(completed)Therapeutic Exercise I – Orthopedic Physical Therapy Flashcards

A comprehensive set of question-and-answer flashcards covering core concepts from the Orthopedic Physical Therapy Therapeutic Exercise lecture notes.

What are the main goals in orthopedic physical therapy?

Heal tissues; decrease pain; improve tissue mobility; improve muscle performance; address functional mobility (bed mobility, gait, stairs); improve proprioceptive and kinesthetic awareness and neuromuscular control; improve balance, agility, coordination; improve cardiovascular fitness/aerobic endurance; enhance posture; educate patients.

What elements are included in a PT evaluation/examination?

Medical history, mechanism of injury, medical conditions, medications, results of diagnostic testing, prior level of function (PLOF), living situation; identification of red flags and precautions; general systems overview (musculoskeletal, neuromuscular, cardiovascular, pulmonary, integumentary); specific exam including joint ROM, muscular assessment, special tests, pain assessment.

Name some essential aspects of physical functioning.

Balance; cardiopulmonary fitness; coordination; flexibility; mobility; muscle performance; neuromuscular control; posture/postural stability.

How is Therapeutic Exercise defined?

A planned performance of body movements, posture, or physical activities to remediate or prevent impairment, improve or restore physical function, prevent or reduce health-related risk factors, and optimize overall health status and well-being.

What characterizes an isometric contraction?

Tension is produced with no change in muscle length; no joint movement occurs; strengthening can occur if held for at least 6 seconds (up to 10 seconds); strengthening may be joint-position specific within ROM (about 10 degrees in either direction). Caution: BP can increase in cardiac patients.

What is an isotonic contraction?

A contraction with a constant load where the muscle can shorten (concentric) or lengthen (eccentric) through the ROM; load is fixed.

Define concentric contraction.

Muscle shortens as it produces tension; origin and insertion move toward each other.

Define eccentric contraction.

Muscle produces tension while lengthening; movement increases distance between origin and insertion; also called negative work.

What is isokinetic exercise and how is it performed?

Movement where velocity is kept constant by equipment; speed controlled by the device; common devices include Biodex, LIDO, Cybex, KinCom; allows training at higher speeds and in concentric and eccentric modes.

What is the force–velocity relationship for concentric contractions?

Greater torque/force at lower speeds and less force at higher speeds; eccentric contractions can produce more force than isometrics, which in turn produce more than concentric.

Describe the length–tension relationship in muscle.

Tension varies with muscle length; maximum tension is typically near the muscle's resting length; less tension occurs when the muscle is too shortened or too lengthened.

What is active insufficiency?

A two‑joint muscle cannot develop effective tension across all joints it crosses when it shortens over two joints simultaneously.

What is passive insufficiency?

ROM is limited by the length of a two‑joint muscle when it is stretched over both joints simultaneously.

How is strength measured?

Manual Muscle Testing (isometric holds by a tester); cable tensiometry; dynamometry; isotonic 1 repetition maximum (1RM) lifts; isokinetics; functional strength assessment.

What are the general principles of strength training?

Overload principle; Specificity (SAID) principle; Transfer of training; Reversibility.

What does the SAID principle stand for?

Specific Adaptation to Imposed Demands: adaptive effects are specific to the training method used.

What is the Transfer of Training principle?

Gains from a training focus will carry over to other areas and modes of exercise.

What is the Reversibility principle?

Detraining or deconditioning can occur when exercise is discontinued, potentially within 1–2 weeks.

How is anaerobic metabolism characterized?

No oxygen required; high intensity, short duration; ATP-PC system (up to ~15 seconds) and anaerobic glycolysis (30–40 seconds) predominant.

How is aerobic metabolism characterized?

Oxygen required; low intensity, long duration; energy from fatty acids, amino acids, and glucose with O2; gradual energy production.

What are Type I and Type II muscle fibers?

Type I: slow-twitch, oxidative, endurance-oriented, fatigue-resistant, highly vascularized. Type II: fast-twitch, glycolytic, higher force, faster fatigue; subtypes IIa/IIb with different characteristics; proportion is genetically influenced.

What are typical distinctions between aerobic and anaerobic training?

Aerobic training uses oxygen, targets Type I fibers, improves endurance and capillary density; Anaerobic training does not require oxygen, targets Type II fibers, increases strength and power; includes high-intensity efforts with limited duration.

What is hypertrophy in response to strength training?

Increase in muscle size due to resistance training.

What is remodeling in muscle physiology?

Enlargement of individual muscle fibers with increased actin/myosin content and sarcomeres.

What changes occur in tendons/ligaments and bone density with resistance training?

Tendons/ligaments increase tensile strength; bone density increases with resistance exercise.

What is disuse atrophy?

Loss of muscle size and strength due to lack of use or immobilization.

What are acute vs DOMS in muscle soreness?

Acute soreness occurs during or immediately after strenuous exercise due to lactic acid and potassium buildup. DOMS (delayed onset) appears 12–24 hours after, lasts 5–7 days, is greatest with eccentric work, and is tender to palpation and passive stretch.

What happens during recovery from exercise?

Energy stores replenished; lactic acid removed; oxygen stores replenished; light activity aids recovery more than total rest.

How does age influence strength and training considerations?

Prepuberty: avoid heavy weight training due to epiphyseal plates; Puberty: rapid strength gains (especially in boys); Early adulthood (18–30): greatest strength potential; Middle age: strength may decline with inactivity; Geriatric: strengthening remains beneficial to delay atrophy and improve function, with considerations for DJD, COPD, etc.

What are the parameters of therapeutic exercise intensity?

Intensity is the amount of resistance; submaximal load for early healing; maximum loading for later strength gains; RM (repetition maximum) is the greatest weight that can be moved through the ROM for a specified number of repetitions; strength-training zone often 70–80% RM.

What are the other essential parameters for therapeutic exercise planning?

Frequency (sessions per day/week); Duration (total weeks/months); Volume (repetitions and sets; e.g., 8–12 reps or 12–20; 1–5 sets); Type of contraction (isometric, concentric, eccentric); Recovery/rest between sets (short <1 min to longer 2–3 min).

What are DeLorme and Oxford regimens?

DeLorme: determine RM; perform 3 sets at 50%, 75%, and 100% of RM. Oxford: same 3 sets but in reverse order (100%, 75%, 50%).

What is circuit training in therapeutic exercise?

A combination of resistance and endurance exercises for total body conditioning with brief rest breaks (30 seconds to 1 minute) between exercises.

What are plyometrics and when should they be used?

Power-generating exercises that involve an eccentric preload followed by a rapid concentric contraction to produce bursts of power; involve GTOs and muscle spindle systems; examples include jumping; not appropriate when muscles are still healing.

What are the modes of exercise related to range of motion and how do they differ?

PROM: passive range of motion with no muscle contraction; AAROM: active assisted range with external help; AROM: active range of motion initiated and performed by the patient; goals relate to mobility and motor control.

What is PRE/RET in resistance training?

Progressive Resistance Training (PRE) or Resistive Exercise Training (RET); systematic progression of resistance to improve strength.

What are manual vs mechanical resistance training?

Manual resistance: tester provides resistance or patient resists self; Mechanical resistance: weights or machines provide resistance; each has advantages and disadvantages in control and progression.

Name some common resistance training equipment.

Free weights (dumbbells, cuffs), pulleys, bikes, upper body ergometers (UBE), elastic tubing/theBand, balance boards, stepping machines, mini trampolines, NuStep, isokinetic machines.

What is the difference between open and closed kinetic chain exercises?

Open chain: distal segment moves freely in space; Closed chain: distal segment is fixed/weight-bearing; closed chain often improves proprioception and neuromuscular coordination due to integrated joint movement.

What is the Valsalva maneuver and why is it important to monitor?

Holding breath during exertion increases thoracic/abdominal pressure, reduces venous return, can cause BP and HR changes; advise patients to exhale (counting aloud) during contractions.

What are some common errors in strength training?

Inadequate rest after vigorous exercise; progressing too quickly; substitution motions due to too much resistance or poor stabilization; improper technique or faulty postures.

Which illnesses are prone to fatigue during exercise?

Multiple sclerosis, Guillain–Barré syndrome; cardiac/pulmonary conditions; neurosurgery or eye surgery; inflammatory/joint disorders; pathological fractures; active cancer treatment; other substitutions.

What strategies promote effective exercise adherence?

Clear instruction and preparation; accommodate learning styles; practice in parts before whole tasks; vary and progress exercises; provide feedback and encouragement.