Chapter 15 - Muscle Energy Flashcards
Explain how ME (post-isometric relaxation) works
Isometric contraction –> Golgi tendon organs sense increase tension –> cause reflex relaxation
Explain how ME (reciprocal inhibition - direct) works
Take the muscle into the restrictive barrier like normal, but then contract the antagonist muscle against resistance (causes reflex relaxation of the agonist muscle)
Explain how ME (reciprocal inhibition - indirect) works
Take the muscle into the position of EASE, then contract the antagonist muscle against resistance (causes reflex relaxation of the agonist muscle)
Joint mobilization using ME - exlain
Flexing a muscle pulls the bony attachment (ex. innominate rotation dysfunction)
Oculocephalogyric reflex ME - explain
Uses EOM contraction to reflexively effect the cervical and truncal musculature
Respiratory assistance ME - explain
Uses voluntary respiratory motion to restore rib motion (ex.)
Crossed extensor reflex ME - explain
Contraction of one muscle relaxes that muscle on the other side and contracts the antagonist muscle on the other side
Which is more important in ME: localization or intensity of force?
LOCALIZATION
Contraindications to ME
Especially what type of ME?
Post-surgery
ICU
Post-isometric relaxation
Upper T spine (T1-4) - ME patient position
Used head and neck to move the segment
Lower T spine (T5-T12) - ME patient position
Patient grabs same side neck with same side hand, then grabs elbow with contralateral hand.
Doc reaches across to manipulate torso.
Lower T spine ME - difference for doc for neutral vs. non-neutral dysfunction
Neutral = under-over Non-neutral = over-over
Inhalation rib dysfunction:
- Target rib
- Patient/doc position/movement
Lowest rib in group
Monitor anterior rib while using knee to flex patient. Sidebend patient if BUCKET-HANDLE dysfunction. Encourage exhalation, resist inhalation. For BUCKET-HANDLE dysfunction, patient reaches for ipsilateral knee during exhalation.
Exhalation rib dysfunction:
- Target rib
- Patient/doc position/movement
Highest rib in group
Patient’s ipsilateral hand on forehead. Grasp rib angle posteriorly and pull INFERIORLY during INHALATION. Hold breath at full inhalation while:
- Raising head to ceiling
- Turning head 30º AWAY and raising to ceiling
- 3-5. Pushing elbow toward opposite ASIS
- 6-9. Push arm anterior
- 10-12. Adduct arm
Rib 1 exhalation ME - muscle?
Anterior and Middle Scalenes
Rib 2 exhalation ME - muscle?
Posterior Scalene
Ribs 3-5 exhalation ME - muscle?
Pec minor
Ribs 6-9 exhalation ME - muscle?
Serratus anterior
Ribs 10-11 exhalation ME - muscle?
Latissimus dorsi
Rib 12 exhalation ME - muscle?
Quadratus lumborum
Lumbar ME - position
Same as lower T-spine (under-over, over-over)
Forward sacral torsion - position
Movement
Monitoring what?
Lateral recumbent, axis down, chest to table (Sims)
Flex hips, drop legs off table (SB, engage axis)
Patient lifts ankles to ceiling
Posterior movement of the moving sacral sulcus
Backward sacral torsion - position
Movement
Monitoring what?
Lateral recumbent, axis down, back to table
Pull lower arm up to rotate torso
Flex hips, drop legs off table (SB, engage axis)
Patient lifts ankles to ceiling
Anterior movement of the moving sacral sulcus
Superior pubic shear - ME
Drop leg off table (EXT hip), Abduct, patient flexes hip and pushes medially (Adducts)
Inferior pubic shear - ME
Flex and abduct hip and knee
Patient pushes knee toward opposite foot (extension, adduction)
Posterior fibular head ME
Prone, flex knee, cup lateral ankle with doc’s hand
Plantarflex and invert foot, internally rotate tibia
Patient dorsiflexes against resistance
