Physics is the natural science that studies matter, its motion and behavior through space and time, and the related entities of energy and force.
You Think You Know Everything About Physics? This Quiz Will Prove You Wrong
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Elite athlete
typical untrained client
client with emphysema
Client with cystic fibrosis
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patients with asthma
patients with COPD
patients with emphysema
all of these patients
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Sp02 < 90%
RR: 19 breaths/min
BP: 130/80
HR: 65
Cystic fibrosis
Pulmonary fibrosis
Musculoskeletal deformities
Pneumothorax
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6 minute walk test
2 minute walk test
Dynamic Gait Index
Borg RPE training range and teach Pt. to self pace
Timed sit to stand
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2 minute tests are less metabolically taxing
Safer for patients with balance and gait dysfunction
6 minute tests are a functionally appropriate assessment of baseline aerobic capacity
These steady state tests assess different aspects of objective exercise intolerance
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220 - age
HR / 90% VO2 max
(VO2 max * 1000)/weight
(15 * max HR)/Resting HR
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Energy
Creatine
Pyruvate
Glycogen
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Anaerobic respiration, CP, aerobic respiration
Aerobic respiration, CP, anaerobic respiration
CP, anaerobic respiration, aerobic respiration
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ATP is used to get cross bridges to bind to actin
ATP is used to get cross bridges to disconnect from actin
ATP is used to get the troponin-tropomyosin complex to move in such a manner to expose the binding site.
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Glycolysis
Aerobic respiration
Anaerobic respiration
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Volume of one breath, or the amount of air moved into and out of the lungs during quiet breathing
Amount of air moved into the lungs during a forced inspiration (beyond tidal inspiration)
Volume remaining after a normal, passive, exhalation.
Amount of air moved out of lungs during forced expiration (beyond tidal expiration)
The volume of air in the lungs upon the maximum effort of inspiration.
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Strengthen accessory respiratory muscles
Increase UE strength for improve ADLs
Increase occurrence of dyspnea
None of the above would occur as the patient should engage in supported UE resistance exercise, not unsupported.
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Mini squats at the counter
Biphosphonates
Abdominal crunches in supine
Whole body vibration exercises
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Behavioral changes
Hemiparesis
Fluent aphasia
Coordination dysfunction
All of the above
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Specificity principle
Motor retraining
Neuroplasticity
The unaffected arm inhibits the affected arm from performing
All of the above.
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The Mt. Everest athlete wins because everybody knows that when you train at high altitudes you always win because your muscles have been trained with low oxygen and now there is a ton of oxygen at sea level.
The Mt. Everest athlete loses because his blood is too viscous from increased hemoglobin and hematocrit after having lived in elevation for that long and the blood cannot circulate fast enough to provide energy to his muscles.
The Mt. Everest athlete loses because the air was so thin, lacking density and resistance, at Mt. Everest that his respiratory muscles are now weak.
The Mt. Everest athlete wins because the lack of Oxygen at high altitudes leads to increased concentric hypertrophy of muscles
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Reversibility principle
Specificity principle
Overload principle
None of the above
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Nitroglycerine is converted to NO to work as a vasodilator
Nitroglycerine is converted to NO to work as a vasoconstrictor
Nitroglycerine works to increase blood pressure in order to improve blood flow to cardiac tissues.
Nitroglycerine is not used to manage angina.
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Overload principle
Salience principle
Reversibility principleÂ
Specificity principleÂ
Transference principle
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Metered dose inhaler 5 minutes before exercise
Skip the warm up as you wouldn’t want to induce an attack prior to getting started with his strength based exercises.
Consider swimming as an option for training in the clinic.
Metered dose inhaler 20-30 minutes prior to exercise
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OA; aerobic and balance training every day
OP; walking and strength training 2-3 times a week
OA; stretching to improve posture every day
OP; high impact loading and explosive exercises 2-3 times a week
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O2 saturation levels drop below 85%
Systolic BP decreases more than 10 mmHg after the onset of activity
A 61-year-old patient reaches a heart rate of 148 beats per minute
You should immediately make the patient stop exercising in all of these situations
A patient with exercise induced asthma has a 15-20% decrease in FEV1/FVC estimated with a peak flow meter
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Exercise pre-oxygen consumption
Excess pre-oxygen consumption
Excess post-exercise oxygen consumption
Exercise post-excess oxygen consumption
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Consider activities involving upper extremity WB in order to increase bone strength
Consider aquatic therapy as the hydrostatic pressure may increase her BP as well as her strength
​​​​​​​ Consider FES to facilitate decreased spasticity in R hand/UE
Consider cardiovascular training with emphasis on decreasing BP
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Increase anaerobic metabolism
Decrease aerobic metabolism
Decrease anaerobic metabolism
Exercise at an intensity of 80% VO2 max for 10 minutes with 2 minute rest breaks
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CHF
Pulmonary dysfunction under discretion of the physician
77 yo with balance deficits
82 yo with strength deficits
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Recommend increased supplemental oxygen at all times in order to keep O2 sats at 100%.
Take small walks within moderate range on RPE scale instructing patient to stay between 2 and 3 and if he starts feeling winded, to stop and catch his breath
Instruct patient on pursed lip breathing
Recommend patient get oximeter for home use and use during your treatment session so patient can understand how to use it
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Performing slow and controlled leg exercises with resistance bands
Performing squats and coming up to standing as fast as he safely can
Spending 30 minutes on an exercise bike set to low resistance
Performing glute squeeze exercises while he sits in his chair, being mindful to hold the muscle contraction for 5 seconds each time
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There is an overall decrease in strength and power
There is a greater proportion of Type IIB muscle fibers
There are fewer muscle fibers to a motor neuron
Endurance increases
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There is a sympathetic response below the level of injury, which is causing vasodilation and decreased blood pressure, which descending control from the brain cannot regulate. Check for noxious stimuli below level of injury, like bladder/bowel fullness.
There is a sympathetic response to positional change above the level of injury, which is causing vasoconstriction and increased blood pressure. Check for spasticity in UE.
There is a sympathetic response below the level of injury causing vasoconstriction and increased blood pressure, which descending control from the brain cannot regulate. Check for noxious stimuli below level of injury, like bladder/bowel fullness.
There is a parasympathetic response below the level of injury, which is causing vasodilation and decreased blood pressure which descending control from the brain cannot regulate. Check for spasticity in LE.
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Showing the patient pictures of elderly athletes and telling them “You can do it too!”
Yes, as we age we lose motor neurons and motor units, but some of these effects are reversible. If you strength train with heavy resistance at a slow speed, you can grow back the powerful muscles you had in your twenties.
Yes, as we age we lose motor neurons and motor units, but some of these effects are reversible. The resistance provided from water during swimming is enough to improve muscle strength and balance on land.
Yes, as we age we lose motor neurons and motor units, but some of these effects are reversible. Resistance training "as fast as you can" with moderate loads will increase muscle fiber size and improve balance.
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Higher glycogen stores and more capillaries in the sprinter, higher oxidative enzymes and mitochondria in the marathon runner.
Higher glycogen stores in the sprinter; more capillaries, oxidative enzymes, and mitochondria in the marathon runner.
More capillaries and mitochondria in the sprinter, higher glycogen stores and oxidative enzymes in the marathon runner.
More capillaries, oxidative enzymes and mitochondria in the sprinter; higher glycogen stores in the marathon runner.
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Functional electrical stimulation (FES)
Decrease muscle tone
Avoid stretching
Practice motor retraining
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Chronic Obstructive Pulmonary disease
Coronary artery disease
Duchenne muscular dystrophy
Osteoporosis
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Friend who runs uphill
Friend who runs downhill
Friend who runs on flat terrain
Friend who does a combination of the three (uphill, downhill, and flat terrain)
Use free weights as they require greater accessory muscle activity to stabilize the load and therefore are more functional
Use machines because they load other muscles/bones too
Use machines because they will isolate one single muscle group
Use free weights because they allow for increased load on cartilage
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1-RM because it is the most accurate measure of strength
7-10RM because of her age and diagnosis
5RM since it is between the 1 rep maximum and 10 rep maximum and she is middle-aged and moderately healthy
She should perform as many reps as she can every exercise session to overload the muscle
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Aerobic exercise
Strengthening
Aquatic exercise
Flexibility
Manual therapy
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Use analgesics before exercise to reduce incisional pain leading to shallow breathing
Avoid lifting over >20 lbs for 6-8 weeks
Do not use the arms to get in/out of the bed, chair, or front wheel walker
Relaxation during low intensity exercise (1-2 METS)
Light aerobic exercise on the treadmill immediately to prevent the formation of clots
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Cystic fibrosis
Pulmonary fibrosis
Musculoskeletal deformities
Pneumothorax
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Cystic fibrosis
Pulmonary fibrosis
Musculoskeletal deformities
Pneumothorax
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Apical Pulse
Brachial Pulse
L Radial Pulse
Carotid artery
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0
1+
2+
3+
4+
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Submaximal
Maximal
Symptom Limited
Objectivitely-limited
Incremental
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Lactic acid signals oxidative pathways beginning in the ECF once O2 is present
Lactic acid is used for various cells and tissues in the bloodstream
Lactic acid is formed from pyruvate and participates in the TCA cycle when O2 isn’t present
Lactic acid may buffer the muscle against increased extracellular NA+ concentrations during fatigue.
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Resistance exercises for quads, hams, transverse abdominis
Interval walking for 1-5 minutes followed by 2-10 minutes of rest
Lower extremity endurance at 60% max work rate
ROM for knees bilaterally
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Generally between 40-60% max HR and 55-60% VO2 max
Generally between 60-80% max HR and 55-60% VO2 max
Generally between 40-60% max HR and 65-70% VO2 max
Generally between 60-80% max HR and 65-70% VO2 max
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