Taping for weak muscle support uses what taping procedure?
FOI (Function Origin to Insertion)
TQ
Know how to apply this to scenario
Taping for overuse/inflammation uses what taping procedure?
RIO (Relaxation Insertion to Origin)
TQ
Know how to apply this to scenario
Your patient has CMP and you found that vastus medialis has delayed firing causing the patella not to track correctly. How would you use light elastic taping to correct this issue?
FOI Origin to insertion on the vastus medialis
How much stretch is added to kinesio taping when taping O to I.
15% of the full 40%
This is in the manual, but not really sure if it is consistent with the rest of the manual
How much stretch is added to kinesio taping when taping I to O.
5-10% of full 40%
This is in the manual, but not really sure if it is consistent with the rest of the manual
When taping, the patient's skin must be free of oils and must be dry. T/F?
True
According to Dr. Bob, how many degrees does the scapula rotate for every 2 degrees of arm abduction?
1 degree
Areas needing to be braced should only be immobilized for short periods... days. T/F?
True
No cervical support, including the skeletal fixed "halo" appliance can totally restrict all cervical motion. T/F?
True
TQ
Soft collars do little except serve as a placebo or as a reminder to limit motion. T/F?
True
TQ
Philadelphia collar is a more effective collar by placing more weight on the shoulders. T/F?
True
TQ
How many minutes do you wait in between each plyometric set?
5-10 min
In a clap pushup, at one point does the amortization phase of the stretch-shortening cycle take place?
When the chest touches the ground
Know how to calculate target heart rate using the Karvonen Method
HR(max) = 220-age
HR(reserve) = HR(max) - HR(resting)
HR(target) = (HR(reserve) x intensity) + HR (resting)
Pg. 131 manual
11/25 vodcast
TQ
Know YMCA 3-Minute Bench Step Test
1. Patient steps up and down on a 12 inch bench
2. 3 minute test at 24 steps per minute
3. Take HR within 5 seconds of completing task
4. Compare HR to chart for fitness level
Pg. 132 manual
11/25 Vodcast
TQ
Postural muscles tend toward _____ (overuse/disuse) and eventual (weakness/shortening).
Overuse; shortening
Phasic muscles tend toward (overuse/disuse) and eventual (weakness/shortening).
Disuse; weakness
Functional testing:
One leg standing
Look for what?
Patient touching raised foot to ground, movement of stance foot, reaches out to balance. Observe hip leveling, ankle wobble, internal or external rotation of the foot or varus or valgus stress of the knee. Should be able to hold posture for 20 seconds.
Functional testing:
One Leg Standing
Purpose?
Assessment of ankle proprioception, gluteus medius coordination, and vestibulosensory input. Gives an overall picture of posture
Functional testing:
Squat Strength/Coordination
Purpose?
Progressive endurance of quadriceps and gluteal
Functional testing:
Squat Strength/Coordination
Look for what?
Heel rising indicative of hypertonicity of soleus, varus or valgus stress to knee, and increased lumbar lordosis. Should be able to perform 50 reps.
Functional testing:
Hip Extension
Purpose?
Checks balance of hip extensors
Functional testing:
Hip Extension
Look for what?
Hyperextended lumbars in first 10 degrees indicates possible overloading of lumbar facets due to hyperactive erector spinae or psoas. Strong contractions of T/L musculature indicate weak hip extensors. Excessive knee flexion indicates hamstrings substitut
Functional testing:
Hip Abduction
Purpose?
Assesses gluteus medius (inhibition), quadratus lumborum, hip adductors, and TFL (overactive)
Functional testing:
Hip Abduction
Look for what?
Hip hiking indicates hyperactive quadratus lumborum. Trunk rotation indicates weak gluteus medius. External rotation of the leg indicates hyperactive piriformis and flexion of the hip indicates hyperactive TFL.
Functional testing:
Trunk Flexion
Purpose?
Spinal stability during abdominal training. Relates to low back and neck strain potential.
Functional testing:
Trunk Flexion
Look for what?
Heels rising off table or hyperextension of the lumbar spine indicates overactive iliopsoas and thoraco/lumbar paraspinals or weak rectus abdominus.
Functional testing:
Dynamic Trunk Flexor
Purpose?
Strength of trunk flexors
Functional testing:
Dynamic Trunk Flexor
Look for what?
50 repetitions
Functional testing:
Sorenson's Test (Static Back Extensors Endurance)
Purpose?
Assesses static endurance of multifidus, gluteals, erector spinae, and hamstrings. Predictive of reoccurence of back pain and first time pain in healthy adults
Functional testing:
Sorenson's Test (Static Back Extensors Endurance)
Look for what?
Ability to hold position for 1 minute
Know Owestry Stuff
Developed in 1980; Good test-retest reliability; Check other stuff on this
Know the tests from the assessment powerpoint
Check blackboard
Minorities, immigrants, and low income population are more likely to not return to work after workman's comp. T/F?
True
What are the four major physiological effects of kinesio taping?
1. Relieves pain or abnormal feeling on the skin and muscles
2. Supports the muscle in movement (expanding effects)
3. Removes congestion of lymphatic fluid or hemorrhages under the skin
4. Corrects misalignment of the joint
Your patient is having difficulty in extending their right shoulder and you find that elbow extension is also compromised. What muscle would you tape and please give specific locations of tape?
Biceps is hypertonic so you would tape it across both the elbow and shoulder joint.
Biceps crosses both joints so in this example is is hypertonic
Taping for a patella tracking disorder in which a more medial track to the patella is desired is:
a) Mechanical correction
b) Fascia correction
c) Space correction
d) Ligament correction
e) Functional correction
f) Lymphatic correction
a) Mechanical correction
Tape is applied with a 20 to 25% stretch; tails are laid down with paper off tension; joint may be moved during tail application to make the correction more functional describes:
a) Mechanical correction
b) Fascia correction
c) Space correction
d) Ligamen
a) Mechanical correction
Which type of taping correction is commonly used to treat lateral epicondylitis:
a) Mechanical correction
b) Fascia correction
c) Space correction
d) Ligament correction
e) Functional correction
f) Lymphatic correction
b) Fascia correction
Y-cut is used with paper off tension on the base and 15 to 20% tension on the tails; the tails are oscillated during application with mild downward pressure describes:
a) Mechanical correction
b) Fascia correction
c) Space correction
d) Ligament correctio
b) Fascia correction
This type of taping is used to create an area of decreased pressure under the stretched portion of the tape, reducing edema, and it is useful over areas of acute spasm and trigger points:
a) Mechanical correction
b) Fascia correction
c) Space correction
d
c) Space correction
Tape is applied with 20 to 25% tension middle of tape with the ends laid down with paper off tension; "band-aid" type application; star pattern may also be used in very acute areas for maximum correction describes:
a) Mechanical correction
b) Fascia corre
c) Space correction
This type of taping is commonly used in ACL insufficiencies:
a) Mechanical correction
b) Fascia correction
c) Space correction
d) Ligament correction
e) Functional correction
f) Lymphatic correction
d) Ligament correction
Similar to space correction strip application except that 75 to 100% tension is applied to center portion of tape; tails are laid down with no tension; active movement of the joint is usually done while laying down the tails describes:
a) Mechanical corre
d) Ligament correction
This type of taping is used to support and aid in muscle concentric contraction and is commonly used in cases such as elbow hyperextension and hamstring sprain/strains:
a) Mechanical correction
b) Fascia correction
c) Space correction
d) Ligament correcti
e) Functional correction
Bowstring" type of application; tape ends are applied 5 to 6 inches above and below the flexed affected joint; joint is then extended whil tape is laid down describes:
a) Mechanical correction
b) Fascia correction
c) Space correction
d) Ligament correcti
e) Functional correction
This type of taping is used to drain areas of edema up the lymphatic chain:
a) Mechanical correction
b) Fascia correction
c) Space correction
d) Ligament correction
e) Functional correction
f) Lymphatic correction
f) Lymphatic correction
Obviously.
What is the progression of taping for shoulder impingement?
1. Eccentric middle deltoid
2. Eccentric anterior deltoid
3. Eccentric posterior deltoid
4. Eccentric upper trap with head in lateral flexion
5. Eccentric upper trap w/ head in lateral flexion and chin turned away
2 degrees of abduction = ____ degrees of scapular motion
1 degree
Bleached tape is more effective than non-bleached tape. T/F?
False.
Both are equally effective
When applying tape, strips should overlap previous strip by ____ inch to ____ inches
1/3 to 1/2
When applying non-elastic tape, wrap ____ (proximal/distal) to ____ (proximal/distal)
Distal; proximal
When applying tape, place the muscle in a position of maximum ____ (contraction/relaxation).
Contraction
Generally speaking, begin taping ______ (medially/laterally).
Medially
When applying tape, skin temperature should be _____ (equal/slightly different) to un-taped side above and below taping.
Equal
Lumbo-sacral brace support is very effective for sacro-iliac strain. True or false?
False
What are the characteristics of a good lumbo-sacral support?
1. Steel stays to reduce lumbar lordosis
2. Support should extend from sacrum to the mid-thoracic spine
3. Should extend to provide abdominal lift to keep viscera within the pelvic basin
Bracing is at least equally effective as taping. True or false?
True. Most studies have shown bracing is slightly better than taping
So... why do we tape?
What is the equation for power?
Force x Speed = Power
What are the 3 phases of the stretch-shortening cycle?
1. Eccentric
2. Amortization
3. Concentric
How much rest should you get between plyometric sessions?
48-72 hours
Target HR using Percentage of HR(max) Method
HR(max) = 220 - age
HR(target) = (HR(max) x Intensity)
HR(recovery) = .6 x HR(max)
Only ____% of diagnoses are structural in nature
20%
Williams states that normal posture is with knees bent and torso slightly bent forward. T/F?
True
Match the Pain Syndrome: Postural Syndrome
a) End range stress of normal structures
b) End range stress leading to contracted or adherent structures
c) Anatomical disruption or displacement of structure "herniated disc
a) End range stress of normal structures
Match the Pain Syndrome: Dysfunction
a) End range stress of normal structures
b) End range stress leading to contracted or adherent structures
c) Anatomical disruption or displacement of structure "herniated disc
b) End range stress leading to contracted or adherent structures
Match the Pain Syndrome: Derangement
a) End range stress of normal structures
b) End range stress leading to contracted or adherent structures
c) Anatomical disruption or displacement of structure "herniated disc
c) Anatomical disruption or displacement of structure "herniated disc
As time goes on, a patient is less likely to go back to work after an injury. T/F?
True
Which assessment is the gold standard in pain assessment?
McGill Pain Questionnaire
What is the Karvonen method of target heart rate?
HR(max) = 220 - age
HR(reserve) = HR(max) - HR(resting)
HR(target) = (HR(reserve) x Intensity) + HR(resting)
What are the four major physiological effects of kinesio taping?
1. Relieves pain
2. supports mm in movement
3. removes congestion of lymph fluid,
4. corrects misalignment of joint
To provide support to a weak muscle and increase its function, how do you apply kinesio tape?
Origin to Insertion
To provide support to an overused, inflamed muscle and increase its relaxation, how do you apply kinesio tape?
Insertion to Origin
T/F: Y cut is used to treat edema
FALSE
How much of a stretch and what type of pressure is used in applying kinesio tape?
Tape is applied with a 20-25% stretch and a downward pressure in the direction of the desired correction.
How are the tails laid down for mechanical correction?
Tails are laid down with a paper off tension
Which tape is used for fascia correction? How are the base and tails laid down?
Y-cut is used with paper off tension on the base and 15-20% tension on tails
(The desired result is fascial lengthening)
How is kinesio tape laid down for functional correction?
Bowstring" type of application. Tape ends are applied 5-6 inches above and below the flexed affected joint
(Used to support and aid in concentric muscle contraction)
What are the five purposes of general taping?
a. Immediate first aid, used to limit excessive joint movement
b. Allows for pain free functional movement
c. Allows early resumption of activity
d. Used during rehabilitation to reduce risk of injury
e. Secures protective pads and ice applications
What should you do before and after taping?
Check pulse distal to tape before & after taping
Which tape is easier to apply?
Elastic tape is easier to apply than non-elastic tape
How does non-elastic tape support the joint?
Supports joint by resisting excessive motion
Why would you choose to use porous non-elastic kinesio tape instead of non-porous?
Porous allows for heat and sweat to pass to keep cool
Non-porous increases chance for damage to underlying skin due to build up of heat and moisture
Why would you choose bleached or non-bleached?
o May be bleached or non-bleached, both equally effective
What is the disadvantage of non-elastic tape?
o Non-Elastic tape is more difficult to apply and has greater potentials for wrinkles with resultant increased chance for blisters and cuts
When applying wraps, how much should each strip overlap the one underneath it?
Strips should overlap previous strip by 1/3 - �
How should the muscle be positioned while wrapping?
Place muscle in maximum contraction when wrapping or taping
How do you avoid wrinkles?
Smooth tape with application to avoid wrinkles
What are the three contraindications to bracing?
� When bracing promotes muscular weakness or atrophy
� When bracing promotes adhesions on fibrotic infiltration
� When bracing produces congestion, ischemia, vascular stasis or neuro compromise
Do cervical supports completely restrict neck motion?
No cervical support, including the skeletal fixed "halo" appliance can totally restrict all cervical motion
What are soft collars used for?
� Soft collards do little except serve as a placebo or reminder to limit motion
What is the ideal collar and why?
� Philadelphia collar is more effective by placing more weight on shoulders
T/F: The "Philadelphia collar" does little except serve as a placebo or as a reminder to limit motion
False
What are the three phases of the stretch-shortening cycle (SSC)?
1.) Eccentric
2.) Amortization
3.) Concentric
How is recovery done with plyometric exercise (power-building)?
o 1:5, or 1:10
For every minute you work out, you must rest 5-10 minutes before next activity
What is the Volume (points of contact/amitorization phase) for an entire plyometric workout for a beginner?
80-100 points of contact per workout
Define aerobics.
� Aerobic exercise is a vigorous exercise that results in a rise in oxygen consumption (from 50-85% of max) and heart rate (from 60-90% of max) and maintains this level for at least 15-20 minutes.
What does aerobic exercise refer to?
� Aerobic exercise refers to cyclic movements caused by contraction of large muscle masses relying on aerobic energy pathways
You have a 20 yoa female patient with a resting HR of 60 bpm and a 75% max. Use the Karvoren Method to calculate her target rate.
You have a 20 yoa female patient with a resting HR of 60 bpm and a 75% max
o 220 bpm (know to start with this) - 20 (yoa) = 200 bpm (max hr)
o 200 - 60 bpm (resting hr) = 140
o 140 x .75 (% max) = 105
o 105 + 60 (resting hr) = 165 Target HR Final Answer!
How do you do an Aerobic Evaluation using the YMCA 3-Minute Bench Step Test?
� Patient continually steps up and down on a 12 inch bench
� 3 minute test at 24 steps per minute
� Within 5 seconds of completing task take recovery heart rate for 1 minute
� Compare heart rate to chart for fitness level
What is the deal with postural muscles and upper/lower crossed syndrome?
Postural muscles - often overused and result in eventual shortening
What are the weak muscles (underuse) in Lower Cross Syndrome?
i. Glut Max (pelvic tilt)
ii. Abdominals (protruding abdomen)
iii. Glut Medius
What are the shortened Muscles (overuse) in Lower Cross Syndrome?
i. Hip flexors
ii. Erector spinae (Hyperlordosis)
iii. TFL & QL
In Lower Crossed Syndrome, which muscles cause these symptoms...
Lumbar Hyperlordosis =
Shortened erector spinae
Anterior Pelvic Tilt =
Weak Gluteus Maximus
Protruding Abdomen =
Weak Abdominals
Foot Turned Out =
Shortened Piriformis
Groove in Iliotibial Band =
Shortened TFL
Lower Cross Imbalances...
Weak Glute Max
and Short Hip flexors
Weak abdominals
and short erector spinae
Weak Glute medius
and short TFL and QL
What are the three functional tests for Lower Crossed Syndrome?
a. One Leg Standing - Assessment of ankle, proprioception, glut medius coordination, vestibular input, gives overall picture of posture
b. Dynamic Trunk Flexor - Strength of trunk flexors
c. Static Back Extensor - Assesses static endurance of multifidus,
What are the three functional tests for Lower Crossed Syndrome?
...
What are the benefits of the McGill Pain Questionanaire?
a. Developed by Melznack in 1975
b. High test-retest reliability
c. Distinguishes sensory and effective domains of pain
d. Easy to administer and score 15 mins
e. Short form now available
f. "Gold Standard" in pain assessment
What are the benefits of the Owestry Low Back Pain Index?
a. Good test-retest reliability
b. Good correlation between high Oswestry scores and abnormal muscle function
What are the benefits of the Rowland Morris Scale?
a. Good test-retest reliability
b. One study found it to be superior to the Owestry index in determining levels of improvements
What are the benefits of Pain Drawing?
a. High test-retest reliability
b. High pain drawing scores correlate well with elevated hysteria and hypochondriasis scores on the Minnesota Multiphasic Personality Index (MMPI), greater chronicity, higher hospitalization rates and higher MPQ scores
What causes Muscle Soreness (DOMS), when and how do you delay it?
a. Appears 24-48 hours after strenuous exercise
b. Due to microscopic tears in the muscle fibers resulting in inflammatory response.
c. To delay DOMS: minimize eccentric contractions early in exercise, start at a low intensity and progress slowly
What are Williams' exercises based upon?
premise is that the cause of most back pain is acquired by walking upright and straight position
What does Williams consider to be normal posture?
Normal posture is with knees bent & torso slightly bent forward
How does Williams treat acute episodes?
Use flat footed squat, 15-20 bounces, stand up and repeat 3x. Repeat every 2 hours for 1-2 days.
What are McKenzie exercises?
spinal assessment and therapy based on dynamic & static loading
What are the three pain syndromes according to McKenzie?
a. Postural - end range stress of normal structures
b. Dysfunction - end range stresses leading to contracted or adherent structures
c. Derangement - anatomical disruption or displacement of structure "Herniated disc
What are the three characteristics of the postural pain syndrome?
i. Intermittent pain
ii. Develops over time d/t sustained end range position
iii. No deformity, no loss of movement, no pain with repeated movements
This picture was TQ'd for Upper Cross Syndome: