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1 Therapeutic Exercise > Lecture 5 > Flashcards

Lecture 5 Flashcards

1
Q

Flexibility

A

ability to move a single joint or series of joints smoothly and easily through an unrestricted pain-free ROM

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2
Q

Dynamic Flexibility

A

degree to which a muscle contraction can actively move a body part through available joint ROM

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3
Q

Passive Flexibility

A

degree to which body part can be moved through available joint ROM by means of assistance. causes more flexibility

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4
Q

ROM assesses

A

osteokinematics (voluntary motions)

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5
Q

Joint play assesses

A

arthrokinematics (involuntary motions)

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6
Q

Mobility

A

used to describe movement of body segments, joints, and tissues as well as locomotion

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7
Q

AROM assesses

A

contractile tissue performance

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8
Q

PROM assesses

A

non-contractile tissue

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9
Q

Hypomobility

A

decreased mobility or restricted motion
caused by extrinsic or intrinsic forces

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10
Q

Extrinsic forces

A

casts, fixators, splints
outside of the body

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11
Q

Intrinsic forces

A

pain, inflammation, bony deformities
sedentary lifestyle
paralysis
postural malalignment

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12
Q

Adaptive shortening

A

shortening of soft tissue relative to its normal resting length

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13
Q

Causes of adaptive shortening

A

prolonged period of time
immobilization
sedentary lifestyle
tissue trauma (results in disuse)

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14
Q

Contracture

A

joint is in a fixed position and highly resistant to passive stretch. May be a complete or partial loss of ROM

caused by surgery, immobilization, burns, paralysis, joint disease

results in remodeling of tissue (bone growing in soft tissue)

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15
Q

How can you determine its a contracture or adaptive shortening?

A

Intrinsic/extrinsic factors
Observation
ROM testing (end feel is different)
MMT (very weak or spastic)
Palpation

AS can be ruled out AROM/PROM are normal

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16
Q

Hypermobility

A

joint mobility, laxity, length of a tissue that is beyond normal range. It is neither painful nor dysfunctional. No associated impairments

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17
Q

Instability

A

osteokinematic and/or arthrokinematic movement that is excessive resulting in dysfunction, pain, and/or impairment

joint is uncontrollable

marfann’s syndrome

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18
Q

Joint mobility is controlled by

A

dynamic muscle contraction
proprioception
non-contractile tissues

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19
Q

Normal mobility

A

osteokinematic motion, arthrokinematic motion, and neuromuscular coordination to achieve purposeful movement

requires:
roll, spin, glide
structural integrity
muscle ROM
normal CNS/PNS
requires healthy muscle units

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20
Q

Cycle of immobility

A

Injury
Immobility
Decreased loading
adaptive shortening
decreased mobility/function
disuse & substitution
pain increase

21
Q

Immobility effects….

A

all tissue types
muscle
tendon
ligament
articular cartilage
bone

22
Q

Immobilization on muscle

A

muscle fiber atrophy
decrease in electrical activity
increased connective tissue
fatty infiltration
position effects # of sarcomeres

23
Q

Mobilization on muscle

A

lengthy rehab necessary to restore muscle performance

24
Q

Immobilization on tendon

A

reduced collagen fiber bundles, disorganized fibers
decreased tensile strength and elasticity
lower tissue turnover compared to muscle

25
Q

Mobilization on tendon

A

early: improvement of tensile strength and energy absorption capacity
facilitates normal gliding and soft tissue relationships
prevents excessive scar formation

26
Q

Immobilization on ligament

A

decreased collagen mass, strength, stiffness
increase stiffness in joint
disproportionate increase in young collagen (becomes weak)
bony resorption & weakening at insertion sites

27
Q

Immobilization on Articular Cartilage

A

degeneration of articular surfaces
collage fiber splitting and fibrillation
subchondral bone sclerosis
osteophyte development

28
Q

Mobilization on ligament

A

exercise and loading restore mechanical and structural properties of insertion sites
tissue response is dependent on immobilization period

29
Q

Mobilization on Articular Cartilage

A

prevent degeneration, degradation, progression to osteoarthritis

30
Q

Mobilization on bone

A

bone changes may not be reversible
depends on bone quality
response exceeds that of all other tissues

31
Q

Immobilization on bone

A

decreased bone mass and synthesis
greater loss occurs in weight-bearing bones

32
Q

Collagen changes

A

immobilization = weak
inactivity = decreased size of fibers
steroids = degeneration
age = slower rate of adapting

33
Q

Interventions to increase mobility

A

stretching
joint mobilizations
soft tissue mobilization
neural glides
hold relax

34
Q

Stretching

A

therapeutic maneuver that increases the extensibility of soft tissues
goal is to produce elongation of muscle tendon unit, collagen, connective tissues

35
Q

Indications for stretching

A

ROM loss due to adhesions/scars
Adaptive shortening
Muscle weakness
sport requires ROM

36
Q

Precautions for stretching

A

don’t exceed normal range
recent fractures
osteoporosis
frail elderly
prolonged immobilization
very weak musculature
chronic steroid use

37
Q

Contraindications for stretching

A

bone block
recent fracture that is unstable
inflammatory or infection
sharp/acute pain
hematoma/tissue trauma
shortened soft tissues

38
Q

Elasticity

A

ability of soft tissue to return to its pre-stretch resting length directly after short-duration stretch has been removed

39
Q

Viscoelasticity

A

time dependent property, resists deformation at first. Allows a change in length then a gradual return to pre-stretch state

40
Q

Plasticity

A

tendency of soft tissue to assume a new and greater length after stretch force has been removed

41
Q

Elastic range is a ____stretch

A

COMFORTABLE

42
Q

Static stretching

A

tissue is elongated past point of tissue resistance
held in that position for a period of time

43
Q

Static progressive stretching

A

stretch is applied, relaxation is felt, new end range is held

44
Q

Cyclic stretching

A

short duration of hold, slow application
good if pt is uncomfortable

45
Q

Ballistic stretching

A

rapid, forceful, high-speed, high-intensity stretch
bouncy movements
athletic populations

46
Q

Determinants of Stretching

A

alignment
stabilization
intensity
duration
speed
frequency
mode

47
Q

Intensity

A

low-moderate
low load

48
Q

Duration

A

90 seconds

49
Q

Frequency of stretching

A

increase: 6 times a week
maintain: 2-3 a week

1 Therapeutic Exercise (16 decks)

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