Physical Therapy Exercises Overview

Indications for Active Assisted Range of Motion Exercises

• Weak muscles that cannot move against gravity (less than grade 3 strength)
• Increasing joint range of motion
• Functional daily living activities
• Subacute tissue healing (with caution)
• After plaster cast removal
• Muscle re-education
• Post tendon/muscle transplantation

Determining Proper Weight for Progressive Resisted Exercise (1RM)

• Choose a weight the patient can comfortably lift 8-10 times
• Gradually increase the weight until the patient can perform only one repetition with proper form
• The maximum weight lifted for one complete repetition is the 1RM
• Ensure safety measures, especially for patients with cardiovascular risks

Contraindications for Active Assisted Range of Motion Exercise

• Deep vein thrombosis (DVT)
• Recent trauma/fractures that haven't stabilized
• Conditions where movement disrupts healing (e.g., acute tears, recent surgeries)

Types of Isometric Resisted Exercise

• Static Isometric Contraction: Muscle contracts without changing length (e.g., pressing against a wall)
• Multiple-Angle Isometrics: Isometric contractions performed at various joint angles for strengthening

Principles of Passive Range of Motion Exercise

• Examination, evaluation, and treatment planning (history, general examination, appropriate PROM/AAROM/AROM, safe motion determination, patient response monitoring, documentation, re-evaluation )

Principles of Active Assisted Range of Motion Exercise

• Starting position
• Fixation
• Support
• Characteristic direction
• Patient co-ordination
• Repetition
• Understanding patterns

Contraindications for Active Free Range of Motion Exercise

• Severe pain during exercise
• Acute inflammation/infection in the joint
• Unstable fractures
• Cardiopulmonary conditions limiting safe movement
• Recent surgery where motion could disrupt healing

Indications for Active Free Range of Motion Exercise

• Maintaining joint mobility and flexibility
• Improving muscle strength and endurance
• Enhancing circulation and preventing blood clots
• Functional training for daily activities
• After injury, in conjunction with medication/other therapies to manage chronic pain

Precautions for Active Resisted Range of Motion Exercise

• Avoid overloading the muscle to prevent injury
• Monitor for signs of fatigue or pain
• Use caution with patients having cardiovascular conditions
• Avoid the Valsalva maneuver to prevent increased blood pressure
• Ensure proper technique to prevent compensatory movements

Benefits of Passive Range of Motion Exercise

• Maintains joint and connective tissue mobility
• Enhances synovial movement for cartilage nutrition
• Prevents contractures and stiffness
• Improves and assists circulation, reducing swelling

Benefits of Active Assisted Range of Motion Exercise

• Improves joint mobility and flexibility
• Enhances circulation, preventing blood clots
• Provides sensory feedback to contracting muscles
• Stimulates bone and joint tissue integrity
• Helps maintain/improve muscle strength in weak muscles
• Aids in muscle re-education/functional training
• Maintains physiological elasticity/contractility
• Develops coordination and motor skills
• Maintains joint and connective tissue mobility

Types of Muscle Contraction

• Isometric: Muscle contracts without changing length
• Isotonic: Muscle changes length during contraction (concentric and eccentric contractions)
• Isokinetic: Muscle contracts at a constant speed against variable resistance

Principles of Resistance Training Exercise

• Individuality
• Progressive overload
• Specificity
• Rest and recovery
• Reversibility

Core Stability Tests

• Prone Instability Test
• Side Bridge Endurance Test
• Prone Extension Endurance Test
• Core Flexor Endurance Test

Physiological Adaptations of Resisted Training Exercise

• Neuromuscular (improved coordination, motor unit recruitment)
• Muscle (increased cross-sectional area)
• Bone density (increased strength and density)
• Cardiovascular System (increased blood flow, COP, stroke volume, O2 consumption, ATP/CP & myoglobin storage, decreased blood pressure/heart rate)
• Connective tissue (increased strength of CT, ligaments, tendons, increased tensile strength)

Difference between Strength, Endurance, and Power

• Strength: Maximum amount of weight lifted in one time
• Endurance: Ability to sustain a contraction or perform repeated contractions over time
• Power: Ability to do maximum weight for a short time as fast as possible

Difference between Isometric, Isotonic, and Isokinetic Exercise

• Isometric: Muscle contracts without changing length
• Isotonic: Muscle changes length during contraction (concentric and eccentric)
• Isokinetic: Muscle contracts at a constant speed against variable resistance

Determinants/Principles/Criteria of Resisted Training Exercise

• Alignment of body segments
• Intensity, mode
• Repetitions sets, frequency, volume, and duration
• Rest intervals
• Periodization
• Sequencing
• Speed or velocity
• Integration
• Warm-up and cool-down

Benefits of Warm-up and Cool-down for Exercise Training

• Preparation of the body physically
• Increased body temperature
• Increased nerve impulse
• Gradual increase in heart rate, respiration rate, and cardiac output
• Preparing joints for activity
• Reaching optimal physical performance
• Cool-down benefits

Comparing Manual and Mechanical Resisted Exercise

• Manual: Resistance is applied by a therapist or individual, useful for early rehabilitation/weak muscles/elderly/children, real-time adjustments possible, prevents substitution
• Mechanical: Resistance is provided by equipment, useful for advanced rehabilitation/strength training, precise resistance control and progression

Progression of Resistance Training Program

• Gradually increase exercise volume
• Gradually increase resistance intensity
• Gradually increase work time while decreasing rest time

Precautions of Resisted Exercise

• Avoid overloading muscles
• Monitor for fatigue or pain
• Use caution with patients with cardiovascular conditions
• Avoid the Valsalva maneuver
• Ensure proper technique

Overcoming Plateau in Resisted Training Exercise

• Increase intensity regularly
• Change the number of sets or repetitions
• Cross-training/transfer training
• Change the type and form of exercise
• Change the type of resistance

Specificity Principle of Resisted Exercise

• Specific to individual sport/specific exercise type/specific goal
• Heavy resistance on type 2 muscle fibers for strength exercises
• Low resistance and high repetitions on type 1 muscle fibers for endurance exercises

Factors Influencing Tension Generation in Muscles

• Cross-sectional area
• Fiber type distribution
• Length-tension relationship
• Motor unit recruitment
• Type of muscle contraction
• Speed of muscle contraction

Progressive Resisted Overload Principles

• Gradually increasing resistance/intensity to challenge muscles and body will adapt

Comparing Oxford and Delorme Training

• Oxford: Designed for intermediate/advanced rehabilitation (5-6 days), starts with maximum resistance and decreases with each set (e.g., 10 reps at 100% of 10RM, then 75%, then 50%) - for endurance training
• Delorme: Designed for early rehabilitation (3-4 days), starts with light resistance and increases with each set (e.g., 10 reps at 50% of 10RM, then 75%, then 100%) - for strength training

Mention Core Muscles and Training

• Core muscles: Rectus Abdominis, Transverse Abdominis, Obliques (Internal and External), Erector Spinae, Multifidus, Pelvic Floor Muscles, Diaphragm

Differentiating Open and Closed Chain Exercises

• Open Chain: Distal segment moves freely, involves isolated joint movements (e.g., leg extension, bicep curls)
• Closed Chain: Distal segment is fixed, involves multiple joints and muscle groups (e.g., squats, push-ups)

Beginning Core Stability Exercises

• Pelvic Tilt
• Bird Dog
• Dead Bug
• Plank

Types of Muscle Soreness and Reduction

• Acute Soreness: Felt during/immediately after exercise (lactic acid buildup)
• Delayed Onset Muscle Soreness (DOMS): Occurs 24-72 hours post-exercise (microtears in muscle fibers)
• Reduction methods: Adequate rest, recovery time, diet, ice packs, stretching, protein intake

Preventing Fatigue During Resisted Training

• Adequate rest/recovery time
• Avoiding overtraining/overworking

Valsalva Maneuver and Prevention

• Deep inhalation, closing the glottis while contracting abdominal muscles, increased intra-abdominal/intrathoracic pressure, increased blood pressure due to rapid venous blood flow, forceful contraction of the heart, can be prevented by teaching proper breathing techniques during exercise

Differentiating Isometric and Isokinetic Training

• Isometric: Muscle contracts without changing length, no joint movement (e.g., plank, wall sit)
• Isokinetic: Muscle contracts at a constant speed against variable resistance, requires specialized equipment (e.g., isokinetic dynamometer)

Defining 1RM and 10RM

• 1RM: Maximum weight lifted for one repetition in full range of motion and without fatigue
• 10RM: Maximum weight lifted for ten repetitions in full range of motion and without fatigue

Reversibility Principle of Resistance Training

• In-training: Adaptive changes in the body's system during exercise
• De-training: Loss of the adaptive changes if exercise is stopped, leading to deterioration of muscle performance

Increasing Coordination in Lumbar Muscle Training

• Start with basic core exercises (e.g., bird dog, dead bug)
• Gradually add resistance (weights, bands) to the limbs
• Ensure proper form to engage lumbar muscles
• Progressively increase load or complexity of movements
• Monitor for compensatory movements

Comparing Isotonic and Isometric Exercise

• Isotonic: Muscle changes length during contraction (concentric/eccentric) (e.g., squats, push-ups)
• Isometric: Muscle contracts without changing length (e.g., plank, wall sit)

This quiz covers essential concepts related to active assisted range of motion exercises, progressive resisted exercise, contraindications, and isometric resisted exercises. It examines indications for practice and safety measures needed for effective physical therapy. Test your knowledge of these fundamental aspects of rehabilitation.