NBCE PhT Questions and Answers correct

NBCE PhT Questions and Answers correct Target Heart Rate Equation 220 beats/min - 20 (age) = 200 (estimated max. heart rate) Max heart rate - 60 (resting heart rate) = 140 x .75( HR range .6-.9) + 60(resting heart rate) = Target heart rate William's Approach - Premise is that cause of most low back pain is acquired by walking upright in a straight position - Williams states that normal posture is with knees bent and torso slightly bent foward - All activities should be geared to reducing lumbar lordosis William Flexion Exercises Mckenzie Approach Spinal assessment and therapy based on the behavior of pain and mechanical response to dynamic and static loading - Promotes Spinal Extension Postural Pain Syndrome end range stress of normal structures Dysfunction Pain Syndrome end range stress leading to contracted or adherent structures Deranged Pain Syndrome Anatomical Disruption or Displacement of Structure (Herniated Disc) Plyometrics Exercises in which muscles exert maximum force in short intervals of time, with the goal of increasing power 3 Phases of Plyometric Stretch-Shortening Cycle 1) Start - Eccentric 2) Mid - Amortization 3) End - Concentric Acute Care Management First 4 weeks of injury Recover Care Management After four weeks What type of muscle fibers do Sprinters use? - Fast Twitch Muscle Fibers - White fibers - Glycogen (Anaerobic metabolism) What type of Muscle fibers do endurance runners use? - Slow Twitch Muscle Fibers - Red Fibers Myoglobin - Mitochondria driven (More Vascular & Oxygen Consumption) Open Chain Exercises Movements in which hands or feet are not in a fixed position & the force applied by the body is great enough to overcome the resistance (such as dumbbells or barbells) Examples: bench press, lat pull-down, machine leg extension Closed Chain Exercises motions in which the body moves on a distal segment that is fixed or stabilized on a support surface; Performed in weight-bearing positions Closed Chain vs. Open Chain Exercises Lower Crossed Syndrome A postural distortion syndrome characterized by an anterior tilt to the pelvis (arched lower back) Upper Crossed Syndrome A postural distortion syndrome characterized by a forward head and rounded shoulders. Muscles that are tight in LCS? iGREAT Iliopsoas Gastroc + Soleus Rectus Femoris Erector Spinae Adductors TFL What Structural Problems occur in LCS? 1) AS Pelvis 2) Hyperlordosis of Lumbar (Erector Spinae) 3) Hyperextension of Knees (Rectus Femoris) 4) Hip Flexion (Iliopsoas) LCS - Iliopsoas Flexes Hip joint by drawing trunk into the femur LCS - Rectus Femoris - Quads Extends Knee - Rectus Femoris Flexes at Hip Joint (Secondary) LCS - TFL - Adducts Flexes, and Medially Rotates the Hips LCS - Erector Spinae - Extension of Lower Thoracic Area - Draws Ribs downward Weak/Inhibited muscles in LCS? gGROH Gluteus Medius Gluteus Minimus Rectus Abdominus Oblique Hamstring Oblique Abdominals 1) Bilateral - Flexes Vertebral Column; Support & Compress Ab viscera 2) Unilateral - Rotates Vertebral Column; Brings Thorax forward or Pelvis Backwards Glute Max -EXTENDS and laterally rotates hip joint -lower fibers assist in aDduction -upper fibers assist in aBduction -helps stabilize knee in extension through its insertion into the IT tracts Glute Medius Hip abduction What are the 2 Abductors of the Hip? 1) Glute Medius 2) Piriformis (Primarily external rotator; Secondarily Abductors) Tight Muscles in UCS? Pec Major & Minor Levator Scap Teres Major Upper Trap Subscapularis Latissimus Dorsi SCM Scalenes Rectus Capitus Upper & Lower Pec Major 1) Adducts & Medially Rotates Humerus 2) Inspiration elevates thorax Core Stabilization Muscles 1) Intrinsic - Muscles Multifidi, Intertransversarii, Rotatores 2) QL, Oblique Ab, Rectus Ab Pectoralis Minor 1) Tilts the Scapula Anteriorly 2) Scapula stabilized to fix the insertion: Helps with forced inspiration levator scapulae A: Elevates and adducts scapula O: Transverse processes of C1-C4 I: Medial border of scapula, superior to the spine Teres Major internal rotation, adduction, extension of the shoulder joint Upper Trapezius Elevation of Clavicle & Assist with respiration External Rotation of the Shoulder 1) Subscapularis 2) Teres Minor 3) Infarspinatus 1 degree of internal rotation of shoulders Subscapularis Subscapularis 1) Internal Rotation 2) Stabilizes head of humerus in the glenoid fossa during movement SCM, Scalenes, and Rectus Capitis Anterior Bilaterally: Flexion of head Unilaterally: Rotation of head Weak Muscles in UCS? Rhombiods Serratus Anterior Lower Traps Posterior Delt Teres Minor Infraspinatus Longus Coli Longus Capitus Rhomboids 1) Adducts and Elevates Scapula 2) Rotates Scapula so that glenoid cavity faces Caudally Lower Trapezius 1) Adduction, depression, and assist with lateral rotation of scapula Weakness of Serratus Anterior: Scapular Winging Posterior Deltoid abduction, extension, horizontal abduction, external rotation Longus Coli Bilateral - Flexion Unilateral - Rotation Inversion Ankle Sprain 1) Anterior Talofibular Sprain 2) Must Strengthen Peroneus Longus and Brevis Muscles Buerger-Allen Patient's with Buerger's, Raynauds, Elderly, Bedridden, or Early Stages Diabetes William's Exercise Abdominal crunches, pelvic tilts and hamstring stretches designed to reduce a hyperlordosis McKenzie's Exercises 1) Extension Type Exercises used for low back conditions 2) Can be used during the acute phase (Acute disc Problem) Codman's exercise 1) Strengthen the Shoulder Girdle while eliminating the use of supraspinatus muscle 2) I.e. Frozen Shoulder and Rotator Cuff Rehab DeLorme's Exercise A Systematic Approach to muscle strengthening by increasing the resistance placed on the muscle i.e. Weight Lifting Kegel's Pelvic Floor Exercises For Pregnant Females, and patients with urinary incontinence Jacobson's Stress Exercises to relax muscles Neer classification (proximal humerus fracture) Stage 1: 25 yo - acute inflammation, edema, hemorrhage in rotator cuff - reversible Stage 2: 25-40yo - tendons progress to fibrosis and tendonitis - requires operation Stage 3: 40 yo - mechanical disruption of rotator cuff tendon and change in coracromial arch with osteophytes - surgery needed Clayton's Exercise Crawling exercises to mobilize the spine, and exercise muscles in scoliosis (Cross-Crawl) Frenkel's Ataxic motion and to develop coordination (wobble board) Thoracolumbosacral Supports Milwaukee brace scoliosis - worn 23 hours/day - employ for scoliosis btwn. 20-40 degrees Lumbar/SI Supports Sacroiliac Girdle (Trochanteric Belt): Hip circumference. For SI called trochanteric belt. For SI hypermobility. Pregnant Females Extremity Braces - Figure 8 / Louisiana Strap: Inversion Ankle Sprain - Lennox-Hill / Derotational Brace: Knee - Cock-Up Splint: Wrist (Carpal Tunnel) Canes - OA in hip: cane in opposite hand - 1 crutch: place crutch in opposite hand - Fitting crutches: 2-10-30 Measure 2" from axilla Tip of crutch 10" from malleolus Crutches should be placed correctly at 30 degrees Contraindications to ALL Modalities 1. Hemorrhage (systemic) 2. Infection with suppuration (NOT inflammation) - Infections: TB & Osteomylitis - Exceptions*: UV superficially 3. Malignancy *most important! Contraindication to ALL Heating Modalities 1) Decreased Thermal Sensations 2) Active TB 3) Low Back and Abdomen during pregnancy 4) Encapsulated Swellings - Herpes Simplex & Non-Draining Sinusitis 5) Diabetes Mellitus - Late Stages Contraindications to ALL Electrical Modalities -pacemaker patients (demand) -Low back and Abdomen during pregnancy -decreased sensation (Low Volt Galvanic ONLY - can burn you) -brain - transcerebral -eyes -heart - transthoracic (coplanar is okay) -carotid sinuses High Frequency Modalities 100,000 Hz or greater UV (Ultra-violet) IF (Infra-Red) SWD (Short wave diathermy) MWD (Microwave diathermy) US (Ultra Sound) Medium Frequency Modalities 2,000 - 10,000 Hz IF (Interferential) Low Frequency Modalities 1-2,000 Hz LVG (Low Volt Galvanic) HV (High Volt Galvanic) SW (Sine Wave) Faradic Tens IF (Interferential) Ultra-Low Frequency Modalities Below 1 Hz Micro current - Increases ATP - Increase AA - Decreases Pain Systematic Approach Action* Physiological Effects Indications Contraindications Depth/Penetration* Dosage ex. 95% are run for 20 min Types Frequency and Wavelength Special Tests -Erythemal patch - UV -Electrodiagnosis - LMNL Massage Action - Mechanical (Kinetic and Friction) - Greatest effect on the vascular system What is the Greatest Physiological effect of massage? Vascular Massage Increases - Blood Lymph flow - HR - Blood Pressure - Breaks Adhesions - Removes Lactic Acid Massage Decreases - Edema - Congestion - Nerve Activity (Sedation) Massage Indications sprains strains bruise tendinitis bursitis Massage Contraindications vascular problems - Phlebitis - Thrombosis - Varicositis - Ulcerations - Local Acute conditions types of massage: effleurage stroking Types of Massage: Petrissage Deep Kneading for muscle tissue Types of Massage: Tapotment Percussion (Hacking, cupping) - Flat Hand, slapping - Fist Pounding - Finger tips tapping for young kids - Ulnar side hacking - Cupping for cystic Fibrosis How to massage for edema? Stroke towards the heart and start proximal to edema Transverse Friction Massage - Breaks adhesions in muscle, ligaments and joint capsule - Decreases Chemical cross linking TFM Indications Sprain, Strain, Tendonitis, and bursitis TFM Contraindication Calcific Tendonitis or bursitis Physiological Effects of Traction - Decrease intradiscal pressure - Increase IVF space - Breaks adhesions - intermittent - Straightens curves - continuous - Breaks muscle spasms - intermittent - Gliding of facet joints Indications for Traction Disc syndromes, IVF encroachment, Hyperlordosis, Fibrotic Adhesions, and chronic muscle spasm Contraindication for Traction - Bone Weakening Conditions - Pregnancy - RA: Transverse Ligaments laxity - Acute Muscle Spasm - Fractures - Hypertensive disorder Cervical Traction - Begin @ 5% body wt and increase 2lbs Max each treatment to a max of 50lbs (Never exceed 50lbs or pt tolerance) Position of Cervical Traction C0-C1: Neutral or 0 degrees C2-C7: Flexion 25-28 degrees Lumbar Traction 25% of body weight nd increase 5lbs max with 150lbs max (50%)... held for 25-30 min. Position of Lumbar Traction 2 Names: - 90/90 Traction - Gouchers Position: relaxes mm & Flattens lumbar curve Cryotherapy Action - Hypothermal: removes heat and reduced tissue temp Physiological Effects of Cryotherapy 1) Local Effects - Vasoconstriction (Followed by Vasodilation [Hunting-Lewis Reaction]) - Dec Capillary pressure - Edema reduction - decreased nerve metabolism - Anesthetic to nervous system 2) Systemic Effect - Increase BP - Decrease Blood Flow Contraindications of Cryotherapy Circulatory Conditions: Raynaud's and Buerger's Patient's hypersensitive to cold Frostbite Chilblains High BP (systemic) Types of Heat Transmission 1. Convection 2. Conduction 3. Conversion 4. Radiation Cryotherapy is good for: 1) Specific Paralysis 2) Non-Pitting Edema 3) Acute Conditions Convection The transfer of heat by the movement of a fluid i.e. Whirlpool, sauna, and heating a hydrocollator pack Conduction The direct transfer of heat from one substance to another substance that it is touching. i.e. Hydrocollator pack, paraffin wax Parafin Wax Not to be done on open wounds; has a low melting point; requires a medium Treatment time is 20 min Decreases Skin Pliability Conversion The transfer of electrical energy into heat i.e. shortwave, microwave and ultrasound Radiation Transmission of heat without the intervening medium getting heated i.e. infrared lamp and ultraviolet lamp, most from sun