Therapeutic exercise

Question 1

What are the 3 purposes of exercise?

Answer 1

• Form of treatment
• Health promotion
• Wellness

Question 2

What are the benefits of exercise?

Answer 2

Pathology – diseases, disorders, condition, abnormality
Impairments of body function- physiological/anatomical (body structure & function)
Personal level – functional limitations, activity
Social level – participation
Psychological level
Prevention level

Question 3

What are the uses of therapeutic exercise?

Answer 3

Remediate or prevent impairment

Improve, restore or enhance physical function

Prevent or reduce health related risk factors

Optimize overall health status, fitness, or sense of well being

Question 4

What are the components of physical function?

Answer 4

• Neuromuscular control
• Balance
• Muscle performance
• Coordination
• Postural control, stability and equilibrium
• Cardiopulmonary
• Stability
• Flexibility
• Mobility

Question 5

What are the types of therapeutic exercise intervention?

Answer 5

Aerobic conditioning & reconditioning

Muscle performance exercises: strength, power & endurance training

Stretching techniques including muscle-lengthening procedures & joint mobilization techniques

Neuromuscular control, inhibition & facilitation techniques 7 posture awareness training

Balance exercises & agility training

Relaxation exercises

Breathing exercises & ventilatory muscle training

Task-specific functional training

Question 6

Name the 3 models of disablement

Answer 6

• Nagi Model
• International Classification of Impairment, Disability & Handicaps (ICIDH) model
• International Classification of Function (ICF)

(**Go over the table in the lecture notes for each model)

Question 7

What are the pathological risk factors of therapeutic exercise intervention?

Answer 7

Disease
Disorders
Conditions
Abnormality

Question 8

What are the impairment risk factors of therapeutic exercise intervention?

Answer 8

Cardiovascular/pulmonary
Integumentary
Musculoskeletal
Neuromuscular
(Each of these have examples - go over them)

Question 9

What are functional risk factors of therapeutic exercise intervention?

Answer 9

Physical
Psychological
Social

Question 10

Name and describe the levels of prevention of disability

Answer 10

Primary prevention: Activities such as health promotion designed to prevent disease in an at-risk population.

Secondary prevention: Early diagnosis & reduction of the severity or duration of existing disease & sequelae.

Tertiary prevention: Use of rehabilitation to reduce the degree or limit the progression of existing disability & improve multiple aspects of function in persons with chronic, irreversible disease.

Question 11

What are the 4 risk factors of disablement and give example of each

Answer 11

Biological
age, sex, race, height, weight, congenital disorders, family history of disease.

Behavioral/Psychological/lifestyle
Sedentary lifestyle, use of drugs, poor nutrition, low level of motivation, inadequate coping skills, difficulty dealing with change, negative affect.

Physical environment characteristics
Architectural barriers in the home, community & work; ergonomic characteristics of the home, work or school environment.

Socioeconomic factors
- Low economic status, low level of education, inadequate access to healthcare, limited family or social support.

Question 12

What are the strategies used for effective exercise and task-specific instructions?

Answer 12

• Select nondestructive environment
• Demonstrate & make patient to model your movement
• Guide patient through movement
• Use clear & concise verbal & written directions
• Complement written instructions for home program with illustration of exercises
• Have the patient demonstrate an exercise to you as you supervise & -provide feedback.
• Provide specific, action-related feedback rather than general, nondestructive feedback.
• Teach an entire exercise program in small increments to allow time for patient to practice & learn components of the programme over several visits.

Question 13

Name and describe the three types of tasks of motor learning

Answer 13

1. Discrete task: involves a movement with a recognizable beginning & end.
2. Serial task: composed of a series of discrete movements that are combined in a particular sequence.
3. Continuous task: involves a repetitive, uninterrupted movement that have no distinct beginning & ending.

Question 14

What factors influence motor learning during exercise instruction & functional training?

Answer 14

Pre-practice consideration
Practice
Feedback (intrinsic feedback, augmented feedback, timing of feedback, frequency of feedback

Question 15

What factors influence adherence to an exercise program?

Answer 15

Characteristic of the patient
Factors to health condition or impairment
Program related variables

Question 16

What is resisted exercise?

Answer 16

Any form of exercise that forces the skeletal muscles (not the involuntary muscles of your heart, lungs, etc.) to contract.

An external resistance (such as heavy weights) is used to cause the contractions, and those contractions lead to increases in muscular mass, strength, endurance and tone

Question 17

What are the benefits of resisted exercise?

Answer 17

Enhance muscle performance.

Increase strength of connective tissue.

Greater mineral density.

Decreased stress on joints during physical activity.

Reduced risk of soft tissue injury during activity.

Possible improvement in balance

Enhanced physical performance during daily living, occupational, recreational activities.

Positive changes in body composition: lean muscle mass & body fat↓

Enhanced feeling of physical well-being

Question 18

What are the 3 components of strengthening?

Answer 18

Strength, power and endurance

Question 19

Define 1RM

Answer 19

One-repetition maximum (one rep maximum or 1RM) in weight training is the maximum amount of force that can be generated in one maximal contraction.

One repetition maximum can be used for determining an individual’s maximum strength and is the method for determining the winner in events such as powerlifting and weightlifting competitions.

One repetition maximum can also be used as an upper limit, in order to determine the desired “load” for an exercise (as a percentage of the 1RM).

Question 20

Describe the 4 levels of intensity with regards to exercise

Answer 20

Low strength 30% to 40% of 1RM for sedentary, untrained individuals

Mild strength 40 to 60% of 1RM

Moderate strength 60% to 70% of 1RM, healthy individuals

Very high strength 80% to 95% of 1RM for highly trained individuals

Question 21

THR (target heart rate) formula

Answer 21

THR = MHR (max HR) x 60%

= (220 - age) x 0.6

Question 22

Name and describe the 6 principles of training

Answer 22

1. Overload
   Increase in demand to force bodily adaptation.
   To stimulate an improvement in the physical condition of the body, it must experience physical stresses greater than those it would normally encounter.

2.Training adaptation
Body’s response to physical stress.
When the body is subjected to appropriate overload, it will adapt to physical demands.

3. Specificity
   Changes occur to the parts that are stressed.
   Type of training effects produced by the exercise are specific to that type of exercise.
   Must be specific to the type of sport/activity.
4. Transfer of training
   Carry over or cross over training
   Training effect can occur from exercised limb to unexercised contra lateral limb
5. Individual differences
   Training must meet individual needs.
   Genetic, individual commitment, level of physical & mental maturity.
6. Reversibility
   Stop strengthening the muscles will weakening the muscles.
   Detraining

Question 23

What are normal factors that affect strength?

Answer 23

Development
Aging
Gender
Body types
Training

Question 24

What are abnormal factors affecting strength?

Answer 24

Injury
Disease
Disuse
Fatigue

Question 25

What are the factors that contribute to the dosage of exercise prescribed at a patient?

Answer 25

``` Alignment of body segments Exercise intensity Volume of exercise Duration Frequency Recovery Mode of exercise (each one has an explanation, see lecture slides) ```

Question 26

Name and describe the types of muscle contraction

Answer 26

- Isometric (static) contraction – muscle tension increases without change in muscle length. - Dynamic concentric contraction - muscle shortens as it contracts. - Dynamic eccentric contraction - muscle lengthens as it contracts - Isokinetic contraction – dynamic contraction under controlled conditions

Question 27

What are the 3 forms of resistance?

Answer 27

Manual resistance Mechanical resistance Body weight

Question 28

What are the precautions or resisted training?

Answer 28

``` Valsalva manoeuvre Substitute motions Compensatory effort Overtraining and overwork Exercise induced muscle soreness Acute soreness Delayed onset muscle soreness – self study ```

Question 29

What are the contraindication of resisted exercise?

Answer 29

During period of acute inflammatory conditions and diseases Severe pain (joint and muscle) Inflammation – 1st phase of healing Severe cardiopulmonary disease

Question 30

Name an describe the 3 types of stretching

Answer 30

1. Static stretching - voluntary passive relaxation of muscle while it is elongated 2. Dynamic stretching - A swinging, bouncing, or bobbing movement during the stretch as the final position in movement is not held 3. Active stretching- involves active contraction of the agonist muscles to move a limb through a full ROM while the functional antagonist is being stretched (Slow movements and Proprioceptive neuromuscular facilitation was also listed here but I don't think it's a type of stretching)

Question 31

What are the components of a single exercise session?

Answer 31

Warm-up, Conditioning, Cool-down and Stretching | Each have a description, see lecture slides

Question 32

What body systems are involved in response to exercise?

Answer 32

Musculoskeletal, Cardiovascular, Pulmonary, Nervous, GIT, Endocrine and Immune

Question 33

What are the aerobic changes that occur in the musculoskeletal system with exercising?

Answer 33

- Increase in size and number of mitochondria - Increase in capacity to generate ATP aerobically - Increase the capacity in muscle to mobilise and oxidise fat - Increase in myoglobin content

Question 34

What are the acute adaptations that occur in the cardiovascular system with exercising?

Answer 34

- increase in heart rate, stroke volume, cardiac output and blood flow - decrease in vascular resistance

Question 35

What are the chronic adaptations that occur in the cardiovascular system with exercising?

Answer 35

- increase in plasma volume, red cell mass, total blood volume, maximal stroke volume, maximal cardiac output - decrease in systolic and diastolic blood pressure

Question 36

What are the long term aerobic changes to the cardiovascular system with exercising?

Answer 36

- heart size increases - heart rate decreases with prolonged training - Stroke volume increases at rest, which increases cardiac output - Blood pressure increases acutely during endurance and strength training, but with prolonged training BP decreases - oxygen uptake increases

Question 37

What acute changes occur in the pulmonary system with exercising?

Answer 37

- rapid increase in ventilation, pulmonary blood flow and lung compliance - airways dilate - decrease resistance to air flow - increased breathing volumes improves oxygen uptake - increase in minute ventilation - increase blood flow to exercising muscle

Question 38

What changes occur in the nervous system with exercising?

Answer 38

- increased SNS activity - increase endorphin release which improves mood - increased NE release which decreases pain - temporary increase in body temperature (contributes to decreased muscle tension, elevated mood, reduced anxiety and improved sleeping pattern) - improve coordination and balance - NE & E release stimulate pulmonary and CVS responses to increase oxygen to the muscles - Growth hormone increases - Testosterone and androgenic hormones increase - cortisol increases to promote production of glucose

Question 39

What changes occur in the immune system with exercising?

Answer 39

- increases in WBC > this promotes healing and repair of injured tissue - overtraining has negative effects on the immune system

Question 40

What changes occur to the GIT system with exercising?

Answer 40

- shunting of blood occurs - increase in GIT mobility --> decreases constipation - prolonged activity causes diarrhea, incontinence, stomach ache, vomiting, reflux and heartburn and sometimes rectal bleeding