Ther Ex Quiz 1

Therapeutic Exercise

Systematic performance of planned physical activities to restore function and prevent impairments.

7 Components of Physical Function

Balance, cardiopulmonary fitness, coordination, flexibility/mobility, muscle performance, neuromuscular control, stability.

Disablement Model Sequence

Pathology → Impairment → Functional Limitation → Disability.

Pathology (Disablement Model)

Disorder at the cellular or tissue level affecting normal function.

Impairment (Disablement Model)

Abnormality of a body structure or organ function resulting from pathology.

Functional Limitation (Disablement Model)

Inability of the whole person to perform a specific physical action.

Disability (Disablement Model)

Inability to perform necessary home, work, or community roles.

Phase I Healing (Acute/Protection)

Focuses on protection, controlling pain and edema, and using PROM.

Phase II Healing (Subacute/Controlled Motion)

Focuses on controlled motion, promoting healing, light stretching, and isometric strengthening.

Phase III Healing (Maturation/Return to Function)

Focuses on progressive strengthening, aggressive stretching, and functional activities.

Patient Management Model Sequence

History → Examination → Diagnosis/Evaluation → Prognosis & Plan of Care → Intervention.

Connective Tissue Layers (Outer to Inner)

Epimysium (whole muscle) → Perimysium (fascicles) → Endomysium (muscle fibers).

Neuromuscular Junction Neurotransmitter

Acetylcholine (ACh).

ATP-PC / Phosphagen System

Anaerobic energy system for short-duration, high-intensity explosive activity.

Glycolysis Energy System

Uses carbohydrates for intermediate-duration, moderate-to-high intensity activity.

Oxidative Energy System

Aerobic energy system requiring oxygen, suited for sustained long-duration activity.

Type I Muscle Fibers

Slow-twitch, highly fatigue-resistant endurance fibers with high aerobic capacity.

Type IIb Muscle Fibers

Fast-twitch, high-power anaerobic fibers that fatigue rapidly.

Type IIa Muscle Fibers

Intermediate fibers possessing properties of both Type I and Type IIb.

Muscle Spindle Function

Monitors changes in muscle length and responds to rapid stretch.

Golgi Tendon Organ (GTO) Function

Monitors tension in the tendon to protect against excessive force.

Cardiac Output Formula

CO = Heart Rate (HR) × Stroke Volume (SV).

Max Heart Rate Formula

220 − age.

Convex-Concave Rule: Moving Concave Surface

Slide occurs in the SAME direction as bone movement.

Convex-Concave Rule: Moving Convex Surface

Slide occurs in the OPPOSITE direction of bone movement.

Joint Mobilization Grades I & II Purpose

Used primarily to treat pain and muscle guarding.

Joint Mobilization Grades III & IV Purpose

Used primarily to stretch joint structures and increase ROM.

Overload Principle

To improve performance, a muscle must be challenged beyond normal demands.

SAID Principle

Specific Adaptation to Imposed Demands; training should mimic the desired task.

Reversibility Principle

Loss of functional gains occurs 1-2 weeks after stopping exercise.

Open Kinematic Chain

Distal segment moves freely in space; isolates prime movers.

Closed Kinematic Chain

Distal segment is fixed; emphasizes weight-bearing and stability.

Delayed Onset Muscle Soreness (DOMS) Cause

Microtrauma and inflammatory response (NOT lactic acid accumulation).

DeLorme vs. Oxford Protocol

DeLorme increases resistance each set; Oxford decreases resistance as fatigue occurs.

Isometric Contraction

Muscle contracts without changing length or producing joint movement.

Concentric vs Eccentric Contraction

Concentric shortens the muscle; eccentric lengthens the muscle under tension.

Isokinetic Contraction

Muscle contraction occurring at a constant angular velocity controlled by a machine.

PROM Key Limitation

Passive ROM does NOT prevent muscle atrophy or increase muscle strength.

Aerobic vs. Anaerobic Exercise

Aerobic requires oxygen to break down ATP; anaerobic breaks down ATP without oxygen.

Fast vs. Slow Glycolysis

Fast glycolysis occurs without oxygen forming lactic acid; slow glycolysis occurs when oxygen is present.

Muscle Mass Loss with Aging

Slow phase loses 10% from age 25-50; rapid phase loses 40% from age 50-80.

Normal Blood Pressure Response to Exercise

Systolic pressure increases incrementally with workload while diastolic pressure changes minimally.

Accessory Movement Types

Component motion, joint play, and muscle energy.

Contraindications for Joint Mobilization

Hypermobility, joint effusion, and active inflammation.

Active Assistive Range of Motion (AAROM)

Joint motion performed by the patient's effort combined with assistance from an external force.

Exercise Heart Rate Formula

Exercise HR = Resting HR + 60-70%(Max HR − Resting HR).

Joint Play Movements

Involuntary motion between joint surfaces including rolling, spinning, sliding, and compression.

Skeletal Muscle Blood Flow During Exercise

Increases from 15-20% of cardiac output at rest to 80-85% during maximal exercise.

Periosteum

The site where new bone formation occurs when applied forces exceed normal stress.

Sustained Translatory Mobilization Grades

Grade I (Loosen), Grade II (Tighten/take up slack), Grade III (Stretch capsule).

DOMS Timeline

Develops 12-24 hours after exercise and peaks between 24-48 hours.

Soft-Tissue Recovery Time

Requires approximately 48 hours of recovery between resistance training sessions.

Sliding Filament Model

Actin and myosin slide past each other, increasing overlap during muscle contraction.

Length-Tension Relationship

Optimal starting muscle length allows maximal actin-myosin cross-bridge interaction and force production.

Physiologic Movement

Osteokinematic joint movement that a patient can perform voluntarily.

Spin (Joint Mechanics)

Rotation of a bone around a stationary axis, usually occurring alongside rolling and sliding.

Resistance Training Progression Rule

Increase workload by approximately 5-10% when all repetitions and sets are completed without fatigue.

Resistance Training Rest Intervals

Rest 30-60 seconds for moderate sets; rest 2-3 minutes for heavy loads or high-risk populations.

AROM Key Limitation

Active ROM does not maintain or increase muscle strength in already strong muscles.

Muscle Contraction Sequence

Nerve impulse → ACh release → motor end plate binding → depolarization → Ca²⁺ binds troponin → actin/myosin slide.

Actin vs. Myosin

Actin forms thin filaments; myosin forms thick filaments within myofibrils.

Forces Causing Bone Deformation

Bending, compression, torsion, and muscular pull at tendon insertions.

Aging Effects on Muscle Fiber Types

Selective loss of Type IIb fast-twitch fibers with a relative increase in slow fibers.

Roll (Joint Mechanics)

Joint movement occurring in the same direction as the moving or swinging bone.

Joint Traction vs. Compression

Traction separates joint surfaces to increase space; compression brings surfaces together, decreasing space.

Factors Regulating Muscle Force

Number of cross-bridges formed, motor unit recruitment/type, and initial muscle length.

Ovoid Joint

A joint structure where one bone surface is convex and the other is concave.

Saddle Joint

A joint structure where both opposing bone surfaces have concave and convex regions.

Indications for Submaximal Exercise

Initiating exercise programs, early soft tissue healing, post-immobilization, and warm-up/cool-down periods.

Indications for Maximal Exercise

Increasing muscle size/strength, final rehab stages, and high-performance training without pathology.

Grade I Oscillation

Small-amplitude rhythmic movement performed near the starting position of joint range.

Grade IV Oscillation

Small-amplitude rhythmic movement performed at the limit of available joint range into tissue resistance.

Fast Glycolysis

Anaerobic breakdown of carbohydrates producing lactic acid during muscle oxygen debt.

Muscle Hypertrophy

An increase in the cross-sectional area of existing muscle fibers in response to exercise.

Neuromuscular Cleft

The gap located between the motor neuron and the skeletal muscle cell at the neuromuscular junction.

Grade II Oscillation

Large-amplitude joint mobilization performed within the available range, not reaching the limit.

Grade III Oscillation

Large-amplitude joint mobilization performed up to the limit of range and into resistance.

Transfer Training

The principle that training one task variation or limb can carry over to a related task or contralateral limb.

Indications for Joint Mobilization

Joint hypomobility, abnormal joint position, and functional immobility.

Therapeutic Exercise Goals

Prevent impairments, restore physical function, reduce health risk factors, and optimize overall fitness.

Phase I Healing Primary Focus

Protect tissue, control pain and edema, and maintain joint mobility without disrupting tissue repair.

Phase II Healing Interventions

Includes light stretching, joint mobilizations, isometric strengthening, weight bearing, and AROM into new ranges.

Patient Management Model: History

Gathers information on injury onset, duration, systems review, and relevant medical background.

Patient Management Model: Plan of Care

Establishes short- and long-term goals, intervention frequency/duration, progression timeline, and discharge plans.

Physiologic Effects of Joint Mobilization

Stimulates synovial fluid flow, improves cartilage nutrition, maintains extensibility, and activates mechanoreceptors.

Precautions for Joint Mobilization

Malignancy, unhealed fractures, total joint replacements, metabolic bone disease, and severe pain.

Coordination (Physical Function)

The correct sequence and force of muscle firing to produce smooth, efficient movement.

Stability (Physical Function)

The ability of the neuromuscular system to hold a body segment or position stationary.

Cardiopulmonary Fitness

The ability to perform sustained, low-intensity, repetitive total-body movements over time.

Neuromuscular Control

The interaction of sensory and motor systems to coordinate muscle responses during physical activity.

Patient Management Model: Examination

Process of collecting data using specific tests and measures such as MMT, ROM, and girth.

Patient Management Model: Evaluation & Diagnosis

Interpreting examination results to identify specific body structure dysfunctions and movement limitations.

Flexibility / Mobility (Physical Function)

The ability to move body segments freely through an unrestricted, pain-free ROM.

Muscle Performance (Physical Function)

The capacity of a muscle to do work, encompassing strength, power, and endurance.

Indications for Isometric Exercise

Acute injury, post-op rehab, weak patients, decreased ROM, or when joint motion is contraindicated.

Factors Affecting Range of Motion

Joint surface shape, joint capsule pliability, muscle strength/flexibility, age, and body composition.

Resistance Training Rest Intervals for Special Populations

Elderly, pediatric, or pathological patients require at least 1-2 minutes of rest between sets.

Phase III Healing Interventions

Progressive strengthening, aggressive stretching, multiplane stabilization, and functional training.

Muscle ROM (Functional Excursion)

The distance a muscle can shorten after being maximally elongated.

Component Motion

An accessory joint movement that accompanies active motion but is not under voluntary control.