Therapeutic Exercises Soft Tissue Chapter 10

C. Grade the exercise to the stage of recovery to stress the tissues safely.

A properly applied and progressed therapeutic exercise program should: A. Follow a pre-established protocol in order to be consistent for all patients with the same diagnosis. B. Push the patient beyond his or her current stage of recovery in order to progress the healing process. C. Grade the exercise to the stage of recovery to stress the tissues safely. D. Begin with passive exercise, progressing to active assistive exercise, active exercise, and then resistive exercise by the third week after injury.

C. Initiation of resistance exercise should begin with eccentric (muscle lengthening) techniques as soon as pain subsides to avoid tissue contracture.

All of the following are considerations for interventions when establishing a rehabilitation program for a patient diagnosed with chronic inflammation resulting from repetitive trauma except: A. Tissues subjected to repetitive trauma may never completely heal. B. Connective tissue sustains structural weakening as a result of the perpetuated inflammatory tissue response. C. Initiation of resistance exercise should begin with eccentric (muscle lengthening) techniques as soon as pain subsides to avoid tissue contracture. D. Inflammatory response must first be managed by controlling the inflammation with modalities or other conservative measures.

D. Thin and unorganized.

During the repair process following tissue injury, the newly developing collagen fibrils are: A. Ready to withstand normal stresses by 3 weeks. B. Slow to be deposited. C. Laid down in alignment exactly replicating the fibers that were damaged. D. Thin and unorganized.

B. Grade II joint mobilization.

During your evaluation, you identify signs of chronic inflammation of a muscle group. Each of the following techniques is tissue-specific for this condition at this time except: A. Cross-fiber massage. B. Grade II joint mobilization. C. ROM within the limits of pain. D. Muscle setting in pain-free positions.

B. Inflammation must be treated before stretching is initiated.

If you determine that chronic irritation and inflammation of scar tissue are the sources of progressive restriction and pain: A. Strengthening exercises are the only intervention that can resolve the patient's problems. B. Inflammation must be treated before stretching is initiated. C. The pain will decrease after stretching exercises are implemented. D. The scar must be stretched vigorously to regain ROM.

B. Should be passive or assisted and should begin as soon as tolerated within the pain-free range.

Movement during the acute stage of healing following soft tissue injury: A. Is contraindicated. B. Should be passive or assisted and should begin as soon as tolerated within the pain-free range. C. Should include the full ROM in order to prevent adhesions. D. Should begin on the fourth day and be tissue-specific.

B. Identifying and treating the cause of the guarding.

Muscle guarding is best treated by: A. Applying modalities and then massaging the muscle. B. Identifying and treating the cause of the guarding. C. Gentle muscle setting exercises with the muscle in a shortened position. D. Massaging the muscle.

A. As the result of repetitive, submaximal stress of a muscle or tendon.

Overuse syndromes occur: A. As the result of repetitive, submaximal stress of a muscle or tendon. B. As the result of a severe blow to a muscle. C. As a result of prolonged immobilization. D. Only if there is impaired circulation to soft tissue.

C. Maintain fluid dynamics and nutrition in a joint

Passive ROM and grade I or II joint-mobilization techniques are appropriate during the acute stage of soft tissue healing. What do these interventions have in common when used during this stage? A. Include movements into tissue resistance B. Affect muscle, ligament, and capsular tissue around the site of injury equally C. Maintain fluid dynamics and nutrition in a joint D. Used to increase ROM

B. Prolongs the inflammation and promotes adhesion formation.

Progressing resistance and stretching exercises vigorously during the early subacute stage of soft tissue healing: A. Decreases recovery time. B. Prolongs the inflammation and promotes adhesion formation. C. Increases the strength of the healing tissues. D. Helps scar tissue resolve more quickly.

D. Introduce and progress stretching to increase mobility and alignment of newly forming scar tissue.

To effectively manage soft tissue lesions during the subacute stage of tissue healing, the role of the therapist is critical. The objective of treatment during the moderate protection/controlled motion phase of rehabilitation should be to: A. Control the pain and inflammation. B. Encourage the patient to permanently stop doing the activity that caused the injury. C. Maintain passive range of motion (PROM). D. Introduce and progress stretching to increase mobility and alignment of newly forming scar tissue.

A. Stretching and strengthening the healing tissues.

Transient or intermittent pain that occurs during the chronic stage of soft tissue healing is best relieved by: A. Stretching and strengthening the healing tissues. B. Applying cold. C. Applying heat and massage. D. Resting.

D. Let patient response guide the progression of exercise

What is the best method for determining the progression of exercise during the subacute stage of healing? A. Increase range of motion 10° each treatment session B. Increase strength training by 1 lb each treatment session C. Increase endurance exercises by 3 repetitions each treatment session D. Let patient response guide the progression of exercise

A. Chronic stage

Which of the following stages of soft tissue healing is characterized by remodeling and maturation of collagen in the scar? A. Chronic stage B. Early subacute stage C. Late subacute stage D. Acute stage

D. Tendinosis

Which of the following terms refers to the degeneration of a tendon due to repetitive microtrauma? A. Tendinitis B. Tenosynovitis C. Tenovaginitis D. Tendinosis

D. Low-intensity muscle setting

Which of the following types of active exercises are the most appropriate to use first during the acute phase of healing after a muscle injury? A. Submaximal isokinetic concentric exercise at slow velocities B. Active ROM exercises C. Multiple-angle isometrics against manual resistance D. Low-intensity muscle setting

C. End-range joint or muscle stretching techniques to increase the mobility of the tight structures

Your examination of a patient who sustained a soft tissue injury reveals that she experiences pain only at the end of the available ROM when you apply overpressure. Based on this finding, which of the following would be the most appropriate technique to include in the treatment plan to decrease the patient's pain? A. Immobilize and rest the painful structures B. Grades I and II joint distraction or gliding techniques C. End-range joint or muscle stretching techniques to increase the mobility of the tight structures D. Progressive resistance exercises to work through the pain

B. Passive knee flexion/extension with the hip positioned in 0° extension

Your patient reports having had a sudden onset of severe pain in the left posterior thigh yesterday while sprinting. Today he is unable to fully extend his left knee while walking because of pain. Which of the following interventions is most appropriate today? A. Passive knee flexion/extension with the hip flexed to 90° B. Passive knee flexion/extension with the hip positioned in 0° extension C. Active knee flexion but no passive or active extension D. Submaximal resisted knee flexion in the prone-lying position