Grimsby Flashcards

Question

History of Exercise Therapy

Answer 1

- De Lorme & Watkins (1951) - progressive resisted exercise - Knight (1985) - daily adjustable progressive resistance exercise (DAPRE) - Odvar Holten (1965) - 'The Holten Curve' and 'Medical Exercise Therapy' (MET) - Ola Grimsby (1995) - 'Scientific Therapeutic Exercise Progression' (S.T.E.P.)

Answer 2

- Medical Exercise Therapy (MET) is an active rehabilitation system based on more than 30 years of clinical experience and research. - Local and global exercises. - Active graded exercise program treating pain, decreased motion, increase endurance and strength as well as improving activities of daily living. - The system accommodates for treating athletes and ordinary patients with tolerance for loading and to normalize muscle imbalance and coordination.

Answer 3

- During this hour most patients who are in an early phase of the treatment, are able to do seven to nine different graded exercises doing three sets of thirty repetitions, up to one thousand repetitions during one treatment session. - The high number of repetitions are aimed at treating the pain experience and to increase range of motion.

Answer 4

- Phase I - pain free phase focuses on coordinated mobility and stability around physiological axes throughout the ROM. - Goals - increase circulation to the tonic system, prevent atrophy, increase protein synthesis, and reduce the level of metabolites.

Answer 5

- Phase II - Restoration of function phase which focuses on increasing tissue tolerance to levels corresponding to the demands of ADL's. - Goals - Restore and enhance function. Strength, endurance, ROM, speed, WB capability, and coordination. Optimum stimulus for regeneration of each specific tissue.

Answer 6

1. To increase the tissue tolerance to ADL's 2. Functional Qualities - elements in active movement that contains the optimal stimulus for tissue improvements, maintenance and regeneration 3. Motion around a physiologic axis - arthrokinematic exercise - tonic muscle - coordination and endurance vs. osteokinematic exercise - phasic muscles - power/strength

Answer 7

1. Reconditioning - Endurance and Strength 2. Stabilize a Hypermobility 3. Mobilize a Hypomobility 4. Coordination/balance/skill 5. Selective Tissue Training - OSR 6. Cardiopulmonary Reconditioning 7. Neuro-physiologic Pain Control - Dorsal Horn inhibition, high frequency afferent - Spinothalamic tract, Opiate System, Endorphin Release, decrease a sympathetic overflow 8. Decrease disability behaviors - psychological functions ***This could be the most important reason.

Answer 8

- Power-Heavy resistance/few reps - Strength - Volume - Speed - Coordination - Endurance-light resistance/many reps

Answer 9

- RM: Resistance Maximum - the amount of weight that can be overcome one time with a group of muscle. DeLorme and Watkins - Exercise with 30 reps at 60% 1 RM can cause increased blood flow to the muscle. - Minimal strength gains begin at 47% 1 RM. - Muscles in atrophy should not exceed 30-40% 1 RM initially. - Initial strength gains are due to improved neurology, not to muscle hypertrophy. Approximately 6 weeks before hypertrophy begins. - How to calculate 1 RM.

Answer 10

- OSR - Biomechanical Energy in the Line of Stress without shearing - Healing Time - 4-6 weeks UE; 6-8 weeks LE

Answer 11

- Type 1 - primarily capsule, ligament, tendon, connective tissue of muscle, nerves, blood vessels - OSR - modified tension in the Line of Stress - Healing Time - 6-8 weeks, skin/subcutaneous 7-10 days - Type 2 - primarily articular cartilage and fibro cartilage - OSR - compression, decompression and gliding - Healing Time - hyaline articular cartilage 4-6 months secondary healing with fibro cartilage; fibro cartilage 3-4 months - meniscus regeneration

Answer 12

- Muscle - not just static biomechanical structures - neurophysiologically controlled from local reflexive activity - gamma bias, muscle spindles, GTO - and upper motor neuron influence. - OSR - modified tension in the line of stress - dosage for functional quality. 2-4 weeks - do not forget CT takes 6-8 weeks.

Answer 13

- Movement is critical to tissue health - Immobilization is destructive - Examples: - Overuse injuries - tissue is only stimulated in a limited ROM, thus outer ROM is immobilized - This area is under stimulated and undernourished - No different than immobilization by splinting, casting, etc.

Answer 14

- Tissue Specific Diagnosis - Cyriax equation to derive inert or contractile lesion - Determine the cause of weakness - inhibition vs. atrophy - Examples - compression when decompression is needed - Over tensioning connective tissue

Answer 15

1. Tissues involved - variables for Healing Time - degree of injury, vascularity. 2. Optimal Stimulus 3. Correct Dosage for that tissue 4. Proper nutrition to the tissues - circulation/vascularity and nutrients, hormones and enzymes. 5. Reactive capacity of the individual - age, complicating factors - diabetes, other disease processes, smoker, etc.

Answer 16

- Tools: apparatus, bolsters, wedges, pillows, tables | - Skills: artificial locking, ligamentous locking, joint locking, coordinative locking

Answer 17

-Many resps -Low speed -Minimal resistance -Outer ROM Goals: -Increase endurance -Increase circulation -Increase exercise ability -Avoid over exertion

Answer 18

-Increase reps -Increase speed -Do not increase resistance Goals: -Further increase endurance and fast coordination

Answer 19

-Stabilizing exercises in the gained ROM - concentric and eccentric Goals: -To increase strength in the gained ROM

Answer 20

-Coordination tonic and phasic function throughout physiologic ROM Goals: -Functional stability

Answer 21

-Many reps -Low speed -Minimal resistance -Beginning to mid range of motion Goals: -Increase endurance -Increase circulation -Increase exercise ability -Avoid over exertion

Answer 22

-Increase reps -Include isometric contractions in inner ROM Goals: -To increase strength and increased sensitivity to stretch.

Answer 23

-Sub maximal (80% 1RM) resistance - concentric and eccentric -Include isometric contractions in the full ROM except the outer ROM Goals: -To further increase dynamic stability

Answer 24

-Coordinate tonic and phasic function throughout the physiologic ROM Goal: -Functional stability

Answer 25

"Prior to attempting to rehabilitate muscle function, it is essential to first minimize the effects of pain and any reflex inhibition of the muscles concerned. In addition, the effect of any tight opposing structures needs to be assessed and treated appropriately.'

Answer 26

Differentiation in: - cervical disc - compression, shearing, flexion - facet entrapment - rotation, sidebending, extension to the side of pain, palpation, pain the same active or passive - facet arthritis - rotation, sidebending, extension to the side of pain, crepitus - nerve root compression - Spurling's, neurologic exam, relief with traction, positive upper limb tension test - uncovertebral pathology - sidebending to the painful side - ligamentous strain - symptoms with stretch/stress of the ligament - capsulitis - rotation, sidebending, flexion away from the side of pain, palpation, resisted testing - muscular - pain with resistance in 3 positions, pain to palpation, pain with stretch

Answer 27

- What is the tissue in lesion? - What are the causative factors? - Do I need to stabilize or mobilize? - What exercise mobilize or stabilize the tissue in lesion? - How do I progress/translate this into function?

Grimsby Flashcards

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