Exam 3 Flashcards
1
Q
how does an electrical current flow (direction)
A
follows path of least resistance
-from negative (cathode) to positive (anode)
-area of high e- concentration to area of low e- concentration
-must be a closed circuit
2
Q
ampere
A
measurement of a current
-how much the electric flow is moving in 1 second
3
Q
charge
A
measured in coulombs (C)
4
Q
voltage (V)
A
measure of electromotive force (aka electrical potential difference)
-the force that pushes the e-
5
Q
resistance (R)
A
opposition to the flow of e- measured in ohms
6
Q
impedance
A
sum of resistance, inductance, capacitance
7
Q
capacitance
A
ability to store an electrical charge
8
Q
Ohms law
A
voltage = current x resistance
9
Q
amplitude
A
-aka intensity
-max distance that the pulse rises above or below the baseline
10
Q
pulse/phase duration
A
horizontal distance required to complete one full cycle of the pulse
11
Q
pulse charge
A
total area within the waveform that represents the amount of current the pulse contains
12
Q
direct currents
A
-uninterrupted, one-directional flow of e- (cathode to anode)
-continuous flow on only one side of the baseline
-example: iontophoresis
13
Q
alternating currents
A
-direction of the flow cyclically changes from + to -
-magnitude is not always equal
-no true + or -
-e- shuffle between the two electrodes
-example: IFC
14
Q
pulsed currents
A
-unidirectional (monophasic) or bidirectional (biphasic) flow of e- that is interrupted by discrete periods of noncurrent flow
-on and off
14
Q
biphasic currents
A
-2 phases, each on opposite sides of the baseline
-lead phase is either above or below the baseline, the last phase is the opposite
-shifts polarity
15
Q
building blocks of pulses
A
phases
15
Q
monophasic currents
A
-1 phase per pulse
-current flows in one direction
-one electrode is + other is -
-equal in amplitude
-all on same side of the baseline
16
Q
physiochemical effect of stim
A
pH change in the tissue
-lotions and other substances alters the skin pH
17
Q
physiological effect of stim
A
depolarization of a nerve produces an action potential
-gate control theory to overpower the pain with mechanical stimulation
18
Q
time-dependent pulse characteristics
A
-phase duration
-pulse duration (phase duration + intrapulse interval + phase duration)
-intrapulse interval
-interpulse interval
-pulse period (pulse duration + interpulse interval)
19
Q
T/F more nerves are stimulated with higher amplitude = stronger sensory/motor response
A
true
20
Q
pulse duration
A
-distance that a pulse covers on the horizontal axis
-from when it is on to when it is off
21
Q
phase duration
A
-duration of biphasic pulses; time requires for each phase to complete its shape
-time it takes to leave the 0 line
22
Q
interpulse interval
A
time between the end of one pulse and the start of the next pulse
-time between pulses
23
intrapulse
interrupts a single pulse or phase
-middle of a pulse
24
pulse period
pulse duration and the interpulse interval and, if present the intrapulse interval
25
pulse charge
number of e- contained within a pulse and is expressed in coulombs
26
phase charge
the charge of each phase
-the higher the phase charge the stronger the contraction
27
pulse rise
amount of time needed for the pulse to reach its peak value
-rapidly rising pulses causes nerve depolarization
28
pulse decay time
amount of time required for the pulse to go from its peak back to zero
29
pulse trains (bursts)
currents that are regularly interrupted by periods of noncurrent flow
-each bursts results in the nerves depolarizing multiple times
30
frequency
-Hertz (Hz)
-pulses per second
31
what affects the number of action potentials elicited
frequency
32
what type of frequency produces physiologic effect
low frequency
-pain modulation
33
what type of frequency is used with Russian
medium
-muscle stimulation
34
Coulombs law
ions move away from the pole having the same charge and migrate toward pole of opposite charge
-opposites attract, likes repel
-ions move in one direction only
35
a nerve's response to electrical stimulation is based on 3 factors
1) diameter of the nerve
2) depth of the nerve relative to the electrode
3) phase duration of the current
36
what nerves are stimulated first
sensory, for pain modulation
37
which nerves are depolarized first
large diameter
38
law of dubois reymond
the effectiveness of a current to target specific excitable tissues is dependent on 3 major factors:
1) intensity greater than tissue threshold
2) rate of voltage change must be rapid enough that tissue accommodation cannot take place
3) length of stimulus or phase duration must be great enough to overcome the capacitance of the tissue to allow an action potential
39
T/F large diameter nerves have a low capacitance
true, cannot store a charge and produces a quick action potential
40
electrode considerations
-minimize resistance (air-skin interface)
-single use vs multi-use
-adjust intensity after electrodes are secured
-determine electrode size and location
-correctly place active and dispersive leads
41
electrodes place closely will
dense current in superficial tissues
42
electrodes placed further apart will
deeper into nerves and blood vessels
43
monopolar
-2+ unequal sized electrodes
-active and dispersive
-active electrode placed at the target site
-example: iontophoresis and wound healing
44
bipolar
-equal sized both over treatment site
-example: TENS
45
quadripolar
-separate medium-frequency generators
-2 sets or 4 electrodes using 2 crossing currents
-example: IFC
46
T/F as the size of the electrode increases, the current density decreases
true
47
T/F larger electrodes produce stronger contractions
true
-no pain produced
-stimulation of the tissues is less specific because the current is distributed over a larger area
48
stimulation points
areas of the skin that are more conducive to electrical stimulation
-motor points, trigger points, acupuncture points
49
muscle fibers are 4x more conductive when the current flows with the direction of what
muscle fibers
50
subsensory level
occurs between the point at which the output intensity rises from zero to the point where the patient first receives a discrete electrical sensation
-no therapeutic benefits
51
sensory level
only depolarizes sensory nerves
-increase the output to the point at which a slight muscle twitch is seen or felt
52
motor level
an intensity that produces a visible muscle contraction without causing pain
-no pain
53
noxious level
current applied at an intensity that stimulates pain fibers
-pain felt
54
muscle fiber level
stimulation is applied with a long phase duration and output intensity that directly causes muscle fibers to depolarize
55
TENS
-used for pain modulation
-sensory (A-beta)
-rhythmical (A-delta)
-noxious (C fibers)
56
low-voltage
-adjustable duration, intensity, frequency, and duty cycle
57
portable TENS unit
-long duration of use (at-home)
-gradually turn up amplitude
58
IFC
-2 medium frequency currents overlapping causing interference
-muscle twitches and sweep setting
-4 electrodes
59
pre-mod
-bursts of medium-frequency currents
-2 electrodes
-sensory pain modulation, muscle spasm reduction, neuromuscular
60
high-volt
-allows deeper penetration
-used for pain control, edema reduction, tissue healing, muscle spasm reduction, muscle reeducation
61
iontophoresis
-ions in solution transferred through skin via electrical potential
-check state practice acts
-monitor for skin burns
62
contraindications of stim
-sensory or mental impairments
-history of seizures
-exposed metal implants
-unstable fractures
SHEU
63
precautions of stim
-menstruation
-areas of nerve sensitivity
-communication impairments
-severe obesity
-electronic monitoring equipment
MACS E
64
T/F motor level stimulation is most commonly used to treat pain
false
65
iontophoresis is which type of current
monophasic current
66
subjective portion of exam
-history
-patient info
-medical history
-special questions
-additional info
-pain history
67
objective portion of exam
-observation and visual inspection
-ROM (AROM, PROM, RROM
-special tests
-neurological tests
-palpations
-functional testing
68
assessment portion of exam
-diagnosis
-differential diagnosis
-problem list
-impairments
-functional limitations
-prognosis
69
plan portion of exam
-progression and potential
-treatment goals
-treatment plan
70
what question does the assessment portion of the exam strive to answer
why does this patient require rehab skills and services
71
impairments
-objective
-limited ROM
-swelling
-decrease motion
72
functional limitations
-how does it affect ADLs, walking, sport-specific
-how does impairments affect functional limitations
73
prognosis
honest statements in regards to the patient's likelihood of recovery
-excellent: likely to attain goals in a timely matter without setbacks
-good: attain goals in timely fashion without setbacks, may still have pain
-guarded: last resort therapy attempt before surgery
-poor: unlikely to succeed in rehab program
74
plan of care
-the big picture
-summary of interventions needed to address the impairment and functional limitations
includes:
-duration of treatment: length of time
-frequency of treatments: number of treatments over a time frame
-intervention list: acts used to meet the goals
-goals: acts as a measure for discharge
75
goal writing must include
-specific action to be performed
-quantifiable, measurable, repeatable
-duration and reps
-impairment
-functional limitations
-timeline
76
common mistakes of goal writing
-no relationship between impairments and functional limitations
-no measurable outcome
-nonspecific task
-more than one measurable outcome
-nonspecific activity
-use of non-descript words
77
records to be maintained
-examination and assessment
-reexaminations and reassessments
-each treatment session
-physician progress notes
-discharge summary
78
record keeping
-institutional specific forms
-records are legal documents
-record legibly and accurately
-used professional terms
-maintain records in secured location
-abide by legal requirements for storage and maintenance
79
the many hats the clinician wears
-detective: puts subjective and objective info together, identifies problems, diagnosis, goals, treatments
-problem solved: adjust treatments for patients needs, makes interesting programs
-innovator: uses equipment with innovation
-educator: informs patient of do's and don'ts, instructs proper exercises
80
rehab program determinants
-magnitude of injury
-type of injury
-body segment involved
-patient's activity level
-patient's response to injury
-patient's goals
81
clinician responsibilities for all injuries
-examine the patient
-identify problems
-establish goals
-create rehab program
-execute treatment program
82
rehab progression
-examination
-modalities
-soft-tissue mobilization
-joint mobilization
-flexibility/ROM exercises
-strength/endurance exercises
-agility, balance, coordination (ABCs)
-pylometrics
-functional and performance-specific
83
phase 1: inactive phase
-through inflammation phase
-goals: relieve pain, swelling, spasm; protect injured tissue; prevent deconditioning
-no exercises
-modalities
-identify causes of chronic or repetitive injuries
84
phase 2: active phase
-proliferation healing phase with advance type 3 collagen
-goals: restore ROM, flexibility, and tissue mobility, control pain and swelling
-exercises for ROM/flexibility
-manual therapy for motion gains
-late phase includes early resistance exercises
85
phase 3: resistive phase
-conversion of type 3 collagen to type 1 collagen, increased tensile strength from late proliferation to late remodeling
-goals: restore muscle strength and endurance, proprioception, balance, and agility
-exercises begin in straight-plane and progress to diagonal-plane
86
phase 4: aggressive phase
-late remodeling phase
-goals: restore patient to optimal performance
-resistive exercises are multiplanar
-plylometrics
-functional exercises progress to performance-specific exercises
87
important rehab points
-program progresses on a continuum
-rehab phases coincides with healing
-all program individualized for the patient
-reexamination and reassessments made throughout program
-use objective measures (goniometry or pain scales)
-record all findings and treatments
-correct patient on all incorrectly performed activities
88
electronic medical records (EMR)
-electronic source for medical documentation
-HIPPA complaint
-serves to standarize documentation across settings and providers
-helps efficiently bill for services
89
ICD
international classification of diseases
-diagnostic codes
90
CPT codes
current procedural terminology
-procedure codes
91
a differential diagnosis is the basis from which the rehab diagnosis is selected, the clinician must be able to ____ to create a differential diagnosis
-recognize signs, symptoms, and causes of various diagnoses
-compare patient's symptoms, and history with those known conditions
-use deductive reasoning to identify the correct rehab diagnosis
92
the aggressive phase of the rehab program coincides with the ____ phase of healing
remodeling
93
mechanical effect of manual therapy
-connective tissue deformation
-break down adhesions
-improve flexibility and mobility
-manual therapy -> mechanical stimulation -> tissue response (decrease spasm, increase ROM and function)
-manual therapy -> mechanical stimulation -> A-beta facilitation -> decrease pain
94
neurological effects of manual therapy
-stimulated dermal A-beta receptors
-affects higher neural centers
-affects pain receptors, reduces pain
95
combined overall effect of manual therapy
improved function
96
direct techniques of manual therapy
-load or bind tissues
-treatment force moves toward point of tissue limitation (restore to normal ROM)
-examples: stretching, joint mobilization, trigger point release, rolfing
97
indirect techniques of manual therapy
-relax or facilitate tissue
-treatment force moves away from point of tissue limitation
-examples: positional release therapy, strain-counterstrain, muscle energy, integrative manual therapy
98
manual therapy treatment principles
-position PT comfortable
-position yourself comfortably
-use proper body mechanics
-obtain patient feedback
-maintain cleaned hands and trimmed nails
-explain application before treatment
-assess before, during, after
-use proper technique
-respect precautions and contraindications
-obtain consent
99
abilities required to perform effective manual therapy
-understanding of injury and the healing process
-identification of structures and problems involved
-analysis of the situation to decide plan of action
-critical appraisal of treatment results to determine effectiveness or need for change
100
definition of massage
systematic and scientific manipulation of soft tissue for remedial or restorative purposes
101
mechanical effect of massage
-improvements in the tissues ability to move
-reduced adhesions
-changes in ROM in joints
-increased mobility of muscle tissue
-reduction in tissue stiffness
-improve blood and lymph flow, promote the mobilization of fluid
-ultimately help reduce edema and improve tissue mobility
102
neurological effect of massage
-combo of pain modulation and muscle spasm relaxation
-reduces neuromuscular excitability so that the muscles with injury-related spasm can relax
-pain subsides because massage facilitates the release of beta-endorphins (gate-control)
103
physiological effect of massage
-blood flow to the are increases along with an increase in skin temp
-increased parasympathetic activity: reduce HR and BP
-reduce in the production of cortisol
104
psychological effects of massage
-relaxation
-reduced anxiety
105
indications for massage
-promote mechanical, neurological, physiological, and/pr psychological effects
106
contraindications of massage
-infection
-malignancies
-skin diseases
-blood clots
-lesions
MIS BL
107
precautions of massage
-patient has clean skin and clinician has clean hands
-hands should be warmed and nails trimmed
-remove jewelry
-use right amount of lotion
108
effleurage
-flat, fingers together movement
-begins distally and moves proximally
-uniform pressure
-relax muscle, reduce pain, relieve edema, relax the patient
109
petrissage
-kneading motion
-clockwise and counter-clockwise movements with slight lifting
-mobilize deeper tissue to improve muscle circulation and relaxation, improve muscle mobility
110
friction massage
-finger or thumb in small areas
-circular motions to mobilize specific tissue
-break adhesions or sofetn scar tissue, improve mobility
111
tapotement
-percussion or tapping via cupped hands
-release lymph or fluids, stimulate afferent nerves
112
myofascial release
manual contact to evaluate and treat soft-tissue restriction and pain, relieve symptoms, and improve motion and function
-treat restricted fascia
113
fascia
continuous structure surrounding and integrating tissues throughout the body
-functions:
-provides tissue form
-lubrication
-nutrition
-stability
-integrity
-force transmission
-movement perception
-support
114
damaged fascia
-occurs with injury, immobilization, poor posture
-impaired structural support
-increased inflexibility
-reduced muscle functional capacity
115
autonomic effect of myofascial release
-increased pulse rate, sweating, or BP changes
116
treatment guidelines of myofascial release
-3-5 minutes
-avoid bruising
-stabilize tissue
117
J-stroke
-finger or thumb to move skin against underlying tissue
-apply downward pressure to pull skin over underlying tissue in a J motion
-relieve restricted fascial and scar tissue adhesions
118
oscillation
-fingers in a cupped position to roll back and forth over a muscle
-circular movements
-relax muscle spasm
119
wringing
-both hands at the same time pulling in opposite directions applying a deep pressure
-release multidirectional deep-tissue restrictions
120
stripping
-one hand anchors and other hand, elbow, or forearm is used to apply a downward and forward force to stretch the tissue below the skin
-release adhesions of scar tissue or adherent fascia
121
arm or leg pull
-traction of an extremity through full ROM
-grasps wrist or ankle and lean body weight away from the limb
-relieve tightness
122
myofascial release contraindications
-malignancy
-hypermobile joints
-recent fractures
-hemorrhages
-sutures
-osteoporosis
-infections
-acute inflammation
123
taut muscle band with focal tender point
trigger point
124
active trigger point
always tender and refers pain (reduce motion)
125
latent trigger point
tender only when palpated
126
trigger point characteristics
-dull ache but can be sharp or stabbing
-may cause referred pain
-more irritable the trigger point, the more severe and extensive is the referred pain
-pain is aggravated by muscle activity, passive stretch, movement after prolonged positioning, cold exposure, direct pressure
127
causes of trigger point
-injury
-overload
-fatigue
-chilling
128
histopathological theory
-dysfunctional sarcoplasmic reticulum causes calcium to release without action potential (sustained muscle contraction)
-cause ischemia
sustained Ca+2 release -> sustained sarcomere contraction -> increased metabolism and ischemia -> localized energy crisis -> Ca+2 outside SR
129
neuroelectric pathology theory
-type 1 muscle fibers put under prolonged activation b/c
-- recruited first, relaxed last
--short recovery times
low-level stress -> Ach release at motor end plate -> sustained Ca+2 release from SR -> sustained muscle fiber activation -> nociceptive stimulation -> pain
130
integrated hypothesis
-motor end plate dysfunction causes contraction of certain muscle fibers, causes ischemia and metabolic needs (energy crisis)
-lack of ATP does not allow full muscle relaxation
combo of other 2 theories
131
trigger point examination
-causes of pain must be assessed to rule out trigger points as a possible factor
-pain-referral chart
-a local twitch confirms the presence of a trigger point
132
trigger point treatment goals
-relieve pain via gate control
-resolve causative factors
-restore flexibility, strength, optimal function
133
trigger point treatment methods
-spray and stretch
-pressure release
-stripping of the taut band
-modality application
-injection
134
muscle energy defintion
manual technique that involves the voluntary contraction of the muscle in a precisely contraction direction, at varying levels of intensity, against a distinct counterforce
135
PNF definition
-proprioceptive neuromuscular facilitation
-combined movement pattern that uses neural stimulation to facilitate proper muscle response
-both a manual technique and an exercise technique
136
use of PNF
-optimal relaxation during stretching exercises
-optimal muscle recruitment during strengthening exercises
-stimulate CNS to increase neural recruitment
-to increase flexibility, the CNS is stimulated to optimize muscle relaxation to produce motion gains
137
D1 flexion upper
-shoulder flexion, lateral rotation, adduction
-forearm supination
-wrist radial flexion
-fingers flexion
138
D1 extension upper
-shoulder extension, medial rotation, abduction
-forearm pronation
-wrist ulnar extension
-fingers extension
139
D2 flexion upper
-shoulder flexion, lateral rotation, abduction
-forearm supination
-wrist radial extension
-fingers extension
140
D2 extension upper
-shoulder extension, medial rotation, adduction
-forearm pronation
-wrist ulnar flexion
-finger flexion
141
D1 flexion lower
-hip flexion, adduction, lateral rotation
-ankle dorsiflexion, inversion
-toes extensions (dorsiflexion)
142
D1 extension lower
-hip extension, abduction, medial rotation
-ankle plantarflexion, eversion
-toes flexion
143
D2 flexion lower
-hip flexion, abduction, medial rotation
-ankle dorsiflexion, eversion
-toes extension, dorsiflexion
144
D2 extension lower
-hip extension, adduction, lateral rotation
-ankle plantarflexion, inversion
-toes flexion
145
agonistic
muscle contracts to shortened state
146
antagonistic
muscle approaches lengthened state
147
PNF stretching
-hold-relax: end motion, contraction 6-10 seconds, relax, move to new end-range
-contract-relax: resist motion to end motion, relax, move to new end range
-slow reversal hold relax: resist thru full ROM, hold contraction at end 6-10 secs, relax, bring to new end range
148
PNF strengthening
-rhythmic stabilization: resist complete movement in all directions with extremity full extended
-slow reversal: resist thru both ranges of motion
-slow reversal hold: resist then contract at end-range of both ranges of motion
149
joint mobilization
-passive movement of a joint to relieve pain or restore mobility
150
physiological joint motion
movement the patient can do voluntarily
151
accessory joint motion
necessary for normal joint motion but cannot be voluntarily performed or controlled
152
movement between bones that form a joint
arthrokinematics
153
roll motion
-occurs between joint surfaces when a new point of one surface meets a new point of the opposing surface
-roll of convex in the direction of bones movement
-example: flexion of the knee; roll of tibial plateau of the joint will be in the same direction of the tibia
154
slide motion
-occurs when one point of the joint surface contacts new points on the opposing surface
-slide and roll occur together in same or different direction
155
spin motion
-occurs in a joint when one bone rotates around a stationary axis
-example: humeroradial joint during pronation or supination
156
compression motion
-decrease space between the joint
-adds stability to a joint
157
distraction motion
-occurs when the two surfaces are pulled apart
-relieve pain in a tender joint
-make mobilization techniques more comfortable
158
convex-on-concave rule
convex joint surface slides on the concave surface in the opposite direction of bone movement
159
concave-on-convex rule
concave joint surface slides on convex surface in the same direction as the bone movement
160
neurophysiological effects of joint mobs
-facilitates gate control
-affect muscle spasm and muscle guarding
161
nutritional effects of joint mobs
-distraction or gliding can cause synovial fluid movement within the joint
-provide nutrient exchange to prevent effects of joint swelling and immobilization
162
mechanical effects of joint mobs
-improve mobility of hypomobile joints
-stretch collagen into their plastic range of deformation to increase tissue mobility and motion
-break down adhesions
163
cavitation effects of joint mobs
-increased pressure in a joint causes a vaporization of gas within synovial fluid, cracking knuckle
164
grade 1
small amplitude movement in begin of ROM
165
grade 2
large amplitude movement in the middle of non-restricted ROM
166
grade 3
large amplitude movement to restricted ROM
167
grade 4
small amplitude movement to restricted ROM
168
grade 1 and 2 usage
relieve joint pain
169
grade 3 and 4 usage
gain joint motion
170
contraindications of joint mobs
-hypermobile joints
-malignancy
-TB
-osteomyelitis
-recent fracture
-ligamentous rupture
-herniated disc
-joint effusion
171
precautions of joint mobs
-osteoarthritis
-pregnancy
-flu
-total joint replacement
-severe scoliosis
-poor general health
-patient inability to relax
172
flexibility
musculotendinous units ability to elongate with application of a stretching force
-how long can our motor unites move and contract
173
ROM definition
-amount of ability of a joint
-determined by the soft tissue and body structures in the area
174
collagen
-provides strength and stiffness
-building block
175
elastin
-provides extensibility (stretch and return to normal)
-more elastin = greater flexibility
176
reticulin
-essentially type 3 collagen
-important during repair after injury
177
ground substance
-structureless organic gel-like materials that reduce friction between collagen and elastin fibers
-maintains spacing between the fibers to prevent excessive cross-linking
-transport nutrients to the fibers
178
connective tissue
supports the body and provides it with framework
-composed of cells and extracellular matrix
179
fibroblasts
cells which create connective tissue components of collagen, elastin, reticulin, and ground substance
180
areolar (loose irregular) CT
loose CT tissue with an unorganized structure and relatively long distance between cross-links
-ex: fascia of the skin and fascia surrounding muscles and nerves
181
dense regular CT
CT with highly organized parallel collagen fibers and more cross-links than loose CT
-ex: tendons and ligaments
182
dense irregular CT
CT consisting of collagen fibers arranged in a haphazard or disarrayed alignment
-ex: joint capsules and bone periosteum
183
immobilization effects on soft tissue
-ground substance is reduced, leading to increased collagen cross-links, reducing mobility
-fiber meshwork contracts so that tissue becomes dense, hard, and less supple
-with injury, new collage formation encourages new/excessive cross-link formation, restricting motion
-wound contraction reduces ROM
-with edema and immobilization, fibrosis increases
-collagen binds to other structures and limits tissue mobility
184
key effects of immobilization on muscle tissue
-decreased muscle fiber size
-reduced number of myofibrils
-reduced oxidative capacity
-increase in fibrous and fatty tissue in the muscle
-reduced intramuscular capillary density
-atrophy seen after 2 weeks
-with prolonged immobilization, normal neural feedback system of movement is lost
185
immobilization effects on articular cartilage
-cartilage becomes thinner
-reduced proteoglycan concentration
-less matrix organization
-necrosis of areas under constant pressure
-increased fibrofatty tissue within the joint that becomes scar tissue
-irreversible damage occurs with continued immobilization
186
immobilization effects on periarticular CT
-CT becomes thick and fibrotic
-reduced GAG and water in ground substance decrease ECM
-diminished tissue mobility occurs secondary to changes in ground substance, increased collagen cross-links
-decrease ROM
187
effects of remobilization on CT
-enhances recovery
-prevents abnormal collagen cross-link formation
-increased fluid content in ECM of CT
188
mechanical properties of CT
elasticity
viscoelasticity
plasticity
189
elasticity
ability of a structure to return to its normal length after application of an elongation force or load
190
viscoelasticity
ability of a structure to use its elastic properties to resist a change of shape when an outside force is applied but an inability to completely return to its former state after changing shape because of its viscous properties
191
plasticity
ability of a substance to undergo a permanent change in size or shape after a deforming force is applied
192
physical properties of CT
force deformation
creep
stress-strain
193
force deformation
amount of force that is applied to maintain a change of length or other deformation of tissue
194
creep
elongation of tissue when a load, usually a low level, is applied over an extended time to cause plastic deformation
195
stress-strain curve
-stress: force that changes the form or shape of a body
-strain: amount of deformation a structure undergoes when a stress is applied
196
neuromuscular influences on ROM
-muscle spindles and GTO are sensitive to tension in the muscle and its tendons
197
golgi tendon organs (GTO)
-less sensitive to stretch than muscle spindle, very sensitive to muscle contraction
-perform autogenic inhibition of the muscle when stimulates
-simultaneous activation of antagonistic muscle
198
effects of muscle spindle and GTO
-if stretched too quickly, muscle contracts
-when stretch is applied slowly, GTO fires to inhibit contraction of the muscle
-contraction of antagonist inhibits agonist contraction
199
dynamic stretching
-patient stretches without outside assistance
-muscle must be relaxed
-segment should be stabilized and isolated
-force application and release are slow
-reciprocal inhibition: when the opposing muscle contracts, relaxation of the muscle being stretched increases
200
static stretching
-performed by clinician or equipment
-short or long term
-segment is stabilized and isolated
-force application and release are slow
-may be more effective than active stretches for plastic changes
201
reciprocal inhibition
when a muscle becomes tighter, its antagonist becomes weaker
202
prolonged static stretch
-low-level force to apply stretch over long period of time
-affects stress-strain curve to make gains in mobility
-creep phenomenon
-tolerance to stretch increases with mobility gains
203
indications of ROM stretches
-deficient ROM
-structures causing lack of ROM
-assess status of tissue
-recent scar tissue
-spasm
-edema
-postural deformities
-weakness of opposing muscles
-soft tissue is shortened
204
contraindication of ROM stretches
-recent fracture
-bony block
-infection of joint capsule
-acute inflammation in joint
-extreme or sharp pain with motion
-tightness of soft tissue contributing to the areas stability
205
precautions of ROM stretching
-explain to the patient the stretch
-need to have a sensation of a stretch but not pain
-slow application
-understand what tissues are involved
-use of extreme cautions after immobilization
-make sure patient is in optimal position
206
choices of stretching technique depends on
-tissues involved
-state of healing
-patient motivation
-time and facilities available
207
after 1st week of injury or surgery
-active exercises throughout the day
-CPM, used for hours a day
-mild short-term passive stretches can begin after day 7 to 21
208
remodeling phase stretches
-prolonged stretches
-short-term active and passive stretches are used to reinforce prolonged stretch (strengthening and balance)
209
scar tissue (3-4 months) stretches
-prolonged stretches
-reinforced with frequent active stretches
210
T/F reticulin is stronger than type 1 collagen
false
211
which of the following is a clinical presentation following muscle tissue immbolization
smaller muscle size
212
during immobilization, which of the following occurs in the articular cartilage
reduced proteoglycan concentration
