NBCE PT Boards

Depth of UV

superficial

1-2 mm (skin)

Depth of Infrared

superficial

8-10 mm (vascular)

Depth of Microwave Diathermy

deep

Depth of Shortwave Diathermy

deep

Depth of Ultrasound

deepest!

4-8 cm

Best Modality for Herpes Zoster

UV and ultrasound

Best modality for Diabetes Mellitus

Infrared

If open growth centers, do NOT use what modalities? (3)

Shortwave Diathermy

Microwave Diathermy

Ultrasound

Goggles are required for what modalities? (3)

UV

Microwave Diathermy (wire-mesh)

Laser

Which electrical modalities are direct current? (3)

Low-Volt Galvanic

High Volt

Microcurrent

What current is unidirectional and monophasic?

Direct Current

What electrical modalities are alternating current? (3)

Sine wave

Faradic

Interferential

What current is bidirectional and biphasic?

Alternating Current

What electrical modality is both alternating and direct current?

TENS

To avoid transcerebral and transthoracic, how do you place the pads?

Co-planar (TMJ)

Which electrical modality do you use iontophoresis?

LVG

What solution do you use to break adhesions when doing iontophoresis?

Potassium Iodine (KI)

(- pole)

What solution do you use for bursitis when doing iontophoresis?

Sodium Salicylate

(- pole)

What solution do you use for edema when doing iontophoresis?

MgSO4

(+ pole)

What solution do you use for fungus when doing iontophoresis?

CuSO4

(+ pole)

What does electrodiagnosis with LVG look for?

Reaction of Degeneration (RD)

AKA LMNL

What are the signs of a lower motor neuron lesion? (4)

Flaccid

Decreased DTR

Atrophy

Facilitation

Which electrical modalities have settings that can give both endorphins and enkephalins? (3)

High Volt

Interferential

Tens

Which heat modality is the best for increasing circulation?

Infrared

Which electrical modalities can be used for pain control? (3)

High Volt

Interferential

TENS

Which modality is both an antibacterial and antifungal?

UV

If your patient has Scheuermann's Disease, what type of exercises should NOT be performed?

FLEXION or Williams

If you patient has facet syndrome, what type of exercises should NOT be performed?

EXTENSION or McKenzie

What device should you use for active recovery for an ankle?

Wobble Board

What is inhibited in lower cross syndrome?

Glutes

T/F: You should strengthen the low back in acute low back patients.

False

If your patient is having toe out problems, what muscle is affected?

Piriformis

If you increase aerobic exercise, what happens to mitochondria activity?

It increases as well

What is the action of the subscapularis muscle?

Assists in medial rotation of the shoulder

What type of stretching do you hold and then stretch?

PNF or Proprioceptive Neuromuscular Facilitation

What is the treatment technique for an upper motor neuron lesion called?

Bobath's

To be considered aerobic exercise, how long must an individual maintain their target heart rate?

15-20 minutes

Aerobic exercise refers to cyclic movements caused by the contraction of what?

Large muscle masses relying on aerobic energy pathways

What are the heart rate percentage ranges and give an example patient for each.

.6 = sedentary / post MI

.75 = average Joe / weekend warrior

.9 = triathlete

What is the target heart rate equation?

((220-age)-Resting HR)*%+Resting HR

Williams believed that the cause of low back pain was acquired how?

By walking upright in a straight position

-he stated that normal posture is with knees bent and torso slightly bent forward

Williams believed that all activities should be geared to reducing what?

Lumbar lordosis

Williams exercises are what kind of exercises?

FLEXION

What muscles are weak and what muscles are tight according to the Williams approach?

WEAK Abs

WEAK Glute max

TIGHT hamstrings

What kind of exercise is BEST for patients with acute disc problems?

McKenzie Exercises (Extension)

--if McKenzie isn't listed...pick Williams!

McKenzie exercises are what kind of exercises?

EXTENSION

McKenzie approach is based on the behavior of pain and mechanical response to what?

Dynamic and Static Loading

What is the formula for power?

Power = Force X Speed

What concept are plyometrics based on?

Power

-they are exercises that enable a muscle to reach maximal force in the shortest amount of time

What are some typical plyometric movements?

Jumps

Hops

Bounds

Box Drills (softball catcher)

Depth Jumps (volleyball and basketball)

How long are plyometrics performed?

until fatigue

What are the 3 phases of the stretch shortening cycle?

Eccentric

Amortization

Concentric

Acute care management takes place when?

first 4 weeks

What are the symptoms of an acute issue? (4)

Rubor (Redness)

Calor (Heat)

Dolor (Pain)

Tumor (Swelling)

What modalities are used in acute care management?

Cryotherapy

Low Volt Galvanic (+ pole)

Pulsed US (takes away thermal component)

How is a muscle stretched?

By going opposite of it's action

When does recover care management begin?

After four weeks

When should you start active care stretching?

During recovery care

What modalities are used in recovery care management?

mild heat--Infrared, hydroculator pack, hot bath

When does the chronic/rehab phase begin?

After 12 weeks

What do you want to do during the chronic/rehab phase?

Strengthen muscles (resistance against action)

Exercises where the hand or foot is free to move

Open Chain Exercises

Exercises where the hand or foot is fixed and cannot move

Closed Chain Exercises

What are some examples of open chain exercises? (4)

Bench press

biceps curl

leg extensions

straight leg raises

What are some examples of closed chain exercises? (5)

Push-ups

HSPU

Pull-ups

Squats

Lunges

What kind of exercise should you do on someone with a knee injury?

Leg Extensions TOE OUT

Why? because weak VMO, lateral tracking patella and chondromalacia patella

What kind of exercises should you use with Lower Crossed Syndrome?

WILLIAMS

What muscles are tight and weak with Lower Crossed Syndrome?

TIGHT Iliopsoas

TIGHT Erector Spinae

WEAK Abdominals

WEAK Gluteus Maximus

What do you do to facilitated muscles? What do you do to inhibited muscles?

Facilitated=Tight...STRETCH these mm

Inhibited=Restricted...STRENGTHEN these mm

What muscles are tight and weak with Upper Crossed Syndrome?

TIGHT Upper Trap & Levator Scap

TIGHT Pectoralis

WEAK Deep Neck Flexor (Longus Colli)

WEAK Lower Trap & Serratus Anterior

How do you strengthen the longus colli?

Tri-flex

Only portion of lower crossed syndrome you wouldn't use Williams exercises on?

Hip Extension...Williams are flexion so use McKenzie

What muscles are tight/facilitated with lower crossed syndrome?

STRETCH THESE

Iliopsoas : perform hip extension (McKenzie)

Rectus Femoris : perform hip extension (McKenzie)

TFL : perform ADDuction

Adductor Group: perform ABduction

Erector spinae: perform flexion

Gastroc: can't isolate because crosses 2 joints

Soleus: can be isolated by flexing the knee

What are the four main postural issues associated with lower crossed syndrome?

Anterior rotation of the pelvis (stretch iliopsoas)

Increased lumbar lordosis (Williams flexion)

Hips in flexion (stretch iliopsoas- McKenzie)

Knees may be hyperextended (genu recuvatum)

Action of the Iliopsoas

Flexes hip joint

Action of the Rectus Femoris

Flexes the hip joint

Quadriceps extends the knee joint

Action of the TFL

Abducts, flexes and medially rotates hip joint

Action of erector spinae

Extension of vertebral column

Action of gastrocnemius

Plantar flexes ankle and assists in knee flexion

Action of soleus

Plantar flexes ankle

Weak/Inhibited muscles in lower crossed syndrome

STRENGTHEN THESE (resistance against action)

Rectus Abdominis : crunches (williams)

Oblique : crunches (williams)

Gluteus Maximus : pelvic rock (williams)

Gluteus Medius : side lying ABduction

Hamstrings : stretch AND strengthen

Common injuries due to weak muscles associated with lower crossed syndrome

Low back pain

Knee pain

Hamstring strains

Action of rectus abdominis

Flexes vertebral column

Action of obliques

Bilaterally: flex vertebral column

Unilaterally: rotate vertebral column

Action of gluteus maximus

Extends and laterally rotates hip

Action of gluteus medius

ABducts hip joint

Action of semitendinosus/semimembranosus

Flexes and medially rotates knee, extends and medially rotates hip

Action of biceps femoris

Flex and laterally rotates knee; extends and laterally rotates hip

Action of tibialis anterior

DORSIflex and INvert

Action of tibialis posterior

PLANTARflex and INvert

Inversion ankle sprain

d/t tight tibialis--stretch these with EVERSION

STRENGTHEN peroneus--this muscle everts the foot

Tight/Facilitated Muscles associated with Upper Crossed Syndrome

STRETCH THESE

Pectorals Major

Pec Minor, Levator Scap, Teres Major*, Upper Trap

Anterior Deltoid

Subscap, Lats, Teres Major

SCM, Scalenes, Rectus capitis

Action of pec major

ADDucts and medially rotates humerus

Action of pec minor

Tilts the scapula anteriorly

Action of Levator scapula

Elevates scapula

Action of teres major

INTERNAL rotation, ADDuction and extension of shoulder

Action of upper trapezius

Adduction of scapula

Action of anterior deltoid

ABduction of shoulder

Action of subscapularis

Internal rotation of shoulder

Action of latissimus dorsi

Internal rotation, ADDuction, and extension of shoulder