BYU EXSC 602 Graduate AT Exam 1 Study

4 Step Problem Solving Process

1. Understand the problem

   1. need to look at whole problem (and sometimes BEYOND)

   2. Look beyond heuristics if it isn’t working. (can be helpful short term, test them and then put them away and test it all)

2. Devise a plan (Translate)

3. Carry out the Plan (Solve)

4. Look Back (Check and Interpret

Heuristics

Heuristics

• Anchoring

• Availability

• Representativeness

• using these is LAZY

Cognitive Biases

• Bandwagon Effect

• confirmation bias 

• framing effect 

• Over confidence

Foundation of Problem Solving

1. Think

2. Meaningful questions

3. Problem solving 

Novice clinician

• rigid adherence to taught rules

• little situational perception

• no discretionary judgement

Competent Clinicians

• sees actions in terms of long-terms or wide spread conceptual framework 

• follows standardized and routinised procedures 

• should be here AFTER BOC

Expert clinicians

• no longer relies explicitly on rules/guidelines

• has intuitive grasp on situations

• doesn’t let the expectations cloud the available data

• uses funnel approach 

• does not come from getting certified, takes lifetime of learning

PRO-ACT-IVE

Problem

Reframe the problem

Objectives

Alternatives

Consequences

Trade-offs

Integration of 

Values

Exploration 

REMEMBER (Problem Solving)

• don’t make assumptions

• have all data been considered?

• do all the data fit the problem?

• have you continued to collect data and make adjustments?

• keep differential diagnoses/treatments in mind don’t settle on your first thought

Training vs. Conditioning

10 principles of conditioning

1. warm up/cool down

2. motivation

3. overload

4. consistency

5. progression

6. intensity

7. specificity 

8. individuality 

9. minimize stress

10. safety 

SAID principle

Specific Adaptation to Imposed Demands

when is this applicable? 

Systems affected by Stress/Load

• enhance heart muscle

• increase the bone density

• calm the nervous system

• reduce the body weight

• fresh air is better for health

• boost the brain function

• strengthen the respiratory system

• raise the immunity

Warm-Up 

• injury prevention

• performance enhancement

• general and specific

• time period???

• temperature of muscle

  • blood flow

  • elasticity

  • nervous system - secret weapon, can manipulate to help us

    • pumps and channels are much more efficient

Cool Down

• Blood pooling following activity

  • important to get blood back centrally from peripheral 

  • clears debris from working muscle 

  • slows re-oxygenation

  • increases HR - stress on heart 

• Same activity as warm-up?

• combine with stretch

Flexibility/Stretching

• ROM possible around joint or series of joints

  • maybe get it through proposed activity and not necessarily stretching

  • warm up first can be helpful 

  • ROM can be limited due to injury and scar tissue on connective tissue

• injury prevention ?? - not really (in those with normal ROM, population is 50/50 that has less ROM) 

• Performance enhancement?? - not really 

Stretching Techniques

• Ballistic

  • bouncing (like a warm up) primes nervous system for activity 

• Static 

  • Holding tension 

• PNF

  • passive stretches with active muscle contractions 

** Ballistic and static have same effectiveness

Strength

• maximum force that can be applied by a muscle during a single contraction

• determines strength

  • size

  • neuromuscular efficiency

  • biomechanical factors

Strength Terms

Hypertrophy - increase size of muscle (fiber)

Atrophy - Decreased size of muscle (fiber)

Reversibility - if strength training is discontinued or interrupted, the muscle with atrophy

Length/Tension Relationship

optimal resting sacromere length is when the protein heads line up with each other (on sarcomere)

Types of muscle contraction

Isometric - generates force with changing length

Isokinetic - at a consistent speed

Plyometric - involves all 3 types of contractions

Isotonic 

• Concentric - shortening

• Eccentric - lengthening

Progressive Resistive Exercise 

work muscles against increasing resistance to build strength and size

Plyometric Training

power exercise 

uses stretch shortening cycle

high injury rate

cardiorespiratory fitness

ability of circulatory and respiratory systems to deliver oxygen to skeletal muscle during exercise

very important part of physical fitness

cardiovascular endurance is inversely related to cardiovascular disease

reduces relative risk of dying prematurely due to CVD

Cardiovascular Endurance

normative values based on VO2 max test

VO2 max indicates how well the heart and lungs work together to deliver oxygen and nutrients to working muscles and how well those muscles can utilize them

aerobic training adaptations

• type I fibers 7-22% increase

• capillary increase 5-15%

• fatty acid oxidation 30% increase

• VO2 improvement 15-20% 

• mitochondrial enzymes 2.5x more 

• mitochondria 15% more and 35% bigger

• myoglobin increase 75-80%

Grains Guideline

make ½ of your grains whole

women 19-30: 6oz 

men 19-30: 8oz

eat at least 3oz of whole grain

Vegetable guidelines

Vary your veggies

women 19-30: 2.5 cups

men 19-30: 3 cups

eat more dark green veggies, orange veggies, dry beans, and pasta

Fruit Guidelines

focus on fruits

2 cups for both men and women 19-30

eat variety (fresh, frozen, canned, dried)

go easy on fruit juices

Milk guidelines

get calcium-rich foods

men and women 19-30: 3 cups

go low fat or fat-free

if not milk, chose lactose free or other calcium sources

Meat and Beans Guidelines

Go lean on protein 

Women 19-30: 5.5oz

Men 19-30: 6.5oz 

choose low-fat or lean meats and poultry 

bake it, broil, or grill 

vary choices - fish, beans, peas, nuts, and seeds

Oil Guidelines

Know your fats

Women 19-30: 6 tsp

Men 19-30: 7 tsp

make most fat sources from fish, nuts, and vegetable oils

avoid butter, margarine, shortening and lard

general guidelines for eating healthy

Carbs 55-70% of caloric intake

Fat 20-25% of caloric intake

Protein 12-25% of daily caloric intake

needs depend on sport, level of training, and nutritional goals

Supplementation

Vitamins and minerals

• iron and calcium tend to be low (in females) 

• sodium and potassium can be replenished via sports drinks or diets

protein 

• daily needs usually exceeded in a normal diet 

performance - enhancing substances 

• creatine and caffeine 

Determining Protein Needs

0.8g/kg for average individual

1.1-1.4g/kg for recreational athletes

1.2-1.4 g/kg for endurance athletes

1.2-1.7g/kg for strength and power athletes

hydration guidelines

pre-exercise: 1.5-2.5 cups 2-3 hours before 

during exercise: 1 cup ever 15-20 min 

post exercise: 2-3 cups of fluid for every pound lost during exercise 

use sports drinks during if it exceeds an hour