Active care exam 1 TQs

How many minutes of aerobic exercise are recommended each week? (TQ)

150 minutes/week of moderate intensity exercise

How much resistance training is recommended each week? (TQ)

Minimum of 2 non-consecutive days each week

The SINGLE best predictor of a senior citizen falling → big toe strength (TQ)

2nd = leg strength!

LOCATION the individual is feeling pain

Source

WHAT is creating pain in the individual's

system, where does the pain stem from

Cause

Active AND passive movement is dysfunctional

Mobility dysfunction

MD = Both

Active movement is dysfunctional, passive movement is functional*

Stability/Motor Control Dysfunction

SCMD= active dysfunction

Should we incorporate movement assessment as part of our standard operating procedure to look at patterns or parts? (TQ)

Patterns

When do you have justification to go look at the PARTS? (TQ)

When a pattern is dysfunctional**

upper trapezius, levator scapulae, suboccipitals, pectoralis major/minor are all _____ in upper cross.

Tight

deep neck flexors, lower trapezius, serratus anterior, rhomboids

Are all _____ in upper cross

Weak

thoracolumbar extensors and hip flexors are all _____ in lower cross.

Tight

abdominals and gluteus maximus are all ___ in lower cross.

Weak

What is the primary tissue/system that mediates the interconnectedness of the kinetic chain? (TQ)

Connective tissue

3 Planes of Movement (TQ)

Sagittarius

Horizontal/ transverse

Frontal/ coronal

a. Flexion/extension

b. Forward/backward bending

c. Dorsi/plantar flexion

What plan of motion?

Sagittal

a. Internal/external rotation

b. Horizontal abduction/adduction

c. Axial rotation

Horizontal/transverse

a. Abduction/adduction

b. Lateral flexion

c. Ulnar/radial deviation

d. Eversion/inversion

Are all in what plane?

Frontal/coronal

**review the purple charts on brightspace - TQ

1 plane →

Stable joint (Prone to stability dysfunction)

3 planes→

Mobile joint

What techniques can help restore optimal length-tension relationship within the muscular system?

1. Stretching

2. Manual Therapies

3. Motor Control

4. Strengthening

What techniques can help restore optimal arthrokinematics within the skeletal system?

1. Chiropractic

2. Repeated ER

3. Regular Movement

4. Exercise/Loading

The 3 R's of Active Care (TQ)

Reset

Reinforce

Retrain

a. Chiropractic adjustments

b. Manual therapies

c. Passive therapies

Is what "R"

Reset (calm, hands on)

a. Pain education

b. Encourage safe movement

c. Protection and biofeedback ie: taping, bracing, splinting, etc

lumbar rolling

Is what "R"?

Reinforce (benefit, education)

a. Block practice

b. Random practice

Retrain ( load management, action + function)

Motor control exercise is an example of which of the 3 R's?

Retrain

4x4 Matrix (TQ

a. Spinal mobility (flexion/extension/rotation)

b. Segmental stability

c. Cervical patterns

d. Shoulder flexion

Is learned in what position?

Supported

a. Spinal curves

b. Cross-crawl pattern

c. Pelvis to trunk dissociation

d. Hip and shoulder flexion and extension

Is learned in what position

Suspended

a. Single leg stance

b. Hip and spine loaded stability

c. Loaded hip extension

Is learned in what position?

Stacked

What are the two ways that we can increase (or decrease) the difficulty of any exercise? (TQ)

1. Change the POSITION

2. Change the RESISTANCE

What is the next most logical step in the 4x4 progression?

- Passive + manual therapies +

adjustments

- Pain reducing interventions

- Low load isometric exercises

Are all what step of evidence-inspired care

Step 1: Desensitize the pain generator

- Primary and secondary load management

- SAID principle

Step 2: Restore the function

T/f: Training is at a higher level BUT end-stage rehab should surpass training requirements

T

Passive ROM of a given joint and surrounding soft tissue

Flexibility

Active ROM of a joint through a given range of motion, under neurological control

Mobility

_______ flexible → SOFT tissue injuries

OR DOMS

Less

______ flexible → JOINT-related injuries

More

Reduction in flexibility of about ___% per decade from 20-49 years of age*

10%

What specific types of treatments do physically remodeled/shortened tissues require?

- 8+ weeks

- Stretching/loading of tissues to end range, sustained for 2+ min

- Gamma motor tone is reduced

- Spindles become less excitable

- Greater ROM around articulation can

Neurological inhibition

- Gamma motor tone is increased

- Spindles become hyperexcitable

- Less ROM is allowed

occur

Neurological facilitation

- Bony block limits motion

- Recent fracture with incomplete non-union

- Acute inflammatory or infectious process

- Soft-tissue healing disruption

- Sharp acute pain with movement or muscle elongation

- Hematoma or other tissue trauma indication

- Hypermobility already exists**

Contraindication of what?

Stretch

T/F? Stretching helps to increase the physical muscle LENGTH

- False! We are not ripping actin/myosin bonds

How long do the effects of stretching endure?

After 5-30 minutes, the gains made from stretching are significantly reduced

Which important factor or parameter is most important to modify in order to counter the short-term effects of stretching?

Repetition and consistency

What causes the acute increase in ROM seen with static stretching?

analgesic response, inhibited nervous system tone, short-term increase in flexibility of muscles

TQ: During what timeframe of stretching do the majority of increased ROM occur?

- First 15 seconds of a stretch

- After the 4th, 30 second stretch, no gains are ma

- Static stretch

- 3-4 sets, 15-30 seconds

- Repeat multiple times per day (5x/week)

- 6-10 weeks

Are the gold standard for what?

Stretching

TQ: What is the optimal duration for static stretching?

30 seconds, 3-4 sets

Muscle __-__ secs

Tendon __-__ mins

15-30sec

2-10 min

How long do you need to stretch a TENDON to see length improvements? (TQ)

- Gentle stretches for up to 10 minutes

- Minimum of 2 minutes to have viscoelastic change

How can someone mitigate the effects of this phenomenon? (TQ)

Maximal contraction of the muscle PRIOR to static stretch minimizes

stretch-induced strength loss**

Stretching causes an acute inhibition of maximal force produced by the muscle

Stretch-Induced Strength Loss:

What types of activities does this primarily impact?

LOW-velocity, strength-based activities (ie: bench press and deadlift)

T/F? DOMS is caused by a buildup of lactate?

- False! Most likely neural feedback, muscle spindles sense inflammation so it is a

protective mechanism

What is recommended in terms of stretching for DOMS?

- Stretching should NOT be performed during DOMS (contraindicated)**

controlled movement through a full range, sport/task specific,

prepares and warms up the body

Active dynamic

bouncing at end range, may improve sport performance but does

NOT result in sustained increases in ROM, neurologic system can't adapt to new

end range

Ballistic

Contraction of the antagonist simultaneously inhibits the action of the agonist?

Reciprocal Inhibition AKA Sherrington's Law (muscle spindles)

What technique is found in both Post-Contraction Inhibition AKA Autogenic Inhibition and Reciprocal Inhibition AKA Sherrington's Law (TQ)?

CRAC

Gamification:

Constraints can be modified by changing the...

1. Environment

2. Task

3. Individual

Dynamic Systems Theory (DST) TQ**

During PFS, what percentage of isometric contraction are we asking from the patient?

100%

After a muscle is contracted, it is automatically in a relaxed state for a brief, latent period

Post-Contraction Inhibition AKA Autogenic Inhibition (TQ) (GTO)