MOD 11: exercise progression framework

Question 1

What is the primary goal during the maximum protection phase?

Answer 1

Protection

Protecting healing structures while preventing secondary complications such as muscle inhibition and stiffness.

Question 2

In the maximum protection phase, what type of exercises are emphasized?

Answer 2

• Low-load activities
• Isometric contractions
• Assisted range of motion
• Gentle mobility
• Low-load stabilization

These exercises maintain neuromuscular engagement without exceeding tissue tolerance.

Question 3

What are the four protection phases of rehabilitation?

Answer 3

• Maximum protection
• Moderate protection
• Minimum protection
• Return to activity

These phases guide decision-making based on tissue irritability, healing, and load tolerance.

Question 4

True or false: Progression out of the maximum protection phase is based solely on time.

Answer 4

FALSE

Progression is based on clinical milestones, not just time.

Question 5

What indicates readiness to progress beyond the moderate protection phase?

Answer 5

• Minimal pain during strengthening exercises
• Full or near full range of motion
• Ability to perform concentric and eccentric contractions without compensation
• Improved movement quality during functional tasks

These milestones indicate improved load tolerance.

Question 6

During the minimum protection phase, what types of exercises are introduced?

Answer 6

• Isotonic exercises
• Multi-joint movements
• Balance and proprioceptive training
• Agility or change-in-direction activities

Exercises begin to resemble real-life movement patterns.

Question 7

What is the focus during the return-to-sport or function phase?

Answer 7

Preparing for physical demands

Training becomes more dynamic, introducing speed, power, and reactive neuromuscular control.

Question 8

What is the Rehabilitation Treatment Specification System (RTSS)?

Answer 8

A framework describing interventions using three core components: treatment target, treatment ingredient, and mechanism of action

It helps clarify the distinction between exercise and treatment goals.

Question 9

What are the treatment targets during the maximum protection phase?

Answer 9

• Pain reduction
• Restoring muscle activation
• Protecting healing tissues

Treatment ingredients include isometric contractions and neuromuscular activation.

Question 10

What is the mechanism of action during the moderate protection phase?

Answer 10

Neuromuscular adaptation and increased force production

This contributes to improved joint stability and movement control.

Question 11

What treatment ingredients are used in the minimum protection phase?

Answer 11

• Multi-joint strengthening
• Balance training
• Progressively dynamic movement tasks

Focus shifts from isolated strengthening to integrated functional movement.

Question 12

What are the treatment targets during the return-to-activity phase?

Answer 12

• Power production
• Reactive neuromuscular control
• Task-specific performance

Treatment ingredients include plyometrics and agility drills.

Question 13

What is the key concept in exercise prescription according to the framework discussed?

Answer 13

Driven by presentation and response

Not simply by the calendar.

Question 14

What does the SINS concept relate to in rehabilitation phases?

Answer 14

Tissue irritability

High irritability aligns with maximum protection, moderate irritability with moderate protection, and low irritability with minimum protection.

Question 15

What is the goal of exercises in the return-to-sport phase?

Answer 15

Performance capacity under realistic conditions

Exercises closely resemble real-world demands.

Question 16

Fill in the blank: The maximum protection phase typically occurs immediately after injury or surgery when tissues are highly _______.

Answer 16

irritable

This phase focuses on protecting healing tissues.