Chapters 3-4 K&C

Question 0

A patient with pain part way through ROM is probably at what stage of healing?

Answer 0

Acute

Question 1

A patient with pain at the end of ROM is probably at what stage of healing?

Answer 1

Subacute

Question 2

A patient with a stretching sensation at the end of ROM is probably in what stage of healing?

Answer 2

Chronic

Question 3

What is the difference between ROM and Stretching?

Answer 3

Stretching is a therapeutic maneuver.

ROM is a technique used for examining movement and for initiating movement.

Question 4

Is there a hold time during ROM exercise?

Answer 4

No

Question 5

Is there a hold time during stretching?

Answer 5

Yes

Question 6

How does stretching improve flexibility?

Answer 6

By elongating structures that have adaptively shortened and become hypomobile.

It is designed to increase extensibility of soft tissue.

Question 7

Is stretching static or dynamic?

Answer 7

It can be either/both.

Question 8

What factors are used to determine what type of ROM is clinically indicated?

Answer 8

Goals
Limitations
Phase of Healing

Question 9

Does AROM maintain or increase strength?

Answer 9

No. Resistance is needed to increase strength.

Question 10

How are contractures named/identified?

Answer 10

By the action of the shortened muscle.

Question 11

What is a myostatic contracture?

Answer 11

Musculotendinous unit has adaptively shortened and there is a significant loss of ROM, but no specific muscle pathology is present.

Question 12

What is a pseudomyostatic contracture?

Answer 12

Impaired mobility and limited ROM due to:
hypertonicity related to a central nervous system lesion
OR
Muscle spasm or guarding
OR
Pain
Involved muscles appear to be in a constant state of contraction but full passive elongation is possible if neuromuscular inhibition procedures are used to reduce muscle tension.

Question 13

What is Functional Excursion?

Answer 13

The distance a muscle is capable of shortening after it has been elongated to its maximum. (aka range of muscle)

Question 14

What is active insufficiency?

Answer 14

When a muscle reaches the point that it cannot shorten any further, preventing further movement of the joint.

Question 15

What is passive insufficiency?

Answer 15

It occurs when a muscle is fully elongated - it cannot lengthen any further.

Question 16

What are the 2 main indicators for using PROM in treatment?

Answer 16

When there is acute, inflamed tissue in the area.

When a patient is not able to or not supposed to actively move the body segment (ex: coma, paralysis, on complete bed rest)

Question 17

What are 8 primary goals of PROM?

Answer 17

1. Maintain joint and connective tissue mobility
2. Minimize the effects of the formation of contractures
3. Maintain mechanical elasticity of muscle
4. Assist circulation and vascular dynamics
5. Enhance synovial movement
6. Decrease or inhibit pain
7. Assist with the healing process
8. Help maintain the patient’s awareness of movement

Question 18

What are the 3 limitations of PROM?

Answer 18

PROM cannot:

1. prevent muscle atrophy
2. increase strength or endurance
3. assist circulation to the extent that active, voluntary muscle contraction does

Question 19

What are the 4 primary indications for using AROM and AAROM?

Answer 19

1. Pt cannot actively contract muscle and move segment with or without assistance
2. Pt has weak musculature and is unable to move joint thru desired range (AAROM)
3. Body segment is immobilized for a period - AROM is used on the regions above and below
4. AROM for aerobic conditioning and to relieve stress from sustained postures

Question 20

What are the precautions & contraindications to ROM exercises?

Answer 20

CONTRAS:
1. Motion is disruptive to the healing process
2. Pt response or condition is life-threatening
PRECAUTIONS:
1. Carefully controlled motion w/in limits of pain-free motion during early phases of healing
2. Signs of too much or incorrect motion
3. Careful PROM to major joints, ankles/feet to reduce venous stasis/thrombus in life-threatening conditions
4. Careful monitoring of AROM of UE and limited walking following MI, CABG or angioplasty

Question 21

What are 5 specific goals associated with AROM?

Answer 21

1. Maintain elasticity & contractility of muscles
2. Sensory feedback from the contracting muscles
3. Stimulus for bond & joint tissue integrity
4. Increase circulation and prevent thrombus formation
5. Coordination & motor skills for functional activities

Question 22

What are combined patterns?

Answer 22

Diagonal motions or movements that incorporate several planes of motion.

Question 23

What are functional patterns?

Answer 23

Motions used in ADLs

Question 24

What is Muscle Range of Elongation?

Answer 24

...antagonistic to the line of pull of the muscle

Question 25

What are 7 benefits of CPM?

Answer 25

1. Prevents adhesions & contractures... which prevents jt stiffness 2. Provides stimulating effect on tendon/ligament healing 3. Enhances healing of incisions over the moving joint 4. Increases synovial fluid lubrication of the joint - which increases the rate of intra-articular cartilage healing and regeneration 5. Prevents degrading effects of immobilization 6. Provides quicker return of ROM 7. Decreases postoperative joint pain

Question 26

Define Flexibility:

Answer 26

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

Question 27

What is Dynamic Flexibility?

Answer 27

aka Active Mobility or Active ROM The degree to which an active musscle contraction moves a body segment through the available ROM of a joint.

Question 28

What is Passive Flexibility?

Answer 28

aka Passive Mobility or Passive ROM The degree to which a body segment can be passively moved through the available ROM. It is dependent on the extensibility of muscles & connective tissues that cross & surround a joint.

Question 29

Define Contracture:

Answer 29

The adaptive shortening of the muscle-tendon unit and other soft tissues that cross or surround a joint, resulting in significant resistance to passive or active stretch and limitation of ROM which may compromise functional abilities.

Question 30

What is the difference between "contracture" - "shortness" - "muscle tightness"

Answer 30

Contracture is an almost complete loss of motion Shortness denotes only partial loss of motion Muscle Tightness denotes adaptive shortening of the contractile AND noncontractile elements of muscle

Question 31

How do Neuromuscular Facilitation and Inhibition Techniques reportedly affect muscles?

Answer 31

They reflexively relax tension in shortened muscles prior to or during muscle elongation.

Question 32

What approach to exercise are Neuromuscular Facilitation and Inhibition associated with?

Answer 32

Proprioceptive Neuromuscular Facilitation (PNF)