Chapter 4

Question 1

Stretching Definition and purpose?

Answer 1

a general term used to describe any therapeutic maneuver designed to increase the extensibility of soft tissues, thereby improving flexibility and ROM by elongating
(lengthening) structures that have ADAPTIVELY shortened and have become hypo mobile over time.

Question 2

Flexibility

Answer 2

Ability to move a single joint or series of joints smoothly and easily through an unrestricted, pain free ROM.

Question 3

Hypomobility

Answer 3

refers to decreased mobility or restricted motion.

Question 4

Contracture

Answer 4

restricted motion can range from mild mm shortening to irreversible contractors.
It is the adaptive shortening of the mm-tendon unit and other soft tissues that cross or surround a joint resulting in significant resistance to passive or active stretch and limitations of ROM

Question 5

Types of Contracture’s?

Answer 5

Myostatic
Pseudomyostatic
Arthrogenic
Periarticular Contractures
Fibrotic contracture 
Irreversible

Question 6

Myostatic Contractures?

Answer 6

No specific pathology present but mm/tendon has shortened.

Question 7

Pseudomyostatic Contractures

Answer 7

Constant state of contraction, leading to excessive resistance to passive stretch.
May be caused by CNS pathology(hypertonicity, spasticity, rigidity)

Question 8

Arthrogenic

Answer 8

Intra-articular pathology such as adhesions, joint effusion (swelling), syovities, osteophyte formation.

Question 9

Periarticular Contracture

Answer 9

Tissues that cross or attach to a joint or the joint capsule loss mobility, thus restricting normal arthrokinematic motion

Question 10

Fibrotic Contracture

Answer 10

Changes in mm & surrounding

Question 11

Irreversible Contracture

Answer 11

Permanet loss of extensibility of soft tissue due to non-extensible fibrous adhesions.
After long period of immobilization.
Longer Fibrotic adhesion (contracture exists the more mm tissue is replaced by scar tissue adhesions).

Question 12

Interventions to increase Mobility of Soft tissues?

Answer 12

Manual or mechanical
MET (Muscle- Energy Techniques)
Selective stretching
Neuromuscular techniques

Question 13

Overstretching

Answer 13

Stretch well beyond the normal length of mm and ROM of a joint and surrounding soft tissues resulting in hyper mobility.

Question 14

Properties of Soft Tissue: Response to Immobilization & stretch

Answer 14

Mechanical properties of contractile tissue.
Neurophysiological properties of contractile tissue.
Mechanical properties of non-contractile tissue.

Question 15

Stress Strain Curve

Answer 15

Necking: considerable weakening of the tissue.
Creeping: Load is applied for extended period of time= elongates tissue.
-viscosity (thickness) of tissue or type
-time dependent
-rate at which force is applied
-load

Question 16

Determinants & types of stretching Ex’s

-Modes of stretch

Answer 16

• Self Stretch

- mechanical stretch

Question 17

Types of PNF stretching

Answer 17

• Hold-relax (HR) or contract-relax(CR)
• Agonist Contraction(AC)
• Hold-relax with agonist contraction(HR-AC)

Question 18

Procedural Guidelines for application of stretching Interventions

Answer 18

• Examination & evaluation of pt. 0-120 degrees. (current measurements ROM)
• preparation for stretching
  
  • never stretch a cold mm. (make sure pt is in proper clothing for those in the environment.
• Application of manual stretching procedures (Get them on the total gym to use the ROM just gained)
• After stretching (TG)

Question 19

Goals for stretching and intervention application?

Answer 19

overall & short term treatment that day current symptoms; pain, edema. (rate every treatment)

Question 20

Precautions for Stretching

Answer 20

• General precautions: do not force joint beyond its normal ROM
• Special Precautions for mass market flexibility program: Yoga, palates, pro stretch.

Question 21

Adjuncts to stretching interventions

Answer 21

• relaxation training
• heat
• massage
• biofeedback
• joint traction or oscillation
• cold