DACRB flashcards

32 cards. Read the term and the definition here. The deck at the top of this page is optional.

SAID principle

Specific Adaptation to Imposed Demands: tissue adapts to the exact load, angle, velocity, and contraction type imposed. Exercise selection must therefore replicate the target function, not merely the muscle group.

Progressive overload order

Sequence for advancing exercise: add repetitions first, then sets, then load, then shorten rest, then add range or instability. Change one variable per progression to isolate the tissue response.

Inflammatory phase dosing

Days 0 to 7 after injury: use protected motion, isometrics, and pain-free range. Avoid aggressive stretching and high load, because collagen is not yet organized or tensile.

Proliferative phase dosing

Roughly weeks 1 to 6: controlled submaximal loading and light isotonic work are introduced. Controlled stress aligns new collagen fibers and increases tensile strength without re-injury.

Remodeling phase dosing

Weeks to months after injury: progressive overload toward functional loads and eccentric work. Collagen cross-linking and fiber orientation mature in response to increasing tensile demand.

Isometric analgesia protocol

Hold 30 to 45 seconds at about 70 percent of maximal voluntary contraction, 4 to 5 repetitions. This reduces tendinopathy pain immediately but briefly, so multiple daily bouts are used.

Eccentric loading for tendinopathy

Three sets of 15 repetitions at about 3 seconds per repetition, progressed by adding load. Eccentric work imposes high tensile load with lower metabolic cost than concentric work.

Delayed-onset muscle soreness

Soreness peaking 24 to 72 hours after unaccustomed eccentric exercise. It reflects mechanical and metabolic stress, not structural injury, and does not require cessation of submaximal movement.

Motor learning focus rule

Novel or painful tasks are learned with external focus, low load, and high repetition. Once accurate, shift to internal focus, added load, and variability to improve retention and transfer.

Reciprocal inhibition technique

To reduce tone in a hypertonic muscle, contract its antagonist, then train the target through the newly gained range. The antagonist contraction reflexively inhibits the target muscle.

Post-isometric relaxation

Take the muscle to its lengthened barrier, contract isometrically at 20 to 30 percent effort for 5 to 10 seconds, relax, then move to the new barrier and repeat 3 to 5 times.

Proprioceptive training progression

Layer difficulty: bilateral static stance, then single-leg stance, then single-leg with eyes closed, then unstable surface, then perturbation and sport-specific reaction drills. Advance when each level is stable.

Manipulation absolute contraindications

Do not manipulate with unstable fracture, suspected aortic aneurysm, advanced osteoporotic fracture risk, spinal infection, malignancy at the site, or progressive myelopathy. Anticoagulation and severe inflammatory arthropathy are relative cautions.

Manipulation plus exercise

For chronic low back pain, spinal manipulation combined with exercise outperforms either alone. Manipulation gives short-term neurophysiological and biomechanical benefit; exercise sustains it.

Ultrasound frequency depth

One megahertz penetrates about 3 to 5 centimeters and is used for deep tissue. Three megahertz penetrates about 1 to 2 centimeters and suits superficial structures. Continuous mode heats; pulsed mode is non-thermal.

Cervical traction starting load

Begin intermittent or static traction at roughly 10 to 15 percent of body weight. Progress by symptom response during and after the session; stop if new or worsening neurological signs appear.

Cryotherapy application parameters

Apply cold for about 10 to 20 minutes to reduce pain and edema. Avoid application over superficial nerves and over areas with compromised circulation or sensation.

Oswestry Disability Index MCID

A change of about 10 points is the minimal clinically important difference for the Oswestry Disability Index in low back pain. Smaller changes are not meaningful improvement.

Neck Disability Index MCID

A change of about 7 points is the minimal clinically important difference for the Neck Disability Index. Report baseline and follow-up scores with the change against this threshold.

QuickDASH MCID

A change of about 16 points is the minimal clinically important difference for QuickDASH in upper extremity conditions. It is scored 0 to 100, with higher scores indicating greater disability.

LEFS MCID

A change of about 9 points is the minimal clinically important difference for the Lower Extremity Functional Scale. The scale runs 0 to 80, with higher scores indicating better function.

Minimal detectable change

The smallest change exceeding measurement error. A change below the minimal detectable change cannot be confidently distinguished from noise and should not be reported as real improvement.

ICF case organization

Structure the case by body structure and function, activity, participation, and contextual factors. This framework links examination findings to real-world limitations and to goal setting.

Irritability classification

High irritability means low-load activity provokes symptoms that settle slowly, favoring gentle frequent intervention. Low irritability permits aggressive loading and functional progression.

Red flag screening set

Unexplained weight loss, unrelieved night pain, fever, cancer history, saddle anesthesia, bowel or bladder change, progressive neurological deficit, and significant trauma require medical referral before progression.

Criterion-based return to activity

Return is judged by pain of 2 or less out of 10 on provocation, near-symmetrical strength and range, and successful completion of sport- or job-specific movement at full demand, not by elapsed time.

Work conditioning versus work hardening

Work conditioning is a single-discipline physical program for strength and endurance. Work hardening is interdisciplinary, includes simulated job tasks, and typically runs 4 or more hours daily.

Plan of care elements

State diagnosis, measurable goals, visit frequency, expected duration, and discharge criteria. Uncomplicated mechanical low back pain commonly runs 4 to 6 weeks with 6 to 12 visits.

Visit frequency titration

Early phase uses 2 to 3 visits weekly for education and load management; middle phase 1 to 2 weekly for progression; late phase every 2 to 4 weeks for criterion testing and independence.

Discharge versus discontinuation

Discharge occurs when goals are met and the patient is independent. Discontinuation occurs with patient decline, a plateau across 2 to 3 re-assessments, or non-compliance, and each reason is documented.

Referral triggers

Refer when expected change is absent by 2 to 4 weeks, neurological signs worsen, new red flags appear, or progress stalls despite appropriate load. Document the referral question and findings.

Case study reporting structure

Report history, examination with baseline outcome scores, diagnosis and prognosis, intervention with dose, re-assessment at set intervals, outcome change versus MCID, and single-subject design limitations.