Therapeutic Intervention Week 2 - Response to Exercise, Pain, ROM

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Questions and Answers

Which of the following physiological responses to acute exercise is higher in youth compared to adults?

  • Systolic blood pressure
  • Heart rate (correct)
  • Absolute oxygen uptake
  • Cardiac output

Which of the following is not a potential benefit of resistance training in youth?

  • Improved bone mineral density
  • Increased genotypic maximum for height (correct)
  • Decreased body fat
  • Increased muscular strength and power

What is the primary reason why prepubescent children should not participate in excessive amounts of vigorous intensity exercise?

  • They are more likely to experience heat exhaustion or heat stroke
  • Their immature skeletons are more susceptible to injury (correct)
  • Their hearts are not yet fully developed and may be strained
  • They have a lower anaerobic capacity and may tire quickly

Which physiological response to acute exercise in youth is lower compared to adults?

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

What is a potential benefit of resistance training in youth, related to psychological well-being?

<p>Enhanced self-esteem and confidence (A)</p> Signup and view all the answers

Which of the following is NOT a consequence of increased motor unit recruitment during muscle contraction?

<p>Increased muscle fiber size (C)</p> Signup and view all the answers

What is the primary role of 'co-contraction' of antagonist muscles?

<p>To increase joint stability and reduce injury risk (D)</p> Signup and view all the answers

According to the 'size principle', how are motor units recruited during muscle contraction?

<p>Smallest motor units are recruited first (B)</p> Signup and view all the answers

What is the primary neural adaptation to anaerobic training, as described in the text?

<p>Substantial changes in spinal cord circuitry (B)</p> Signup and view all the answers

How does chronic resistance training affect the relationship between muscle size and neural activation?

<p>As muscle size increases, less neural activation is required to lift a given load (A)</p> Signup and view all the answers

Which of the following is NOT a neural adaptation typically observed with aerobic training?

<p>Increased muscle hypertrophy (A)</p> Signup and view all the answers

What is 'cross-education' in the context of neuromuscular adaptations?

<p>Transfer of strength gains from one limb to the other, even if only one is trained (A)</p> Signup and view all the answers

What is the primary reason for the difference in muscle mass gain between boys and girls during puberty?

<p>Boys have a higher level of testosterone, which stimulates muscle growth. (C)</p> Signup and view all the answers

Which of the following physiological adaptations is primarily associated with chronic aerobic training?

<p>Increased aerobic capacity of trained muscles (A)</p> Signup and view all the answers

Which of the following best describes the mechanism responsible for muscle mass increases during adolescence?

<p>Enlargement of existing muscle fibers (hypertrophy) (B)</p> Signup and view all the answers

At what age does peak height velocity typically occur in females and males, respectively?

<p>12 in females and 14 in males (D)</p> Signup and view all the answers

What happens to muscular strength with chronic aerobic training?

<p>No change (A)</p> Signup and view all the answers

Which of the following is NOT a typical neural adaptation observed during anaerobic exercise?

<p>Increased recruitment of slow-twitch motor units (D)</p> Signup and view all the answers

What is the physiological consequence of incomplete myelination of nerve fibers in children?

<p>Impaired balance and coordination (C)</p> Signup and view all the answers

In the context of youth resistance training, what is the primary focus for program design?

<p>Developing proper form and technique (D)</p> Signup and view all the answers

What is the relationship between motor unit firing rate and force production?

<p>Higher firing rates lead to increased force production (C)</p> Signup and view all the answers

Which of these is a critical factor in the expression of muscular power during high-force production?

<p>Selective recruitment of motor units (B)</p> Signup and view all the answers

What is the most appropriate approach to resistance training for youth?

<p>A multi-modality approach using various exercises and equipment (B)</p> Signup and view all the answers

Which of the following is a potential risk factor for overuse injuries in children during the pubertal growth spurt?

<p>Alterations in center of mass (C)</p> Signup and view all the answers

What is the primary neural adaptation that improves aerobic performance?

<p>Rotation of neural activity among motor units (B)</p> Signup and view all the answers

Which of these adaptations is primarily a result of chronic aerobic training?

<p>Increased aerobic power (A)</p> Signup and view all the answers

What is the most accurate statement regarding the strength of boys and girls during pre-adolescence?

<p>The strength of boys and girls is essentially equal during pre-adolescence. (C)</p> Signup and view all the answers

How does the nervous system adapt to the need for increased neuromuscular function, such as during a new movement?

<p>By increasing the activity of the primary motor cortex (C)</p> Signup and view all the answers

What is a key consideration for the safe implementation of youth resistance training programs?

<p>Ensuring qualified supervision and proper technique (B)</p> Signup and view all the answers

What physiological adaptation is primarily responsible for increases in strength during childhood and adolescence?

<p>Improved coordination and motor control (A)</p> Signup and view all the answers

What physiological variable is typically decreased in older adults due to aging, but can be increased with resistance training?

<p>Resting metabolic rate (A), Bone mineral density (B), Muscle fiber size (C)</p> Signup and view all the answers

Which of the following is NOT a recommended consideration for resistance training programs for older adults?

<p>Increase training frequency to three times per week from the beginning (D)</p> Signup and view all the answers

What is the recommended approach to training intensity for young children participating in resistance training?

<p>Low to moderate intensity with a focus on proper form (D)</p> Signup and view all the answers

Which of the following measures can be used as a surrogate for one-rep max (1RM) in youth resistance training?

<p>Vertical jump height (B)</p> Signup and view all the answers

What is the recommended intensity range for moderate-intensity resistance training in older adults, expressed as a percentage of their 1RM?

<p>40-50% (D)</p> Signup and view all the answers

Why is it important to emphasize the development of upper body strength specifically for female athletes?

<p>Females tend to have lower absolute upper body strength compared to males (D)</p> Signup and view all the answers

Why is it important to include dynamic warm-up exercises before resistance training in children?

<p>To reduce the risk of injuries (C)</p> Signup and view all the answers

Which of the following is NOT a recommended guideline for youth resistance training program design?

<p>Prioritize maximal strength development over proper technique (D)</p> Signup and view all the answers

What is the primary reason why females tend to have greater flexibility than males?

<p>Increased levels of estrogen and relaxin (C)</p> Signup and view all the answers

What is the primary function of the adrenal glands in the context of the general adaptation syndrome?

<p>Respond to stressors with an initial alarm reaction followed by increased resistance (D)</p> Signup and view all the answers

Why is it important to ensure that youth resistance training programs are periodized?

<p>To prevent overtraining and promote long-term progress (D)</p> Signup and view all the answers

Which hormone(s) exhibit(s) increased levels in response to resistance training?

<p>Testosterone (A), Growth hormone (C)</p> Signup and view all the answers

What is the primary role of qualified professionals in youth resistance training?

<p>To ensure the safety and effectiveness of the training program (B)</p> Signup and view all the answers

During high-intensity exercise of short duration (5-10 seconds), what type of hormonal changes primarily occur?

<p>Increased circulating levels of epinephrine and norepinephrine (B)</p> Signup and view all the answers

Which of the following is NOT a common physiological adaptation to aerobic exercise?

<p>Increased circulating levels of testosterone (B)</p> Signup and view all the answers

What is the primary reason why aerobic training often leads to an initial net protein breakdown from muscle tissue?

<p>Stress-induced cortisol secretion (A)</p> Signup and view all the answers

What is the primary reason for the difference in absolute strength between men and women?

<p>Women have lower levels of muscle mass (D)</p> Signup and view all the answers

What is the recommended intensity range for power training in older adults, expressed as a percentage of their 1RM?

<p>40-60% (C)</p> Signup and view all the answers

What does "relative strength" refer to?

<p>Strength expressed relative to muscle cross-sectional area (A)</p> Signup and view all the answers

Why is it essential for older adults to consume adequate amounts of protein?

<p>Protein is needed for muscle hypertrophy and repair (D)</p> Signup and view all the answers

What is the primary reason for the increased risk of falls, fractures, and long-term disability in older adults?

<p>Decreased bone mineral density (C), Decreased muscle mass and strength (D)</p> Signup and view all the answers

When providing assistance during active range of motion exercises, what should be considered?

<p>Assistance should only be provided during upward movements against gravity. (C), Assistance should be minimized when moving parallel to the ground, allowing the muscles to work. (D)</p> Signup and view all the answers

What is a key consideration when teaching self-assisted range of motion (ROM) exercises?

<p>Observing and correcting any inappropriate or unsafe movements during the exercise. (C)</p> Signup and view all the answers

Which of the following is a red flag that should stop exercise training immediately?

<p>A significant drop in systolic blood pressure with an increase in workload. (C)</p> Signup and view all the answers

What form of self-assisted ROM involves the use of an uninvolved extremity to move the involved one?

<p>Manual ROM (D)</p> Signup and view all the answers

What is the primary focus of providing drawings and clear guidelines when teaching self-assisted ROM?

<p>Providing detailed instructions on the number of repetitions and exercise frequency. (B)</p> Signup and view all the answers

Which of the following is a red flag that should stop exercise training during the initial stages?

<p>Uncontrolled cardiac dysrhythmia with hemodynamic compromise. (B)</p> Signup and view all the answers

What is a key element in providing assistance during active range of motion exercises?

<p>Providing assistance only when necessary for smooth and controlled motion. (C)</p> Signup and view all the answers

What is a red flag during exercise that indicates potential acute heart failure?

<p>A significant drop in systolic blood pressure with an increase in workload. (D)</p> Signup and view all the answers

What primarily characterizes hyperplasia in muscle fibers?

<p>Increase in the number of muscle fibers (C)</p> Signup and view all the answers

Which type of muscle fibers experience greater increases in size with resistance training?

<p>Type 2 fibers (C)</p> Signup and view all the answers

What effect does heavy resistance training have on mitochondrial density?

<p>A decrease in mitochondrial density (C)</p> Signup and view all the answers

How is mitochondrial density typically expressed?

<p>Relative to muscle area (D)</p> Signup and view all the answers

What change occurs in the angle of pennation with resistance training?

<p>Increases in pennation angle (A)</p> Signup and view all the answers

Which energy store may see an increase as a result of resistance training?

<p>Stored ATP (D)</p> Signup and view all the answers

What adaptation occurs in glycogen content after training in bodybuilding styles?

<p>Significant increase in glycogen content (A)</p> Signup and view all the answers

Which statement correctly describes the relationship between muscle hypertrophy and capillary density?

<p>Capillary density decreases during hypertrophy (D)</p> Signup and view all the answers

Which statement best describes acute pain?

<p>It can be treated with various pharmacological and non-pharmacological methods. (D)</p> Signup and view all the answers

What characterizes chronic pain compared to acute pain?

<p>It lasts beyond the normal healing time. (A)</p> Signup and view all the answers

How does neuropathic pain differ from nociceptive pain?

<p>Nociceptive pain originates from tissue damage. (D)</p> Signup and view all the answers

What is allodynia?

<p>Pain from a stimulus that is normally not painful. (B)</p> Signup and view all the answers

What does the term hyperalgesia refer to?

<p>Increased sensitivity to a stimulus. (B)</p> Signup and view all the answers

In the context of pain treatment, why is an interdisciplinary approach often recommended for chronic pain?

<p>Chronic pain management requires addressing various aspects of the individual's condition. (A)</p> Signup and view all the answers

Which type of pain can be considered a maladaptive response and requires a lower stimulus to trigger?

<p>Chronic pain. (B)</p> Signup and view all the answers

What is the primary experience of patients with secondary hyperalgesia?

<p>Pain experienced outside the area of primary injury. (A)</p> Signup and view all the answers

What distinguishes cutaneous pain from deep tissue pain?

<p>Cutaneous pain is typically easy to locate. (C)</p> Signup and view all the answers

What is typically involved in nociplastic pain mechanisms?

<p>Alterations in nociceptive processing (D)</p> Signup and view all the answers

Which type of pain is primarily associated with lesions or diseases in the somatosensory system?

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

In which condition does sensitization of the central nervous system contribute significantly to pain?

<p>Chronic widespread pain (C)</p> Signup and view all the answers

Which treatment approach would be least effective for patients with central sensitization?

<p>Surgical removal of peripheral injuries (A)</p> Signup and view all the answers

The most common example of referred pain is:

<p>Pain radiating down the arm during a heart attack (B)</p> Signup and view all the answers

Which condition is typically characterized by enhanced excitability and diminished inhibition within the central nervous system?

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

According to specificity theory, which of the following statements is true regarding pain receptors?

<p>They only produce sensations of pain when stimulated (A)</p> Signup and view all the answers

What type of pain is typically associated with conditions like fibromyalgia?

<p>Nociplastic pain (D)</p> Signup and view all the answers

What adaptation allows trained athletes to utilize fat more effectively during exercise?

<p>Glycogen sparing (D)</p> Signup and view all the answers

What could be a result of enhanced peripheral and central sensitization?

<p>Increased muscle contraction (C)</p> Signup and view all the answers

Which muscle fiber type has a higher pre-existing aerobic capacity?

<p>Type 1 fibers (B)</p> Signup and view all the answers

What does an increase in capillary density indicate in muscle fibers after aerobic training?

<p>Improved oxygen delivery (D)</p> Signup and view all the answers

Which of the following may not effectively treat nociceptive pain?

<p>Cognitive behavioral therapy (B)</p> Signup and view all the answers

Which of the following adaptations does NOT occur in type 1 muscle fibers with aerobic training?

<p>Increased myofibril volume (B)</p> Signup and view all the answers

What is one of the main effects of aerobic endurance training on stored energy in the muscles?

<p>Increased stored ATP (B)</p> Signup and view all the answers

Which of the following is true regarding the effects of aerobic training on bone density?

<p>Bone density has no change or can increase (D)</p> Signup and view all the answers

What is a primary reason muscle hypertrophy occurs in response to resistance training?

<p>Increase in actin and myosin synthesis (C)</p> Signup and view all the answers

Which physiological adaptation occurs in muscle fibers as a result of resistance training?

<p>Increased cross-sectional area (B)</p> Signup and view all the answers

What adaptation in the neuromusculoskeletal system is related to increased muscular strength?

<p>Increased cross-sectional area of muscle fibers (C)</p> Signup and view all the answers

How does aerobic training affect the percentage of body fat?

<p>Decreases body fat percentage (B)</p> Signup and view all the answers

What type of muscle fiber is primarily recruited during aerobic activities?

<p>Type 1 fibers (C)</p> Signup and view all the answers

What is the role of myoglobin in muscle tissue after aerobic endurance training?

<p>Increases oxygen storage capacity (A)</p> Signup and view all the answers

What adaptation is primarily responsible for enhanced aerobic performance in trained athletes?

<p>Improved oxygen extraction by muscles (D)</p> Signup and view all the answers

What physiological change occurs in response to resistance training that enhances muscular endurance?

<p>Increased fat-free mass (A)</p> Signup and view all the answers

Which of the following adaptations improves the ability of muscles to utilize oxygen?

<p>Increased number of mitochondria (C)</p> Signup and view all the answers

What happens to pain following a lesion of the central pain pathways?

<p>Pain can return after the lesion. (A)</p> Signup and view all the answers

Which phenomenon occurs when touch elicits pain?

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

In Gate Control Theory, what role does the substantia gelatinosa (SG) play?

<p>It has an inhibitory effect on T cells. (A)</p> Signup and view all the answers

How does increasing input from large diameter afferents affect pain perception?

<p>It inhibits pain by closing the gate. (B)</p> Signup and view all the answers

What does the Neuromatrix Theory propose about the experience of pain?

<p>Pain is influenced by a complex network of genetic and environmental factors. (B)</p> Signup and view all the answers

What is one goal of pain assessment?

<p>To guide effective treatment initiation. (C)</p> Signup and view all the answers

Why is valid and reliable measurement of pain crucial in clinical settings?

<p>It identifies patients needing intervention and evaluates treatment efficacy. (B)</p> Signup and view all the answers

What characteristic pattern does the Neuromatrix Theory suggest pain outputs are termed?

<p>Neurosignature (C)</p> Signup and view all the answers

What role do non-neural cells play in the modulation of pain?

<p>They influence nociceptor and central nociceptive neuron activity. (B)</p> Signup and view all the answers

What is one way the Gate Control Theory was applied in treatments?

<p>By using TENS to increase large diameter input. (D)</p> Signup and view all the answers

Why is pain considered the fifth vital sign?

<p>It aids in diagnosing and adjusting therapy. (C)</p> Signup and view all the answers

What do nociceptors primarily respond to?

<p>Noxious stimuli leading to pain (C)</p> Signup and view all the answers

What aspect of pain assessment should be monitored regularly?

<p>Age-appropriate scales for patients. (B)</p> Signup and view all the answers

What is considered the gold standard method for assessing pain?

<p>Self-report measures (D)</p> Signup and view all the answers

Which factor does NOT influence the intensity of memory pain?

<p>Duration of pain (B)</p> Signup and view all the answers

Which type of pain assessment involves measuring multiple constructs simultaneously?

<p>Multidimensional assessment (C)</p> Signup and view all the answers

Which physiological parameter is NOT typically used to assess pain response?

<p>Motor activity (D)</p> Signup and view all the answers

What is a major limitation of physiological measures in assessing pain?

<p>They often lack specificity and sensitivity. (B)</p> Signup and view all the answers

Which type of pain assessment would be best for a child unable to communicate verbally?

<p>Facial expression scales (C)</p> Signup and view all the answers

What is typically used to determine pain intensity through patient behavior?

<p>Observation and behavioral checklist (B)</p> Signup and view all the answers

Why are self-report measures considered the most valid in pain assessment?

<p>They reflect the patient's personal experience of pain. (D)</p> Signup and view all the answers

Which scale uses a line to determine pain intensity levels for patients?

<p>Visual analogue scale (A)</p> Signup and view all the answers

What is a common characteristic of behavioral indices in pain rating scales?

<p>They can include vocal and postural behaviors. (D)</p> Signup and view all the answers

Which of the following factors is NOT directly related to the assessment of pain intensity?

<p>The patient's coping mechanisms (D)</p> Signup and view all the answers

Which is an example of a nonverbal measure of pain?

<p>Visual analog scales (D)</p> Signup and view all the answers

How does memory of pain intensity generally correlate with actual pain experiences?

<p>It strongly correlates with peak pain intensity. (C)</p> Signup and view all the answers

What type of pain assessment is defined by measuring a single construct?

<p>Unidimensional assessment (C)</p> Signup and view all the answers

Which pain assessment tool allows a patient to draw the location of their pain?

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

What is a key characteristic of the McGill Pain Questionnaire?

<p>It includes sensory, affective, and motivational dimensions. (D)</p> Signup and view all the answers

What scoring range indicates the probability of a neuropathic pain component using PainDETECT?

<p>-1 to 35 (C)</p> Signup and view all the answers

Which of the following best describes Pain Catastrophizing?

<p>The tendency to magnify the threat of pain. (D)</p> Signup and view all the answers

What does the Fear-Avoidance Beliefs Questionnaire assess?

<p>Beliefs about how activity affects low back pain. (B)</p> Signup and view all the answers

What is the primary purpose of the Brief Pain Inventory?

<p>To assess functional impact of pain. (B)</p> Signup and view all the answers

How does the number of pain areas relate to functionality?

<p>More pain areas correlate with increased disability. (D)</p> Signup and view all the answers

What is a fundamental aspect of psychological questionnaires concerning pain?

<p>They assess emotional responses and beliefs related to pain. (D)</p> Signup and view all the answers

Which statement is true regarding the Numeric Pain Rating Scale (NPRS)?

<p>It is administered to cognitively intact individuals. (D)</p> Signup and view all the answers

What does a score of less than or equal to 12 on the PainDETECT suggest?

<p>The absence of neuropathic pain. (C)</p> Signup and view all the answers

Which questionnaire is primarily focused on evaluating fear-avoidance behaviors?

<p>Fear-Avoidance Beliefs Questionnaire (B)</p> Signup and view all the answers

What is a critical measure in the McGill Pain Questionnaire?

<p>Selection of pain descriptors across various subclasses. (B)</p> Signup and view all the answers

What is indicated by high scores on psychological questionnaires related to pain?

<p>Increased risk of developing chronic pain. (D)</p> Signup and view all the answers

What component does the Brief Pain Inventory evaluate in relation to pain?

<p>The degree of pain interference with daily activities. (B)</p> Signup and view all the answers

What is a primary goal of passive range of motion (PROM) exercises?

<p>Maintain joint and connective tissue mobility (B)</p> Signup and view all the answers

What does the Chronic Pain Self-Efficacy Scale (CPSS) primarily measure?

<p>Perceived self-efficacy to cope with pain (C)</p> Signup and view all the answers

When is active range of motion (AROM) indicated?

<p>When the patient is conscious and able to contract muscles (B)</p> Signup and view all the answers

One limitation of passive range of motion (PROM) is that it does not effectively prevent what?

<p>Muscle atrophy (A)</p> Signup and view all the answers

Which of the following factors can lead to a decreased range of motion?

<p>Surgical interventions (A)</p> Signup and view all the answers

What is the primary assessment tool mentioned for measuring range of motion?

<p>Goniometer (C)</p> Signup and view all the answers

What type of range of motion exercise is characterized by an external force acting to move a segment?

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

In what situation is active-assistive range of motion (AAROM) commonly utilized?

<p>When prime mover muscles need support to complete the motion (B)</p> Signup and view all the answers

What best describes the goal of range of motion activities in therapy?

<p>To maintain joint mobility and flexibility (C)</p> Signup and view all the answers

What is a primary indication for using passive range of motion (PROM)?

<p>Acute, inflamed tissue (B)</p> Signup and view all the answers

What is a key benefit of early controlled motion after an injury?

<p>It increases recovery rate. (B)</p> Signup and view all the answers

What type of feedback do active range of motion exercises provide?

<p>Sensory feedback from contracting muscles (B)</p> Signup and view all the answers

Why should range of motion exercises be monitored during therapy?

<p>To note any changes in the patient's condition (C)</p> Signup and view all the answers

Which of the following is a limitation of active range of motion (AROM)?

<p>It does not develop skill or coordination in other movement patterns. (C)</p> Signup and view all the answers

What type of exercises should athletes select to promote bone formation effectively?

<p>Multi-joint structural exercises (D)</p> Signup and view all the answers

What happens to cardiac output during acute exercise?

<p>It increases. (A)</p> Signup and view all the answers

Which physiological response is typically enhanced with aerobic exercise compared to resistance training?

<p>Oxygen extraction (A)</p> Signup and view all the answers

How does chronic resistance training affect heart rate during rest?

<p>It decreases heart rate at rest. (A)</p> Signup and view all the answers

What role does connective tissue play in response to muscle strength?

<p>Connective tissues must increase their capabilities. (C)</p> Signup and view all the answers

During ventilatory response to anaerobic exercise, which statement is true?

<p>Ventilation is unaffected or moderately improved. (B)</p> Signup and view all the answers

What is the primary reason women generally report higher incidences of pain than men?

<p>Biological and hormonal differences. (D)</p> Signup and view all the answers

What physiological change occurs in stroke volume at the onset of exercise?

<p>Stroke volume begins to increase. (A)</p> Signup and view all the answers

Which dimension of pain refers to the characteristics of pain such as its intensity and quality?

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

What happens to diastolic blood pressure during aerobic exercise?

<p>It can slightly decrease or remain stable. (C)</p> Signup and view all the answers

What is the relationship between oxygen uptake and exercise intensity?

<p>Oxygen uptake increases with intensity. (C)</p> Signup and view all the answers

Which factor influences pain perception according to individual experiences?

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

What is a possible outcome of resistance training related to body composition?

<p>Increase in daily metabolic rate. (A)</p> Signup and view all the answers

What does the term 'maximal oxygen uptake' (VO2 max) signify?

<p>The maximum volume of oxygen used by tissues during exercise. (B)</p> Signup and view all the answers

Flashcards

Age-Related Exercise Responses

Physiological responses to exercise vary with age, affecting performance.

Youth Resistance Training Benefits

Youth resistance training increases strength, lowers body fat, and enhances psychosocial skills.

Aerobic Capacity in Youth

Youth have lower absolute oxygen uptake but higher relative oxygen uptake than adults during exercise.

Growth Impact of Resistance Training

Resistance training can favorably influence growth without affecting maximum height.

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Physiological Differences in Exercise

Youth display lower cardiac output, stroke volume, and anaerobic capacity compared to adults.

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Hyperplasia

Increase in the number of muscle fibers via splitting due to resistance training.

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Type 1 vs Type 2 Fibers

Type 2 fibers grow larger than Type 1 fibers with resistance training.

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Mitochondrial Density

Mitochondrial density decreases relative to muscle area during hypertrophy.

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Pennation Angle

The angle of muscle fibers to the tendon affecting force and motion.

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Fascicle Length

Length of muscle fibers that increases in strength-trained athletes.

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Stored ATP

ATP storage increases with resistance training for energy.

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Creatine Phosphate Storage

Increased creatine phosphate concentration after resistance training.

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Glycogen Content Increase

Glycogen can increase up to 112% with anaerobic training programs.

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Neuromusculoskeletal Response

Processes affected by exercise related to neuromuscular systems.

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Neural Adaptations

Changes in the nervous system that improve muscle performance during training.

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Motor Unit Recruitment

Activation of more motor units during muscle contraction.

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Synchronization of Motor Units

Motor units firing together to enhance force production.

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Improved Firing Rates

Motor neurons fire optimally for greater force and endurance.

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Efficiency of Neuromuscular Junctions

Neuromuscular junctions transmit signals more effectively.

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Reduced Co-Contraction

Decreased contraction of antagonist muscles, reducing resistance.

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Increased Activation of Agonist Muscles

More effective activation of muscles that produce movement.

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Improved Intermuscular Coordination

Muscles working together more efficiently for movements.

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Enhanced Reflex Response

Increased responsiveness of reflex pathways for faster reactions.

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Neural Adaptations in CNS

Changes in central nervous systems affecting motor activities.

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Size Principle

Motor units are recruited based on size and force needed.

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Selective Recruitment

Critical for high-force production and muscular power.

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Cross-Education

Strength gained in one muscle also benefits its opposite muscle.

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Aerobic Training Responses

Physiological changes from aerobic training affecting muscle efficiency.

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Biological Age

The stage of maturation based on physical development rather than chronological age.

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Puberty Onset

The age range when physical changes of puberty begin, differing between genders.

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Menstruation as Maturation Indicator

Menstruation marks sexual maturity in girls.

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Peak Height Velocity

The period of maximum growth rate generally occurring at ages 12 for girls and 14 for boys.

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Muscle Mass Growth

Increase in muscle mass due to hormonal changes during puberty.

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Epiphyseal Plate

Growth plate where bone growth occurs; its fusion stops bone growth.

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Strength Gains in Youth

Increased strength from resistance training, influenced by biological age and training quality.

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Resistance Training Safety

Resistance training can be safe for children with proper supervision and guidelines.

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Neural Maturity

Development of the nervous system affects children's performance in strength and skill activities.

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Dynamic Warm-Up

A preparatory set of exercises to enhance performance before resistance training.

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Training Program Periodization

Systematic planning of training loads and recovery to optimize training outcomes in youth.

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Growth Cartilage Vulnerability

Children's growth plates are susceptible to injury from trauma and overuse.

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Intrinsic Motivation in Training

Encouraging personal success and enjoyment in youth resistance training.

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Resistance Training Guidelines

Recommendations for youth include low to moderate intensity and gradual progression.

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Thermoregulation in Exercise

Children's thermoregulatory systems can limit their ability to perform in hot conditions.

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Older Adults Definition

Individuals aged 65+ or 50-64 with significant movement limitations.

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Physiologic Aging Response

Aging varies; individuals of the same age may respond differently to exercise.

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Health vs. Chronological Age

Health and function are better activity indicators than actual age.

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Bone Loss Risk Factors

Increased bone fragility and fall risks due to aging.

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Sarcopenia

Loss of muscle mass and strength associated with aging.

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Effects of Aging on Muscle

Aging decreases muscle strength, power, endurance, and mass.

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Resistance Training for Older Adults

Resistance training helps counteract muscle loss in seniors.

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Intensity Levels in Older Adults

Activities should be prescribed based on perceived exertion scales.

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Resistance Training Frequency

Twice a week is recommended for older adults during adaptation.

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Recovery Time

Older adults should have 48-72 hours of recovery between sessions.

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Progressive Resistance Training

Start with low intensity and gradually build up to higher loads and sets.

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Nutrition for Muscle Health

Adequate protein intake is vital for muscle growth in older adults.

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High-Velocity Power Exercises

Introduce fast movements in training to improve power.

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Sex Differences in Strength

Women generally have about 2/3 the strength and power of men, but train similarly.

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Hormonal Adaptations to Exercise

Exercise impacts hormone levels, enhancing performance and recovery.

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Acute Pain

Pain that occurs due to tissue damage and has a clear onset and pathology.

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Nociceptive Pain

Pain originating in the peripheral nervous system from activated pain receptors.

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Chronic Pain

Pain that persists beyond normal healing time and does not serve a biological function.

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Allodynia

Pain from a stimulus that does not normally provoke pain.

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Hyperalgesia

Increased sensitivity to pain, even from minor stimuli.

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Centralized Pain

Pain that has a lower threshold and can occur from non-painful stimuli.

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Neuropathic Pain

Pain due to dysfunction of the somatosensory nervous system.

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Cutaneous Pain

Sharp, easily locatable pain, usually not referred.

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Deep Tissue Pain

Difficult to locate pain originating from deep structures, often referred elsewhere.

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Secondary Hyperalgesia

Increased sensitivity outside the injury site due to central nervous system changes.

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Bone Adaptation

The process where bones strengthen in response to stress and load from exercise.

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Multi-Joint Exercises

Exercises that involve multiple muscle groups and joints simultaneously for optimal bone formation.

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Axial Force Vectors

Forces applied through the spine and hip during exercises to maximize bone strength.

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Heavy Load Exercises

Resistance training that uses high weights to enhance bone mass and strength.

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Resistance Training Effects on Body Fat

Resistance training can reduce body fat by up to 9% while increasing lean tissue mass.

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Cardiac Output

The amount of blood the heart pumps in a minute, influenced by stroke volume and heart rate.

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Stroke Volume

The volume of blood ejected from the heart per contraction, increases with exercise intensity.

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Oxygen Uptake

The total amount of oxygen consumed by the body during exercise, correlates with fitness levels.

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Ventilation Rate Changes

The rate of breathing can increase with exercise intensity but may decrease during rest after high effort.

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Diastolic Blood Pressure Response

Pressure in arteries when the heart is at rest; often decreases with aerobic training.

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Nociception vs Pain

Nociception is sensory input; pain is a complex experience unique to each individual.

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Dimensions of Pain

Pain consists of sensory, motivational, cognitive, behavioral, and physiological aspects.

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Acute vs Chronic Adaptations

Acute refers to immediate changes after exercise, chronic refers to long-term effects of consistent training.

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Individual Pain Experience

Pain experiences vary widely due to biological, psychological, and social factors.

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Pain Terminology

Correct usage of words related to pain helps in understanding and communicating about it effectively.

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Glycogen Sparing

Using less glycogen and more fat for energy during exercise.

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Blood Lactate Accumulation

The point at which lactate builds up in the bloodstream during exercise.

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Capillary Density

The number of capillaries in the muscle tissue, which increases with aerobic training.

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Type 1 Muscle Fibers

Muscle fibers with higher aerobic capacity suitable for endurance.

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Oxidative Capacity

The muscle's ability to use oxygen for energy during exercise.

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Stored Triglycerides

Fats stored in the body that can be used for energy during prolonged exercise.

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Bone Density and Aerobic Training

Bone density may remain unchanged or increase with regular aerobic exercise.

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Body Fat Percentage

The proportion of body fat that tends to decrease with aerobic training.

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Muscular Endurance

The ability of muscles to continue exerting force without fatigue.

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Hypertrophy

An increase in muscle size due to increased contractile proteins.

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Rate of Force Production

The speed at which a muscle can produce force, which tends to increase with training.

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Muscle Fiber Cross-Sectional Area

The size of muscle fibers that increases with resistance training.

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Myofibril Density

The number of myofibrils in a muscle fiber, which helps increase strength.

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Anaerobic Power

The ability to perform high-intensity exercise without relying on oxygen.

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Referred Pain

Pain perceived outside the area of injury, often following a dermatome.

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Peripheral Sensitization

Increased nociceptor activity leading to pain via central neurons activation.

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Central Sensitization

Activation of sensitized central nervous systems resulting in pain without peripheral signal increase.

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Nociplastic Pain

Pain due to alterations in the central nervous system, often chronic and widespread.

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Pain Mechanisms

Categories include nociceptive, nociplastic, and neuropathic, each with different causes and characteristics.

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Specificity Theory

Suggests separate nerve endings for different sensations like pain, cold, and warmth.

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Nociplastic vs Nociceptive Pain

Nociplastic pain results from central changes, while nociceptive pain originates from nociceptor activation.

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Central and Peripheral Sensitization

Both types of sensitization can contribute to pain, often affecting treatment outcomes.

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Passive to Active ROM Transition

The shift from passive assistance to active movement during rehabilitation.

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Gravity's Role in ROM

Gravity impacts muscle function and support needed during movement.

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Self-Assisted ROM

Techniques where the patient uses their unaffected limb to move the affected limb.

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Red Flags in Exercise Training

Indicators that suggest stopping exercise due to health risks.

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Unilateral Weakness

Weakness on one side of the body requiring adaptation in recovery.

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Body Alignment in Exercises

The correct positioning of the body to ensure safe and effective movement.

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Observing Patient Performance

Monitoring the patient during exercises to ensure safety and correct form.

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Signs of Poor Perfusion

Indicators showing inadequate blood flow, like pallor or cyanosis.

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Gate Control Theory of Pain

A theory explaining pain modulation at the spinal cord level.

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Nociceptors

Specialized nerve endings responsible for detecting harmful stimuli.

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Substantia Gelatinosa (SG)

A region in the spinal cord where pain signals are modulated.

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T Cell

A neuron that initiates pain responses in the spinal cord.

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Neuromatrix Theory

A theory proposing a network in the brain that processes pain.

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Neurosignature

A characteristic output from the neuromatrix related to pain perception.

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Pain Assessment Goals

To gather accurate data on a patient's pain experience.

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Biopsychosocial Domain

A model considering biological, psychological, and social factors in pain.

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Phantom Limb Pain

Pain experienced in a body part that has been amputated.

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Transcutaneous Electrical Nerve Stimulation (TENS)

A treatment using electrical currents to relieve pain.

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Pain as the Fifth Vital Sign

The concept that pain assessment is essential during medical evaluations.

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Sensory Input Influence

How different stimuli can modify pain perception.

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Effective Pain Measurement

Using reliable tools to quantify pain and treatment outcomes.

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Noxious Stimuli

Harmful stimuli that can cause pain.

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Types of Pain Descriptions

Patients may describe pain using terms like 'ache' or 'sharpness'.

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Pain Memory Accuracy

Long-term memory of pain intensity is less accurate than current pain assessments.

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Factors Influencing Pain Memory

Pain memory is influenced by pain intensity, emotion, and expectations.

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Unidimensional Assessment

A method measuring only one aspect, typically pain intensity.

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Multidimensional Assessment

A method that measures multiple aspects of pain simultaneously.

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Self-Report Method

Best method for assessing pain where patients report their own pain levels.

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Verbal Self-Report Measures

Includes structured interviews and self-rating scales to assess pain verbally.

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Nonverbal Pain Measures

Tools like facial expression scales to assess pain without words.

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Pain Behaviors Observation

Pain behaviors can misrepresent pain intensity and indicate distress sources.

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Physiological Parameters in Pain

Measurements like heart rate or blood pressure that may indicate pain levels.

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Behavioral Checklists for Pain

Lists of pain behaviors that are marked for presence or absence.

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Visual Analogue Scale (VAS)

A pain scale using a line to indicate pain intensity from no pain to extreme pain.

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Numeric Rating Scale (NRS)

Pain intensity rated from 0 (no pain) to 10 (worst pain possible).

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Importance of Pain Assessment Tools

Tools should have reliability and validity to effectively measure pain outcomes.

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Children’s Pain Assessment Needs

Special scales measure pain in children unable to communicate verbally.

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Verbal Rating Scale

A method for patients to verbally rate their pain.

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Numeric Pain Rating Scale (NPRS)

A scale for patients to rate their pain numerically from 0 to 10.

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Body Diagrams

A tool for patients to draw their pain location on a diagram.

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McGill Pain Questionnaire

A comprehensive tool assessing sensory, affective, and evaluative dimensions of pain.

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Brief Pain Inventory

A tool measuring pain severity and its impact on daily life.

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PainDETECT

A questionnaire to identify neuropathic pain in low back pain patients.

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Fear-Avoidance Belief Questionnaire

Assesses beliefs about how physical activity affects pain.

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Pain Catastrophizing

Negative thought patterns related to experiencing pain.

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Number of Pain Areas

More pain areas correlate with higher functional difficulties.

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Pain Rating Index

A way to quantify pain based on descriptors chosen by the patient.

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Sensory Dimensions of Pain

The raw perception of pain's physical characteristics.

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Affective Dimensions of Pain

Pain's emotional response and feelings associated with it.

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Evaluative Dimensions of Pain

How patients assess or judge their pain intensity.

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Chronic Pain Risk Factors

Factors like anxiety and low self-efficacy increase chronic pain risk.

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Functional Impact of Pain

How pain affects various aspects of a person's life.

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Chronic Pain Self-Efficacy Scale (CPSS)

A questionnaire measuring a patient's confidence in coping with chronic pain.

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Range of Motion (ROM)

The full motion possible around a joint, including four key movements.

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Passive Range of Motion (PROM)

Movement of a joint initiated by an external force without muscle contraction.

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Active Range of Motion (AROM)

Movement performed by the patient actively contracting muscles across a joint.

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Active-Assisted Range of Motion

Movement where the patient gets assistance to help complete joint motion.

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Contraindications for ROM

Situations where ROM exercises should not be performed due to patient condition.

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Goals of Passive ROM

Focus on maintaining mobility, minimizing contractures, and enhancing circulation.

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Limitations of Passive ROM

Does not prevent muscle atrophy or increase strength.

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ROM Techniques

Methods applied to facilitate safe and effective joint movement.

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Principles for Applying ROM

Guidelines to follow for safely administering range of motion exercises.

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Sensory Feedback in AROM

Information from muscle contractions important for movement awareness.

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Mechanics of Promoting ROM

Using body mechanics to assist movement while ensuring patient safety.

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Patient Communication for ROM

Essential interactions to prepare a patient for range of motion exercises.

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Monitoring Patient Condition

Observing vital signs and tissue responses during ROM activities.

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Study Notes

  • Physiological responses to exercise vary significantly with age.
  • Youth and older adults have different responses to exercise.
  • Health and functional status are better indicators of exercise ability than chronological age in older adults.

Youth Exercise Training

  • Resistance training can increase muscular strength, power, endurance, and bone mineral density.
  • It may improve cardiometabolic risk factors, weight control, and psychological well-being.
  • Potential to prevent sports-related injuries and positively impact cognition and academic achievement.
  • Resistance training may favorably influence growth, but does not affect maximum height potential.

Physiological Responses to Acute Exercise in Youth

  • Youth have lower absolute oxygen uptake but higher relative oxygen uptake compared to adults.
  • Youth generally exhibit higher heart rates and lower cardiac output, stroke volume, systolic blood pressure, diastolic blood pressure, tidal volume, and minute ventilation than adults.
  • Respiratory exchange ratios are also lower in youth.
  • Anaerobic capacity is much lower in children than adults.
  • Prepubescent children have immature skeletons and should avoid excessive vigorous exercise.

Chronological vs. Biological Age

  • Substantial variations in physical development exist within a given chronological age.
  • Biological age considers skeletal, somatic, and sexual maturation.
  • Maturation correlates with fitness levels, like muscular strength and motor skills.
  • Physical training does not delay or accelerate growth or maturation in children who are adequately nourished.

Muscle and Bone Growth in Youth

  • Muscle mass is approximately 25% at birth and increases to about 40% in adulthood.
  • Hormonal changes during puberty influence muscle mass in boys (muscle mass and shoulder widening) and girls (body fat, breast development, and hip widening).
  • Muscle growth in girls occurs more slowly during adolescence.
  • Muscle fiber hypertrophy, not hyperplasia, drives increases in muscle mass.
  • Peak muscle mass varies by sex and occurs later in males.
  • Bone growth occurs primarily in diaphysis then growth cartilage (epiphyseal, joint surface, and apophyseal plates).
  • Full bone maturity occurs earlier in girls than boys.
  • Growth cartilage is vulnerable to trauma and overuse.

Special Considerations in Youth

  • Unstructured active play is important in young children.
  • Avoid sustained heavy exercise in extreme heat/humidity.
  • Overweight/inactive youth should start with moderate intensity and gradually increase duration/frequency.

Older Adults and Exercise

  • Physiological aging varies among individuals.
  • Health and functional status are better indicators of exercise ability than chronological age in older adults.
  • Bone loss and muscle loss elevate fall and fracture risk.
  • Bone porosity increases with age due to decreased bone mineral content.
  • Sarcopenia is loss of muscle mass/strength with advanced aging.
  • Older adult exercise prescription should be relative to individual fitness, using a perceived exertion scale.

Physiology: Aging and Impact of Resistance Training

  • Resistance training can improve muscular strength, power, endurance, muscle mass, muscle fiber size, muscular metabolic capacity, resting metabolic rate, and bone mineral density while decreasing body fat in older adults.

Resistance Training for Older Adults

  • Free weights, multi-joint exercises are optimal, though resistance machines may be used initially.
  • Avoid Valsalva maneuver.
  • Allow 48-72 hours of recovery between sessions.
  • Ensure exercises are technically appropriate to minimize injury risk.

Concerns for Older Adults

  • Pre-existing medical conditions, prior training history, and nutrition are important considerations.
  • Adequate protein intake is crucial.

Female Athletes: Strength and Power

  • Women generally have about 2/3 the absolute strength of men.
  • Relative strength (strength/muscle cross-sectional area) shows no significant sex differences.
  • Female athletes have approximately 2/3 the power output of males.
  • Women can increase strength at rates similar to or faster than men.

Program Considerations for Women

  • Resistance training programs for women should be no different from men's programs.
  • Use appropriate resistance based on individual strength capabilities, focusing on upper body strength in women to benefit specific sports needs.

Gender and Flexibility

  • Females typically exhibit higher flexibility compared to males.
  • Higher estrogen and relaxin levels contribute to joint laxity and flexibility.
  • Women's wider pelvis and different muscle attachment sites affect flexibility.

Endocrine Response to Exercise

  • Exercise impacts hormone levels and receptor activity.
  • Hormonal responses vary with exercise intensity and duration (e.g., higher intensity = higher absolute hormone secretion).
  • Aerobic training potentially increases net protein synthesis.

Neuromusculoskeletal Responses to Exercise

  • Neural adaptations involve increased motor unit recruitment, synchronization, firing rates, neuromuscular junction efficiency, antagonist muscle co-contraction reduction, agonist muscle activation increase, intermuscular coordination, and reflex responses.
  • Anaerobic training increases agonist recruitment and firing rates.
  • Neural adaptations often precede structural changes in muscle.
  • Training can influence motor unit recruitment patterns based on the load and training type

Neuromusculoskeletal Response to Aerobic Training

  • Aerobic training improves aerobic capacity primarily due to changes in glycogen sparing. Increased fat utilization prolongs performance.
  • Muscle fiber type 1 shows greater capacity and response to oxidative adaptations.
  • Increased capillary density, mitochondrial density.

Metabolic Energy Stores

  • Aerobic and resistance training increase metabolic energy stores.

Connective Tissue Adaptations

  • Aerobic and resistance training improve connective tissue strength.

Body Composition

  • Aerobic training typically decreases body fat percentage.

Cardiopulmonary Response to Anaerobic Training and Aerobic Training

  • Cardiac output, stroke volume, heart rate, oxygen uptake, systolic blood pressure, and blood flow to active muscles increase acutely with resistance training, whereas diastolic blood pressure may slightly decrease.
  • Chronic resistance training leads to less acute cardiovascular response.

Introduction to Pain

  • Pain is a complex, individual experience.
  • Common sources of pain include low back pain, neck pain, migraines, and peripheral joint pain; women experience higher rates of musculoskeletal pain.

Pain Mechanisms

  • Nociceptive pain (due to injury/inflammation).
  • Nociplastic pain (disturbance in central pain processing).
  • Neuropathic pain (nerve damage).

Pain Theories

  • Gate control theory suggests that pain transmission is modulated based on neural activity (large and small diameter afferents).
  • Neuromatrix theory proposes a widespread network of neurons for pain processing which is influenced by various factors including neural, cortical, and body self.

Pain Assessment

  • Valid and reliable tools across the biopsychosocial domain measure pain.
  • Pain is considered the 5th vital sign.
  • Self-report is the gold standard and often uses scales (e.g., VAS, NRS, VRS).
  • Physiological measures are used as supplementary, especially in the short-term.

Pain Questionnaires

  • McGill Pain Questionnaire, Brief Pain Inventory (BPI), and PainDETECT questionnaires assess multidimensional pain, functional impact, and neuropathic pain components, respectively.

Psychological Questionnaires

  • Fear-avoidance beliefs and pain catastrophizing.
  • High fear avoidance beliefs can negatively impact physical activity.
  • Pain catastrophizing involves negative cognitive and affective responses to pain, leading to worse pain outcomes.

Range of Motion

  • ROM interventions maintain joint/soft tissue mobility, reducing contracture formation.
  • Types include passive ROM (PROM), active ROM (AROM), and active-assisted ROM.
  • Precautions/contraindications to ROM exist in acute injury and recovery periods, demanding proper physician consultation.
  • Proper body mechanics are crucial for safe application of ROM techniques.

Red Flags with Exercise Training

  • Various red flags exist during and before exercise, necessitating careful monitoring and professional guidance.

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