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ATTH 3130 > Chapter 8: ROM And Flexibility > Flashcards

Chapter 8: ROM And Flexibility Flashcards

1
Q

Define flexibility:

A

Ability to move a joint or series of joints through a full, non restricted pain free ROM

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2
Q

Flexibility is dependent on a combination of the following:

A
  1. Joint ROM

2. Muscle flexibility

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3
Q

What structures are most often responsible for limiting ROM?

A

Muscles, tendons, surrounding fascial sheaths

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4
Q

In what types of situations do ligaments and jt capsules lose some elasticity and shorten?

A
  • long periods of immobilization
  • after surgical repair of an unstable joint
  • long periods of inactivity
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5
Q

Name different structures that can restrict ROM:

A
  • connective tissue
  • bony structure
  • fat
  • skin
  • neural tissue tightness
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6
Q

What factors that limit flexibility cannot be altered?

A
  • bone structure
  • age
  • gender
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7
Q

AROM aka

A

Dynamic flexibility

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8
Q

AROM applies to the ability to move a joint _____ with little _____ to motion.

A
  • efficiently

- resistance

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9
Q

PROM aka

A

Static flexibility

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10
Q

If muscle does not have enough elasticity to compensate for the additional stretch associated with PROM, it is likely that the ____ ____ will be injured.

A

Musculotendinous unit

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11
Q

The goal of any effective stretching program should be to improve the ____ at a given articulation by altering the ______ of the ______ units that produce movement at the joint.

A
  • ROM
  • extensibility
  • neuromusculotendinous
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12
Q

2 mechanoreceptors in stretch reflex:

A
  • muscle spindle

- golgi tendon organ (GTO)

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13
Q

Muscle spindle is sensitive to changes in…

A

Muscle length

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14
Q

GTO is sensitive to changes in…

A
  • muscle length

- muscle tension

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15
Q

Both muscle and tendon are composed largely of _____ _____ and _____ _____.

A
  • noncontractile collagen

- elastin fibres

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16
Q

Collagen enables tissue to resist _______ forces and ______.

A
  • mechanical

- deformation

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17
Q

Elastin composes ____ ____ tissues that assist in recovery from ______.

A
  • highly elastic

- deformation

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18
Q

What are the 3 mechanical properties of collagen, and how does it help in withstanding high tensile stress?

A
  • elasticity: capability to recover to normal length after elongation
  • viscoelasticity: allows for slow return to normal length and shape after deformation
  • plasticity: allows for permanent change or deformation
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19
Q

What are the 3 physical properties of collagen, and how does it help in withstanding high tensile stress?

A
  • force-relaxation: decrease amount of force needed to maintain tissue at a set amount of displacement or deformation over time
  • creep response: ability of a tissue to deform over time while a constant load is imposed
  • hysteresis: amount of relaxation a tissue has undergone during deformation and displacement.
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20
Q

What happens if the mechanical and physical limitations of connective tissue are exceeded?

A

Injury

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21
Q

What are the 2 active contractile components that are in muscle but not tendons?

A
  • actin myofilaments

- myosin myofilaments

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22
Q

What are the 2 factors that influence the % of contribution from contractile and non contractile components for flexibility?

A
  • degree to which the muscle is stretched or deformed

- velocity of deformation

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23
Q

Non-contractile elements are primarily resistant to ….

A

The degree of lengthening

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24
Q

Contractile elements are resistant to …

A

High-velocity deformation

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25
Q

The greater the stretch, the more ______ components contribute.

A

Non contractile

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26
Q

Lengthening of a muscle via stretching allows for ______ and _____ changes to occur in the collagen and elastin fibres.

A
  • viscoelastic

- plastic

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27
Q

The greater the velocity of deformation, the greater the chance for….

A

Exceeding the tissue’s capability to undergo viscoelastic and plastic change

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28
Q

Joint hypomobility ethology can often be traced back to:

A
  • faulty posture
  • muscular imbalances
  • abnormal neuromuscular control
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29
Q

Muscle tightness and hypertonicity have a significant impact on _____ _____.

A

Neuromuscular control

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30
Q

How can muscle tightness cause reciprocal inhibition?

A

Increase muscle spindle activity in a specific muscle will cause decreased neural drive to that muscle’s functional antagonist.

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31
Q

Synergistic dominance:

A

Neuromuscular phenomenon that occurs when synergistic compensate for a weak and/or inhibited muscle to maintain force production capabilities.

32
Q

Why is it important to increase muscle temp prior to stretching?

A
  • positive effect on ability of collagen and elastin components to deform
  • enhanced ability for GTO to reflexively relax through autogenic inhibition.
33
Q

What is the optimal temp of muscle to achieve beneficial effects of stretching?

A

39 degrees C

34
Q

It is recommended that ____ be used as the primary means for increasing intramuscular temperature.

A

Exercise

35
Q

When would you use cold prior to stretching?

A

Decrease muscle guarding associated with DOMS

36
Q

Dynamic stretching uses _____ _____ movements to stretch muscles.

A

Controlled functional

37
Q

Synergestic muscle groups:

A

Muscles that work in concert with one another (ex. Quads contract and hams relax with knee flexion)

38
Q

Agonist muscle:

A

Muscle that contracts to produce a movement

39
Q

Antagonist muscle:

A

The muscle being stretched in response to contraction of the agonist muscle

40
Q

What are the 4 types of stretching?

A
  • ballistic
  • dynamic
  • static
  • proprioceptive neuromuscular facilitation (PNF)
41
Q

Why can the safety of ballistic stretching be of concern? What population is this especially significant for?

A
  • creates somewhat uncontrolled forces within the muscle that can exceed the extensibility limits of of the muscle fibre = small micro tears within MT unit
  • sedentary individuals or those who have sustained muscle injuries
42
Q

What is the difference between ballistic stretching and dynamic stretching?

A

Controlled vs uncontrolled

43
Q

What are the benefits of a progressive velocity flexibility program?

A
  • velocity and degree of lengthening are progressively controlled
  • pt controls both range and speed with no assistance
44
Q

Static stretching:

A
  • stretching antagonist muscle passively by placing it in a maximal position of stretch
  • optimal time: 15-30s
  • over 30s can become uncomfortable
  • repeated 3-4 times
  • can be accomplished by contraction of agonist muscle.
45
Q

A passive stretch requires the use of one of the following:

A
  • body weight
  • assistance from a partner
  • use of a t-bar (UE)
46
Q

3 different PNF techniques used to stretching:

A
  • contract-relax
  • hold-relax
  • slow reversal-hold relax
47
Q

Contract relax PNF:

A
  • body part moved passively into agonist pattern
  • pt pushes by contracting the antagonist (Mm being stretched) isotonically against resistance of AT
  • pt relaxes while AT moves passively into more range until limitation is felt again
48
Q

Contract-relax PNF is beneficial when…

A

ROM is limited by muscle tightness

49
Q

Hold-relax PNF:

A

Isometric contraction of antagonist (Mm being stretched) against resistance + light pressure from therapist to produce max stretch.

50
Q

When is hold-relax PNF beneficial?

A

When there is muscle tension on one side of a joint. Can be used with either the agonist or the antagonist.

51
Q

Hold-relax PNF is aka

A

Muscle energy technique

52
Q

Slow reversal-hold-relax PNF:

A
  • isotonic contraction of the agonist
  • isometric contraction of the antagonist (Mm that will be stretched) during push phase.
  • antagonists relaxed and agonist contract during relax phase.
53
Q

When is slow reversal-hold-relax PNF beneficial?

A

For increasing ROM when primary limiting factor is the antagonistic muscle group.

54
Q

PNF stretching techniques can be done with a _____ or a _____ as resistance.

A
  • partner

- wall

55
Q

PNF stretching is capable of producing …

A

Greater improvement in flexibility over an extended training period

56
Q

Disadvantage of PNF stretching

A

Partner is usually required

57
Q

To see improvement in flexibility, stretching must be done ____ times per week.

A

3-5

58
Q

AT should perform both active and passive movements that create tension in neural structures that are…

A
  • exacerbating pain
  • limiting ROM
  • increasing neural symptoms (n/t)
59
Q

Pilates method of stretching:

A
  • conditioning program that improves muscle control, flexibility, coordination, strength, and muscle tone
  • make pt more aware of their bodies as single integrated units
  • improve body alignment and breathing
  • increase efficiency of movements
  • does not require repetition. Has a sequence of carefully performed movements
  • specific breathing patterns for each exercise
60
Q

Yoga:

A
  • stress can be reduced through combined mental and physical approaches
  • unite body and mind to reduce stress
  • body postures and breathing exercises (slow deep)
  • positions increase mobility and flexibility
  • Can be dangerous for those that are inexperienced
61
Q

Name some manual therapy techniques for increasing mobility:

A
  • myofascial release
  • strain-counter strain technique
  • positional release therapy
  • active release technique
  • graston technique
  • massage
  • structural integration
  • postural restoration
62
Q

Myofascial release

A
  • relieving soft tissue from abnormal grip of tight fascia
  • fascia: composed primarily of collagen and some elastic fibres
  • aka soft tissue mobes
  • superficial to deep
  • add in stretching of MT unit
  • can be done manually by AT or foam roller
63
Q

Strain-counter strain technique:

A
  • an approach to decreasing muscle tension and guarding to normalize muscle function
  • AT finds tendon points (often in painless area opposite to site of pain). Then let go.
  • passive, places the body in a position of greatest comfort = pain relief. Hold position for min. 90s.
  • slowly return to neutral position
  • explained by stretch reflex
64
Q

Positional release therapy:

A
  • based on strain-counter strain technique
  • difference: use of a facilitating force (compression) to enhance effect of positioning
  • Maintain contact with tender point during treatment period
65
Q

Active release technique (ART)

A
  • to correct soft tissue problems in muscle, tendon, and fascia caused by formation of fibrotic/scar adhesions that result from acute injury, overuse injuries, constant pressure, tension injuries
  • palpate and locate adhesions.
  • trap affected muscle by applying pressure with thumb over lesions in the direction of fibres
  • ask pt to actively move the body part so that the musculature is elongated from a shortened position while continually applying tension to the lesion
  • repeat 3-5x/treatment session
  • softens and stretches scar tissue
  • can be uncomfortable during
66
Q

Graston technique:

A
  • instrument assisted soft tissue mobes
  • break down scar tissue and fascial restrictions + stretch connective tissue and muscle fibres
  • stainless steel instruments
  • palpate, find painful spots and unusual nodules, tensions or barriers.
  • apply precise pressure with special lubricant on skin to decrease irritation
  • cross friction massage - initiate/promote healing process
  • pt may experience discomfort or bruising
67
Q

Types of massage that can help with flexibility:

A
  • Hoffa (Swedish) massage (classic form of massage)
  • friction massage
  • acupressure
  • connective tissue massage: stroking that affects circulatory pathologies
  • myofascial release techniques
  • Rolfing
  • Trager
68
Q

Structural integration:

A
  • uses manual therapy and sensorimotor movement education
  • based on Rolfing (massage)
  • focuses on connective tissue or fascia
  • 10 hour-long sessions.
  • Practitioner identifies habitual patterns and imbalances to educate patient about corrective changes
69
Q

Structural integration attempts to lengthen, stretch, soften, release fascial adhesions to reduce ______ stress and _______ irritation, restore ______ balance, and, thus, ______ of movement

A
  • mechanical
  • nociceptive
  • postural
  • efficiency
70
Q

Postural restoration is a treatment technique that is used to identify and correct ______ postural patterns that negatively influence normal ______, ______, ______, and _____.

A
  • asymmetrical
  • sitting
  • standing
  • walking
  • breathing
71
Q

Any asymmetries found with postural restoration can create adaptive and compensatory changes in ____ _____ and ____ ____ that eventually result in movement patterns that restrict ____ ____ and negatively influence _____ _____ and, thus, ______ control.

A
  • soft tissue
  • bone structures
  • functional range
  • structural alignment
  • postural
72
Q

Several muscles such as the _____ and ____ _____ are important for both postural control/stabilization and for respiration.

A
  • diaphragm

- transversus abdominis

73
Q

A goal of PRI is to maintain what is referred to as a zone of ______ which is an area of the diaphragm that directly opposes the ____ _____.

A
  • apposition

- rib cage

74
Q

What has PRI been used to treat?

A
  • low back pain
  • SI jt pain
  • acetabular labral tear
  • anterior knee pain
  • thoracic outlet syndrome
  • sciatica
  • asthma
  • COPD
75
Q

PRI treatment focuses on ______ patterns and _____ joint muscles in combination with ______ breathing.

A
  • asymmetrical
  • multiple
  • diaphragmatic

ATTH 3130 (4 decks)

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