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CATA 263 midterm > Lec.2 - ROM, flexibility and manual muscle testing > Flashcards

Lec.2 - ROM, flexibility and manual muscle testing Flashcards

1
Q

Injury assessment principles - Diagnostic sign

A

Objective & measurable

It is what you hear, feel, see or smell when you assess the patient

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2
Q

Injury assessment principles - Symptom

A

Subjective, provided by the injured individual.

Their own perception of the problem

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3
Q

Injury assessment principles - Acute injury

A

Sudden onset of symptoms

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4
Q

Injury assessment principles - Chronic injury

A

Slow, insidious onset of symptoms

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5
Q

Injury assessment principles - Microtrauma

A

Multiple small stimuli that culminate to a painful reaction

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6
Q

Injury assessment principles - Macrotrauma

A

Large stimuli that leads to an instantaneous painful reaction

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7
Q

Ex: acute or chronic
ankle sprain
stress fracture

A

ankle sprain = acute/macro

stress fracture = chronic/micro

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8
Q

Evaluation process - why evaluate the uninjured side? (2)

A
  1. Find a baseline

2. Find a goal to reach after the rehab

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9
Q

HOPS acronym

A

History
Observation
Palpation
Stress tests/physical assessment

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10
Q

History

A

Primary complaint, cause or MOI, S/S, past injuries, changes in training or equipment, etc.

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11
Q

Observation

A

Posture, gait, deformities, bruising, swelling, etc.

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12
Q

Palpation

A

Deformities, tenderness, heat, etc.

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13
Q

Stress tests/physical assessment

A

AROM, PROM, RROM, flexibility, ligament testing, neurological exam, etc.

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14
Q

Physical tests (3)

A
  • Uninjured side to establish the baseline
  • Multiple joints may be necessary
  • The spine should also be assessed
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15
Q

ROM (assesses?)

A

Assess the osteokinematic movements (ex: gross movement of knee flexors)

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16
Q

Motion available at a single joint is affected by (2)

A
  • Joint arthokinematics (bony structures)

- Soft tissue (muscles, ligaments, capsules)

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17
Q

Flexibility (mobility)

A

Ability to move freely without restriction

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18
Q

T or F: flexibility will affect ROM

A

TRUE

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19
Q

To measure joint ROM in a joint in which 2 joint are involved :

A

The second joint should be placed in a shortened position

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20
Q

To measure muscle length or flexibility of a 2 joint muscle :

A

The muscle should be placed in an elongated position across all joints

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21
Q

AROM (infos)

A

Perform voluntary movement
Assess for muscle function
Total amplitude, willingness and fluidity of movement

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22
Q

PROM (infos)

A

Performed by the professional without the participation of the patient
Assess for inert/noncontractile structures
Assess for end feel sensations and amplitude

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23
Q

RROM

A

Muscle contraction against a resistance
Assess for muscle function at specific locations
Assess for strength and endurance of a muscle

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24
Q

Open pack

A

With PROM

Allows for accessory movements to occur

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25
Q

Accessory movements

A

Assess for the capsular/ligament limitations

Distraction, sliding, compression, roll and glide

26
Q

Close pack

A

When two structures fit precisely and accessory movement are not possible

27
Q

Types of stretching - Active

A

When a person supplies the force of the stretch

28
Q

Types of stretching - Passive

A

When an external force causes or increases a stretch

29
Q

Location of muscle spindles

A

Intrafusal muscle fibers

30
Q

Location of golgi tendon organs

A

Musculotendinous junction

31
Q

Golgi tendon organs

A

Sensitive to changes in muscle tension

Stimulation causes a muscle to reflexively relax

32
Q

Muscle spindles

A

Monitor changes in muscle length
Creates stretch reflex when sensory neuron from muscle spindle innervates a motor neuron
Muscle contraction with a rapid muscle lengthening

33
Q

Autogenic inhibition

A

• Relaxation that occurs in the same
muscle experiencing muscle
tension
• Accomplished via active contraction of muscle immediately before passive stretch of that same muscle
• Tension built up during active contraction stimulates GTO causing a reflexive relaxation of the muscle
during the subsequent passive stretch

34
Q

Reciprocal inhibition

A 
• Relaxation that occurs in the 
muscle opposite the muscle 
experiencing tension
• This occurs when one 
simultaneously contracts the muscle opposing the muscle that is being passively stretched 
• Tension in contracting muscle stimulates GTO and causes a 
reflexive relaxation of the stretched 
muscle
35
Q

Static stretching

A

Slow constant stretch that holds at end ROM for 15-30 sec

**Do not want to activate muscle spindles (stretch reflex- no contraction or the reflex is activated)

36
Q

Dynamic stretching (mobility drills)

A

Functionally based stretching
Use sport and activity specific movements to prepare the body for warm up
Promote dynamic flexibility

37
Q

Ballistic stretching

A

Involves active muscular effort and uses bouncing-type movement
End position is not held
Used pre-exercise
Usually triggers stretch reflex

38
Q

Proprioceptive Neuromuscular Facilitation Stretch (PNF)

A

Designed to relax muscles with increased tone or activity
Facilitates muscular inhibition
Either isometric or concentric muscle contraction of the antagonist muscle + passive stretch of the antagonist muscle

39
Q

Hold-Relax

A 
Passive stretch (10 sec)
Isometric contraction (6 sec)
Relax, then passive stretch performed in new ROM
Repeat until no further gain in ROM (3-6x)
40
Q

Contract-Relax

A

Passive stretch (10 sec)
Concentric contraction through full ROM
Relax + passive stretch performed in new ROM
Repeat until no further gain in ROM (3-6x)

41
Q

Slow Reversal Hold Relax

A 
Passive stretch (10 sec)
Isometric contraction (6 sec)
Relax + athlete contracts agonist muscle to bring into new ROM
Repeat until no further gain in ROM (3-6x)
42
Q

T or F: Slow reversal hold relax is the most effective due to autogenic and reciprocal inhibiton

A

True
Hammies isometrically
Antagonist to increase ROM

43
Q

Why is manual muscle testing important? (4)

A
  • Need to know our anatomy
  • Determine the integrity of the muscular tissues
  • Determine the ability of athlete to RTP
  • Important to know for prescribing exercises
44
Q

Why do we get muscle weakness? (3)

A
  1. Muscle imbalances (posture, repetitive movements)
  2. Fatigue
  3. Injury (ligamentous, muscular, nerve, joint)
45
Q

Weakness may be due to: (5)

A 
Nerve involvement
Disuse atrophy
Stretch weakness
Pain
Fatigue
46
Q

Return of muscle strength may be due to: (6)

A

Recovery following the disease process
Return of nerve impulse
After trauma and repair
Hypertrophy of unaffected muscle fibers
Muscular development resulting from exercises to overcome disuse atrophy
Return of strength after the tightness/stretch have been relieved

47
Q

Muscle weakness: If due to lack of use, then_____

A

exercise

48
Q

Muscle weakness: If due to overwork and fatigue, then ___

A

Rest

49
Q

Muscle weakness: If due to stretch and strain, then ____

A

Relief of stretch and stress before the stress of additional exercise

50
Q

Break test

A
  • At the end of available ROM

- Patient is asked to hold position and do not allow the therapist to “break” the hold with manual resistance

51
Q

Active resistance

A
  • Therapist gradually applies manual resistance until it reaches the maximal resistance the patient can tolerate
  • Requires skill and experience
52
Q

MRC scale - score of 0

A

No visible or palpable contraction

53
Q

MRC scale - score of 1

A

Visible or palpable contraction

54
Q

MRC scale - score of 2

A

Full ROM gravity eliminated

55
Q

MRC scale - score of 3

A

Full ROM against gravity

56
Q

MRC scale - score of 4

A

Full ROM against gravity, moderate resistance

57
Q

MRC scale - score of 5

A

Full ROM against gravity, maximum resistance

58
Q

Optimal position for muscle testing

A

End of the available ROM for 1 joint muscles

For 2 joint muscles testing is done at mid range of overall length

59
Q

Basic rules of applying MMT (8)

A
  1. Place subject in a position that offers the best fixation of the body
    (supine, prone or sidelying)
  2. Stabilize the part proximal to the tested part or adjacent to
  3. Place the part to be tested in precise antigravity test position, whenever
    appropriate, to help elicit the desired muscle action and aid in grading
  4. Use test movements in horizontal plane when testing muscle that are too
    weak to function against gravity
  5. Apply pressure directly opposite the line of pull of the muscle
  6. Apply pressure gradually, allowing the patient to “get set and hold”
  7. Use a long lever whenever possible
  8. Use a short lever if the muscles do not provide sufficient fixation for use of a long lever
60
Q

T or F : Muscles that are excessive in length are usually weak and allow adaptive shortening of opposing muscles

A

TRUE

61
Q

T or F: Muscles that are too short are usually strong and maintain opposing muscles in a shortened position

A

FALSE, maintain in a lengthened position

CATA 263 midterm (7 decks)

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