Therapeutic Exercise Final

When assessing the needs of the patient, which of the following is not considered to be objective data?

patient report of pain level

The proper patient evaluation and program development sequence is as follows?

assess the needs of the patient→ develop treatment plan→ implement treatment plan→ re-assess patient’s needs

The goals of therapeutic exercise include all of the following except (choose incorrect answer)

inhibit blood flow to the target tissues

T/F: the ultimate goal of a therapeutic exercise program program is the achievement of an optimal level of symptom-free movement during basic to complex physical activities.

true

What type of range of motion is defined as follows: “a type of active ROM in which assistance is provided by an outside force, either manually or mechanically, because the prime mover muscles need assistance to complete the motion.”

active assistive ROM

Which of the following answers is correct regarding the indications for passive range of motion?

all of the above are correct answers

Which of the following answers is correct regarding the indications for active range of motion?

inhibit neuromuscular feedback from the contracting muscles

T/F: In order for a technique to be considered range of motion (not stretching), the motion must be performed within a pain-free range.

true

The most accurate assessment tool to measure a joint’s range of motion is:

goniometer/inclinometer

In regards to recording the results of a range of motion assessment of the knee, which of the following is considered the most appropriate documentation

right knee flexion AROM = 0-125 degrees

Which technique for increasing soft tissue flexibility is based on the notion that maximal muscle relaxation can be achieved following a maximal or sub-maximal contraction of the muscle to be stretched?

contract/relax techniques

When applying manual passive stretching techniques, the “optimal” duration and frequency of the stretch is now generally accepted to be as follows:

force is applied for 20-30 seconds and repeated 4-5 times per session

Which type of joint contracture often results from a sedentary lifestyle and results in the patient complaining of “tightness”?

myostatic contractures

T/F: If an athlete lacks the necessary strength and joint structure to hold a joint stable during functional activities, overstretching the joint should be avoided.

false

Contraindications for stretching include all of the following except:

all of the above are contraindications for stretching

The glenohumeral joint consists of what type of joint geometry?

ovoid

Which of the following statements is correct regarding the Convex-Concave Rule of joint motion?

sliding is in the same direction as the angular movement of the bone if the moving surface is concave

T/F: accessory movements are movements within the joint and surrounding tissues that are necessary for normal range of motion, but they cannot be performed by the patient voluntarily; these movements include component motions and joint play motions

true

Which grade of mobilization involves large amplitude rhythmic oscillations performed up to the limit of the available motion and stressed slightly into the tissue resistance?

grade lll

If your goal is to primarily stretch hypomobile (tight) soft tissue structures within and surrounding the joint, which grade(s) of mobilization should you choose?

grades lll-lV

Which of the following statements is incorrect regarding the “Early Motion Exercises” stage of exercise progression?

should be initiated before pain reduction/control has been achieved

Which of the following statements is incorrect regarding the “Endurance Exercise” state of exercise progression?

low-repetition and high-resistance exercises are the focus of this stage

Which of the following statements is incorrect regarding the “Proprioceptive/Closed Kinetic Chain (CKC) Exercises” stage of exercise progression?

bilateral standing on a firm surface with eyes open is more difficult than unilateral standing on a firm surface with eyes open

T/F: during the “Strengthening Exercises” stage of exercise progression, the focus is on implementing high-resistance and low repetition exercises

true

T/F: in regard to the “Power Exercises” stage of exercise progression: Power is critical for functional activities, such as work demands, sporting demands, and activities of daily living, because as the amount of time required to complete a given workload decreases, the amount of stress or overload on the injured tissue increases.

true

What variable are used to progress any particular exercise?

all the above are correct answers

T/F: in general, we should try not to change no more than one variable at a time when progressing an exercise. This will help to determine what aspect of the exercise progression might be causing increased pain, stiffness, and/or swelling.

true

T/F: exacerbations that reverse functional gains for a short period of time rarely occur during the rehabilitation progression process, so it is of little value to explain to the patient that these “minor setbacks” could occur.

false

Behavioral and Cognitive techniques that can be used to help increase rehabilitation compliance include:

all the above are correct answers

The proper sequence for exercise progression is as follows:

pain control→ early motion exercises→ endurance exercises→ proprioception/CKC exercises→ strengthening exercises→ power exercises→ functional exercises

What is mobilization?

a passive movement performed by the clinician at a speed slow enough that the patient can stop the movement

What is stretching?

a therapeutic technique used to lengthen shortened soft tissue structures with the resultant increase in ROM

What is a sellar joint?

one joint surface is concave in one direction and convex in the other direction, with the opposing joint surfaces being convex and concave respectively

What are physiological motions?

motions that the patient can do voluntarily- such as flexion, extension, abduction, adduction, and rotations

What is active range of motion?

movement within the unrestricted ROM for a segment that is produced by an active contraction of the muscles crossing that joint

What is flexibility?

the ability of soft tissues to relax and yield to a stretching force

What is glide?

the same point on one joint surface comes into contact with new points of the opposing joint surface

What is traction/distraction?

separation of the joint surfaces

What is active assistive range of motion?

a type of ROM in which assistance is provided by an outside force, either manually or mechanically, because the prime mover muscles need assistance to complete the motion

What is roll?

new points of one surface meet new points on the opposing surface

What is range of motion?

the amount of available motion in a joint

What is contracture?

a shortening of the muscle and/or other soft tissue that surrounds a joint, which results in a limitation of joint ROM

What are accessory motions?

movements within the joint and surrounding tissues that are necessary for normal range of motion, but they cannot be performed by the patient voluntarily

What are ovoid joints?

one joint surface is convex, while the other joint surface is concave

Regarding recording the results of range of motion assessment of the ankle, which of the following is considered the most appropriate documentation?

right ankle dorsiflexion AROM = 0-20 degrees

T/F: in order for a technique to be considered passive range of motion (not stretching), the motion must be performed within a pain-free range and not engage tissue resistance.

true

What are isotonic exercises?

a dynamic form of exercises that is carried out against a constant or variable load as a muscle lengthens (eccentric) or shortens (concentric) through the available ROM

What is manual resistance exercise?

a form of active resistance exercises in which the resistance force is applied by the clinician to either a dynamic or static muscle contraction

What are isokinetic exercises?

a form of dynamic exercise in which the velocity of the muscle shortening or lengthening is controlled by a rate-limiting device that controls (limits) the speed of the movement of a body part

What is mechanical resistance exercise?

a form of active exercise in which resistance is applied through the use of equipment or a mechanical device

What are isometric exercises?

a static form of exercise that occurs when a muscle contracts without a change in length of the muscle and/or without visible joint motions

T/F: if an athlete possesses the necessary strength and joint structure to hold a joint stable during functional activities, overstretching the joint can be employed to gain additional flexibility that may be needed for a particular sporting motion

false

Which grade of mobilization involves small-amplitude rhythmic oscillations performed at the beginning of the available motion, and not stressed into the tissue resistance?

grade l

The hip joint consists of what type of joint geometry?

sellar

If your goal is to primarily limit the amount of pain within a joint, which grade of mobilization should you choose?

grades l-ll

T/F: when a muscle contracts maximally and shortens, it cannot generate as much tension as when it contracts maximally and lengthens. In other words, muscles are stronger when performing eccentric contractions that when performing concentric contractions.

true

Which of the following statements is incorrect regarding manual resistance exercises?

a form of active exercise during which resistance is applied using equipment mechanical device

Indications for resistance exercise training include all the following except:

increase joint mobility

T/F: greater delayed muscle soreness often results from concentric exercise programs as compared to eccentric exercise programs

false

T/F: when using isokinetic training methods, the velocity of the movement is held constant, but the resistance level varies throughout the arc of motion.

true

Which of the following statements is incorrect regarding isokinetic training?

at faster velocities, muscle generate more torque and more compressive forces on the joints

T/F: numerous studies have shown that manual passive stretching techniques produce better outcomes than prolonged mechanical passive stretching techniques

false

Which of the following statements is incorrect regarding isometric training?

strength gains occur only when 100% maximal isometric contractions are performed

Which of the following statements is incorrect regarding the effect of tissue temperature on stretching of soft tissues?

the higher the temperature, the les the amount of deformation possible prior to failure

T/F: a muscle can generate greater tension with a maximal isometric contraction than with a maximal concentric contraction, but not as much as with a maximal eccentric contraction

true

Which type of stretching involves a slow, maintained stretching motion which does not facilitate the stretch reflex?

static stretch

T/F: a “myostatic contracture” results from a chronic inflammation and fibrotic changes of the soft tissues

false

Effects of joint motion include:

all the above

Examples of “joint play” motions (a form of accessory movements) include all of the following except:

flexion

T/F: because there is limited carry-over from one training speed to another, isokinetic exercise programs should be performed at a variety of velocities

true