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NBCE PT Boards
Depth of UV - ANS superficial 1-2 mm (skin) Depth of Infrared - ANS superficial 8-10 mm (vascular) Depth of Microwave Diathermy - ANS deep Depth of Shortwave Diathermy - ANS deep Depth of Ultrasound - ANS deepest! 4-8 cm Best Modality for Herpes Zoster - ANS UV and ultrasound Best modality for Diabetes Mellitus - ANS Infrared If open growth centers, do NOT use what modalities? (3) - ANS Shortwave Diathermy Microwave Diathermy Ultrasound Goggles are required for what modalities? (3) - ANS UV Microwave Diathermy (wire-mesh)
Laser Which electrical modalities are direct current? (3) - ANS Low-Volt Galvanic High Volt Microcurrent What current is unidirectional and monophasic? - ANS Direct Current What electrical modalities are alternating current? (3) - ANS Sine wave Faradic Interferential What current is bidirectional and biphasic? - ANS Alternating Current What electrical modality is both alternating and direct current? - ANS TENS To avoid transcerebral and transthoracic, how do you place the pads? - ANS Co-planar (TMJ) Which electrical modality do you use iontophoresis? - ANS LVG What solution do you use to break adhesions when doing iontophoresis? - ANS Potassium Iodine (KI) (- pole) What solution do you use for bursitis when doing iontophoresis? - ANS Sodium Salicylate
Which electrical modalities can be used for pain control? (3) - ANS High Volt Interferential TENS Which modality is both an antibacterial and antifungal? - ANS UV If your patient has Scheuermann's Disease, what type of exercises should NOT be performed? - ANS FLEXION or Williams If you patient has facet syndrome, what type of exercises should NOT be performed? - ANS EXTENSION or McKenzie What device should you use for active recovery for an ankle? - ANS Wobble Board What is inhibited in lower cross syndrome? - ANS Glutes T/F: You should strengthen the low back in acute low back patients. - ANS False If your patient is having toe out problems, what muscle is affected? - ANS Piriformis If you increase aerobic exercise, what happens to mitochondria activity? - ANS It increases as well What is the action of the subscapularis muscle? - ANS Assists in medial rotation of the shoulder What type of stretching do you hold and then stretch? - ANS PNF or Proprioceptive Neuromuscular Facilitation
What is the treatment technique for an upper motor neuron lesion called? - ANS Bobath's To be considered aerobic exercise, how long must an individual maintain their target heart rate? - ANS 15-20 minutes Aerobic exercise refers to cyclic movements caused by the contraction of what? - ANS Large muscle masses relying on aerobic energy pathways What are the heart rate percentage ranges and give an example patient for each. - ANS .6 = sedentary / post MI .75 = average Joe / weekend warrior .9 = triathlete What is the target heart rate equation? - ANS ((220-age)-Resting HR)*%+Resting HR Williams believed that the cause of low back pain was acquired how? - ANS By walking upright in a straight position -he stated that normal posture is with knees bent and torso slightly bent forward Williams believed that all activities should be geared to reducing what? - ANS Lumbar lordosis Williams exercises are what kind of exercises? - ANS FLEXION What muscles are weak and what muscles are tight according to the Williams approach? - ANS WEAK Abs WEAK Glute max
What are the 3 phases of the stretch shortening cycle? - ANS Eccentric Amortization Concentric Acute care management takes place when? - ANS first 4 weeks What are the symptoms of an acute issue? (4) - ANS Rubor (Redness) Calor (Heat) Dolor (Pain) Tumor (Swelling) What modalities are used in acute care management? - ANS Cryotherapy Low Volt Galvanic (+ pole) Pulsed US (takes away thermal component) How is a muscle stretched? - ANS By going opposite of it's action When does recover care management begin? - ANS After four weeks When should you start active care stretching? - ANS During recovery care What modalities are used in recovery care management? - ANS mild heat--Infrared, hydroculator pack, hot bath When does the chronic/rehab phase begin? - ANS After 12 weeks
What do you want to do during the chronic/rehab phase? - ANS Strengthen muscles (resistance against action) Exercises where the hand or foot is free to move - ANS Open Chain Exercises Exercises where the hand or foot is fixed and cannot move - ANS Closed Chain Exercises What are some examples of open chain exercises? (4) - ANS Bench press biceps curl leg extensions straight leg raises What are some examples of closed chain exercises? (5) - ANS Push-ups HSPU Pull-ups Squats Lunges What kind of exercise should you do on someone with a knee injury? - ANS Leg Extensions TOE OUT Why? because weak VMO, lateral tracking patella and chondromalacia patella What kind of exercises should you use with Lower Crossed Syndrome? - ANS WILLIAMS What muscles are tight and weak with Lower Crossed Syndrome? - ANS TIGHT Iliopsoas TIGHT Erector Spinae
What are the four main postural issues associated with lower crossed syndrome? - ANS Anterior rotation of the pelvis (stretch iliopsoas) Increased lumbar lordosis (Williams flexion) Hips in flexion (stretch iliopsoas- McKenzie) Knees may be hyperextended (genu recuvatum) Action of the Iliopsoas - ANS Flexes hip joint Action of the Rectus Femoris - ANS Flexes the hip joint Quadriceps extends the knee joint Action of the TFL - ANS Abducts, flexes and medially rotates hip joint Action of erector spinae - ANS Extension of vertebral column Action of gastrocnemius - ANS Plantar flexes ankle and assists in knee flexion Action of soleus - ANS Plantar flexes ankle Weak/Inhibited muscles in lower crossed syndrome - ANS STRENGTHEN THESE (resistance against action) Rectus Abdominis : crunches (williams) Oblique : crunches (williams)
Gluteus Maximus : pelvic rock (williams) Gluteus Medius : side lying ABduction Hamstrings : stretch AND strengthen Common injuries due to weak muscles associated with lower crossed syndrome - ANS Low back pain Knee pain Hamstring strains Action of rectus abdominis - ANS Flexes vertebral column Action of obliques - ANS Bilaterally: flex vertebral column Unilaterally: rotate vertebral column Action of gluteus maximus - ANS Extends and laterally rotates hip Action of gluteus medius - ANS ABducts hip joint Action of semitendinosus/semimembranosus - ANS Flexes and medially rotates knee, extends and medially rotates hip Action of biceps femoris - ANS Flex and laterally rotates knee; extends and laterally rotates hip Action of tibialis anterior - ANS DORSIflex and INvert Action of tibialis posterior - ANS PLANTARflex and INvert
Action of latissimus dorsi - ANS Internal rotation, ADDuction, and extension of shoulder Action of SCM, Scalenes, and Rectus capitis anterior - ANS Bilaterally: Flexion of head Unilaterally: Rotation of head Long, Weak/Inhibited Muscles with Upper Crossed Syndrome - ANS STRENGTHEN THESE Rhomboids Lower Trapezius/serratus anterior : Rows Posterior deltoid : Flys Teres Minor, Infraspinatus, Posterior deltoid Longus colli Impingement syndrome - ANS Teres major is too TIGHT--> stretch Teres minor is too WEAK-->strengthen Action of rhomboids - ANS ADDuct and elevate scapula Action of lower trapezius - ANS ADDuction, depression and lateral rotation of scapula Action of serratus anterior - ANS ABDucts scapula Action of teres minor - ANS EXTERNAL rotation Action of posterior deltoid - ANS ABDuction of shoulder joint
Action of infraspinatus - ANS External rotation of the shoulder Action of longus colli - ANS Bilaterally: flexion Unilaterally: rotation Rotator Cuff Muscles - ANS Supraspinatus Infraspinatus - can't isolate bc both externally rotate Teres minor - can't isolate bc both externally rotate Subscapularis Contraction where length doesn't change; no joint movement; not very efficient - ANS Isometric Contraction where weight/resistance stays the same; change in length and joint movement present - ANS Isotonic Contraction where muscles changes in length while a constant resistance is applied at a constant speed - ANS Isokinetic ex. CYBEX machine What kind of contraction should you use anytime there is a pathology? (brace, cast, etc.) - ANS Isometric What kind of contraction is weightlifting? - ANS Isotonic (eccentric and concentric) Concentric - ANS Shortening of the muscle
done with arm hanging over chair FOR: frozen shoulder (adhesive capsulitis) and RTC rehab start passive, making circles--> active with help aBDuction--> active full ROM - ANS Corman's Exercises AKA Pendular Exercises Typical weightlifting 3 sets of 10 reps - ANS DeLorme's Exercises for pregnant females, and patients with urinary incontinence - ANS Kegel Pelvic Floor Exercises Mental imagery stress exercises to relax muscles done in biofeedback labs uses galvanic skin temp device (lie detector machine) measures stress - ANS Jacobson's Exercises Crawling exercises to mobilize the spine and exercise muscles in scoliosis (cross-crawl) - ANS Clayton's Exercises Ataxic motion and to develop coordination (wobble board) rocker-->wobble-->wobble with vibratory platform - ANS Frenkel's Exercises
Dead Bug exercise - ANS Supine Strengthens core Superman exercise - ANS Prone Strengthens core Bridge Exercise - ANS Supine strengthens glute max Planks - ANS Prone strengthens core Side Planks - ANS Strengthens QL Side to side glide - ANS Strengthens glute med Knee Extension Toes Out - ANS Strengthens VMO Wall Angel - ANS Strengthens rhomboids Brace used for thoracic scoliosis; worn 23 hours/day For scoliosis between 20-40º - ANS Milwaukee brace <20º scoliosis= monitor and exercise
40º scoliosis= surgery
- Encapsulated swellings (ex. Herpes simplex and non-draining sinusitis)
- Late stages of diabetes mellitus Contraindications to ELECTRICAL modalities (7) - ANS 1. Pacemaker
- Low back and abdomen during pregnancy
- Decreased sensation (LVG only)
- Brain = transcerebral
- Eyes
- Heart = transthoracic
- Carotid sinuses Systematic Approach - ANS 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 Dosage time - ANS 95% are run for 20 min
the exceptions- US - max treatment time is 10 min UV - max treatment time is 3 min What is the frequency of IF? - ANS 2,000-10, medium frequency Action of Massage - ANS Mechanical (kinetic and friction) Greatest effect on the vascular system (not good for patients with vascular compromise) General indications for modalities - ANS Musculoskeletal -itis' NOT osteomyelitis or uveitis... these are infections! Physiological Effects of Massage - ANS Increases: Blood and lymph flow HR and BP Breaks adhesions - transverse friction Removes lactic acid Decreases: Edema
