LECTURE 2: ROM and Stretching

Question 1

ROM is what?

Answer 1

basic technique for examining movement/initiating movement into purposeful therapeutic intervention

Question 2

functional excursion

Answer 2

distance muscle is capable of shortening after its been max elongated

Question 3

passive insufficiency

Answer 3

ROM limited by lengthened muscle

Question 4

A-AROM

Answer 4

motion combo of external force and active muscle contraction

Question 5

PROM example in ther-ex technique

Answer 5

myofascial release

Question 6

AROM example technique in ther-ex

Answer 6

ART

Question 7

Indications for PROM

Answer 7

1. recent repair/Sx
2. ton of pain
3. ASIA A: maintenance of joint mobility/ROM if pt cannot activate to avoid contracture

Question 8

Indication for AROM/AAROM

Question 9

ROM should not be done when

Answer 9

motion is disruptive to healing process!!!!
-follow specific precautions during early phases of healing
-ROM should not be done when PT’S RESPONSE/CONDITION IS LIFE THREATENING
(broken rib)

Question 10

If you check AROM and PROM, they are similarly limted, they have a

Answer 10

passive limitation
(capsule, ligament

Question 11

If you check AROM and PROM is much higher, then they have a

Answer 11

muscle problem

Question 12

what is a CPM?

Answer 12

passive motion mechanical device moving joint slowly and continously through pre-set, controlled ROM
-for when there is a risk of scarring down with contracture

Question 13

benefits of CPM

Answer 13

-prevent adhesions, contractures
-brings healing through blood (stimulate healing of tendons, ligaments, healing of incisions, increase synovial fluid)
-prevent degrading effects of immob
-quicker return to ROM
-decrease post-op pain

Question 14

acute general ROM exercise Rx

Answer 14

PROM 3-5 reps within pain tolerance
several x/day

Question 15

subacute general ROM exercise Rx

Answer 15

PROM–>AAROM–>AROM
gravity eliminated then antigravity (no cheat)
10-15 reps, brief hold periods (3-5 seconds) within pain free range 2-3x/day

Question 16

chronic AROM

Answer 16

over 30 reps for mm re-ed
maintain ROM
stretching to gain ROM

Question 17

stretching is

Answer 17

increasing soft tissue mobility to improve ROM by lengthening structures that have shortened and become hypomobile over time
FOR CHRONIC STAGE

Question 18

flexibility

Answer 18

related to muscle shortness
-dynamic and passive

Question 19

hypomobility

Answer 19

limited arthrokinematic movement of joint

Question 20

contractures

Answer 20

designated by location and position the joint is “stuck in”

Question 21

myostatic contracture

Answer 21

MT unit shortened

Question 22

pseudomyostatic contracture

Answer 22

hypertonicity due to CNS lesions (CVA, TBI, SCI)

Question 23

arthrogenic and periarticular contractures

Answer 23

passive structures!
Adhesions, synovial proliferation, joint effusion, osteophytes

Question 24

fibrotic contracture/irreversible contracture

Answer 24

fibrous changes in connective tissue leads to adhesions

Question 25

selective stretching

Answer 25

TENODESIS
Purposefully stretch or mobilize certain muscles and joints while letting others become hypomobile to improve function

Question 26

manual or mechanical stretching

Answer 26

use external force to perform passive stretch
PROM

Question 27

types of stretching

Answer 27

manual stretching
passive stretching
assisted stretching

Question 28

indications for stretching exercises

Answer 28

adhesions, contractures, scar tissue
muscle weakness/shortening of muscles
part of total fitness program
pre-post vig exercise

Question 29

contraindications for stretching exercise

Answer 29

Bony Block
Non-Union Fracture
Acute Inflammation or Infection : will spread it!
Sharp or Acute Pain With Elongation
Hematoma or Tissue Trauma
Hypermobility
Hypomobility Provides Stability or Neuro-muscular Control

Question 30

benefits and outcomes for stretching exercises

Answer 30

increased flexibility and ROM
general fitness
other benefits: injury prevention (evidence not shown for passive stretching techniques), reduced post-exercise soreness, enhanced performance

Answer 31

elasticity: temporary change in tissue length then return to previous length once force is removed

Question 32

viscoelasticity

Answer 32

Only non-contractile connective tissue
Non-contractile connective tissue initially resists stress and strain
Tissue lengthens as the stress is repeated to the tissue
Dependent on velocity, direction, magnitude of force, and tissue temperature

Question 33

plasticity

Answer 33

permanent change in tissue length