Question 1

Which of the following is true of resistance training for the patient with known osteoporosis?
A)Safe resistance training imposes only submaximal loads-no more than the patient encounters during activities of daily living.
B)Only isometric exercises should be prescribed in order to eliminate torque on the bones.
C)Evidence has shown that resistance exercise is an essential element in the rehabilitation, conditioning, and aerobic programs of patients both at risk for and with known osteoporosis.
D)Resistance training is contraindicated for patients with known osteoporosis due to the risk of pathological stress fracture.

Accepted Answer

Evidence has shown that resistance exercise is an essential element in the rehabilitation, conditioning, and aerobic programs of patients both at risk for and with known osteoporosis. However, safe resistance training imposes only submaximal loads-no more than the patient encounters during activities of daily living. Isometric exercises alone are not sufficient, and resistance training should be prescribed as part of a comprehensive exercise program for patients with osteoporosis.

Question 2

You are having a patient perform manual resistance exercise in a PNF pattern, specifically the D₂ flexion pattern for the upper extremity.As the patient flexes the shoulder and brings the arm overhead against your resistance, what other muscle groups at the shoulder are being strengthened?
A)Abductors and external rotators
B)Adductors and external rotators
C)Abductors and internal rotators
D)Adductors and internal rotators

Accepted Answer

The D₂ flexion pattern for the upper extremity involves shoulder flexion, abduction, and external rotation, thus strengthening the abductors and external rotators of the shoulder.

Question 3

Each of the following is characteristic of DOMS except:
A)Tends to peak 48 to 72 hours after the conclusion of high-intensity exercise.
B)Increased soreness seen during passive lengthening of the involved muscle groups.
C)Occurs more frequently after eccentric exercise than isometric exercise.
D)Is believed to be caused by postexercise muscle spasm.

Accepted Answer

DOMS is not believed to be caused by postexercise muscle spasm. Rather, it is caused by microscopic tears in muscle fibers and inflammation in the affected area.

Question 4

You are having a patient perform manual resistance exercise of the lower extremity using a proprioceptive neuromuscular facilitation (PNF) diagonal pattern.In which of the following lower extremity patterns is ankle dorsiflexion coupled with eversion resisted?
A)D₁ flexion
B)D₁ extension
C)D₂ flexion
D)D₂ extension

Accepted Answer

In the D2 flexion pattern, ankle dorsiflexion is coupled with eversion, which is the motion being resisted in this question. In the other patterns, ankle dorsiflexion is either coupled with inversion or not present at all in the pattern.

Question 5

Which of the following is the most efficient way to neutralize the effects of muscle fatigue during an exercise session?
A)Perform active exercises during the rest interval between sets
B)Stop all exercise and rest completely between sets
C)Apply cold to the muscle/muscle groups between sets
D)Massage the muscles between sets

Accepted Answer

Performing active exercises during the rest interval between sets, also known as active recovery, has been shown to be an effective way to reduce the effects of muscle fatigue. This allows for increased blood flow and removal of metabolic waste products from the muscle, leading to quicker recovery and less fatigue. Stopping all exercise and resting completely or applying cold may help with immediate relief, but will not have the same long term benefits as active recovery. Massage can also be helpful, but may not be as practical during an exercise session.

Question 6

When applying manual resistance to the upper extremity using the D₁ extension pattern (PNF), the muscle groups being facilitated (strengthened) are the shoulder extensors and the:
A)Adductors, internal rotators, and wrist and finger flexors.
B)Abductors, external rotators, and wrist and finger extensors.
C)Adductors, external rotators, and wrist and finger flexors.
D)Abductors, internal rotators, and wrist and finger extensors.

Accepted Answer

The answer of When applying manual resistance to the upper...

Question 7

Of the following, which is the best definition of an "8 RM"?
A)The number of repetitions of a particular exercise a patient can perform in 8 seconds against a specific load (amount of resistance)
B)The number of sets (bouts) of a specific exercise a patient can perform for 8 repetitions
C)The greatest amount of resistance (load) a patient can lift or lower through the available ROM in 8 seconds
D)The greatest amount of resistance (load) a patient can lift or lower through the available ROM for 8 repetitions (no more, no less)

Accepted Answer

An "8 RM" refers to the greatest amount of resistance (load) a patient can lift or lower through the available range of motion for 8 repetitions. This is commonly used in strength training programs to prescribe the appropriate weight for a patient to use in order to achieve their desired training goals.

Question 8

To selectively strengthen the flexor digitorum superficialis using manual resistance exercise, position the patient's forearm in supination and wrist in neutral on a table.What should happen next?
A)Stabilize the metacarpophalangeal and proximal interphalangeal (PIP) joints in neutral, then apply resistance to the distal phalanx as the patient flexes the distal interphalangeal (DIP) joint.
B)Stabilize the metacarpophalangeal and DIP joints in neutral, then apply resistance to the middle phalanx as the patient flexes the PIP joint.
C)Stabilize the PIP and DIP joints in neutral, then apply resistance to the proximal phalanx as the patient flexes the metacarpophalangeal joint.
D)Without additional stabilization, apply resistance to the distal phalanx and ask the patient to flex the metacarpophalangeal, PIP, and DIP joints simultaneously.

Accepted Answer

The flexor digitorum superficialis muscle is responsible for flexing the proximal interphalangeal (PIP) joints of the fingers. To isolate this muscle, the metacarpophalangeal and distal interphalangeal (DIP) joints must be stabilized in neutral, and resistance should be applied to the middle phalanx as the patient attempts to flex the PIP joint. This ensures that the exercise specifically targets the action of the flexor digitorum superficialis.

Question 9

To strengthen the posterior tibialis using manual resistance, have the patient assume a long sitting position on a table or mat.Support and hold the lower leg with one hand and:
A)Apply resistance to the plantar and medial surfaces of the foot at the first metatarsal as the patient plantar flexes and inverts the ankle and foot.
B)Apply resistance to the plantar and lateral surfaces of the foot at the fifth metatarsal as the patient plantar flexes and everts the ankle and foot.
C)Apply resistance to the dorsal and medial surfaces of the foot at the first metatarsal as the patient dorsiflexes and inverts the ankle and foot.
D)Apply resistance to the dorsal and lateral surfaces of the foot at the fifth metatarsal as the patient dorsiflexes and everts the ankle and foot.

Accepted Answer

The posterior tibialis muscle is responsible for plantar flexion and inversion of the foot. Therefore, applying resistance to the plantar and medial surfaces of the foot at the first metatarsal as the patient plantar flexes and inverts the ankle and foot is the correct method to strengthen this muscle.

Question 10

You have a patient assume a prone-lying position and prop symmetrically on his forearms.You apply manual resistance in several directions at the shoulder girdles as you ask the patient to hold (maintain) the symmetrical position.This technique is known as:
A)Agonist-contraction.
B)Rhythmic stabilization.
C)Recurrent facilitation.
D)Repeated contractions.

Accepted Answer

The technique described is rhythmic stabilization, which involves applying manual resistance in various directions while the patient maintains an isometric contraction. This is intended to improve neuromuscular control and stability in the joint. Agonist-contraction involves active muscle contraction against resistance, recurrent facilitation involves facilitating muscle contraction through various techniques such as tapping or vibration, and repeated contractions involve performing a series of contractions and relaxations to improve muscle strength and endurance.

Question 11

A patient is holding a piece of elastic tubing with both hands in front of the body.Both elbows are flexed to 90°, and both upper arms are held gently against the sides of the patient's chest.Instruct the patient to internally and externally rotate both shoulders simultaneously in this position.This activity strengthens the:
A)Internal rotators concentrically and eccentrically.
B)External rotators concentrically and the internal rotators eccentrically.
C)Internal rotators concentrically and the external rotators eccentrically.
D)External rotators concentrically and eccentrically.

Accepted Answer

In this exercise, the patient is holding the elastic tubing at the front of the body with both elbows flexed to 90°, and both upper arms gently held against the sides of the chest. The instructed movement is to internally and externally rotate both shoulders simultaneously in this position. The exercise targets the external rotators of the shoulder joint more concentrically and eccentrically, helping to strengthen these muscles. Therefore, option D is the correct answer.

Question 12

Mr.Z is a 68-year-old man who underwent abdominal surgery 3 months ago.Since his surgery, he has had difficulty walking.You determine that during the period of bed rest and modified activity, his legs have become quite weak, contributing to his difficulty walking.The ROM of his lower extremities is within normal limits.You determine that the 10 RM for the hip extensors and quadriceps bilaterally (measured on a bilateral leg press unit) is only 20 lb.After a brief warm-up on a stationary bicycle, you have Mr.Z perform the following PRE regimen: 10 repetitions of hip and knee extension against 20 lb; 10 repetitions against 15 lb; and 10 repetitions against 10 lb with a rest between each set of 10 repetitions.This approach to PRE is known as:
A)Circuit weight training.
B)Oxford regimen.
C)DeLorme regimen.
D)DAPRE regimen.

Accepted Answer

The described PRE (Progressive Resistance Exercise) regimen for Mr. Z starts with the highest load (20 lb) and decreases the load with each subsequent set (to 15 lb, then 10 lb). This approach, where the resistance decreases with each set, is characteristic of the Oxford regimen.

Question 13

Your patient is lying supine and you are strengthening the iliopsoas on the (R) using manual resistance.The main reason you would want to place the patient's (L) hip and knee in flexion (foot planted on the table) is to:
A)Stretch the erector spinae muscles in the lumbar region of the back.
B)Improve the mechanical efficiency of the iliopsoas on the (R).
C)Stabilize the pelvis in a neutral to posteriorly rotated position to lessen the possibility of an anterior pelvic tilt occurring, placing stress on the low back.
D)Place the pelvis in a slight anterior tilt so the trunk is more stable and the iliopsoas can generate greater tension.

Accepted Answer

Placing the patient's (L) hip and knee in flexion with the foot planted on the table stabilizes the pelvis in a neutral to posteriorly rotated position. This helps to prevent an anterior pelvic tilt, which can place stress on the low back. This position also improves the mechanical efficiency of the iliopsoas on the (R) by allowing it to generate greater tension with less compensatory movements from other muscles. While stretching the erector spinae muscles is important, it is not the main reason for placing the patient in this position. A slight anterior tilt of the pelvis can create instability and is not ideal for strengthening the iliopsoas.

Question 14

Which factors affect the amount of resistance provided by elastic resistance bands during exercise?
A)Length of the muscle and stretch of the band
B)Stretch of the band and speed of movement
C)Stretch of the band and angle of the band in relation to the moving bone
D)Angle of the band in relation to the moving bone and length of the muscle

Accepted Answer

The amount of resistance provided by elastic bands during exercise primarily depends on the stretch or elongation of the band and the angle of the band in relation to the moving bone. The more the band is stretched and the closer it is to perpendicular to the moving bone, the greater the resistance. The length of the muscle and speed of movement may play a secondary role but are not as significant as the other factors.

Question 15

You are designing an exercise program for a patient with a history of hypertension.Which of the following types of exercise is associated with the highest risk of causing an increase in blood pressure during exercise?
A)Isokinetic exercise at medium to fast velocities
B)High-effort isometric exercise
C)Muscle setting exercises
D)High-effort dynamic resistance exercise

Accepted Answer

High-effort isometric exercise, where the muscle contracts without any movement, is associated with the highest risk of causing an increase in blood pressure during exercise in patients with hypertension. This is because isometric exercise creates a sustained increase in blood pressure, while dynamic resistance exercise (option D) results in a more temporary increase in blood pressure during the lifting phase and a decrease in blood pressure during the relaxation phase. Isokinetic exercise (option A) and muscle setting exercises (option C) usually do not cause a significant increase in blood pressure.

Question 16

Which of the following describes the research evidence regarding the effective treatment of delayed-onset muscle soreness (DOMS) once it occurs?
A)Modalities consisting of electrical stimulation and cold are the only treatments that are consistently effective at reducing muscle soreness experienced with DOMS.
B)Postexercise massage reduces both the signs and symptoms of DOMS in the elite athlete but not in the casual athlete.
C)Use of compression sleeves on the affected muscles improves the strength deficits that occur as a result of DOMS.
D)Continuation of the training program that has induced DOMS does not worsen the muscle damage or slow the process of recovery.

Accepted Answer

Research suggests that continuation of the training program that has induced DOMS does not worsen the muscle damage or slow the process of recovery. There is limited evidence to support the effectiveness of electrical stimulation and cold modalities, while postexercise massage may only be effective for elite athletes. The use of compression sleeves may improve strength deficits but does not necessarily reduce muscle soreness.

Question 17

You test the muscle strength of the middle deltoid and determine it to be 2/5.The goal of an exercise you are having a patient do is to increase muscular endurance of the middle deltoid.Of the exercises described, which is most appropriate to meet the goal at this point in the exercise program?
A)Place the patient in a side-lying position and have her actively abduct the arm without assistance as many times as possible.
B)Place the patient in a sitting position with the elbow flexed and have her abduct the arm through the full ROM 8 to 10 times against light resistance.
C)Place the patient in a supine position on a large mat.As you support the weight of the arm, have the patient abduct the arm through a full ROM as many times as possible against a minimal amount of manual resistance.
D)Have the patient assume the supine position.Provide as much assistance as needed to enable the patient to flex the shoulder from 0° to 90° for as many repetitions as possible.

Accepted Answer

The patient has a muscle strength of 2/5, indicating they can move the limb with gravity eliminated but not against gravity. Option C provides a gravity-eliminated position (supine) with minimal resistance, allowing the patient to perform more repetitions to build endurance.

Question 18

If a patient who has an inflammatory muscle disease such as polymyositis engages in a vigorous resistance training program, it is possible that irreversible progressive deterioration, rather than improvement, in muscle strength can occur.The term that best describes this phenomenon is:
A)Overwork weakness.
B)Progressive muscle fatigue caused by overtraining.
C)Muscle overload.
D)Delayed-onset myopathy.

Accepted Answer

Overwork weakness is a well-known phenomenon in patients with inflammatory muscle diseases. Vigorous resistance training can lead to progressive muscle weakness, rather than improvement, due to the underlying muscle inflammation and damage. The inflammation is exacerbated by the increased demands of resistance training, leading to irreversible muscle damage and weakness. This underscores the importance of careful exercise prescription in patients with inflammatory muscle diseases.

Question 19

Which of the following best describes cross-training or cross-exercise, a phenomenon that has been observed as a result of resistance training?
A)When resistance exercise is carried out by a muscle, the antagonist to that muscle also shows an increase in strength.
B)When exercise is carried out concentrically against resistance, an increase in eccentric muscle strength in the same leg also occurs.
C)When resistance exercise is carried out by a muscle group on the right side of the body, small gains in strength occur in the same unexercised muscle on the opposite side of the body.
D)When training is carried out for the purpose of developing strength, muscular endurance also develops in that same muscle.

Accepted Answer

Cross-training or cross-exercise refers to the phenomenon where exercising a muscle group on one side of the body can lead to strength gains in the same muscle group on the opposite, unexercised side of the body. This is due to neural adaptations that affect both sides of the body, even though only one side is being actively trained.

Question 20

In addition to an isokinetic dynamometer, which of the following types of resistance equipment can be used safely and effectively to improve muscle strength at fast velocities of limb movement?
A)Free weights
B)Variable resistance equipment made up of a weight-cable and cam system
C)Variable resistance equipment that employs pneumatic or hydraulic resistance
D)Simple weight-pulley system

Accepted Answer

Variable resistance equipment that employs pneumatic or hydraulic resistance is specifically designed to allow for safe and effective muscle strengthening at various speeds, including fast velocities of limb movement, without the need for gravity-dependent weights. This makes it suitable for high-speed training.

Quiz 6: Resistance Exercise for Impaired Muscle Performance

Which of the following is true of resistance training for the patient with known osteoporosis?

You are having a patient perform manual resistance exercise in a PNF pattern, specifically the D₂ flexion pattern for the upper extremity.As the patient flexes the shoulder and brings the arm overhead against your resistance, what other muscle groups at the shoulder are being strengthened?

Each of the following is characteristic of DOMS except:

You are having a patient perform manual resistance exercise of the lower extremity using a proprioceptive neuromuscular facilitation (PNF) diagonal pattern.In which of the following lower extremity patterns is ankle dorsiflexion coupled with eversion resisted?

Which of the following is the most efficient way to neutralize the effects of muscle fatigue during an exercise session?

When applying manual resistance to the upper extremity using the D₁ extension pattern (PNF) , the muscle groups being facilitated (strengthened) are the shoulder extensors and the:

Of the following, which is the best definition of an "8 RM"?

To selectively strengthen the flexor digitorum superficialis using manual resistance exercise, position the patient's forearm in supination and wrist in neutral on a table.What should happen next?

To strengthen the posterior tibialis using manual resistance, have the patient assume a long sitting position on a table or mat.Support and hold the lower leg with one hand and:

You have a patient assume a prone-lying position and prop symmetrically on his forearms.You apply manual resistance in several directions at the shoulder girdles as you ask the patient to hold (maintain) the symmetrical position.This technique is known as:

Your patient is lying supine and you are strengthening the iliopsoas on the (R) using manual resistance.The main reason you would want to place the patient's (L) hip and knee in flexion (foot planted on the table) is to:

Which factors affect the amount of resistance provided by elastic resistance bands during exercise?

You are designing an exercise program for a patient with a history of hypertension.Which of the following types of exercise is associated with the highest risk of causing an increase in blood pressure during exercise?

Which of the following describes the research evidence regarding the effective treatment of delayed-onset muscle soreness (DOMS) once it occurs?

You test the muscle strength of the middle deltoid and determine it to be 2/5.The goal of an exercise you are having a patient do is to increase muscular endurance of the middle deltoid.Of the exercises described, which is most appropriate to meet the goal at this point in the exercise program?

If a patient who has an inflammatory muscle disease such as polymyositis engages in a vigorous resistance training program, it is possible that irreversible progressive deterioration, rather than improvement, in muscle strength can occur.The term that best describes this phenomenon is:

Which of the following best describes cross-training or cross-exercise, a phenomenon that has been observed as a result of resistance training?

In addition to an isokinetic dynamometer, which of the following types of resistance equipment can be used safely and effectively to improve muscle strength at fast velocities of limb movement?