Week 3 TI

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Questions and Answers

A patient is performing a bicep curl with a dumbbell. What represents the external torque in this scenario?

  • The joint angular velocity at the elbow.
  • The force generated by the biceps brachii muscle.
  • The length-tension relationship of the biceps brachii muscle.
  • The force of gravity acting on the dumbbell and forearm. (correct)

During a squat exercise, which of the following best describes the kinetic chain?

  • Open chain, as the hips and knees are extending independently.
  • Both open and closed chain, as the upper body is free to move independently.
  • Closed chain, as the feet are fixed and the hips and knees are moving. (correct)
  • Open chain, as the feet are fixed and the hips and knees are moving.

Which of the following factors has the MOST influence on internal torque production?

  • The time of day the exercise is performed.
  • The color of the resistance band being used.
  • The muscle's cross-sectional area. (correct)
  • The patient's age.

A physical therapist is using manual resistance during a shoulder abduction exercise. How does this impact the external torque?

<p>It adds an external force that the patient must overcome, thus increasing external torque. (C)</p> Signup and view all the answers

Which of the following exercises would be MOST appropriate for initiating muscle activation and maintaining fiber mobility in the acute phase of rehabilitation, without significantly increasing strength?

<p>10 repetitions of 6-second isometric holds at a low intensity. (A)</p> Signup and view all the answers

In an open chain exercise, what is a defining characteristic of joint motion?

<p>Joint motions are independent. (D)</p> Signup and view all the answers

Which scenario would primarily target stabilization through isometric contractions?

<p>A patient performing core stabilization exercises after a spinal injury. (B)</p> Signup and view all the answers

How does increasing the length of the lever arm (distance from joint center to the application of an external load) affect the external torque?

<p>It increases the external torque required to resist the motion. (B)</p> Signup and view all the answers

Which training adaptation is most likely to occur earliest in a rehabilitation program following a surgery that caused muscle inhibition?

<p>Neural adaptations improving motor unit recruitment (A)</p> Signup and view all the answers

A physical therapist is designing an exercise program for a patient with osteopenia. What type of training is MOST effective for increasing bone mineral density (BMD)?

<p>High load, high strain rate (power) training (A)</p> Signup and view all the answers

What adaptation within muscle fibers is possible due to training?

<p>Transition from type IIx to type IIa fibers (C)</p> Signup and view all the answers

For a patient with type 2 diabetes, what muscular adaptation to exercise is MOST beneficial in managing their condition?

<p>Increased insulin sensitivity (B)</p> Signup and view all the answers

Which factor influencing bone adaptation to loading is primarily addressed by increasing the weight lifted during resistance training?

<p>Magnitude of the load (B)</p> Signup and view all the answers

A patient can perform 10 repetitions of a bicep curl with 50 pounds. Based on the provided table, what is their estimated 1RM?

<p>Approximately 66.6 pounds (B)</p> Signup and view all the answers

Electrical stimulation (NMES) is used during rehabilitation to primarily target what?

<p>Improve neural recruitment when muscles are inhibited (A)</p> Signup and view all the answers

For a muscle endurance training goal, what is the recommended load and rest interval?

<p>&lt;65% 1RM, &gt;1 min (D)</p> Signup and view all the answers

In early rehab, what is the primary purpose of muscle setting exercises?

<p>Maintain fiber mobility and muscle recruitment (A)</p> Signup and view all the answers

Which training variable is MOST associated with power training to improve bone mineral density?

<p>High strain rate (D)</p> Signup and view all the answers

Why might initial strength gains be observed even before significant muscle hypertrophy occurs?

<p>Neural adaptations improve muscle recruitment. (D)</p> Signup and view all the answers

During early rehab, what is the recommended load for Active Range of Motion (AROM) exercises aimed at motor control?

<p>Negligible (B)</p> Signup and view all the answers

What repetition range is most appropriate for an exercise aimed at improving strength?

<p>1-6 (A)</p> Signup and view all the answers

What is the approximate percentage of 1RM that would allow an individual to perform 15 repetitions of an exercise?

<p>65% (B)</p> Signup and view all the answers

You are prescribing exercises for a client in early-stage rehabilitation. They are performing isometric exercises. How long should they hold each repetition?

<p>6 seconds (D)</p> Signup and view all the answers

What RPE value is most appropriate for strength focused training.

<p>RPE 6-8 (hard-somewhat hard) (D)</p> Signup and view all the answers

A physical therapist is designing an exercise program for a patient who needs to improve motor control after an injury. Which type of exercise would be MOST appropriate to incorporate into the early stages of their program?

<p>Active Range of Motion exercises with minimal resistance (C)</p> Signup and view all the answers

In early rehabilitation, what set and rep scheme is most appropriate for muscle activation?

<p>2 sets of &gt;12 reps (D)</p> Signup and view all the answers

For a beginner starting a new strength training program, what is the primary reason for initial strength gains?

<p>Enhanced neural adaptations improving muscle activation. (D)</p> Signup and view all the answers

According to the principle of Specific Adaptation to Imposed Demands (SAID), what is the MOST important factor when designing a training program for an athlete?

<p>Ensuring exercises mimic the speed, joint angles, and forces of their sport. (B)</p> Signup and view all the answers

A physical therapist is designing a therapeutic exercise program for a patient recovering from a muscle strain. Which of the following considerations is MOST crucial for determining the appropriate intensity level?

<p>The stage of tissue healing, the specific tissue injured, and the overall goals. (D)</p> Signup and view all the answers

A powerlifter wants to increase the weight they can lift. Over time, what should be the MOST important focus of their training?

<p>Increasing volume, and including heavier loads to recruit larger motor units. (B)</p> Signup and view all the answers

After an athlete stops resistance training, how quickly does the reversibility principle suggest that the gains achieved may be lost?

<p>Within 1-2 weeks of ceasing exercise. (A)</p> Signup and view all the answers

To externally increase the torque of an exercise, which strategies could be implemented?

<p>Changing the external resistance or the lever arm. (A)</p> Signup and view all the answers

A patient is having difficulty maintaining balance during single-leg stance. Which of the following progressions would be MOST appropriate to improve their stability?

<p>Progressing from a stable surface to an unstable surface. (C)</p> Signup and view all the answers

For an athlete aiming to improve the functional performance of a movement, what aspect of training velocity is MOST critical?

<p>Training velocity should match the velocity required for the specific function. (B)</p> Signup and view all the answers

Why is applying mechanical load so important in tendon rehabilitation?

<p>It stimulates adaptation in the tendon, with greater load leading to greater adaptation. (C)</p> Signup and view all the answers

Where can adaptations typically occur in a tendon structure in response to mechanical loading?

<p>At both the junctions and the mid-structure of the tendon. (B)</p> Signup and view all the answers

What role does loading and unloading play in cartilage health?

<p>It facilitates nutrition to the cartilage through diffusion from joint fluid. (D)</p> Signup and view all the answers

What is the potential benefit of regular, moderate loading through range of motion (ROM) for cartilage?

<p>It can increase cartilage thickness. (B)</p> Signup and view all the answers

During acute cardiovascular responses to exercise, which of the following does NOT increase?

<p>Resting heart rate (D)</p> Signup and view all the answers

What effect does resistance training have on resting heart rate (HR) and blood pressure (BP)?

<p>It does not lead to adaptations in resting HR or BP. (B)</p> Signup and view all the answers

How does resistance training typically affect aerobic power?

<p>It has no adverse affects on aerobic power. (D)</p> Signup and view all the answers

In early stages of rehabilitation, what type of exercise can be initiated to promote cartilage health?

<p>Passive range of motion (PROM) (C)</p> Signup and view all the answers

Flashcards

External Torque

The torque generated by an external force acting against muscle torque.

Internal Torque

The torque produced by the muscle force acting on the bone to counter external torque.

Open Chain Exercise

An exercise where the distal segment is moving and the proximal segment is fixed.

Closed Chain Exercise

An exercise where the distal segment is fixed and the proximal segment is moving.

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Tendon Insertion

The position and angle of tendon insertion that influences muscle torque.

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Active Insufficiency

The reduced ability of a muscle to generate force when it's too short.

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Passive Insufficiency

The reduced ability of a muscle to generate force when it's too stretched.

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Contraction Velocity

The speed at which a muscle contracts, influencing its torque.

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Initial strength gains

Early improvements in strength primarily due to neural adaptations rather than muscle growth.

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Long-term strength progress

To continue strength gains, higher volume and load are necessary over time after initial training.

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SAID principle

Specific Adaptation to Imposed Demands; training should match the goal activity for effectiveness.

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Reversibility of training

Gains from training can be lost if exercise is ceased for 1-2 weeks.

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Progressive loading

Gradually increasing intensity and volume to improve healing of injured tissue.

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Changing exercise variables

Adjusting aspects like torque, stability, and speed to progress in training.

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Movement complexity

Altering exercises from single to multi-joint and single to multi-plane motions to enhance training.

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1 Rep Max (1 RM)

The maximum weight a person can lift for one repetition.

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Estimating 1 RM

Using repetitions and resistance to predict 1 RM using a percentage table.

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Repetitions and Percentages

More reps correlate to lower percentages of 1 RM.

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Strength Training Load

For strength, use >85% of 1 RM with RPE 6-8.

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Endurance Training Load

For endurance, use lower weights with higher repetitions.

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Rest Interval

The break taken between sets of exercise.

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Muscle Setting

A type of exercise involving isometric contractions to activate muscles without movement.

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Active Range of Motion (AROM)

The movement patients can achieve through their muscle control.

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RPE Scale

Rate of Perceived Exertion helps gauge workout intensity.

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NMES

Neuromuscular Electrical Stimulation to promote muscle activation.

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Poststroke recovery

Training and exercise strategies to enhance recovery after a stroke.

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Mental practice

Technique using mental visualization to enhance physical performance and strength.

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Resistance training progression

Structured increase in load and intensity during resistance training for optimal muscle gain.

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Therapeutic exercise

Targeted physical activity to restore function and improve health.

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Exercise for osteoporosis

Physical activity to prevent and treat osteoporosis by increasing bone strength.

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Mechanical Load Response

Greater mechanical load leads to greater strain and adaptations in tissues.

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Tendon Rehabilitation Importance

Loading is crucial in tendon rehab for promoting healing and strength.

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Cartilage Nutrition

Cartilage needs loading/unloading for nutrition via joint fluid diffusion.

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Cartilage Thickness Increase

Regular moderate loading increases cartilage thickness over time.

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Acute Cardiovascular Responses

Cardiac output, stroke volume, heart rate, oxygen uptake, and blood pressure all increase during acute exercise.

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Resistance Training Effects

Resistance training does not change resting heart rate or blood pressure, but does not harm aerobic capacity.

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Loading During Rehab

Initiating rehab with passive range of motion (PROM) helps start loading process safely.

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Joint Fluid Movement

Regular movement through range of motion enhances nutrient flow to cartilage.

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Neural Adaptations

Changes in the nervous system that improve muscle recruitment and strength before muscle size increases.

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Fast-Twitch Motor Units

Muscle fibers responsible for rapid, powerful contractions; recruit more with training.

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Muscle Hypertrophy

Increase in the size of muscle fibers due to training.

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Muscle Hyperplasia

Increase in the number of muscle fibers, often a result of intense training.

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Insulin Sensitivity

How effectively cells respond to insulin; improved by training.

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Increase in Glycogen Storage

Training enhances muscles' ability to store glycogen, given enough glucose.

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Bone Mineral Density (BMD)

the amount of minerals (like calcium) in bone; increased through high-load training.

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Factors Influencing Bone Adaptation

Intensity, rate, direction, and volume of loads affect bone health and strength.

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Study Notes

Energy Systems for Exercise

  • Duration of events from 0-6 seconds to more than 3 minutes impacts the primary energy systems used.
  • Extremely high intensity events (0-6 seconds) utilize the phosphagen system.
  • Events lasting 6-30 seconds use a combination of phosphagen and fast glycolysis systems.
  • Very high intensity (6-30 sec) and high intensity (30 seconds to 2 minutes) events mainly use fast glycolysis.
  • Moderate intensity (2-3 minutes) events use fast glycolysis and oxidative systems.
  • Low intensity events (over 3 minutes) primarily rely on the oxidative system.

Biomechanics of Resistance Training

  • Torques Involved:
    • External/Resistance Torque: Torque generated by external forces like gravity acting against muscle force.
    • Internal/Muscle Torque: Torque produced by muscle action to counter external torque.
  • External Resistance Torques (Clinical Applications):
    • Gravity: Acts at the center of mass on an unloaded limb.
    • Exercise Equipment: Includes cables, resistance bands, and manual resistance.
    • Length of Level Arm: Distance from the joint center to the load application point.
    • Open vs. Closed Chain:
      • Open Chain: Proximal segment fixed, distal moving (independent joint movements).
      • Closed Chain: Distal segment fixed, proximal moving (interdependent joint movements).
    • Refer to Kisner Table 6.7 for more.

Internal (Muscle) Torques

  • Factors influencing internal torque include tendon insertion position/angle, muscle length-tension relationships, active and passive insufficiency, muscle cross sectional area, muscle fiber pennation angle, contraction velocity, and joint angular velocity.
  • Concentric, isometric, and eccentric muscle actions are discussed.

Application to Exercise Prescription

  • Reasons to Prescribe Exercise:
    • Tissue loading for optimal healing (low load)
    • Manage pain/swelling (AROM/PROM low load)
    • Increase muscle function/performance (progressive loading)
    • Improve ROM/flexibility/balance (joint mobilization/stretching)
    • Improve balance/coordination/agility (neuromotor training)
    • Improve functional movement (increasing complex movement patterns).
  • Concepts of Muscle Performance:
    • Strength: Ability to exert force.
    • Power: Force x velocity (speed dependent).
    • Hypertrophy: Building muscle mass/volume.
    • Muscular Endurance: Sustaining force over multiple reps/prolonged holds.
  • Exercise Prescription for Specific Goals: Relates repetition counts to a desired training goal (strength, power, hypertrophy, muscular endurance) and gives percentages of 1RM to perform the exercise prescription.

Exercise Prescription for Early Rehab

  • Muscle Setting and Isometrics: 10 reps of 6-second holds using a muscle setting and appropriate load.
  • Rest B/t Sets: 10 seconds rest in between repetitions.
  • Purpose: Muscle recruitment/maintenance, fiber recruitment/maintenance, stability
  • Complexity: Joint involvement/muscle involvement (single joint, single muscle etc)
  • Active ROM (AROM): Movement range in active mode (30 seconds).

Variations, Modifications, and Progressions in Exercises

  • Considerations for Fitness Levels: Prescribe low volume (single set) for those new to exercise. 8-12 reps per set is suggested.
  • Specificity of Training: SAID (Specific Adaptations to Imposed Demands)
  • Overall Therapeutic Exercise: Intensity must be relevant to healing stage, tissue injury, and goal (progressive loading of injured tissues & movement patterns).
  • Progressing an Exercise:
    • Increase external torque (changing resistance, lever arm)
    • Change the base of support (narrow to wide, stable to unstable)
    • Change surface (stable to unstable, compliant to firm)
    • Change speed (moderate velocity training shows carry over for functional performance)
    • Increase the complexity of movement (single versus multi-joint, planes, isolation exercises, tasks).

Adaptations to Training (Clinical Applications)

  • Neural Response: Increased recruitment of fast-twitch motor units, usually precedes muscle structural adaptations.
  • Muscular Adaptations: Muscle fiber hypertrophy/increase in size, hyperplasia/increase in number of fibers, and fiber types transition. Increased insulin sensitivity, improved energy stores (increased glycogen storage).
  • Connective Tissue Adaptations: Increased BMD (bone mineral density) in response to mechanical forces and also related to load, rate/speed of loading and quantity of repetitions.
  • Tendons, Ligaments, Fascia: Adaptations to loading
  • Cartilage: Adapts to loading and unloading, receiving nutrition via diffusion from joint fluid (more cartilage thickness),
  • Cardiovascular Adaptations: Acute changes (increased cardiac output, stroke volume, heart rate, etc) and adaptations involving blood flow, oxygen uptake, and resting HR/BP, during exercise.

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