Kinesiology Flashcards
Kinesiology
The study of movement and active and passive structures involved
Frame of Reference
Explains human behavior
Specific treatment
Provides rationales for why techniques work
Assumpstions, Function-dysfunction continuum, evaluation, treatment
Why do we take measurements
To determine presence or absence of dysfunction
To establish baselines
To objectively measure amount or lack of progress
To help set realistic goals
Research the effectiveness of therapeutic techniques
Fabricate orthoses and adaptive equipment
Screening
Look in medical record at past tests
Observation of PROM, AROM
Non-Pathological Factors Effecting ROM
Sex Age Hereditary factors Occupation Physical training Anxiety or stress Fear of injury
Types of goniometers and uses
Finger
“180”
Larger goniometers used for larger joints of the body
Parts of goniometer
Stationary arm (Proximal bar) Moveable arm (Distal bar) Axis
How to record findings
Determined by setting –
use 180 degree scale;
some use form, some just write it in narrative.
State position of the patient while measured
ROM recorded as an arc of motion
State whether recorded motion is passive (PROM) or active (AROM)
We do not measure AAROM
How to record findings
E.G.: Elbow flexion:
Normal: 0˚ → 135˚ → 150˚
Limited elbow / : 15˚ → 135˚ → 150˚
Limited elbow v : 0˚ → 100˚
Limited elbow / and v : 20˚ → 100˚
Hyperextension: -20˚ → 135˚ → 150˚
If not tested: N/T or N/A
Documenting Goniometric Measurements
Patient name, age, sex, diagnosis
Therapist name (will sign)
Date and time of measurement
Joint and motion being measured (including side of the body)
Type of motion - passive or active
Subjective information such as pain
Objective information such as crepitus, capsular pattern
Describe deviation from recommended position
Factors Effecting Muscle Strength
Subject factors General health status Pathology Gender Age Activity level/occupations
Psychological/psychosocial factors
Motivation/perceived effort/expectation Cognition Distress and anxiety Depression Fear of injury Self efficacy
Muscle factors
Type of fibers Innervation ratio Fiber architecture Type of contraction Number of joints crossed Vascularity Fatigue Angle of pull
Types of Skeletal Muscle
Fusiform Penniform (Stronger than fusiform muscles) Unipennate Bipennate Multipennate
Innervation ratio
Average number of muscle fibers per motor unit in a givin muscle
Red Muscle Fibers
Slow twitch Smaller for endurance Aerobic- Uses ATP stored in muscles depends on oxygen or air to function Made for strength Fast reaction
White Muscle fibers
Fast twitch Larger for speed Anaerobic Does not need Oxygen to function Uses energy from another source
Isometric
Contraction of muscle without visable movement
Isotonic
With movement
Angle of pull
Direct line of pull on the muscle
Ways to assess muscle strength
Screening- tools exist that give a general estimate (MR, observation, gross check comparing limbs)
Functional motion testing – infer strength through observing engagement in daily activities
Manual muscle testing – break test, active resistance, testing of muscle groups vs. individual muscles
Why Do We Take Measurements?
To establish baseline, set goals, plan treatment
To discern how muscle weakness interferes with ADL
To assist with diagnosis (doctor)
To prevent deformities
To objectively measure amount or lack of progress
To aid in activity selection
Establish need for AE
Research the effectiveness of therapeutic techniques
Screen for job placement & return to work
Medical-legal (once signed becomes legal doc)
When Do We Take Measurements
At initial evaluation
At re-evaluations
At D/C
Muscle Grades
Normal N 5
Good G 4
Fair + F+ 3+
Fair F 3
Fair- F- 3-
Poor + P + 2+
Poor P 2
Poor- P- 2-
Trace T 1
Zero
Articulations or Joints
Synarthrosis
Amphiarthrosis
Diarthrosis
Diarthrodial (Synovial) Joint
Synovial fluid Articular cartilage Articular capsule Synovial membrane Capsular ligaments Blood vessels Sensory nerves Fat Pads Bursa Meniscus
Types of Synovial Joints
Hinge joint Pivot joint Ellipsoid joint Ball-and-socket joint Plane joint Saddle joint Condyloid joint
Joint Forces
Forces occur in the joint secondary to primary forces of the muscles contracting, gravity, external resistance, or friction
Joint may be distracted by gravity/weight
Joint may be compressed by weight bearing
At a normal level of activity a joint can resist the forces imposed on it
Joint Pathology
Trauma Acute Chronic Micro-traumas Overuse Disease Re: osteoarthritis Re: rheumatoid arthritis
Effects of Aging
Can be modified, positively and negatively, by activity, nutrition, and medical factors
Micro-traumas can contribute to structural failure
Less water, prone to adhesions
Functions of the muscular system
Generate tension that is transferred to the bone via tendons
When tension is generated a compression force is applied across the bones stability enhanced
Depending on the line of pull & direction of movement, muscles can also pull segments apart stability reduced movement occurs
Functions of the muscular system
It also distribute loads & act as shock absorbers protect the skeleton
Support and protect organs & internal tissues
Have an effect on pressure inside body cavities & on body temperature
Muscles
Smooth - involuntary muscle; No control over contraction
Cardiac - a type of involuntary muscle
Skeletal (striated)* - voluntary muscle; You contract the muscle at will.
Structure of Skeletal Muscle
Muscles - comprised of fasciculi Fasciculus - bundle of muscle fibers Muscle fiber comprised of myofibrils Myofibril consists of: Actin Myosin
5 General characteristics of skeletal muscle
Contractility – muscle contracts produces tension between the bonesexerts a pull
Irritability- ability to respond to stimuli and transmit impulses
Relaxation – the opposite of contraction
Distensibility – can be lengthened or stretched by a force outside itself – antagonist,gravity or other resistance (therapy)
Elasticity – the ability to recoil after a stretch
Nervous System
Provides control/coordination of contraction of muscles - fine control over speed, length, tension
Central nervous system (CNS)
Brain and spinal cord
Peripheral nervous system (PNS)
Peripheral nerves, effectors (motor nerves) and receptors (sensory nerves) of the body
Motor Unit
Nerve-muscle functional unit
Primarily all motor neurons in skeletal muscles called alpha motor neuron
Vary in size
Fibers of each motor unit are dispersed throughout the muscle with fibers of other units – a number of units need to fire to make a joint angle change
All or None
All muscle fibers in a motor unit either contract or relax at the same time - One fiber can not contract while others relax
Muscle Tone
Firmness of palpation
Postural tone – muscle tone in postural or tonic muscles, or antigravity muscles
Joint, Tendon, and Muscle Receptors
Detect changes in tension and position of structures – provide feedback to nervous system
Joint compression
Joint distraction
Golgi tendon organs and muscle spindles
Energy Sources for Muscle Contraction
Anaerobic metabolism – chemical energy (from ATP) stored in skeletal muscle.
Aerobic metabolism – chemical energy (from stored carbohydrates, fats, proteins) stored in body
Attachment of Muscles
Bone - directly through fleshy fibers Bone - indirectly Tendon Aponeurosis - broad flat thin tendon Ligaments (part of joint capsule) Skin Muscles of facial expressions
Insertions
Usually most moveable
Usually distal attachment
Usually attached to lighter segment
Usually smaller attachment
Tonic Muscles
Constructed for stability - stabilizers Usually non-parallel; uni, bi, multi pennate Fibers usually short and wide Uniarthrodial Usually medially located Usually lie deep Usually attach near to joint they cross Have a predominance of red fibers
Phasic Muscles
Constructed to produce movement - mobilizers Usually parallel; Longitudinal, fusiform Fibers long and narrow Multiarthrodial Usually laterally situated Usually more superficial Usually attached further from joint crossed Predominately white fibers
Antagonist
muscle (group) has opposite action of agonist
Agonist
muscle directly responsible for a given joint action; Principle muscle producing a movement
Synergist
muscle which contracts at the same time as the agonist.
Assistant movers
assist primary mover
Neutralizers
neutralize unwanted movement
Stabilizers
stabilize movement creating smoother motion
Prime mover
(agonist), muscle directly responsible for a given joint action
Assistant movers
also capable of movement directly but of less importance
Emergency muscles
muscles which help prime movers and assistant movers only under emergency conditions.
Origins
Usually least moveable
Usually proximal attachment
Usually attached to heavy segment
Usually broader attachment
