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Ther. Ex. Final Exam
| Question | Answer |
|---|---|
| Q1: Dominant hostile | -Stubborn/ argumentative -Fixed positions & sticks to them -Talks a lot, rather than listen, interrupts -Pushy, arrogant, brash, beligerent |
| Q2: Submissive-hostile | -Uninvolved, quiet, withdrawn, sullen -Passive & backs down easily -Talks little & doesn't listen well -Avoids/ ignores issues |
| Q3: Submissive-warm | -Outgoing, friendly, social -Appeases, compromises, glosses over issues -Talks a lot, listens some, unbusinesslike -Meanders, lacks organization, unfocused |
| Q4: Dominant-warm | -Sincere, open, candid, responsive -Explores, listens, summarizes others positions -Open-minded, flexible, understanding -Analytical, task- oriented, non-blaming |
| Most personalities are: | Q3 and Q4 |
| How to observe the whole pt: | -Facial grimaces -Compensations -Guarding -Conversations |
| Examination | -Data collection and scales |
| Evaulation | -Processing and applying data |
| Palpation of skin | -Warm -Cold -Turgor -Swelling |
| Dermatomes | -Light vs. Sharp touch -Hypo-, normal, hyper- sensitive |
| Myotomes | -Looking for endurance of max contraction, fatiguing weakness |
| ROM important note: | -Not just an issue of a tight muscle -Tissue integrity: not only or always strength issue/ more endurance as you know it |
| PROM Indications: | -P! -Swelling/ impaired circulation -Muscle guarding -Shortened tissue -Prevent loss of ROM -Limited tissue tolerances/ proliferation |
| PROM contraindications: | -MD orders -Empty end feel/impingement -Bony end feel -Jt. crepitus -Infection/ hematoma -Unstable direction/ jt. |
| AAROM and AROM won't: | -Will not develop pure strength unless very weak/ low level |
| Toe region | -Collagen waves removed -1st tissue stop at end of region -Shorter with age |
| Elastic region | -Elongated but returns to normal |
| Plastic region | -2nd tissue stop -Microscopic failure -Length changes -More velocity dependent |
| Necking | -Weakening -Less force needed for elongation -Failure quickly even with less force |
| Creep phenomenon | -Longer stress= greater strain or viscosity |
| Warmer tissue = | -Less chance of injury and greater lengthening |
| Viscous | -Resistance to flow; thick and sticky |
| Muscle spindle | -Mechanoreceptor that senses speed of strain |
| Golgi Tendon Organ (GTO) | -Mechanoreceptor that senses amount of strain |
| Tissues limiting ROM | -Skin adhesions -Muscle/ tendon -Various types of muscle guarding -Neurological facilitation of muscle from spine -Capsule: hypo/hyper mobility, impaired arthrokin. -Bursa -Cartilage -Neurological- impingement/ neuropathy -Disc lesion -Bone |
| Stretching Evidence | -No beneficial effect on preventing sports injuries |
| Stretching Precautions | -Osteoporosis -Prolonged immobilization due to tissue sensitivity to stretch -Don't stretch a contracting tissue |
| Stretching Contraindications | -Same for all ROM and.... -Non-elastic/ capsular end feel -Tissues shortening provides stability to the jt in place of the normal stability -Tissue shortening allows for increased function due to other limitations |
| Stretch Evidence: Static stretch | -Best results @ 5-30 min. static stretch -No greater benefit between 30-60 min |
| PNF: Hold/ relax | -Stimulate spinal reflexes that create muscle resistance to stretch -Isometric action of tight muscle for 5 sec. -Relax and move into new range |
| Static vs PNF | -Equally effective |
| Active vs Passive | -No significant difference |
| Muscle Energy Technique | -Similar to PNF -Applied to H. Abds vs ERs and control |
| Active Isolated Stretching Evidence | -Static stretching better |
| Lumbar JM Stretching Evidence | -Significantly increased hamstring length vs. stretching or controls |
| Stretching for less/more rigid muscles | -Short duration for less rigid muscle restrictions -Hamstring studies: static significant increase; passive hold lasted 3 min. -Long duration for more rigid muscle restrictions (i.e after immobilization, fxs) |
| Stretching evidence: Refutes increased mm extensibility due to: | -Neuromuscular relaxation with Static/ Ballistic/ PNF -Viscoelastic deformation of mm -Plastic deformation o |
| Stretching recent theories | -Sensory Theory: Increased muscle extensibility due to alteration in perceived sensation/ Uncertain peripheral and/or central phenomenon -Psychological alteration of willingness to tolerate more “stretch |
| Adaptive shortening | -i.e. a muscle contracture or decreased muscle extensibility cannot be determined by ROM alone |
| Post injury/ sx scar tissue strength | -10% at 1 wk -40% at 6 weeks- safe with 2nd tissue stop Rx -70% at 2 months (8-9 weeks) -100% at 1 year |
| Measuring Strength | -Repetition maximum (RM) -Dynamometry- isometric -Cable tensiometry- isometric -Isokinetic machines -Manual muscle testing (MMT) |
| Resistance | -Force that opposes motion |
| Thera-band | -Less resistance than tubing |
| Resistance exercise indications | -Best injury prevention |
| Resistance exercise precautions | -Acute injury -Cardiovascular Dx- Valsalva maneuver -Deconditioned patients -Progressive weakening -Elderly re: positions/parameters -DOMS -Dehydration |
| Overload principles | -Tissue must be challenged to perform at a level greater than to which it is accustomed; guiding principle of exercise prescription |
| SAID | Specific adaptation to imposed demands |
| Isometric beneficial with: | Isotonic |
| Remodeling phase | 2 wks to a month |
| Repair phase | 48 hrs to 10 wks |
| Dense connective tissue is what type of collagen | Type I; resists tension |
| Ligament/Capsule healing: Tensile strength | 50% @ 6mths 80% @ 1 yr 100% in 1 to 3 yrs |
| Bone | Type I collagen; resists tension -1/3 organic 2/3 inorganic |
| Bone healing | Repair: soft boney callus forms ( 1 to 3 wks) Modeling- hard boney callus Remodeling- heals 100% original collagen (3 to 4 mths) |
| Fracture | -Start PT @ 3-8 wks of immobilization |
| Articular cartilage | -Type II collagen; compression; ends of long bones; avasular |
| OA most common @ what jts | Hip and knee -OA heals with type I collagen (tension) |
| Fibrocartilage Healing: Tensile strength | -Improves @ 3-5 wks (40% integrity) even better when dense fibrous tissue fills @ 10-12 wks (70% integrity) |
| Difference in partial meniscectomy vs Meniscal repair | Partial: faster recovery, early ROM, FWB sooner, higher risk of degeneration Repair; longer time line, slow recovery, lower risk of degeneration |
| Tendon | Type I collagen; tension; hypovascular/neural |
| Tendon ruptures | higher forces during fast eccentrics |
| Tendon healing | Tensile strength really improves @ ~3-5 wks (~40% integrity) Even greater tensile strength when dense fibrous tissue fills in @ ~ 10-12 wks (~70% integrity) |
| Sarcomere | functional unit of skeletal mm |
| Muscle healing | ~ 1 wk- central zone of injury filled in with dense fibrous tissue ~ 3 wks- central zone of injury has all but disappeared in most strains but remodeling still occurring |
Created by:
alovedaytn
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