Level 2: Stability Certification Test (2nd Attempt)

Describe the structural characteristics of trunk muscles, particularly the erector spinae muscles and multifidus, and how these characteristics contribute to their function in providing spinal stability and support for extremity movements.

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Which collagen type accounts for about 60% of the dry mass of the tendon?

Type 1

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Type 2

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Type 3

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Type 4

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What are the three main theories of etiology of tendinopathy?

Hormonal Theory

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Vascular Theory

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Mechanical Theory

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Lymphatic Theory

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Neural Theory

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What is the result of eccentric training on neovascularization and capillary blood flow for 12 weeks?

Enhanced tendon oxygen saturation with decreased peritendinous capillary blood flow.

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Increased neovascularization and decreased capillary blood flow.

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Reduction of neovascularization, pathologically increased capillary blood flow and peritendinous capillary blood flow without changes in tendon oxygen saturation.

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What is the percentage makeup of ligaments?

50% Collagen, 50% Elastin and Proteoglycans.

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75%- Collagen, 25%- proteoglycans, elastin, and other proteins in glycoproteins

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60% Proteoglycans, 40% Water.

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Where are there more nerves located in an epiligament?

Throughout the ligament body evenly

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the bony ligament insertion sites

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Exclusively within the collagenous fibers of the epiligament

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Within the ligament's mid-substance

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What are the three phases of tendon and ligament healing?

The inflammatory phase, proliferation phase or fibroplasia, and remodeling and maturation phase.

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The regenerative phase, fibrotic phase, and resolution phase.

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Why is early mobilization with accelerated rehabilitation considered effective after ligament strains, and what negative effects can prolonged immobilization have on ligament physiology?

Early mobilization is ineffective, and prolonged immobilization enhances tissue regeneration.

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Long periods of unloading are harmful to the tissue and cause ligament physiology to switch from anabolic to a more catabolic state.

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Extended periods of immobilization promote anabolic states and accelerate ligament healing.

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How does functional rehabilitation align with the principles of mechanotherapy?

Functional rehabilitation hinders mechanotherapy by causing excessive tissue strain.

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It aligns by mechanical loading, prompts cellular responses that promote tissue structural change.

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Functional rehabilitation focuses solely on chemical responses, neglecting mechanical loading effects.

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What are the factors that can affect the healing response of ligaments to injury, and how do genetics, hormonal effects, comorbidities, and neurovascular elements play a role in the healing process?

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What is the connection between hypercholesterolemia, the development of tendon xanthomas, and its potential contribution to chronic tendon degeneration, along with the impact of lowering hypercholesterolemia on tendon health, as discussed in the text?

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How does peripheral neurogenic pain differ from other pain mechanisms, and what is the role of neurodynamic exercises in its treatment?

A misconception suggests that peripheral neurogenic pain is primarily caused by direct nerve damage, overlooking the fact that it often arises from nerve entrapment or compression by adjacent connective tissues. Unlike other pain types where the nerve itself is the source of pain, peripheral neurogenic pain involves alterations in the relationship between the nerve and surrounding tissues. This misinterpretation can lead to misguided treatment approaches that do not address the root cause of neurogenic symptoms.

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Peripheral neurogenic pain differs from other pain mechanisms as it stems from neural tissue outside the dorsal horn, manifesting symptoms due to alterations in nerve structure, function, conduction, and dynamics. Unlike some pain types where the nerve itself is the culprit, in peripheral neurogenic pain, the nerve becomes entrapped or compressed by adjacent connective tissues, resulting in neurogenic symptoms. Treatment involves restoring tissue balance and using neurodynamic slider movements to improve the relationship between movement and the affected nerve and surrounding tissues.

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Peripheral neurogenic pain is inaccurately characterized as a pain mechanism resulting solely from inflammation within the dorsal horn of the spine. Contrary to this, peripheral neurogenic pain actually originates from neural tissue outside the dorsal horn, presenting symptoms due to changes in nerve structure, function, conduction, and dynamics. This form of pain is not exclusively confined to the spine but extends to peripheral nerves, making it distinct from centrally mediated pain.

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What are the key characteristics of nociceptive/inflammatory pain, and how can movement therapy be applied to address this type of pain, especially in the presence of ischemia?

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What are the 3 factors that can trigger the detection or response of nociceptive/inflammatory pain at the neuronal level?

Pressure

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Time

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Chemical

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Temperature

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What is the Pain Mechanism Classification System (PMCS), and how many fundamental pain mechanisms make up this system?

The Pain Mechanism Classification System (PMCS) is a three-tier system, classifying pain as either sensory, emotional, or mixed

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The Pain Mechanism Classification System (PMCS) a binary classification, categorizing pain as either purely physical or psychological.

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This system encompasses six fundamental pain mechanisms, recognizing pain as a complex continuum with different dimensions and mechanisms. It aims to move beyond isolated structural views or patho-anatomy considerations in diagnosing, staging disorders, and planning treatments.

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Why does a traditional rehabilitation approach focusing solely on motor control strategies or structural pathology interventions often fall short, and what challenges can arise from categorizing muscles into simplistic groups like “deep/local,” “tonic/phasic,” and “stabilizers/prime movers”? How does a biopsychosocial (BPS) model address these limitations and respect the complexity of the human system in managing musculoskeletal health?

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How does obesity contribute to tendon degeneration, and what are the key mechanisms involved in this process? Additionally, how can individuals prevent or mitigate these degenerative issues, and what role can programs like Physiokinetix play in preparing the body for physical activity?

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How does prolonged immobilization affect the water and proteoglycan content, collagen cross-links, and mechanical properties of tendons, as demonstrated in a study involving 90 days of bed rest, and what is the specific change in gastrocnemius tendon stiffness and the young modulus?

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How do nerves in ligaments contribute to joint proprioception and the protection and stabilization of the joint after injury?

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Choose an example of spinning.

The movement of the carpal bones during wrist flexion and extension.

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The motion of the ulna and radius during pronation and supination.

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The radial head of the proximal humeroradial joint during supination and pronation of the forearm.

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The tibia on the femoral condyles during knee flexion and extension.

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True or False: Trigger points can be considered more of a symptom than a source of pain.

True

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False

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Do higher level supersystems and lower level subsystems have the same levels of control? Give an example of a supersystem and a subsystem.

Yes, the have the same level of control. Supersystem- The nervous system, Subsystem- Brain, spinal cord, peripheral nerves

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No, higher level supersystems have more control. Supersystem- The nervous system, Subsystem- Brain, spinal cord, peripheral nerves

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Yes, the have the same level of control. Supersystem- Brain, spinal cord, peripheral nerves, Subsystem- The nervous system

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No, higher level supersystems have more control. Supersystem- Brain, spinal cord, peripheral nerves, Subsystem- The nervous system

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Where is force transmitted between the gluteus maximus and latissimus dorsi?

Across the spinal discs.

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Via the iliotibial band.

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Through the thoracolumbar fascia.

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Fill in the Blank:

Tensegrity is defined as “structures that stabilize their shape by continuous tension or Fill in the blank 1 of 1 rather than continuous compression.”

True or False: Whole-body stability can more narrowly be defined as the ability of the spinal column or its components to resist buckling when undergoing load.

True

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False

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Choose the three stages of mechanotransduction.

Cell-cell communication

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Effector Response

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Cellular Adaptation

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Mechano Coupling

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Define Mechanotransduction

The processes whereby cells convert physiological mechanical stimuli into biomechanical responses.

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The transmission of electrical signals within cells.

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The biological response to changes in temperature.

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The conversion of chemical signals into mechanical responses.

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What happens to muscle fiber length as you get older?

Muscle fiber length becomes variable and unpredictable with age.

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There is no change in muscle fiber length over time.

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Muscle fiber length increases with age.

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Muscle fiber length decreases with age

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Do muscles in the upper extremity have longer or shorter fibers to meet the need of fast contraction?

Longer fibers

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Shorter fibers

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Fiber length has no effect

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What are the three basic stages of arthritis?

First- Synovial fluid inflammation, Second- Tendon rupture, Third- Ligament strengthening.

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First- extracellular matrix damage occurs, Second- Chondrocytes respond to the damage, Third- Progressive tissue loss.

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First- Cartilage regeneration, Second- Bone fusion, Third- Joint lubrication.

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First- Muscular atrophy, Second- Nerve compression, Third- Joint instability.

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True or False: Continued physical activity will lead to increased longevity in life.

True

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False

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Describe the difference between cortical and trabecular bone.

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What is the formula for torque?

F (force) ÷ r (moment arm)

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F (force) x r (moment arm)

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F (force) – r (moment arm)

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Define and describe the five forces the body can endure.

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What are the three planes of motion?

Fill in the blank 1 of 3
Fill in the blank 2 of 3
Fill in the blank 3 of 3

What type of pain can manifest physical symptoms from negative emotions?

Perceptual Pain

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Experiential Pain

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Effective Pain

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Affective Pain

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Name and explain 3 ways that fear-avoidance behavior leads to deconditioning.

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Fill in the blank:

Good Fill in the blank 1 of 2 strength without proper coordination between the abdominals and diaphragm can lead to spine Fill in the blank 2 of 2 during challenging aerobic activities.

How does injury occur?

Injury occurs when tissues are extremely flexible and adaptive to loads

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Injury occurs when load exceeds tissue tolerance.

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Injuries only happen when there is no external load on the tissues.

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Tissues can withstand any amount of load without reaching a tolerance level, preventing injury.

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What are the two parts of stability?

Static Stability

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Dynamic Stability

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Whole Body Stability

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Spinal Stability

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After injury to a ligament, how long does it take for the acute inflammatory phase to begin and how long does it continue to last?

It starts within hours and lasts under the next 24 hours.

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It starts within minutes and lasts over the next 48 to 72 hours.

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It starts within days and lasts over the next month.

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What are the three types of sprains and how can you differentiate them?

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Name four of the Strategies / Modalities / Principles that we pull from to create our treatments in PKT.

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How do we create CHANGE of the brain and body on our therapy table?

long bursts of simple, passive movement done in repetition

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short bursts of complex, active movement done in repetition

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long burst of complex, active movement done once

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short burst of simple, passive movement done once

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Describe the acronym: S.M.A.R.T. … Why do we use it with clients?

Sporadic, Mixed, Abstract, Reversible, Temporary: Use with clients to create goals that are flexible and can change frequently, allowing for abstract thinking and temporary achievements that can be easily reversed.

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Superficial, Malleable, Arbitrary, Redundant, Timeless: Use with clients to establish goals that can be easily changed on a whim, are not bound by time, and may not hold much significance in their lives.

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Specific, Measurable, Attainable, Relatable, Time-Sensitive: Use with clients to help them overcome specific hurdles in life that they can achieve realistically and simply so they will actually do them and eliminate their pain and reestablish a healthy lifestyle.

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What does N.A.R.K. stand for and how do we use it in our treatments of the musculoskeletal system?

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How do bands improve pain and learning?

Bands improve pain and learning by increasing blood flow to the muscles, which directly enhances memory retention and eliminates pain through muscular hydration.

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Bands increase concentration and focus or increase the output required by the cortical and subcortical levels of the brain that help with mediation of pain through the substantia nigra and the dopamine centers. Improves the memory through opening channels to the hippocampus.

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Bands work by balancing the body’s pH levels, which reduces pain and sharpens cognitive function by neutralizing acidic environments in the brain.

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Bands improve pain and learning by emitting low-frequency vibrations that align the body's energy fields, reducing pain and enhancing memory through vibrational healing.

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What are the 2 types of motor learning?

Explicit & Implicit

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Reactive and passive

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Voluntary and involuntary

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Conscious and subconscious

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Match the 4 types of neuromuscular contractions to what it is used for:

Sort elements

Shortening
Lengthening
Managing / Reducing Pain
Controlled Movement

Concentric

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Eccentric

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Isometric

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Isolytic

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What is the largest predicting factor of arthritis?

Increased muscle mass

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High levels of flexibility in the joints

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Elevated bone density

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increased body fat

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During injuries, do muscles tend to go into a flexion dominant pattern or extension?

Flexion

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Extension

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What are the 3 most important factors for stability and overall health? (Select Each)

Strength / Load Training

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High Intensity Training

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Cardiovascular exercise

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Sleep

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How are stiffness and stability related?

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What type of training is best to improve joint stability?

Speed Training

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Endurance training

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Weightlifting

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Stretching

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What are the two groups motion is divided into?

Linear

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static

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dynamic

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Angular

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Fill in the Blank:

Tonicity and tightness of the spinal muscles is related to a (increase or decrease) Fill in the blank 1 of 1 in endurance and stability of the trunk.

What are the 4 main spinal erectors?

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What exercise would be good to restore lateral hip abduction and extension while increasing stability and strength of shoulder girdle?

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Poor coordination between abdominals and diaphragm occurs with aerobic challenges and increases what?

Muscular hypertrophy

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Cardiovascular endurance

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Spinal Instability

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Bone density

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Fill in the Blanks:

Back pain Fill in the blank 1 of 2 and spinal stability Fill in the blank 2 of 2 with a lack of aerobic activity. (Words: increases and decreases)

Level 2: Stability Certification Test (2nd Attempt)

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