Mobility and Flexibility Training

Question 1

Prolonged, Low Intensity stretching

Answer 1

• external F = 5-15 lb to 10% BW applied mechanically
  
  • 20-30 min or several hours
• dynamic splint = 8-10 hrs
• serial cast = 5-7 days and then replaced
• has been shown to be more effective than manual, passive stretching with long standing contractures.

Question 2

Types of Stretching

Answer 2

Manual

Ballistic (bad)

Prolonged low intensity

active (using agonist to stretch antagonist)

facilitated (PNF)

Question 3

Neurophysiological Properties of Contractile Tissue

Answer 3

• muscle spindle
  
  • monitors velocity and length change
• alpha motor neurons
  
  • sense quick stretch and facilitate ms contraction via monosynaptic stretch reflex
• GTO
  
  • inhibit contraction of muscle.
  • when excessive tension develops, GTO inhibit alpha MN and decrease tension in muscle
  • slow stretch (end range) causes GTO to inhibit ms (autogenic inhibition) allowing ms to lengthen (stretch protective reflex)

Question 4

Non Contractile tissue

Answer 4

ligaments, tendons, joint capsules, fasciae and skin

• low magnitiude stretch over time allows rearragnement of collagen bonds
• 15-20 min 5 consecutive days
• Reminder: collagen loses its elasticity w/ age and to stretch elderly w/ caution

Question 5

Common Errors Associated with Mobility and Flexibility Training

Answer 5

• passively forcing joint beyond ROM
• aggressively stretching pt w/ fracture or OP
• using ballistic stretching on tissues that have been immobilized or are spastic
• stretching without additional strengthening
• overstretching weak ms (postural muscles) used for antigravity position