Arthrogenic Muscle Inhibition and Biofeedback

Question 1

components of neuromuscular control

Answer 1

volitional contractions
reflex reactions
complex functional movements

Question 2

AMI definition

Answer 2

compromised ability to contract a muscle due to injury

Question 3

what is volitional muscle contractions affected by (what causes AMI)

Answer 3

swelling, pain, and altered mechanoreceptor input

Question 4

how does swelling impact muscle contractions

Answer 4

-stimulate stretch receptors
-trigger reflex inhibition

Question 5

how does pain impact muscle contractions

Answer 5

-deficits in neuromuscular control
-slow down recovery because it inhibits muscle groups which changes movement patterns

Question 6

how does altered input impact muscle contractions

Answer 6

-altered patterns may affect function
-ex: ankle- decrease position sense, balance sense, and postural control

Question 7

what is used to address AMI after injury or surgery

Answer 7

nueromuscular electrical stimulation
-increase muscle strength

Question 8

a nerves response to electrical stimulation is based on 3 factors

Answer 8

1) diameter of the nerve
2) depth of the nerve to the electrode
3) phase duration of the current

Question 9

what nerves are stimulated fisrt

Answer 9

sensory

Question 10

what diameter nerves are depolarized first

Answer 10

large diameter

Question 11

exogenous contraction

Answer 11

NMES elicitied
-entire motor unites stimulated until fatigue
-fast-twitch first then slow-twitch once stimulation is increased
-low capacitance
-synchronous firing

Question 12

endogenous contraction

Answer 12

physiological
-slow-twitch fiber recruitment first
-asychronous firing
-minimal fatigue

Question 13

what enhances neuromusuclar facilitation

Answer 13

NMES

Question 14

parameters for NMES

Answer 14

duty cycle: 1:5 on to off time
high phase duration: 250-300 us
pulse rate: 35-50 pps
amplitude: strong, yet tolerable contractions

Question 15

Russian stim

Answer 15

-instruct patient to contract muscle when stim is applied and relax when it stops
-used for muscle re-education

Question 16

PENS

Answer 16

asymmetrical low-voltage pulsed current

Question 17

ramp time

Answer 17

time to get to the high sense, slowly increases until it peaks

Question 18

parameters of Russian

Answer 18

burst duty cycle: 10%
on/off duty cycle: 10:50
ramp: 2 seconds
electrode placement: bipolar; proximal and distal ends of the muscle
output intensity: strong muscle contraction, possible discomfort
treatment duration: 10 cycles or until fatigues

Question 19

treatment of inhibited AMI muscle

Answer 19

-apply NMES
-recruit motor neurons being reflexively inhinited

Question 20

treatment of disinhibited AMI muscle

Answer 20

-apply disinhibitory TENS and cryo
-decrease relative inhibitory activity and cause reflex activation of inhibited motor neuron

Question 21

goal of stimulation on a muscle

Answer 21

overcome capacitance of the muscle

Question 22

biofeedback

Answer 22

visually or audio representation of a muscle contraction
-“electrodes” do not transmit any current
-used to see muscular neural recruitment
-1 sensor placed per muscle, can compare which muscle is being contracted during movements

Question 23

goal of EMG

Answer 23

regain ability to contract muscle

Question 24

goal of neuromuscular stimulation

Answer 24

restart motor efferent-proprioceptive feedback loop, induce contraction

Question 25

3 things EMG biofeedback does

Answer 25

-regain neuromuscular control
-restore force production
-facilitate relaxation

Question 26

example of AMI inhibition

Answer 26

inability to extend the knee after ACL tear

Question 27

how can swelling lead to AMI

Answer 27

stimulates muscle spindles

Question 28

what is a contraindication to NMES

Answer 28

unstable fracture

Question 29

T/F NMES if an efficient modality to increase muscle strength

Answer 29

true

Question 30

typical off-to-on time duty cycle when begining NMES

Answer 30

1:5

Question 31

T/F biofeedback uses electrical stimulation to elicit a muscle contraction

Answer 31

false