Mobility Impairments Flashcards
ability to move a jt easily throughout a full biomechanically correct ROM. Particularly 2 jt mm
flexibility
fixed jt that has high resistance to passive or active stretch. described by action of shortened mm/tissue
contracture
shortening of tissue relative to its normal resting length over time. “postural syndromes”
adaptive shortening
adequate tissue length to move through full ROM. dealing with blockage issues
passive mobility
neuromuscular skill to control movement. dealing with strength issues
active mobility
“tissues remodel in response to the demands/lack of demands placed on them”
Wolfe’s law
Static, highly used mm are at greater risk for
atrophy
high periods of immobility result in a greater ________ than loss of mm mass
functional loss
Immobilization effects on tendons (2)
- Reduce load tolerance
2. Cross linking of fibers
immobilization effects on ligaments (2)
- Cross linking of fibers
2. Bone resorption at insertion sites
immobilization effects on articular cartilage
Cartilage softens from increased water and decreased proteoglycan
immobilization effects on bone (2)
- Resorption increases
2. Formation decreases
immobilization effects on CV system (2)
- Venous return decreases
2. CO decreases
immobilization effects on respiratory system (2)
- Restricted lung expansion
2. Decrease gas exchange
immobilization effects on GI system
Peristalsis decreases
immobilization effects on urinary system (3)
- Kidneys can’t drain
- Kidney stones
- Infection
during remobilization, _____ heals the fastest and ____ heals the slowest
bone, articular cartilage
Indications for PROM (3)
- active motion disrupts healing
- pain
- maintain/increase available ROM
Indications for AAROM (3)
- maintain/increase available ROM
- increase circulation
- can’t complete full AROM
Indications for AROM (3)
- increase mm strength/endurance
- increase circulation
- improve mvmt mechanics
stretching contraindications (3)
- infection
- bony block
- hypermobility
stretching precautions (3)
- recent fracture
- osteoporosis
- elderly
force applied to a tissue
stress
deformation of tissue in response to external load
strain
Stress/strain regions in order (4)
- toe region
- elastic range
- plastic range
- Failure range
Initial application of force on collagen fibers. Tension developes
Toe region
Area where mm is deformed but returns to original shape once load is removed.
Elastic range/deformation
Area where increasing stress on a mm results in progressive failure, microscopic tearing of collagen. Permanent change. Increases ROM of tissue
Plastic range/deformation
Area where change in tissue produces mechanical failure. Fracture, rupture, strain, sprain
Failure range
load is applied for an extended period of time (>60s) to cause tissue elongation that does not return to original length. turns off mm spindles
Creep
Chronic effect of stretching
Sarcomeres added
acute effects of stretching (2)
- elongation of elastic tissue
2. decreased mm spindle activity
four considerations when stretching
- alignment
- stability
- intensity
- duration
application of steady force for a sustained period at a point just past tissue resistance. 30-60s w/ less force
static stretching
relatively short duration stretch that is repeatedly applied, released, applied. 5-30s hold. Spindles never desensitize
cyclic stretching
high velocity, bouncing movements at end range or quick movements that impose rapid change in mm length. Bounce 15-60 sec. More risky
dynamic/ballistic stretching
four types of stretching
- static
- cyclic
- dynamic/ballistic
- PNF
use neurophysiologic effects of autogenic inhibition. useful for mm spasms
PNF stretching
reduction in tone after brief periods of isometric contraction
post-isometric relaxation
high tension in a mm causes relaxation of the same mm (GTO)
autogenic inhibition
process by which mm on one side of a jt relax to accommodate contraction on the other side of jt
reciprocal inhibition
- bring limb to end ROM
- pt isometrically contracts
- relax
- pt passively moves limb further into range
hold relax passive PNF
- bring limb to end ROM
- pt isometrically contracts
- relax
- pt actively moves limb further into range
hold relax active PNF
- bring limb to end ROM
- pt concentrically contracts
- relax
- pt actively moves limb further into range
Contract relax active PNF
Goal of hold relax passive
autogenic inhibition
goal of hold relax active
autogenic inhibition then reciprocal inhibition
goal of contract relax
autogenic inhibition
Stretching no nos (3)
- Don’t force beyond normal ROM
- Don’t stretch w/out strengthening
- Don’t overstretch postural mm
Congenital neuro condition w/ tissue attached to spinal cord. PT contraindicated.
Tethered cord syndrom
Postural neuro condition that responds well to neural mobilization and neural tension stretching
nerve root and dural movement disorder
manual therapy aimed at restoring arthrokinematic motion
jt mobilization
indications for jt mobilization
- jt pain
- mm spasm/guarding
- jt hypomobility
facilitates mm contraction
jt compression
facilitates mm relaxation, pain relief
jt distraction
Grades of jt mobilization PTAs are able to practice
I-IV
Jt mobilization contra/precautions (4)
- hypermobility
- jt swelling
- malignancy
- jt replacement
