Functional Assessments Flashcards
factors that contribute to flexibility
1) age
2) gender
3) joint structure
4) past injury
5) tissue temperature
6) circadian variations
T/F: Females are more flexible than males.
True
The increased hydration of intervertebral disks during sleep, and the subsequent swelling of the disks upon waking, has 3 significant implications for flexibility in the lumbar spine
1) swelling accounts for the increased stiffness in the spine during lumbar flexion upon waking
2) lumbar disks and ligaments are at greater risk for injury in the early morning
3) range of motion increases later in the day
the principle stating that the activation of a GTO inhibits a muscle spindle response
autogenic inhibition
the lengthening of tissue that occurs when a stretch force is applied
creep
possible reasons for the increase in range of motion after an acute static-stretching session
1) creep
2) reductions in tension (stress-relaxation response)
the principle stating that activation of a muscle on one side of a joint (agonist) coincides with the neural inhibition of the opposing muscle on the other side of the joint (antagonist) to facilitate movement
reciprocal inhibition
T/F: An example of reciprocal inhibition is when the gluteus maximus is activated for 6-15 seconds, this reciprocally inhibits the hip flexors temporarily, allowing the hip flexors to be stretched.
True
stretch performed by moving the joints to place the targeted muscle group in an end-range position and holding that position for up to 30 seconds
static stretching
a reflexive muscle contraction that occurs in response to rapid stretching of the muscle
stretch reflex
stretch that occurs when the individual applies added force to increase the intensity of the stretch
active stretch
stretch that occurs when a partner or assistive device provides added force for the stretch
passive stretch
a method of promoting the response of neuromuscular mechanisms through the stimulation of proprioceptors in an attempt to gain more stretch in a muscle; often referred to as a contract/relax method of stretching
proprioceptive neuromuscular facilitation (PNF)
3 basic types of PNF stretching techniques
1) hold-relax
2) contract-relax
3) hold-relax with agonist contraction
An individual holds and resists the force provided by a partner so that an isometric contraction occurs for 6 seconds in the muscle group targeted for the stretch. The individual then relaxes the muscle group and allows for a passive stretch force from the partner (held for 30 seconds) to increase range of motion in the muscle group that was previously in isometric contraction.
hold-relax stretch technique
An individual pushes against the force provided by the partner so that a concentric contraction occurs throughout the full range of motion of the muscle group targeted for the stretch.
contract-relax stretch technique
identical to the hold-relax technique except that a concentric action of the opposing muscle group is added during the final passive stretch to add to the stretch force
hold-relax with agonist contraction
stretch that mimics a movement pattern to be used in the upcoming workout or sporting event
dynamic stretch
stretch that incorporates bouncing-type movements
ballistic stretch
This stretch is never held for more than two seconds. The stretch is then released, the body segment returned to the starting position, and the stretch is repeated for several repetitions, with each subsequent movement exceeding the resistance point by a few degrees.
active isolated stretching (AIS)
T/F: Proponents of AIS claim that this technique targets specific muscles and prepares the body for physical activity better than static stretching can, while also protecting the joint attachments that static stretching can sometimes weaken.
True
technique that applies pressure to tight, restricted areas of fascia and underlying muscle in an attempt to relieve tension and improve flexibility
myofascial release
a densely woven, specialized system of connective tissue that covers and unites all of the body’s compartments
fascia
purpose of fascia
to surround and support the bodily structure, which provides stability as well as a cohesive direction for the line of pull of muscle groups
natural configuration of fascia
relaxed and wavy
3 reasons fascia can lose its pliability
physical trauma, scarring, and inflammation
T/F: Myofascial release reduces hypertonicity within the muscles.
True
a change in the shape of tissue as a result of being subjected to an external force
deformation
3 factors that determine the extent of deformation of tissue
1) type of tissue
2) amount of force applied
3) temperature of the tissue
T/F: One of the major determinants in long-term adaptations in flexibility is the collagen found in connective tissues.
True
T/F: Structures containing small amounts of collagen tend to limit motion and resist stretch.
False
large amounts
T/F: A collagenous fiber is relatively inextensible when compared to a sarcomere.
True
muscle imbalances associated with kyphosis-lordosis posture
Facilitated/Hypertonic (shortened):
- hip flexors
- lumbar extensors
- anterior chest/shoulders
- latissimus dorsi
- neck extensors
Inhibited (lengthened):
- hip extensors
- external obliques
- upper back extensors
- scapular stabilizers
- neck flexors
muscle imbalances associated with flat-back posture
Facilitated/Hypertonic (shortened):
- rectus abdominis
- upper back extensors
- neck extensors
- ankle plantar flexors
Inhibited (lengthened):
- iliacus/psoas major
- internal obliques
- neck flexors
- lumbar extensors
muscle imbalances associated with sway-back posture
Facilitated/Hypertonic (shortened):
- hamstrings
- upper fibers of posterior obliques
- lumbar extensors
- neck extensors
Inhibited (lengthened):
- iliacus/psoas major
- rectus femoris
- external obliques
- upper back extensors
- neck flexors
postural muscles are deeper muscles that contain greater concentrations of this muscle fiber type
type 1 (slow twitch)
increased anterior lumbar curve from neutral
lordosis
increased posterior thoracic curve from neutral
kyphosis
decreased anterior lumbar curve
flat back
decreased anterior lumbar curve and increased posterior thoracic curve from neutral
sway back
lateral spinal curvature often accompanied by vertebral rotation
scoliosis
correctible factors for muscle imbalance
1) repetitive movements (muscular pattern overload)
2) awkward positions and movements (habitually poor posture)
3) side dominance
4) lack of joint stability
5) lack of joint mobility
6) imbalanced strength-training programs
non-correctible factors for muscle imbalance
1) congenital conditions (e.g., scoliosis)
2) some pathologies (e.g., rheumatoid arthritis)
3) structural deviations (e.g., tibial or femoral torsion, or femoral anteversion)
4) certain types of trauma (e.g., surgery, injury, or amputation)
Movement Efficiency Pattern
1) joints are correctly aligned and have muscle balance
2) normal length-tension and force-coupling relationships function efficiently
3) facilitation of proper joint mechanics
4) efficient force acceptance and generation
5) promotes joint stability and mobility
6) promotes movement efficiency
General Chronological Plan for a Client
1) Health history and lifestyle information
2) Static postural analysis
3) Identification of correctible postural compensations
4) Administration of appropriate movement screens
5) Stability and mobility training (restorative exercise)
6) Movement training (movement patterns)
7) Progression: load and performance training
muscles suspected to be tight when shoulders are not level
upper trapezius, levator scapula, rhomboids
muscles suspected to be tight when shoulders are not symmetrical to the midline of the body
lateral trunk flexors (flexed side)
muscles suspected to be tight when shoulders are protracted (forward, rounded)
serratus anterior, anterior scapulo-humeral muscles, upper trapezius
muscles suspected to be tight with a medially rotated humerus
pectoralis major and latissimus dorsi (shoulder adductors), subscapularis
muscles suspected to be tight with kyphosis and depressed chest
shoulder adductors, pectoralis minor, rectus abdominis, internal oblique
5 primary movements people perform during daily activities
1) bending/raising and lifting/lowering movements (e.g., squatting)
2) single-leg movements
3) pushing movements
4) pulling movements
5) rotational movements
Thoracic Spine Mobility Screen: What is good/acceptable rotation?
45 degrees in both directions
Thomas Test for Hip Flexion / Quadriceps Extension (suspected muscle tightness): the back of the lowered thigh does not touch the table and the knee does not flex to 80 degrees
primary hip flexors
Thomas Test for Hip Flexion / Quadriceps Extension (suspected muscle tightness): the back of the lowered thigh does not touch the table but the knee does flex to 80 degrees
iliopsoas - prevents the hip from rotating posteriorly and inhibiting the thigh from being able to touch the table
Thomas Test for Hip Flexion / Quadriceps Extension (suspected muscle tightness): the back of the lowered thigh does touch the table but the knee does flex to 80 degrees
rectus femoris - does not allow the knee to bend
Passive Straight-Leg Raise (PSL) purpose
assess the length of the hamstrings
PSL desirable movement
raised leg achieves >= 80 degrees of movement before pelvis rotates posteriorly (tight hamstrings if don’t achieve)
Desirable shoulder flexion movement
flex shoulders 170-180 degrees (hands touching/nearly touching the floor)
Desirable shoulder extension movement
extend shoulders 50-60 degrees off the floor
Shoulder flexion mobility issues
1) Tightness in latissimus dorsi - low back arch
2) Tightness of the pectoralis minor - anterior tilt of scapulae
3) Tight abdominals - depression of rib cage
4) Thoracic kyphosis - rounding of thoracic spine
Shoulder extension mobility issues
1) Tight abdominals
2) Tight biceps brachii
Desirable external/lateral shoulder rotation
externally rotate 90 degrees and touch mat
Desirable internal/medial shoulder rotation
internally rotate 70 degrees toward mat
External/lateral shoulder rotation mobility issues
1) Tightness in internal rotators of arm (e.g., subscapularis)
2) Tightness in joint capsule and ligaments
Internal/medial shoulder rotation mobility issues
1) Tightness in external rotators of arm (e.g., infraspinatus and teres minor)
2) Tightness in joint capsule and ligaments
movements of Apley’s Scratch Test for shoulder mobility
1) shoulder flexion and extension
2) internal and external rotation of the humerus at the shoulder
3) scapular abduction and adduction
reasons to stop the Sharpened Romberg Test (standing, eyes closed, arms crossed, one foot in front of the other)
1) client loses postural control and balance
2) client’s feet move on the floor
3) client’s eyes open
4) client’s arms move from the folded position
5) client exceeds 60 seconds with good postural control
reasons to stop the Stork-Stand Balance Test (standing, hands on hips, bottom foot against lower leg between ankle and knee)
1) hands come off hips
2) stance or supporting foot inverts, exerts, or moves in any direction
3) any part of the elevated foot loses contact with the stance leg
4) the heel of the stance leg touches the floor
5) client loses balance
good score/time for Sharpened Romberg Test
> 30 seconds
good score/time for Stork-Stand Balance Test (males)
Excellent: >50 seconds Good: >40 seconds Average: >30 seconds Fair: >20 seconds Poor <20 seconds
good score/time for Stork-Stand Balance Test (females)
Excellent: >30 seconds Good: 25-30 seconds Average: 16-24 seconds Fair: 10-15 seconds Poor <10 seconds
3 tests of the McGill’s Torso Muscular Endurance Test Battery
1) trunk flexor endurance test
2) trunk lateral endurance test
3) trunk extensor endurance test
reasons to terminate trunk flexor endurance test
1) deviation of neutral spine (e.g., shoulders rounding forward)
2) part of back touches the back rest
reasons to terminate the trunk lateral endurance test
1) deviation of neutral spine (e.g., hips dropping downward)
2) hips shifting forward or backward in an effort to maintain balance and stability
reason to terminate the trunk extensor endurance test
1) when client can no longer maintain parallel position
Desired comparison ratios of trunk, lateral, and extensor tests - flexion:extension; right side:left side bridge; side bridge (each side): extension
Flexion : Extension - ratio less than 1.0
Right side : Left side Bridge - no greater than 0.05 from a balanced score of 1.0 (e.g., 0.95 to 1.05)
Side Bridge (each side) : Extension - ratio less than 0.75
