction 5/5
Open chain, lying on plinth, straight leg raise to help with hip flexion, extension, abduction with 5 lb ankle weight
Which system is the primary energy source for long duration/endurance Ex?
Oxidative Phosphorylation
25 year old with anterior shoulder pain 4 weeks, has no pain at rest and can sleep on Right shoulder. It only hurts with tennis. Full PROM and AROM Right shoulder except PROM External Rotation is 55 degrees with no pain, and AROM External Rotation is 55 degrees with no pain. Right Shoulder External Rotation 3/5. Exercise Prescription:
PROM with gentle stretch R shoulder into External Rotation 30 second hold x 5 reps, followed by AROM External Rotation 2x10 reps
Evidence suggesting Lateral epicondylagia or "tennis" elbow
Pain with passive wrist flexion with elbow extension and forearm pronated
Which is a positive sign that a patient has golfer's elbow?
Pain with resisted wrist flexion tested with elbow in extension
Which describes this stretch? (Guy sitting on floor, one knee bent, one knee straight out. He is touching his lower leg with his hands)
Passive Stretch
Range of motion of a limb or joint that is produced by an external source is the definition for which one of the following terms?
Passive range of motion
Most efficient way to neutralize effects of muscle fatigue during exercise
Perform unresisted exercise during rest intervals between sets
Lateral Prehension
Picture of holding a key.
Secondary mover of hip extension
Piriformis
The ability of soft tissue to assume a new length after a stretch force is removed
Plasticity
Which of the following statements is a benefit of AROM?
Prevention of joint and muscle contracture
Motions at the Scapulothoracic Joint:
Protraction, retraction, elevation, depression
Your patient develops a contracture as a result of hypertonicity after a TBI. This hip contraction is called what?
Pseudo Myostatic contracture
After performing resistive exercise to point of exhaustion recovery from exercise (recovery from fatigue) occurs most efficiently with which 1 of the following practices?
Pt performs low-intensity, active exercise using fatigued muscle
A 45-year-old male underwent a subacromial decompression surgery for left shoulder impingement syndrome about 4 weeks ago. The doctor gave him a few exercises to work on and a home pulley system. Now, he is starting physical therapy today. The patient exam reveals the following deficits: Right shoulder winging during postural assessment Right shoulder serratus anterior 4/5 Right shoulder lower trapezius 4/5 Which of the following exercises will address these impairments/deficits?
Quadruped position with PT applying alternating isometrics 15second 5 reps. Prone position arm off the table for shoulder flexion 1lb 3 sets 15 repetitions
Moderate Left knee effusion with limited AROM knee extension by 15 degrees with supine Straight Leg Raises, but full PROM knee extension. Which is true?
Quads muscle reflex inhibition due to distention of synovial capsule from moderate effusion
With lower crossed syndrome, these muscles benefit from stretching
Rectus femoris & iliopsoas
46 y/o male 5'9", 305 lbs self referral with PMH: HTN, hypercholesterolemia, smoked 25 yrs; what do you need to do
Refer to physician
Scapulothoracic muscle that does downward rotation, retraction with shoulder extension or pulleys
Rhomboids
You have a patient assume a prone position and prop symmetrically on forearms. You apply manual resistance in several different directions and ask patient to maintain symmetrical position. What technique are you using?
Rhythmic Stabilization
Your client has been working AROM of Left hip abductors and the PT wishes to progress him with exercise against gravity. Which positions would be the best exercise left hip abduction against gravity?
Right side lying
Left hip abduction progression (position)
Right sidelying
Physical Therapists prescribe exercises to strengthen rotator cuff muscles to increase dynamic stability of shoulder, especially for elevated positions. What is the best explanation of how rotator cuff muscles can increase the stability of the shoulder joint?
Rotator cuff tendons blend with the shoulder ligaments and labrum to tighten these restraints during shoulder elevation
A 12 yo female sprained her right knee playing tennis 1 week ago. She no longer has pain at rest and is walking with only one 1 crutch while at school. She walks without it at home. PT exam reveals no swelling, full AROM/PROM of right knee, MMT 3/5. Which of the following would help knee extension strength
Seated Knee Extension with no resistance, repetitions to failure
A preseason testing program for high school athletes includes testing stability of the glenohumeral and scapulothoracic joints. If you identify an athlete with signs of shoulder instability, you will suggest an exercise program to prevent or reduce risk of injury during the season. This is an example of what type of prevention?
Secondary
Designing and directing an exercise class for patients who have been diagnosed with HTN or heart disease falls within the definition of what type of prevention?
Secondary
Which of the following scapulothoracic muscles is responsible for protraction when the shoulder is used for pushing or elevation activities?
Serratus Anterior
Picture of Client performing push up:
She is able to maintain pelvic neutral and has some scapular winging.
Which of the following would place biceps in passive insufficiency?
Shoulder extension, elbow extension, forearm pronation
(Picture) Pt holding elastic tubing in both hands, elbows flexed to 90 degrees, both held against their chest. Pt internally rotates and externally rotates both shoulders at the same time
Shoulder external rotation concentrically and eccentrically
While instructing a pt to fully elongate the lats you would place her limb in what?
Shoulder flex, Abduction, ER
Your client just reached 8 weeks after his right shoulder rotator cuff repair. He is now able to start with strengthening but has a 5lb lifting restriction from MD. List 2 exercises for his home exercise program include sets/reps. Explain why you chose the position and type of resistance (constant vs. variable).
Shoulder flexion, extension, abduction, adduction, internal rotation, external rotation, or scapular strengthening. Rotator cuff and scapula will be weak and lack strength and endurance. Constant versus variable resistance depend on body position gravity assisted versus eliminated. Resistance must be less than 5lb lifting restriction.
A patient has knee extension of only 3/5.. What is most appropriate for strengthening?
Sidelying knee extension with Theraband
20 year old soccer player 12 weeks s/p Right ACL reconstruction has no precautions/ restrictions. PT intervention reveals full AROM and 5/5 strength, but some Right LE atrophy of quadriceps and gastroc. Exercise prescription
Single leg Right balance on foam pad with theraband on Left leg stimulating kicking, standing alternating forward/backward lunges, single Right leg squat on gym machine
Which of the following is an example of a closed environment motor task?
Sitting in a chair eating
Which one of the following joints is the only direct bony attachment of the shoulder complex to the axial skeleton?
Sternoclavicular joint
What physiological factor shows fastest decrease when a conditioned healthy person stops exercising and becomes sedentary?
Stroke Volume
Which one of the following is true regarding stroke volume response to exercise?
Stroke volume changes are dependent on body position and intensity of exercise
55 year old male 2 weeks s/p Right knee replacement has swelling and pain. 4 wheeled walker and WBAT. Right knee extension lacking 10 degrees AROM, 5 degrees PROM, extension . What is the best exercise prescription to address these deficits?
Supine knee quad sets 3x15 with towel under the knee
T/F: SV decreases 30% age 25 to 35
TRUE
T/F: Symptom limited testing provides accurate assessment of functional capacity
TRUE
T/F: When prescribing tendon glides, PT instructs the client to block the proximal phalynx and work on active flexion at the PIP joint to focus on gliding of Flexor Digitorum Superficialis
TRUE
T/F: With Patellofemoral tracking dysfunction, it is best to avoid knee extension exercises with constant resistance at 30 degrees
TRUE
Hormone for protein synthesis, growth, strength and power in regards to resistance training
Testosterone
As a therapist, one way you can be relatively confident that motor learning has taken place is when a patient demonstrates which of the following?
The ability to perform a slight variation of the task in a new context during treatment session.
Name 2 muscles that are tight in upper crossed syndrome. Describe a stretch for the muscles you named.
Tight Upper Traps
What is true regarding total peripheral resistance in response to aerobic exercise?
Total peripheral resistance is reduced by vasoconstriction in non-working muscles with vasodilation to working muscles
Which muscle is the primary target for core strength exercises?
Transversus Abdominis
Which is true about Core Exercises?
Transversus Abdominis and multifidi muscle activation occurs independent of rectus abdominis and erector spinae
In general, resting stroke volume decreases 30% from age 25 to age 85 but it may not decrease in persons who are free of arterial disease as they age true or false?
True
T/F: After >= 5 weeks deconditioning, unloading, or bed rest, a client is at high risk of injury during recover/reloading which may prolong recovery time.
True
T/F: Hip joint actively flexes, pelvis wants to rotate into ant pelvic tilt that can be prevented by strong ab muscle strength
True
T/F: In patients with poorly controlled diabetes mellitus, exercise may increase blood glucose levels because of counter regulatory hormones
True
T/F: Symptom-limited maximal exercise testing results most accurate assessment of patients functional capability
True
T/F: Wrist flexors are needed to stabilize and flex the wrist as the fingers and thumb extend to open the hand. This allows the extensor digitorum, extensor indicis, extensor digiti minimi, and extensor pollicis longus to function more efficiently during prehension
True
True or False? At rest, the body is able to extract or use approx. 25% of oxygen from blood but with exercise, body is able to extract 75% of oxygen from blood
True
What is the difference between acute CV response to UE and LE exercise at a fixed work output?
UE Ex trigger > HR, SBP, DBP, & VO2
Left elbow fracture with elbow flexion deficits: what would be the greatest functional impairments?
Use of a cell phone, eating and drinking
Muscles that are weak or insufficient in clients with patella tracking dysfunction
VMO, glute med, piriformis
Due to supraspinatus impingement syndrome, Mrs. J is unable to fully lift her arm overhead without pain. You plan to design an exercise program consisting of both discrete and serial tasks. You do NOT want to include continuous tasks at this time. Which of the following should NOT be included?
Warming up on the UE ergometer (UE cycling)
Which of the following indicates need for stretching?
Weak anterior tibialis muscle or ankle dorsiflexion
Which of the following would indicate a need for stretching?
Weakness of the anterior tibialis muscle or dorsiflexors
Each of the following is a prescreening question that should be addressed before participation in a health promotion program EXCEPT:
What is your blood pressure and heart rate normally?
Which of the following BEST describes cross-over effect, a phenomenon that has been observed as a result of resistance training?
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.
Case scenario; grip deficits, wrist flexion and extension, AROM deficits, wrist flection and extension4/5; which would best address these impairments?
Wrist extension and flexion gentle stretches 15 seconds x 4 reps followed by wrist extension with 1 lb weight x 15 reps and wrist flexion with 1 lb weight x 15 reps
You are asked to do "selective stretching" with a patient with a spinal cord injury. Which of the following best describes the concept of a particular technique?
You allow tightness of specific muscle to remain in order to optimize function.
Two criteria that would indicate a pt needs core exercises
Young age <40 and Greater General Flexibility
D1 extension pattern works shoulder extension and...
abductors, internal rotators, and wrist/finger extensors
Over 10‐12 weeks of cardiovascular training and physiologic cost
able to perform the same amount of exercise at a lower physiologic cost
Lateral elbow pain all the time pt education includes
activity modification, active rest, ICE, gentle PROM and AAROM and isometric at pain‐free ranges
Contraindication for resistant training
acute pain/inflammation
True respiratory response to aerobic exercise
alveolar ventilation may increase 10‐20x rest with heavy exercise
Picture of leg up from bent position in supine
antagonist hamstring, active stretch, dynamic flexibility
Balance training in order to decrease falls, PT sets up obstacle course
anticipatory control
Walking up and down a grassy hill
anticipatory control
Which term best describes use of a client's hamstring tendon as a graft for his or her own ACL reconstruction surgery?
autograft
Which site may result in Median Nerve entrapment?
between the heads of the pronator teres
Pt goal is to walk dog with leash up and down hills in neighborhood
body transport, open environment, with intertrial variability, object manipulation
Which of the following is true regarding age and thermoregulation?
children have consistently lower sweat rate and rely more on radiation and convection for heat dissipation than adults
Motor learning stage in which frequent errors are made
cognitive stage
Catabolic hormone for protein degradation and decreases protein synthesis
cortisol
Which of the following vitals means poor prognosis during the 1st min of recovery
decrease in HR less than 12 beats per min
Which is true regarding response of contractile tissue to immobilization
decrease muscle activation for strength loss
Physiological adaptation with cardiorespiratory training
decreased in BP at rest
All of the following are risk factors for deep vein thrombosis EXCEPT:
diabetes and gender
Absolute indication to stop exercise testing for a low risk adult
drop of BP more than 10 mmHg in SBP with dizziness
Picture of active quad stretch
dynamic flexibility of quads, active insufficiency of hams
What applies to the following quad stretch (prone with knee bent no weight)
dynamic flexibility of quads, active insufficiency of hamstrings
Pic of someone doing a prone leg curl
dynamic flexibility of the quads, active insufficiency of the hamstrings
25 y/o R tennis elbow almost completely resolved; Stretch for right lateral epicondylitis
elbow extended, forearm pronated, wrist flexed
Which one of the FULL PROM positions would be appropriate to fully lengthen the triceps?
elbow flexion WITH shoulder flexion
T/F: Bodybuilders use split routines to allow for increased fatigue, and decreased recovery time and decrease in the total volume of training
false
Forward sway using ankle strategy
gastrocnemius, hamstrings, paraspinals
Which best explains exertional angina
heart is unable to take enough O2 from the blood because as HR is increasing, diastolic filling time is decreasing which sacrifices coronary blood flow
Designing exercise progression for a patient with HTN, what is the highest risk?
high effort isometrics
If strength of muscles is good and active ROM cannot be done, repetitive sitting will accomplish all except?
increase strength in muscles
Which technique is most appropriate in the autonomous stage of learning
increased complexity of the task
Factors responsible for increased cardiac output during exercise
increased systolic BP, increased HR, increased SV
Muscle spasms that occur after injury has healed
intrinsic muscle spasm
What is an acute hormone response to resistive exercise? (3 hormones released)
large muscle groups show increase in testosterone, cortisol, and growth hormone
The best order for LE exercises:
leg press, leg extension, leg curl, single leg calf raise
Best order of exercises when exercising all major LE muscle groups during a single workout
leg press, leg extension, leg curl, standing single leg calf raise
Why is CO lower in children
lower stroke volume
16 y/o R elbow fracture ~12 wk ago, and immobilized for 8 wk; R hand dominant, 25 degrees off full extension. Most difficult task?
most difficult is open/close doors
Activation of the patella tendon reflex
muscle spindle activation with reciprocal inhibition
What is most responsible for joint position sense
muscle spindles
What CV system responses best describe why static isometric exercises are contraindicated in cardiac patients?
neurogenic mediated response with increase in SBP, decrease in DBP, and increase in heart rate with peripheral vasoconstriction
Pt has been very compliant with shoulder strengthening, showing a change in shoulder abduction strength, 5/5 over 4 wk period; most likely adaptation responsible for change in strength:
neuromuscular changes
Least to most difficult core exercises (pictures):
no variable surface, arms only, legs only, legs and arms combined
PRE regimen 10 reps of hip and knee extension against 20lbs, 10 reps against 15lbs, and 10 reps against 10lbs. This approach is known as
oxford regimen
Energy system used for endurance training
oxidative phosphorylation
Primary energy system primarily with long duration endurance exercise
oxidative phosphorylation
Pic of person doing a half kneeling stretch for hip flexors, what type of stretch is this considered
passive stretch
Mr. K has lower back pain and lives a sedentary lifestyle. He was referred by his physician to physical therapy. He initially doesn't think exercise will help his LBP, so he does not consider making any lifestyle changes, but he goes to the PT anyways. After the first PT session, he realizes that regular exercise may help decrease his LBP. He decides to continue PT twice a week for one month. Following this first session, what stage of the TTM does Mr. K present himself in?
preparation
What is a goal related to PROM?
prevent cartilage degeneration
Closed chain exercises compared to open chain exercises
produce less shear force
55 year old patient just reached 3 weeks s/p rotator cuff repair. He is now able to start AAROM. List 2 exercises for home?
pulleys, pendulums, table slides for flexion and abduction, wall finger ladder for flexion and abduction, wand or cane for flexion, abd, IR, ER
Right shoulder cuff repair...AAROM exercises
pulleys, pendulums, table slides, wand/cane
How to tell the difference between an infection or bursitis
redness that track proximally and distally
How do you determine infection rather than bursitis
redness tracking proximally and distally
Match inflammation stage with appropriate characteristic: acute, subacute, chronic redness, swelling, heat, pain Muscle weakness, poor neuromuscular control 14‐21 days after injury; collagen synthesis
redness, swelling, heat, pain = acute Muscle weakness, poor neuromuscular control = chronic 14‐21 days after injury; collagen synthesis = subacute
Balance control, shortest latency
reflex
Components of PNF D2 flexion UE pattern (Server position)
shoulder abduction, shoulder external rotation, forearm supination, wrist extension
When applying manual resistance during the D1 extension pattern, the muscle groups being strengthened are: shoulder extensors AND
shoulder abductors, internal rotators and wrist and finger extensors
Biceps in passive insufficiency
shoulder ext, elbow ext, forearm pronation
A patient has 3/5 MMT knee extension, what is the best exercise?
side‐lying with theraband resistance
Client is practicing controlled squatting and partial lunges and eccentric quad and glutes in weight bearing to improve her sit to stand what principle does this represent?
specificity of training
Mrs. B has a T12 vertebrae fracture. She does resistance training to focus on eccentrics of her quads and glutes in weight bearing (controlled squatting and lunges). What principle of therapeutic exercise is this?
specificity of training
Mrs. B is an 87 yo at skilled nursing facility, works on glutes because she has falls when transferring sit to stand
specificity of training
With a large perturbation that pushes the COM outside the BOS what strategy is used?
stepping strategy
Which is true regarding metabolic response to exercise?
submaximal exercise can be maintained for 10‐60min using carbs and fat for energy
Patient that presents with a history of pressure ulcers and a L2 spinal cord injury that occurred 5 years ago would be considered what type of therapy prevention
tertiary prevention
Which one of the following hormones helps with protein synthesis
testosterone
Best defines VO2 MAX?
the body's ability to use oxygen per minute while performing max effort.
Untrained persons activate 71% muscle cross sectional area during max effort
true
True regarding fibers:
type IIB fast twitch fibers are recruited for intensity, power with high glycolytic capacity.
Resistance training that is most appropriate for a patient with elbow muscle weakness
underhand toss with a weighted ball
Scapular upward rotation when arm is elevated which muscles?
up/low trapezius and serratus posterior
Hand and wrist work together to function using a balance and control of forces; what occurs when fingers and thumb flex
wrist extensors active to stabilize and prevent FDP, FDL, and FPL from flexing the wrist and fingers
Match the stage of recovery ○ 4 to 6 days, PRICE ○ begin stretching ○ progressing to OKC and CKC
○ 4 to 6 days, PRICE-- Acute ○ begin stretching-- subacute ○ progressing to OKC and CKC-- chronic
List 2 key elements PT must know with post‐op pts.
○ Components of Surgery ○ Post-op Protocol ‐ know/ get directly from MD/research if no protocol available ○ Precautions ○ Contraindications
List 2 pre‐op PT interventions
○ Education about surgery ○ post-op Ex ○ Use of Assistive Devices ○ post-op WB status: NWB PWB TTWB WBAT? ○ Assess ROM
Match the stage of recovery with appropriate PT interventions
○ Minimum Protection Phase ‐ Progressive Balance/coordination training ○ Moderate Protection Phase ‐ AAROM/AROM within limits of pain, Multi Angle Isometrics ○ Maximum Protection Phase ‐ PROM/AAROM Isometrics
Match post‐surgical phase with POC objectives: ○ Minimum protection phase ○ moderate protection phase ○ max protection phase restore full joint and soft tissue mobility gradually improve soft tissue and joint mobility decrease post-op pain, ms guarding and spasm
○ Minimum protection phase: restore full joint and soft tissue mobility ○ moderate protection phase: gradually improve soft tissue and joint mobility ○ max protection phase: decrease post-op pain, ms guarding and spasm
Which of the following is true regarding BP response to Ex?
○ SBP increases linearly proportional to Ex intensity ○ SBP should NEVER be > 250 mmHg
A physical exam for pre-participation in exercise screening should include all of the following except:
○ abdominal palpation
Match the activity with the stage ○ isometrics ○ teach safe body mechanics ○ controlled motions phase
○ isometrics: acute stage ○ teach safe body mechanics: chronic stage ○ controlled motions phase: subacute stage
Unable to extend right elbow after cast removed due to fracture
○ myostatic elbow flexion contracture
List 3 balance exercises for patient and list the order from least difficult to most difficult
○ one for young patient with ACL repair standing on one leg ○ One for 75 y/o man pic with chair
Which statement is true regarding post-op recovery s/p muscle and tendon repairs
○ post-op PT is similar except tendon tissue repair time frame is up to 8 weeks > muscle repair time
Match soft tissue lesions
○ tenosynovitis ○ tendinitis ○ tendinosis ○ hemarthrosis
