Joint Behavior And Injury - Week 7

Question 1

Zones of movement

Answer 1

• Neutral zone
• Elastic zone
• Plastic zone

Question 2

Normal barriers to movement

Answer 2

• Articular shape - bone and cartilage
• Restraining ligament tension
• Capsular tension
• Muscle length
• Synovial fluid

Question 3

Neutral zone

Answer 3

• Little to no resistance to movement
• Early/ mid range

Question 4

Elastic zone

Answer 4

• First barrier to motion encountered
• Joint is the same when you come out of it

Question 5

Plastic zone

Answer 5

• Permanent deformation, may lead to energy

Question 6

Hypomobile descriptors

Answer 6

• Internal derangement (loose body)
• Arthrosis
• Ankylosis
• Myofascial length
• Effusion, hemarthrosis
• Capsular (+ ligament)

Question 7

Hyper mobile

Answer 7

• Generalized, multi-joint
• Localized hypermobility
• Instability

Question 8

What is neurodynamic tension?

Answer 8

Nerve isn’t gliding or stretching properly

Question 9

Hypomobility management

Answer 9

• Manual therapy to address underlying impairments
• Exercise to promote normal movement
• Medical intervention - surgical release, debridement, repair (very joint and tissue specific)

Question 10

Exercises to promote normal movement with hypomobility

Answer 10

• Preserve/increase range gains
• Regain strength in lost motions
• Re-educate proper movement patterns
• Work into functional activities

Question 11

Laxity

Answer 11

• State of more than typical motion present at a joint, though not a problem unless associated with symptoms
• Lot of people have this w/o issues

Question 12

Hypermobility

Answer 12

Laxity + symptoms associated with inability to control joint during movement

Question 13

Flexibility

Answer 13

• Function of contractile tissue length/resistance
• Can also be function of joint passive restraints (capsule/ligaments)
• Related to amount of motion available (static) and the ease or quality of joint motion (dynamic)

Question 14

Generalized hypermobility

Answer 14

• Multi-joint
• Activity related
• Individual variability
• Genetic disease

Question 15

Beighton scale (>4 adults)

Answer 15

• Elbow, knee hyperextension > 10 (1 pt ea)
• Thumb touches volar forearm (1 pt ea)
• 5th finger extension > 90 (1 pt ea)
• Bend over wit palms on floor (1 pt ea)

Question 16

Localized hypermobility

Answer 16

• Response to neighboring hypomobility - after injury, immobilization, after surgical fusion or arthrodesis

Question 17

Instability

Answer 17

• Loss of joint congruity in response to loading
• Increased ROM without adequate neuromotor control
• Multifactorial
• Altered arthrokinematics (translational)
• Altered physiological motion (anatomical)
• Interferes with function

Question 18

Components of joint stability

Answer 18

• Joint integrity: articular surfaces, congruity
• Muscle: static stability and dynamic stability
• Passive restraints: ligament, capsule, skin
• Motor control: activation, magnitude, timing

Question 19

Hypermobility management - generalized

Answer 19

Neuromuscular control, supportive garments/orthotics

Question 20

Hypermobility management - localized

Answer 20

• Supportive garments/orthotics as needed
• Treat neighboring hypomobilites
• Exercise for muscular stability (isometrics, WB, co-contraction)
• Exercise for improved strength
• Retrain movement patterns, function

Question 21

Hypermobility management - medical intervention

Answer 21

Surgical stabilization, fusion