REHAB MCQ/SAQ

• PROS of Oxford scale

  Universally used

  Simple

  Inexpensive/free

  Quick

  Sensitivity improved with + and -
• CONS of Oxford scale

  Crude

  Disproportionate distance between grades

  Grade 5 is subjective

  No idea of absolute strength
• ISOTONIC: 'One tension' resistance is not changing throughout the movement but the length of the muscle is always changing
• CONCENTRIC: When a muscle shortens under tension or resistance
• ECCENTRIC: When a muscle lengthens under tension or resistance
• ISOMETRIC: 'One length' - length of muscle is not changing during contraction
• OUTER RANGE: Muscles working in the longest/stretched position in first 1/3 of movement
• MID RANGE: Muscles working between outer and inner range
• INNER RANGE: Muscles working in the shortest/shortened position in the last 1/3 movement
• MUSCLE STRENGTH: is the ability of a muscle to develop maximal contractile force against resistance
• MUSCLE ENDURANCE: The ability of a muscle group to exert submaximal force for an extended period of time
• The key principles of muscle testing state that:

  • Must be specific to the muscle group being tested
  • Must be specific to the type of muscle contraction being performed (isometric, concentric or eccentric)
• Assessing static muscle strength and endurance

  • Handheld dynamometry
  • Grip strength dynamometry
  • V-sit test
  • Side bridge
• Assessing dynamic strength and endurance

  • Estimated 1RM/Multiple RM
  • Multiple repetitions at a set percentage of 1RM
  • Arm curl test (older adults)
  • 30 second chair stand test)
• Intrinsic factors that affect joint ROM

  • Shape of bony surfaces
  • Congruency of bony surfaces
  • Pliability of joint capsule
  • Pliability of ligaments and tendons
  • Pliability of skin
  • Muscle strength
  • Muscle flexibility
• Extrinsic factors that affect joint ROM

  • Age
  • Body segment size
  • Disease (e.g. osteo or rheumatoid arthritis)
  • Injury
  • Overuse
  • Immobilisation or joint disuse
• PROS of goniometry

  • Universally used
  • Inexpensive
  • Joint specific
• CONS of goniometry

  • Accuracy is heavily dependent on assessor experience and skill
  • Relies on ability to identify axis of rotation and bony landmarks
• PROS of V sit and reach and back scratch tests

  • Inexpensive
  • Little equipment required
  • Normative data available
  • Good functional relevance
• CONS of V sit and reach and back scratch tests

  • Not joint specific
  • Can be biased due to limb length (except modified sit and reach)
  • Poor evidence for validity of using sit and reach to assess lower back flexibility and correlation with lower back pain
• Assessing joint ROM

  • Goniometry
  • V-sit and reach
  • Back Scratch test
• Cardiorespiratory fitness can be defined as the ability of the circulatory system and respiratory systems to supply oxygen to skeletal muscles during sustained physical activity
• What is the criterion measure of cardiorespiratory fitness?

  Maximum oxygen uptake (VO2 Max)
• VO2 can be expressed in two ways:

  1. Absolute terms: milliliters of oxygen per minute (ml.min-1)
  2. Relative terms: milliliters of oxygen per minute per body weight (ml.kg-1.min-1) - most commonly reported
• Other than ml.kg-1.min-1 what other unit of measurement can VO2 be expressed in?

  METS (Metabolic equivalents), 1 MET = 3.5ml.kg-1.min-1
• Assessing cardiorespiratory fitness

  SINGLE STAGE:

  • 6 Minute walk test

  GRADED:

  • Incremental shuttle walk test
  • Chester step test
• Why are you not allowed to walk next to the patient during the 6 minute walk test?

  Single stage tests are meant to be self paced, and you may have an impact on the speed the patient walks at and thus it would no longer be self paced
• What patient groups do you think would be most appropriate to assess using the 6 minute walk test?

  Patients who may need to sit and rest during the test
• Is the incremental shuttle walk test a maximal or submaximal test?

  Submaximal
• Why might you choose to use the incremental shuttle walk test over the 6 minute walk test?

  • Provide external pacing
  • Result in slow increase in physiological responses
  • Provide more accurate estimates of exercise capacity
  • Avoids patients starting at a workload greater than their maximal capacity
• Is the Chester step test a direct or indirect measure of cardiorespiratory fitness?

  Indirect because it predicts VO2 max
• What is the limitation of the Chester step test compared to the criterion method of a VO2 Max test?

  You are estimating there is a risk of error (over or under estimate)
• What are the 3 main types of stretching that can be prescribed?

  1. Static stretching
  2. Ballistic stretching
  3. Proprioceptive neuromuscular facilitation (PNF)
• What are the two types of static stretch?

  1. Active (force of stretch is produced by the opposing muscle group)
  2. Passive (force of stretch is reliant on an external force)
• Proprioceptive Neuromuscular Facilitation (PNF) typically involves an isometric contraction of a muscle tendon group followed by static stretching of the same group
• Static stretching is slow sustained muscle lengthening to increase ROM - can be active or passive
• Ballistic stretching uses bouncing movements to lengthen target muscles and increase range of motion.
• Range of movement is the extent of osteokinematic motion available for movement activites
• Joint flexibility is the ability of a joint to move through an unrestricted, pain free range of movement
• Physical activity is any bodily movement produced by the skeletal muscles that results in energy expenditure above resting