CH 4: Stretching of soft tissue contractures

Question 1

What do stretching of soft tissue contractures involve?

Answer 1

• Muscle
• Capsule
• Tendon
• Ligaments
• Bursa
• Skin

Question 2

What type of stretching has been effective technique that produces long-lasting connective tissue changes?

Answer 2

Low-duration, low-load static stretching

Question 3

What is a permanent or transient limitation of movement or shortening of muscles or soft tissue?

Answer 3

Contracture

Question 4

What is the result of healed tissue that forms a fixed, rigid scar and causes cosmetic deformity or functional deficits?

Answer 4

Contracture

Question 5

What involves a limitation of function resulting from scar tissue that forms between structures?

Answer 5

Adhesion

Question 6

How many weeks is immature scar tissue adaptable?

Answer 6

8 weeks

Question 7

When does a scar become a mature scar and less changeable (inadaptable)?

Answer 7

14 weeks

Question 8

What type of scar is highly vascular with many cells (myofibrocytes) that give the scar the ability to contract?

Answer 8

Adaptable

Question 9

What type of scar tissue has a high rate of remodeling?

Answer 9

Immature

Question 10

What is the process of tissue restructuring in response to stress or stimulation?

Answer 10

Remodeling

Question 11

As new scar tissue forms, what becomes highly unorganized and arranged randomly, creating an immobile structure?

Answer 11

Collagen

Question 12

What type of scar tissue becomes increasing organized and oriented with specific directional lines of stress?

Answer 12

Adaptable or immature scar tissue

Question 13

What forms in response to stress imposed from mechanical loads?

Answer 13

Collagen

Question 14

What are the critical components where stretching is concerned?

Answer 14

• Time dependent, stress reactive nature of scar tissue
• Fragility of immature adaptable scar
• New scar tissue organizes and aligns itself along lines of stress, so appropriately place stress helps remodel
• Low load, long duration stretching combined with preheating the involved are to improve treatment

Question 15

At 5 days, new scar is only ____ of its maximum potential strength?

Answer 15

10%

Question 16

At 40 days, new scar is only _____ of its maximum potential strength?

Answer 16

40%

Question 17

At 60 days, new scar is only _____ of its maximum potential strength?

Answer 17

70%

Question 18

At 12 months, new scar is approx _____ of its maximum potential strength?

Answer 18

100%

Question 19

What is the low-load, prolonged stretching technique?

Answer 19

• Preheat involved area
• Place structures in position of comfort
• Maintain moist heat application during entire course of treatment (20-60 min)
• Apply stress or load gradually and minimally
• Allow rest, recovery
• Maintain heat application for 5-10 min after removal of load
• Initiate isometric contractions after heat and passive stretching

Question 20

What is equipment used to facilitate stretching?

Answer 20

• Patient specific
• Skin integrity must be addressed
• Careful use in elderly
• Can use simple tools at home (wands, canes, broomsitcks)
• Codman’s pendulum exercises for shoulders