Compiled NASM Corrective Exercise Specialist CERTIFICATION EXAMS (CES)- *Q&A* (100% Correct) 2025/2026 |VERIFIED|

Compiled NASM Corrective Exercise Specialist CERTIFICATION EXAMS (CES)- *Q&A* (100% Correct) 2025/2026 |VERIFIED| What is the primary goal of corrective exercise when applied to clients with postural dysfunction? The primary goal is to restore optimal alignment and improve movement patterns by addressing muscular imbalances and dysfunctions. Explain the role of the length-tension relationship in corrective exercise and how it influences posture. The length-tension relationship describes how the muscle's ability to generate force is influenced by its length. In corrective exercise, muscle imbalances due to altered length-tension relationships can lead to poor posture and movement dysfunction. What are common signs of overactive muscles in the upper crossed syndrome? Common signs include tightness in the upper traps, levator scapulae, pectoralis major, and pectoralis minor. Describe the difference between an overactive and underactive muscle in the context of lower crossed syndrome. Overactive muscles in lower crossed syndrome include the hip flexors and lumbar extensors, while underactive muscles include the gluteus maximus and the abdominal muscles. How does the activation of the core stabilize the pelvis during corrective exercise interventions? The core stabilizes the pelvis by activating the deep abdominal muscles, such as the transverse abdominis, to prevent excessive pelvic tilting and to maintain neutral alignment during movement. What role does proprioception play in corrective exercise and rehabilitation? Proprioception enhances the body’s ability to sense its position in space, which helps improve balance, posture, and movement patterns during corrective exercise. 1 How would you approach a client with knee valgus during squatting? The approach would involve strengthening the gluteus medius and minimus to improve hip stability and teaching proper alignment during the squat to prevent excessive knee inward collapse. Explain how breathing techniques can be used to enhance corrective exercise outcomes. Proper breathing techniques help to activate the diaphragm, improve core stability, and reduce tension in the neck and shoulders, allowing for better posture and movement patterns. What is the importance of the eccentric phase in corrective exercise for improving muscle function? The eccentric phase plays a key role in strengthening muscles, improving flexibility, and correcting imbalances by lengthening muscles under tension during controlled movement. Describe the importance of scapular stability in corrective exercise. Scapular stability is crucial for shoulder function and overall upper body posture. Correcting dysfunctional scapular movement patterns can help alleviate shoulder pain and improve performance. What are the primary components to address when designing a corrective exercise program for a client with forward head posture? The primary components would include strengthening the deep cervical flexors, lengthening the upper trapezius and levator scapulae, and encouraging proper head alignment and posture. In the context of corrective exercise, how do you differentiate between muscular tightness and muscle weakness? Muscular tightness typically refers to overactive muscles that are shortened or restricted, whereas muscle weakness refers to underactive muscles that fail to provide proper support or movement control. What are common musculoskeletal issues that corrective exercise can address in clients with sedentary lifestyles? Corrective exercise can address issues like rounded shoulders, tight hip flexors, weak glutes, and poor core stability, all of which are common in sedentary individuals. 2 Explain the role of joint mobility in corrective exercise and its impact on overall movement. Joint mobility allows for proper range of motion and efficient movement. Limited mobility can lead to compensations and imbalances that can be addressed with corrective exercises. What corrective exercise techniques can be applied to improve ankle mobility in clients with a history of sprains? Techniques such as calf stretching, ankle dorsiflexion mobilizations, and strengthening the tibialis anterior and posterior can improve ankle mobility and reduce the risk of further injury. How does muscle imbalance contribute to common knee injuries, and what corrective exercises would you recommend? Muscle imbalances, particularly weak quadriceps and tight hamstrings, can alter knee mechanics. Corrective exercises should focus on strengthening the quadriceps, hamstrings, and gluteus medius to restore proper alignment and movement. What is the significance of functional movement assessments in corrective exercise? Functional movement assessments identify areas of weakness, imbalance, and dysfunctional movement patterns, providing the necessary data to design targeted corrective exercise programs. How can you use resistance bands for corrective exercise to improve muscle activation? Resistance bands provide external resistance, enhancing muscle activation by improving neuromuscular control and stimulating the targeted muscles more effectively during corrective exercises. What is the recommended approach to address compensations during the squat pattern? The approach includes teaching proper squat mechanics, addressing overactive muscles (e.g., hip f lexors, lower back), and strengthening underactive muscles (e.g., glutes, hamstrings). What corrective exercise modifications should be made for clients with shoulder impingement? Modify exercises to avoid overhead movements that cause pain, and focus on strengthening the rotator cuff and scapular stabilizers while improving shoulder mobility. 3 Explain how corrective exercise for a client with lumbar lordosis would differ from a client with kyphosis. For lumbar lordosis, corrective exercises would focus on stretching the hip flexors and strengthening the abdominals and glutes. For kyphosis, exercises would involve stretching the chest and strengthening the upper back and postural muscles. What role does functional strength training play in corrective exercise? Functional strength training helps to improve the efficiency of movement by focusing on exercises that mimic real-life actions, addressing imbalances and improving posture and muscle coordination. Describe the importance of neuromuscular re-education in the corrective exercise process. Neuromuscular re-education helps retrain the brain to improve communication with muscles, leading to better coordination, posture, and movement patterns. What corrective exercise strategies can you use for clients with IT band syndrome? Strategies include foam rolling the iliotibial band, stretching the TFL (tensor fascia latae), strengthening the glutes and hip abductors, and correcting faulty movement patterns during running or other activities. What types of stretches are recommended for clients with tight hip flexors and how do they contribute to corrective exercise? Stretches such as lunges and the pigeon pose target the hip flexors. These stretches help lengthen tight muscles, improve flexibility, and reduce the risk of imbalances that affect posture and movement. How can you address a client’s overactive hip flexors during a corrective exercise program? Focus on strengthening the glutes and core muscles, while also incorporating stretches and mobility work for the hip flexors to restore proper movement patterns. Why is it essential to maintain a neutral spine during corrective exercise? Maintaining a neutral spine reduces the risk of injury, ensures proper activation of stabilizing muscles, and helps maintain optimal posture during movement. 4 What corrective exercises would you recommend to improve thoracic spine mobility for a client with poor posture? Foam rolling the upper back, seated thoracic rotations, and banded thoracic stretches are effective exercises to improve mobility and reduce stiffness in the thoracic spine. What is the role of corrective exercise in improving muscular endurance? Corrective exercise can improve muscular endurance by targeting weak or underactive muscles, improving their stamina and functionality over time through progressive resistance and proper technique. How does poor posture contribute to lower back pain, and what corrective exercises can alleviate this? Poor posture can place excessive strain on the lumbar spine, leading to discomfort. Corrective exercises should focus on strengthening the core, glutes, and lower back muscles while improving overall posture. How can corrective exercise interventions help clients recover from a herniated disc? Corrective exercises can strengthen the muscles that support the spine, improve flexibility, and correct posture, all of which help reduce pressure on the disc and promote healing. Explain the concept of active release therapy and how it complements corrective exercise. Active release therapy is a technique used to release tight muscles and fascia. It complements corrective exercise by enhancing flexibility and mobility, helping to restore optimal muscle function. What is the purpose of strengthening the posterior chain in corrective exercise, and what muscles are targeted? Strengthening the posterior chain, which includes the hamstrings, glutes, and lower back, helps improve posture, stabilize the pelvis, and prevent lower back pain. How do you determine which muscles to target in a corrective exercise program? Muscle selection is based on the results of a postural assessment and movement screening, where overactive and underactive muscles are identified to correct imbalances and dysfunctional patterns. 5 How does corrective exercise contribute to injury prevention during physical activity? Corrective exercise improves muscle balance, joint stability, and movement patterns, reducing the risk of compensations that can lead to injury during physical activity. What role does tissue quality play in the corrective exercise process, and how can it be addressed? Tissue quality influences muscle function and movement efficiency. Corrective exercise addresses t issue quality through techniques like foam rolling, myofascial release, and targeted stretching to improve flexibility and muscle health. Corrective exercise A term used to describe the systematic process of identifying a neuromusculoskeletal dysfunction, developing a plan of action, and implementing an integrated corrective strategy. Corrective Exercise Continuum The systematic programming process used to address neuromusculoskeletal dysfunction through the use of inhibitory, lengthening, activation, and integration techniques Inhibitory techniques Corrective exercise techniques used to release tension or decrease activity of overactive neuromyofascial tissues in the body. Lengthening techniques Corrective exercise techniques used to increase the extensibility, length, and range of motion of neuromyofascial tissues in the 6 body. Activation techniques Corrective exercise techniques used to reeducate or increase activation of underactive tissues. Corrective exercise techniques used to retrain the collective synergistic function of all muscles through functionally progressive movements. Integration techniques the International Obesity Task Force obesity________________ an epidemic one third 33% In 1985, deemed the prevalence of Today, approximately _______ of adults are estimated to be obese overweight 40 years ago 18% of today's adolescents and teenagers are considered Research suggests that musculoskeletal pain is more common now than it was__________because of the advancements of technology and manuallabor-saving devices. 1 million ambulatory care (doctor) visits per year accounts for more than $26 billion In the general population, plantar fasciitis It has been estimated that the annual costs attributable to low-back pain in the United States are greater than 7 21% of the general population Shoulder pain is reported to occur in up to higher the risk of injury? of injury? The less conditioned our musculoskeletal systems are, the higher the risk R.I.C.E. (rest, ice, compress, elevate). strategy using the According to the text, a comprehensive corrective exercise Corrective Exercise Continuum includes all of the following steps EXCEPT: Biomechanics A study that uses principles of physics to quantitatively study how forces interact within a living body Force An influence applied by one object to another, which results in an acceleration or deceleration of the second object. Rotary motion Torque Movement of the bones around the joints A force that produces rotation Antagonists Synergists Stabilizers Muscles that act in direct opposition to prime movers Muscles that assist prime movers during functional movement patterns. Muscles that support or stabilize the body while the prime movers and the synergists perform the movement patterns. Motor behavior stimuli Th e human movement system's response to internal and external environmental 8 Motor control Th e study of posture and movements with the involved structures and mechanisms used by the central nervous system to assimilate and integrate sensory information with previous experiences Motor learning Motor development Internal (sensory) feedback Th change in motor behavior with time throughout the lifespan Th e process by which sensory information is used by the body via length-tension relationships, force-couple relationships, and arthrokinematics to monitor movement and the environment. External (augmented) feedback Information provided by some external source, for example, a health and fitness professional, videotape, mirror, or heart rate monitor. Knowledge of results Used after the completion of a movement to inform individuals about the outcome of their performance Knowledge of performance Length-tension relationship produce at this resting length. Force-velocity curve Provides information about the quality of the movement The resting length of a muscle and the tension the muscle can The relationship of a muscle's ability to produce tension at differing shorting velocites Force-couple The synergistic action of muscles to produce movement around a joint Local musculature system stabilization. Muscles that are predominantly involved in joint support or 9 Global musculature system Muscles responsible predominantly for movement and consisting of more superficial musculature that originates from the pelvis to the rib cage, the lower extremities, or both Sensory information The data that the central nervous system receives from sensory receptors to determine such things as the boidy's position in space and limb orientation, as well as information about the environment, temperature, texture Sensation A process by which sensory information is received by the receptor and transferred either to the spinal cord for reflexive motor behavior, to higher cortical areas for processing, or both. Perception The integration of sensory information with past experiences or memories. Sensorimotor integration The ability of the central nervous system to gather and interpret sensory information to execute the proper motor response. Feedback The utilization of sensory information sensorimotor integration to aid in the development of permanent neural representations of motor patterns for efficient movement Sagittal plane The ______________________ bisects the body into right and left halves, and primarily includes flexion and extension movements. Frontal plane The ______________________ bisects the body into front and back halves, and primarily includes abduction and adduction of the limbs (relative to the trunk), lateral flexion of the spine, and eversion and inversion of the foot and ankle complex. Transverse plane The ______________________ bisects the body to create upper and lower halves, and primarily includes internal rotation and external rotation for the limbs, right and left rotation for the head and trunk, and radioulnar pronation and supination. Pronation ______________________ is a multiplanar, synchronized joint motion that occurs with eccentric muscle function. 10 Supination ______________________ is a multiplanar, synchronized joint motion that occurs with concentric muscle function. Eccentric contraction lengthening Isometric contraction An ______________________ occurs when a muscle develops tension while An ______________________ occurs when the contractile force is equal to the resistive force, leading to no visible change in the muscle length Concentric contraction A ______________________ occurs when the contractile force is greater than the resistive force, resulting in shortening of the muscle and visible joint movement. Gluteus medius, tensor fascia latae, adductor complex, quadratus lomborum muscle groups of the lateral sub-system? What are the major Erector spinae, thoracolumbar fascia, sacrotuberous ligament, biceps femoris, peroneus longus What are the major muscle groups of the deep longitudinal sub-system? Internal and external obliques, adductor complex, hip external rotators muscle groups of the anterior oblique sub-system? Posterior oblique sub-system What are the major Which sub-system works synergistically with the deep longitudinal sub-system and consists of the gluteus maximus, thoracolumbar fascia, and contralateral latissimus dorsi? Transverse abdominis, multifidus, internal oblique, diaphragm, pelvic floor muscles support system of the lumbo-pelvic-hip complex (LPHC) includes the following muscles. Proprioception The joint What is the cumulative neural input from sensory afferents to the central nervous system? Central What part of the nervous system is designed to optimize muscle synergies? 11 Dorsifl exion Flexion at the ankle is more accurately termed what? Accelerates ankle dorsifl exion and inversion t ibialis? Decelerates hip adduction and internal rotation medius (posterior fibers)? What is the concentric function of the anterior What is the eccentric function of the gluteus Shoulder extension, adduction, and internal rotation latissimus dorsi? Accelerates ankle plantar flexion and inversion t ibialis? Accelerates knee flexion and tibial external rotation femoris (short head)? Accelerates hip flexion, abduction, and internal rotation fascia latae? What is the concentric function of the What is the concentric function of the posterior What is the concentric function of the biceps What is the concentric function of tensor Decelerates shoulder extension, horizontal abduction, and external rotation function of the pectoralis major? What is the eccentric The ability of the neuromuscular system to allow agonist, antagonists, synergists, and stabilizers to work synergistically to produce, reduce, and dynamically stabilize the HMS in all three planes of motion. Neuromuscular efficiency The independent and interdependent alignment (static posture) and function (transitional and dynamic posture) of all components of the HMS at any given moment, controlled by the central nervous system. Posture 12 The alignment of the HMS, which allows posture to be balanced in relation to one's center of gravity. Structural efficiency The ability of the neuromuscular system to recruit correct muscle synergies, at the right time, with the appropriate amount of force to perform functional task with the least amount of energy and stress on the HMS. Functional efficiency A cycle whereby an injury will induce inflammation, muscle spasm, adhesion, altered neuromuscular control, and muscle imbalances. Cumulative injury cycle Refer to the state in which the structural integrity of the HMS is compromised because the components are out of alignment. Movement impairment syndrome The process whereby a tight muscle (short, overactive, myofascial adhesion's) causes decreased neural drive, and therefore optimal recruitment of its functional antagonist. Altered reciprocal inhibition The process by which a synergist compensates for a prime mover to maintain force production Synergistic dominance Usually characterized by excessive foot pronation (flat feet), increased knee valgus (tibia internally rotated and femur internally rotated and adducted or knock-kneed), and increased movement at the LPHC (extension or flexion) during functional movements. Lower extremity movement impairment syndrome Usually characterized as having rounded shoulders and a forward head posture or improper scapulothoracic or glenohumeral kinematics during function movements. Upper extremity movement impairment syndrome True Because the human movement system is an integrated system, impairment in one system leads to compensations and adaptations in other systems. 13 True If one segment in the human movement system is out of alignment, then other movement segments have to compensate in attempts to balance the weight distribution of the dysfunctional segment. True If the gluteus medius is underactive, then the tensor fascia latae (TFL) may become synergistically dominant to produce the necessary force to accomplish frontal plane stability of the lumbo-pelvic-hip complex. True Once a joint has lost its normal arthrokinematics, the muscles around that joint may spasm in an attempt to minimize the stress at the involved segment. False Synergistic dominance is the process by which a tight muscle causes decreased neural drive of its functional antagonist. True A tight psoas decreasing the neural drive and optimal recruitment of the gluteus maximus is an example of synergistic dominance. True If a client has a weak gluteus medius, then synergists (tensor fascia latae, adductor complex, and quadratus lumborum) oft entimes become synergistically dominant to compensate for the weakness. True Individuals with a lower extremity movement impairment syndrome are usually characterized by excessive foot pronation (flat feet), increased knee valgus (knock-kneed), and increased movement at the lumbo-pelvic-hip complex (extension or flexion) during functional movements. True Individuals with the upper extremity movement impairment syndrome are usually characterized as having rounded shoulders and a forward head posture or improper scapulothoracic or glenohumeral kinematics during functional movements. False Individuals who present with the lower extremity movement impairment syndrome typically develop predictable patterns of injury including rotator cuff impingement, shoulder instability, biceps tendinitis, thoracic outlet syndrome, and headaches. 14 It is hypothesized that decreased posterior glide of the ___ can decrease ___at talus, dorsiflexion the ankle deceleration, transverse plane. Most knee injuries occur during noncontact ___ in the frontal and ___ vastus medialis oblique, vastus lateralis Abnormal contraction intensity and onset timing of the ______________ and ______________ have been demonstrated in subjects with patellofemoral pain ( anterior tibialis Potentially tightened or overactive muscles accompanying a lower extremity movement impairment syndrome include the following EXCEPT: pes anserine complex Potentially weakened or inhibited muscles accompanying a lower extremity movement impairment syndrome include the following EXCEPT: rhomboids. Potentially tightened or overactive muscles accompanying an upper extremity movement impairment syndrome include the following EXCEPT: teres minor Potentially weakened or inhibited muscles accompanying an upper extremity movement impairment syndrome include the following EXCEPT: increased gluteus medius activity According to research, subjects demonstrating increased dynamic knee valgus typically exhibit all of the following EXCEPT transverse abdominis and multifidus. Subjects with low-back pain (LBP) have been reported to demonstrate impaired postural control, delayed muscle relaxation, and abnormal muscle recruitment patterns (diminished activation) of the Rhomboids, lower trapezius Which muscles are lengthened, altering the normal scapulothoracic force-couple relationship when an individual exhibits a rounded shoulder posture? Physical readiness for activity 15 General lifestyle information Medical History What are the three main pieces of information a health and fitness professional should obtain from the health risk appraisal? Design to help to determine if a person is ready to undertake low-to-moderate to high activity levels What is the purpose and function of the Physical Activity Readiness Questionnaire? Lead to tight hip flexors that can cause postural imbalances within the kinetic chain. Tendency for the shoulders and cervical spine to fatigue under the constant influence of gravity. This often leads to a postural imbalance of rounding of the shoulders and a forward head. Briefly explain how sitting for extended periods of time has an impact on the human movement system? working with the arms overhead for long periods of time may Lead to shoulder soreness that could be the result of tightness in the latissimus dorsi and pectorals and weakness in the rotator cuff. From a human movement system standpoint, briefly describe how construction workers and painters can develop muscle imbalances and injury of the upper extremities? Lead to tightness in the gastrocnemius and soleus causing postural imbalance, such as overpronation at the foot and ankle complex (flattening of the arch of the foot, which can lead to foot and ankle injury). Brief y describe how wearing shoes with an elevated heel (dress shoes, high heels) can have an impact on the human movement system. True Mental stress or anxiety can lead to a dysfunctional breathing pattern that can further lead to postural distortion and kinetic chain dysfunction. False Questions pertaining to an individual's recreational activities and hobbies are not an essential component of the health risk appraisal. True True One of the best predictors of future injuries is past injury. Ankle sprains have been shown to decrease the neural control to the gluteus medius and gluteus maximus muscles. 16 True Low-back injuries can cause decreased neural control to stabilizing muscles of the core, resulting in poor stabilization of the spine and possible further dysfunction of the upper or lower extremities. True Surgery will cause pain and inflammation that can alter neural control to the affected muscles and joints if not rehabilitated properly False It is estimated that roughly 25% of the American adult population does not partake, on a daily basis, in 30 minutes of low-to-moderate physical activity. False One of the roles of a health and fitness professional (i.e., personal trainer, athletic trainer, strength coach) is to administer, prescribe, and educate on the usage and effects of common medications. True At best, an individual/client can recall only half his or her injury history, so a close examination of imbalances through further assessments can turn up additional areas of potential risks. extended long period of time seating, wearing dress shoes, mental stress Below are answers to a client's health risk appraisal. What are some potential "red flags" that may need to be considered when designing a corrective exercise program? How an individual physically presents themeselves in stance. It is reflected in the alignment of the body. Static posture How an individual is able to maintain an erect posture while performing functional tasks. posture Restricted motion Hypomobility The connective tissue in and around muscles and tendons. Establish normal Muscle imbalance Myofascial Dynamic 17 The rate of muscle recruitment and the timing of muscular contractions within the kinetic chain Coordination A postural distortion syndrome characterized by a anterior tilt to the pelvis and lower extremity muscle imbalance Lower crossed syndrome A postural distortion syndrome characterized by a forward head and rounded shoulders with upper extremity muscle imbalances. Upper crossed syndrome A postural distortion syndrome characterized by foot pronation and lower extremity muscle imbalances Pronation distortion syndrome True A static postural assessment provides indicators of problem areas that must be further evaluated to clarify the problems at hand. Ankle sprains True Which of the following is reported to be the most common sports-related injury? Treating symptomatic complaints using anti-inflammatory medications, modification of activities, or simply pushing through the pain may lead to further dysfunction, adding layer on layer of structural and neuromuscular adaptations. True Looking for causative factors (versus treating symptomatic complaints) of inflammation, discomfort, or poor performance will likely result in the selection of effective intervention strategies to alleviate the dysfunction. False A static postural assessment can accurately identify whether a problem is structural (or biomechanical) in nature or is derived from the development of poor muscular recruitment patterns with resultant muscle imbalances. True There may be several causative factors for changes in joint alignment including quality and function of myofascial tissue and alterations in muscle-tendon function. 18 False patterns True The combination of tight and weak muscles typically does not alter normal movement Work (computer) stations both at home and at the office frequently contribute to neck and arm dysfunction True Muscle that is repeatedly placed in a shortened position, such as the iliopsoas complex during sitting, will eventually adapt and tend to remain short. True Chronic use of the right lower extremity while driving, without awareness of trying to maintain symmetry, may allow the body to shift to the right and promote external rotation of the left lower extremity. True to tighten Immobilizations through splinting or self-immobilization as a result of pain may allow tissue Vastus medialis oblique lengthening (weakness)? Pectoralis major/minor t ightness? According to the text, which of the following muscles is prone to According to the text, which of the following muscles is prone to static stretching of overactive tissues before competition that cause postural imbalance EXCEPT Lower crossed syndrome All of the following are potential factors Which postural distortion pattern is characterized by increased lumbar lordosis and an anterior pelvic tilt? Upper crossed syndrome and a forward head posture? Which postural distortion pattern is characterized by rounded shoulders 19 Pronation distortion syndrome Which postural distortion pattern is characterized by excessive foot pronation (flat feet), knee flexion, internal rotation, and adduction (knock-kneed)? Lower crossed syndrome posterior tibialis. Which postural distortion pattern is demonstrated in the image above? All of the following muscles are MOST likely tight (overactive) EXCEPT the hip flexor complex Upper crossed syndrome teres minor All of the following muscles are MOST likely weak (underactive) EXCEPT the: Which postural distortion pattern is demonstrated in the image above? All of the following muscles are typically tight when an individual exhibits this postural distortion pattern EXCEPT the: lower trapezius All of the following muscles are typically weak when an individual exhibits this postural distortion pattern EXCEPT the Pronation distortion syndrome above? soleus Which postural distortion pattern is demonstrated in the image Functionally weakened (inhibited) muscles associated with this postural distortion pattern include all of the following EXCEPT the: hip external rotators Functionally tightened muscles associated with this postural distortion pattern include all of the following EXCEPT the: Establishing normal length-tension relationships, which ensure proper length and strength of each muscle around a joint. Muscle balance 20 Kinetic denotes the force transference from the nervous system to the muscular and skeletal systems as well as from joint to joint, and chain refers to the interconnected linkage of all joints in the body. Kinetic chain Assessments that involve movement without a change in one's base of support movement assessment Assessments that involve movement with a change in ones base of support assessment Transitional Dynamic movement The distance one can squat down on one leg while keeping the knee aligned in a neutral position (in line with the second and third toes). Balance threshold True Muscle balance is essential for optimal recruitment of force-couples to maintain precise joint motion and ultimately decrease excessive stress placed on the body. True Any muscle, whether in a shortened or lengthened state, can be underactive or weak because of altered length-tension relationships or altered reciprocal inhibition. True Alterations in muscle activity will change the biomechanical motion of the joint and lead to increased stress on the tissues of the joint and eventual injury. True Movement assessments can be categorized into two types: transitional assessments and dynamic assessments. False Transitional movement assessments are assessments that involve movement with a change in one's base of support such as walking and jumping. False Dynamic movement assessments are assessments that involve movement without a change in one's base of support such as squatting, pressing, pushing, pulling, and balancing. 21 False Knee valgus during the overhead squat test is influenced by decreased hip adductor and hip internal rotation strength, increased hip abductor activity, and restricted ankle plantar flexion True If an individual's knees move inward during the overhead squat assessment, but the compensation is then corrected after elevating the heels, the primary region that mostly likely needs to be addressed is the foot and ankle complex. True If an individual's low back arches during the overhead squat assessment, but the compensation is then corrected when performing the squat with hands on hips, the primary regions that most likely need to be addressed are the latissimus dorsi and pectoral muscles. True The single-leg squat assessment assesses dynamic flexibility, core strength, balance, and overall neuromuscular control. Knees move inward What is the primary movement compensation demonstrated during the overhead squat assessment? Adductor complex Gluteus medius Excessive forward lean pulling assessment? Hip flexor complex Gluteus maximus Shoulders elevate assessment? Which muscle is most likely overactive? Which muscle is most likely underactive? What is the primary movement compensation demonstrated during the Which muscle is most likely overactive? Which muscle is most likely underactive? What is the primary movement compensation demonstrated during the pulling 22 Upper trapezius Which muscle is most likely overactive? Lower trapezius Low back arches assessment? Latissimus dorsi Which muscle is most likely underactive? What is the primary movement compensation demonstrated during the pressing Which muscle is most likely overactive? Intrinsic core stabilizers Low back arches assessment? Erector spinae Which muscle is most likely underactive? What is the primary movement compensation demonstrated during the gait Which muscle is most likely overactive? Gluteus maximus Shoulders elevate Which muscle is most likely underactive? What is the primary movement compensation demonstrated during the horizontal abduction test? Upper trapezius Which muscle is most likely overactive? Middle and lower trapezius Low back arches off wall shoulder flexion test? Erector spinae Which muscle is most likely underactive? What is the primary movement compensation demonstrated during the Which muscle is most likely overactive? 23 Rhomboids Shoulders elevate Which muscle is most likely underactive? What is the primary movement compensation demonstrated during the shoulder internal rotation test? Levator scapulae Rotator cuff Which muscle is most likely overactive? Which muscle is most likely underactive? The amount of motion available at specific joint. Range of motion The amount obtained by the examiner without any assistance by the client. motion Passive range of The amount of motion obtained solely through voluntary contraction from the client. of motion True Active range Precise neuromuscular control of range of motion at each joint will ultimately decrease excessive stress placed on the body. True If one joint lacks proper range of motion (ROM), then adjacent joints and tissues (above or below) must move more to compensate for the dysfunctional joint's ROM. True If an individual possesses less than adequate ankle dorsiflexion, he or she may be at greater risk of injury to the knee, hip, or low back. False In most normal subjects, active ROM is slightly greater than passive ROM. 24 True Some joints are constructed so that the joint capsule is the limiting factor in movement whereas other joints rely solely on ligamentous structures for stability. True A soft end-feel may acknowledge the presence of edema, whereas a firm end-feel may describe increased muscular tonicity. False Intertester reliability refers to the amount of agreement between goniometric values obtained by the same tester. False Intratester reliability refers to the amount of agreement between goniometric values obtained by different testers. True Reliability of joint motion assessment reflects how closely the measurement represents the actual angle or total available range of motion. False Validity refers to the amount of agreement between successive measurements The axis is the center of the goniometer that is attached to the body. This part of the goniometer will be placed on the stable, nonmoving limb or body segment that forms the jointline (or axis of rotation for the joint). axis The body represents the arc of measurement. The goniometer shows the measurement recorded in degrees of a circle (0-360 degrees). Body The stabilization arm (SA) is a structural part of the goniometer that is attached to the body. This part of the goniometer will be placed on the stable, nonmoving limb or bony segemt that forms the joint being measured. Stabilization arm The movement arm (MA) is the only moving component of the goniometer. It is placed on the moving limb of the joint being measure to provide the measurement reading. Movement arm Dorsiflexion of the talocrural joint What joint motion is being assessed? 25 Gastrocnemius and soleus 20° What are the primary muscles being assessed? What is the normal value when taking this measurement? Extension of tibiofemoral joint soleus. All of the following structures are being assessed EXCEPT: All of the following structures are being assessed EXCEPT: 20° What is the normal value when taking this measurement? Flexion of tibiofemoral joint What joint motion is being assessed? psoas or rectus femoris may be overactive the hip during this assessment, the 120° If the client reports a pinching sensation in the front of What is the normal value when taking this measurement? Internal rotation of iliofemoral joint What joint motion is being assessed? adductor complex and medial hamstring complex being assessed EXCEPT: 45° All of the following muscles and ligaments are What is the normal value when taking this measurement? External rotation of iliofemoral joint What joint motion is being assessed? Piriformis, hip external rotators, and adductor magnus (oblique fibers) potentially underactive if range of motion is limited? What antagonists are 26 45° What is the normal value when taking this measurement? Extension of iliofemoral joint What joint motion is being assessed? gluteus minimus, biceps femoris (short head), and semimembranosus. muscles and tissues are being assessed EXCEPT: 0° to -10° What is the normal value when taking this measurement? Flexion of shoulder complex What joint motion is being assessed? Latissimus dorsi, teres major, and teres minor All of the following What are the primary muscles being assessed? 160° What is the normal value when taking this measurement? Internal rotation of glenohumeral joint What joint motion is being assessed? Infraspinatus, teres minor, and posterior glenohumeral joint capsule structures are being assessed? 45° What is the normal value when taking this measurement? External rotation of glenohumeral joint Which muscles and What joint motion is being assessed? 90° Strength What is the normal value when taking this measurement? The ability of the neuromuscular system to produce internal tension to overcome an eternal force. 27 Isokinetic testing Muscle strength testing performed with a specialized apparatus the provides variable resistance to a movement, so that no matter how much effort is exerted, the movement takes place at a constant speed. Such testing is used to assess and improve muscular strength and endurance, especially after injury. Dynamometry The process of measuring forces at work using a handheld instrument (dynamometer) that measures the force of muscular contraction Break test At the end of available range, or at a point in the range where the muscle is most challenged, the client is asked to hold that position and not allow the examiner to break the hold with manual resistance. True True The ability of the nervous system to recruit and activate muscles dictates muscle strength One must be a qualified health and fitness professional (i.e., licensed professional) to apply manual muscle testing techniques on clients. False difficulty True Manual muscle testing provides an opportunity to assess muscle function with low cost and Overactivity of a shortened muscle will reciprocally inhibit its functional antagonist leading to a false reading that a muscle is weak when in fact the strength impression is purely a factor of joint position. True Manual muscle testing is an assessment process used to test the recruitment capacity and contraction quality of individual muscles or movements. True In addition to tight muscles, restrictions in skin, neural tissue, and articular ligaments can also result in muscle inhibition. False The numeric grade of 1 represents a client who maintains good structural alignment and holds the end-range position against the assessor's pressure. 28 False A numeric grade of 3 indicates little to no ability of the client to withstand or resist pressure from the assessor. True Muscle weakness can be related to several factors, but the most common factors in a healthy individual are atrophy and inhibition. place the muscle in a maximally lengthened position and retest. muscle testing process includes all of the following EXCEPT Step 1 of the NASM manual manual resistance should be applied at a 45-degree angle to the primary axis of a body part. improve reliability and safety, as well as reduce errors with a manual muscle test, the following guidelines should be followed EXCEPT: Anterior tibialis What is the prime mover being assessed? plantar flexion and eversion To To execute the test, the health and fitness professional should apply gradual and increasing pressure to the medial dorsal surface of the foot in the direction of Posterior tibialis What is the prime mover being assessed? dorsifl exion and eversion To execute the test, the health and fitness professional should apply gradual and increasing pressure to the medial plantar surface of the foot in the direction of Semimembranosus and semitendinosus Quadriceps and biceps femoris What are the prime movers being assessed? What are potentially overactive muscles if strength is limited? Iliacus and psoas major What are the prime movers being assessed? 29 hip extension. To execute the test, the health and fitness professional should apply gradual and increasing pressure at the distal end of the femur in the direction of Gluteus medius What is the prime mover being assessed? hip flexion and abduction To execute the test, the health and fitness professional should apply gradual and increasing pressure to the lateral aspect of the lower leg just above the ankle joint Adductor complex and hip flexor complex (TFL, iliopsoas, rectus femoris) potentially overactive muscles if strength is limited? Gluteus maximus What is the prime mover being assessed? hip flexion, adduction, and internal rotation. What are some To execute the test, the health and fitness professional should apply gradual and increasing pressure to the upper leg just above the knee in the direction of Iliopsoas, rectus femoris, adductor longus/brevis, and pectineus overactive muscles if strength is limited? Rhomboids What is the prime mover being assessed? downward direction toward the floor. What are some potentially To execute the test, the health and fitness professional should apply gradual and increasing pressure to the distal humerus just above the elbow in a Shoulder external rotators (infraspinatus and teres minor) assessed? shoulder internal rotation What are the prime movers being To execute the test, the health and fitness professional should apply gradual and increasing pressure to the lower arm just above the wrist in the direction of 30 A flexibility technique used to inhibit overactive muscle fibers. Self-myofascial release Soft tissue will model along the lines of stress. Davis's law The phenomenon of the human movement system seeking the path of least resistance during functional movement patterns (or movement compensation). Relative flexibility Inhibition of the muscle spindle resulting from the Golgi tendon organ stimulation. inhibition Autogenic The reflex arc consisting of small anterior horn nerve cells and their small fibers that project to the intrafusal bundle to produce its contraction, which initiates the afferent impulses that pass through the posterior root to the anterior horn cells, inducing, in turn, reflex contraction of the entire muscle. Gamma loop Evidence supporting the rationale for using self myofascial release (SMR) for flexibility purposes is derived from research on ischemic compression and myofascial release techniques. True Any trauma to the tissue of the body creates inflammation. Inflammation in turn activates the body's pain receptors and initiates a protective mechanism, increasing muscle tension or causing muscle spasm. True Adhesions (i.e., knots or trigger points) can begin to form permanent structural changes in the soft tissue that is evidenced by Davis's law. True Self-myofascial release techniques may help in releasing the microspasms that develop in traumatized t issue and break up the facial adhesions that are created through the cumulative injury cycle process. True Self-myofascial release is believed to stimulate receptors located throughout the muscle, fascia, and connective tissues (Golgi tendon organ, interstitial receptors, and Ruffi ni endings) through sustained pressure to produce an inhibitory response to the muscle spindle and decrease gamma loop activity. True 31 Adhesions (i.e., knots or trigger points) can begin to form permanent structural changes in the soft tissue that is evidenced by Davis's law. True Self-myofascial release techniques may help in releasing the microspasms that develop in traumatized t issue and break up the facial adhesions that are created through the cumulative injury cycle process True Self-myofascial release is believed to stimulate receptors located throughout the muscle, fascia, and connective tissues (Golgi tendon organ, interstitial receptors, and Ruffini endings) through sustained pressure to produce an inhibitory response to the muscle spindle and decrease gamma loop activity. True Type III and type IV receptors (interstitial receptors) in conjunction with Ruffini endings have been shown to have autonomic functions that include changes in heart rate, blood pressure, respiration, and tissue viscosity. True Decreasing vasodilation improves the ability of tissues to receive adequate amounts of oxygen and nutrients as well as removal of waste byproducts (via the bloodstream) to facilitate tissue recovery and repair. True Faulty breathing patterns (shallow chest breathing) can lead to synergistic dominance of secondary breathing muscles. True The autonomic nervous system's response to sustained pressure increases global muscle tonus as well as f luid dynamics to increase viscosity and the tonus of the smooth muscle cells located in fascia. True Increasing sympathetic tone reduces the prolonged faulty contraction of muscle tissue that can lead to the cumulative injury cycle. False Individuals who have never performed self-myofascial release should begin by using a dense and rigid roller (such as a PVC roller) because it offers increased penetration into the soft tissue. False 32 Progression when using balls as a self-myofascial release tool should be made by beginning with a large diameter ball (i.e., medicine ball), then going to a smaller diameter, firmer ball (i.e., tennis ball, soft ball, baseball, golf ball). True True At the current time, there are no known reasons that self-myofascial release cannot be performed on a daily basis. Individuals performing self-myofascial release should hold the foam roller on a tender area for roughly 30 seconds at high intensity (maximal pain tolerance) and 90 seconds for lower intensity (minimum pain tolerance) before moving to the next region. True Precautionary measures do not apply for self-myofascial release techniques, and it is considered safe for all populations including people with organ failure, bleeding disorders, cancer, and contagious skin conditions. False Gastrocnemius Peroneals Thoracic spine Latissimus dorsi Piriformis Quadriceps Adductors What is the primary muscle being addressed in the image below? What is the primary muscle being addressed in the image below? What is the primary region being addressed in the image below? What is the primary muscle being addressed in the image below? What is the primary muscle being addressed in the image below? What is the primary muscle(s) being addressed in the image below? What is the primary muscle(s) being addressed in the image below? 33 Hamstring complex What is the primary muscle(s) being addressed in the image below? NMS piriformis What neuromuscular stretch (NMS) is being demonstrated in the image below? NMS adductor complex (straight knee) in the image below? NMS hip flexor complex What neuromuscular stretch (NMS) is being demonstrated What neuromuscular stretch (NMS) is being demonstrated in the image below? NMS hamstring complex below? What neuromuscular stretch (NMS) is being demonstrated in the image NMS gastrocnemius/soleus complex the image below? What neuromuscular stretch (NMS) is being demonstrated in The ability of the neuromuscular system to allow optimal levels of motor unit recruitment and synchronization within a muscle. Intramuscular coordination Th e progressive activation of a muscle by successive recruitment of contractile units (motor units) to accomplish increasing gradations of contractile strength. Motor unit activation 1.The process by which neural impulses that sense tension are greater than the impulses that cause muscles to contract, providing an inhibitory effect to the muscle spindles. 2. Inhibition of the musce spindle resulting from the Golgi tendon organ stimulation. Autogenic inhibition A feedback circuit that can decrease the excitability of motor neurons via the interneuron called the Renshaw cell. Recurrent inhibition A muscle contraction in response to stretching within the muscle. Stretch reflex 34 True The second phase in the Corrective Exercise Continuum is to lengthen overactive or tight neuromyofascial tissues. True The ability of an individual to perform static stretching without assistance and the slow minimal to no motion required has led this form of flexibility training to be associated with the lowest risk for injury during the stretching routine and deemed the safest to use. True Neurologically, static stretching of neuromyofascial tissue to the end range of motion appears to decrease motor neuron excitability, possibly through the inhibitory effects from the Golgi tendon organs (autogenic inhibition) as well as possible contribution from the Renshaw recurrent loop (recurrent inhibition). True Mechanically, static stretching appears to affect the viscoelastic component of neuromyofascial tissue, decreasing the passive resistance a muscle has to a stretch force throughout most of the range of motion. False In general, it is thought that static stretching for 5 to 10 seconds causes an acute viscoelastic stress relaxation response, allowing for an immediate increase in range of motion. True Increasing musculotendinous flexibility through stretching will lead to a decrease muscle energy absorption and trauma to muscle fibers with a decrease in injury risk being the potential result. True Decreasing muscle stiff ness through stretching will decrease the work required to perform a particular activity and potentially increase overall performance. True Stretching exercises are primarily used to increase the available range of motion (ROM) at a particular joint, specifically if the ROM at that joint is limited by tight neuromyofascial tissues. False The scientific literature does not support the use of stretching exercises to achieve increased joint range of motion. 35 False Several researchers suggest that each joint and muscle group may respond similarly to stretching protocols; thus stretching protocols may not need to be different for each range of motion (ROM) limitation found. True A tight or shortened hip flexor group may create an anterior pelvic tilt, causing the hamstring complex to be lengthened under normal resting positions, which may inhibit normal hip flexion range of motion. True Reviews of the best available research suggest that, acutely, stretching may have a detrimental effect on muscular strength and power. False The current evidence suggests that acute pre-exercise stretching has a significant impact on injury risk although the effects of chronic, long-term stretching protocols tend to lead to increased injury rates. True Recent research suggests that range of motion (ROM) can be improved via the application of heat or ice (either heating or cooling the tissue), suggesting that warming-up of tissues is not necessary to improve ROM. True There is moderate evidence to indicate that regular stretching improves range of motion, strength, and performance, and decreases injury risk in healthy individuals without identified limitations in flexibility. True There is moderate evidence to indicate that acute, pre-exercise stretching performed in isolation decreases strength and performance and does not affect injury risk in healthy individuals without identified limitations in flexibility. True Studies have found that stretching reduces both physiologic (electromyographic) and self reported muscle tension, results in a decreased feeling of sadness, and can decrease the levels of stress related hormones. True Contraindications for applying stretching techniques include osteoporosis, acute rheumatoid arthritis, and acute injury or muscle strain or tear. 36 False In a corrective exercise program, static stretching should only be applied to muscles that have been determined to be underactive, weak, or lengthened during the assessment process. False Most of the current research has demonstrated that neuromuscular stretching is not as effective at increasing range of motion when compared with static stretching. True Neuromuscular stretching is a technique that involves a process of isometrically contracting a desired muscle in a lengthened position to induce a relaxation response on the tissue, allowing it to further elongate. True It is believed that the isometric contraction used during neuromuscular stretching increases motor neuron excitability as a result of stimulation to the muscle spindle and that this leads to an increased resistance to a change in length (or, ability to increase length of tissue). True The premise behind neuromuscular stretching (NMS) is very similar to static stretching; however, NMS usually requires the assistance of another person, and thus it is traditionally used under the supervision of a health and fitness professional. True True (PNF). True Neuromuscular stretching can be performed daily unless otherwise stated. Neuromuscular stretching is commonly called proprioceptive neuromuscular facilitation Neuromuscular stretching involves taking the muscle to its end range of motion (ROM), actively contracting the muscle to be stretched for 5 to 10 seconds, then passively moving the joint to a new end ROM and holding this position for 20 to 30 seconds. True Typically neuromuscular stretching involves the aid of a partner to provide a resistance to the active muscle contraction and passively stretch the joint into the new range of motion.` False Acute static stretching held for at least 30 seconds does appear to decrease muscular strength and power, whereas ballistic or neuromuscular stretching does not have the same effect. 37 True Like static stretching, neuromuscular stretching should only be applied to muscles that have been determined to be overactive or tight during the assessment Gastrocnemius Soleus What is the primary muscle being stretched in the image below? What is the primary muscle being stretched in the image below? Pectoralis major Latissimus dorsi Piriformis Posterior deltoid Biceps femoris Upper trapezius Sternocleidomastoid Levator scapulae NMS piriformis What is the primary muscle being stretched in the image below? What is the primary muscle being stretched in the image below? What is the primary muscle being stretched in the image below? What is the primary muscle being stretched in the image below? What is the primary muscle being stretched in the image below? What is the primary muscle being stretched in the image below? What is the primary muscle being stretched in the image below? What is the primary muscle being stretched in the image below? What neuromuscular stretch (NMS) is being demonstrated in the image below? NMS adductor complex (straight knee) in the image below? What neuromuscular stretch (NMS) is being demonstrated 38 What neuromuscular stretch (NMS) is being demonstrated in the image NMS hip flexor complex below? NMS hamstring complex below? What neuromuscular stretch (NMS) is being demonstrated in the image The ability of the neuromuscular system to allow optimal levels of motor unit recruitment and synchronization within a muscle. Intramuscular coordination The progressive activation of a muscle by successive recruitment of contractile units (motor units) to accomplish increasing gradations of contractile strength. Motor unit activation The synergistic activation of multiple motor units. The frequency at which a motor unit is activated. Synchronization Firing rate The ability of the neuromuscular system to allow all muscles to work together with proper activation and t iming between them. Intermuscular coordination True True Activation refers to the stimulation (or reeducation) of underactive myofascial tissue. The use of multiple joint actions and multiple muscle synergies helps to reestablish neuromuscular control, promoting coordinated movement among the involved muscles. True The eccentric component involved with isolated strengthening has been proven to play a role in the recovery of muscle injury and tendinopathies, and in preparation for integrated training. True Integrated dynamic movement enhances the functional capacity of the human movement system by increasing multiplanar neuromuscular control 39 True" Multi-joint motions versus single-joint motions promote and require greater intermuscular coordination. False Research has shown that the short-term use of unilateral exercises is ineffective at increasing performance measures. True Overhead movements, often used in integrated dynamic movements, help to place increased stress on the core musculature. False Resistance training performed on unstable surfaces may be challenging and should not be considered as an effective mode to improve a clien