Arthrogenic Muscle Inhibition and Biofeedback Flashcards
components of neuromuscular control
volitional contractions
reflex reactions
complex functional movements
AMI definition
compromised ability to contract a muscle due to injury
what is volitional muscle contractions affected by (what causes AMI)
swelling, pain, and altered mechanoreceptor input
how does swelling impact muscle contractions
-stimulate stretch receptors
-trigger reflex inhibition
how does pain impact muscle contractions
-deficits in neuromuscular control
-slow down recovery because it inhibits muscle groups which changes movement patterns
how does altered input impact muscle contractions
-altered patterns may affect function
-ex: ankle- decrease position sense, balance sense, and postural control
what is used to address AMI after injury or surgery
nueromuscular electrical stimulation
-increase muscle strength
a nerves response to electrical stimulation is based on 3 factors
1) diameter of the nerve
2) depth of the nerve to the electrode
3) phase duration of the current
what nerves are stimulated fisrt
sensory
what diameter nerves are depolarized first
large diameter
exogenous contraction
NMES elicitied
-entire motor unites stimulated until fatigue
-fast-twitch first then slow-twitch once stimulation is increased
-low capacitance
-synchronous firing
endogenous contraction
physiological
-slow-twitch fiber recruitment first
-asychronous firing
-minimal fatigue
what enhances neuromusuclar facilitation
NMES
parameters for NMES
duty cycle: 1:5 on to off time
high phase duration: 250-300 us
pulse rate: 35-50 pps
amplitude: strong, yet tolerable contractions
Russian stim
-instruct patient to contract muscle when stim is applied and relax when it stops
-used for muscle re-education
PENS
asymmetrical low-voltage pulsed current
ramp time
time to get to the high sense, slowly increases until it peaks
parameters of Russian
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
treatment of inhibited AMI muscle
-apply NMES
-recruit motor neurons being reflexively inhinited
treatment of disinhibited AMI muscle
-apply disinhibitory TENS and cryo
-decrease relative inhibitory activity and cause reflex activation of inhibited motor neuron
goal of stimulation on a muscle
overcome capacitance of the muscle
biofeedback
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
goal of EMG
regain ability to contract muscle
goal of neuromuscular stimulation
restart motor efferent-proprioceptive feedback loop, induce contraction
3 things EMG biofeedback does
-regain neuromuscular control
-restore force production
-facilitate relaxation
example of AMI inhibition
inability to extend the knee after ACL tear
how can swelling lead to AMI
stimulates muscle spindles
what is a contraindication to NMES
unstable fracture
T/F NMES if an efficient modality to increase muscle strength
true
typical off-to-on time duty cycle when begining NMES
1:5
T/F biofeedback uses electrical stimulation to elicit a muscle contraction
false
