Exercise for joint mobility and muscle extensibility Flashcards
What are some reasons for reduced ROM?
- Pain
- Muscle weakness
- Fear avoidance
- Joint stiffness
- Muscle tightness
What can cause joint stiffness?
- Immobilisation
- Stroke
- Hospitalisation
- Respiratory condition that affects exercise capacity
- Post-surgery
- Pain
- Sedentary lifestyle
- Prolonged fixed postures e.g. office work
- Neurological conditions
- Nerve injury
- Injury
- Joint disease
What are effects of immobilisation on ligaments?
- Total collagen mass decreases
- Decreased tensile strength and stiffness
- Shorten
What are effects of immobilisation on joint capsules?
- Decreased tensile strength and stiffness
- Shortens
- Adheres to underlying hyaline cartilage and other intra-articular structures e.g. menisci
What are effects of immobilisation on hyaline cartilage?
- Decreased proteoglycan content and increased water content
- Softening and chondrocyte loss, collagen fibre splitting which can lead to OA
- Adhesion formation between joint surfaces
What are the benefits of joint mobility exercises?
- Can reverse most of these things apart from cartilage.
- Increase/maintain ROM.
- Maintain elasticity and contractility of muscles .
- Prevent cartilage degeneration- increase proteoglycan content and thickness.
- Restore mechanical and structural properties of ligaments, joint capsules and tendons- Increase tensile strength, stiffness and total weight.
- Improve proprioception.
- Reduce pain.
- Prevent DVT.
- Enhance synovial diffusion
What are active joint mobility exercises?
Mobility exercise performed by active contraction of the muscles surrounding the joint, without external assistance
What are active assisted joint mobility exercises?
- Mobility exercise performed by some active contraction of the muscles surrounding the joint and some external force (e.g. other limb, therapist, belt)
- Used when patient not allowed to fully activate muscle, unable to fully activate muscle or extra force is required to obtain desired range
What is the standard procedure for mobility exercises?
- Patient in stable, safe comfortable position
- Area free from restrictive clothing
- Isolate specific joint and movement
- Move through complete range
- Short hold (approx. 3 secs)
- Approx. 5-10 reps
- Repeat approximately 3 times a day
- Perform regularly
Contraindications of mobility exercises
- When it will disrupt healing process or surgical repair
- When increases pain
- When increases inflammation
What are the effects of immobilisation on muscle extensibility?
- Net loss of sarcomeres (although remaining sarcomeres lengthen)
- Decreased muscle length
- Decreased extensibility
- Increased stiffness- less energy absorbed before failure.
Types of stretching exercises
- PNF
- Ballistic
- Static
- Dynamic
What is PNF stretching?
- Aims to cause muscle relaxation so that the muscle can then be stretched.
- Usually requires assistance.
What is ballistic muscle stretching?
- quick uncontrolled movement to change muscle length
- greater risk of soreness and injury
What is static muscle stretching?
Patient in position to allow muscle relaxation, move limb slowly through range to point of gentle stretching sensation, hold for min 30 seconds, approx. 3 reps, perform regularly.
