biomechanical limitations Flashcards
biomechanical limitation
resistance from shortening , stiffness
biomechanical limitation from
abnormal positioning/movement prolonged immobilization impaired mm function infection swelling ossification
mm stiffness due to
passive stiffness
active stiffness
neurally mediated stiffness
increased mm stiffness from
changes in
mm length
mm thixotropy
connective tissue
changes in mm fibers
how mm length impacts stiffness
less extensibility makes more stiff,
mm thixotropy
connective tissue gets solid state
connective tissue impacts stiffness
scar tissue
changes in mm fibers impacts mm stiffness
size, fatigibuality, alignment
neurally mediated stiffness
spinal reflexes aren’t modulated by nervous system
PNS you see UMN or LMN signs
LMN
LMN signs
hypotonia
hyporeflexia
flacid
paralysis
UMN signs
hypertonia, hyperreflexia, spasticity
paralysis
__ results in decreased neural mediated stiffness
PNS
__ results in increased neural mediated stiffness
CNS
T/F not possible in mm innervated by damaged peripheral nerve to have increased neural stiffness
true
T/F CNS pathology can result in decreased neural mediated stiffness too
T
why CNS can be decreased neural mediated stiffness too
hypotonia early after injury (spinal shock)
what can cause joint limiation
client posture
alignment
speed of movement (spasticity)
heterotrophic ossification treatment consideratsion
same as for other biotech limitations
what can you not do for HO
no forced stretch
just acitve/ pass ROM
no casting / immbolization
what do for HO
functional activity
cardio
lease with MD
HO
bone forming inside soft tissue
clinical indicators of HO
sudden / dramatic decrease ROM
feel a bony block
confirmed on X-ray
what can HO be confused with
DVT, infection, trauma
T/F any individual with challenged in mobility and motor function is at risk of developing biomechanic limitat
T
always include __ in biomech limit patients
prevent / minimize loss of ROM and flexibility
5 things you should consider in neuro population
motor control tone flacid neglect sensory changes
safety screening for neuo
assess sublax/ sulcus
flacid/tone
ER
AROM/PROM with humerus in ER (thumbs up)
Overhead pulleys for hemiparetic shoulder?
NO, NO, NO
condition that requires decrease mm extensibitly for function
tenodesis grip
condition requires increase mm extensibility for function
hamstring
does soleus or gastroc impact sit to stand
soleus
treatment for biomech strategies
maintain ROM
anticipate loss of PROM
treat limits
consider individual needs
goal of passive stretch
provide low load, long positional stretch
t/f casting helpful with post head injury with CP
yes
casting for HO or seizures?
no
t/F stretch duration established in neuro population
no, FITT principals must be individually assessed
contraindications for streching
bony block limts recent fracture not united acute inflam acute join piain hematoma when the contracture is helping stability post tendon transfer surgery
precautions for stretching
dont force beyond normal PROM newly united fraction prolonged immboization osteoporosis edema when contractors are helping
