Muscle Energy

Question 1

Muscle energy founder

Answer 1

Fred Mitchell (muscle energy technique)

Question 2

what is muscle energy

Answer 2

patient muscles are actively used on request, from a precisely controlled position, in a specific direction, against a distinctly executed physician counterforce

ACTIVE & DIRECT

Question 3

eccentric contraction

Answer 3

muscle tension allows origin & insertion to separate, lengthens the muscle

Question 4

concentric contraction

Answer 4

contraction of muscle resulting in approx of origin/insertion to shorten muscle

Question 5

isotonic contraction

Answer 5

can be eccentric/concentric

against steady weight but yielding counterforce, allows constant tone

Question 6

describe a bicep curl

Answer 6

curl up is isotonic concentric (shorten w/ constant weight)

curl down is isotonic eccentric (lengthen w/ constant weight)

Question 7

isokinetic contraction

Answer 7

concentric contraction where joint motion is @ constant rate/speed (different weight or resistance)

Question 8

how is stationary bike isokinetic?

Answer 8

keeping same RPMs while changing the resistance

Question 9

isometric contraction

Answer 9

distance between origin & insertion of muscle is maintained @ constant rate

Question 10

how is a wall squat isometric?

Answer 10

constant weight & rate b/c no movement along wall

Question 11

isolytic contraction

Answer 11

type of eccentric contraction where muscle’s concentric contraction is overpowered by a stronger counterforce, leads to lengthening of muscle

Question 12

describe example of isolytic contraction

Answer 12

person has bicep flexed, physician adds force to pull arm away from body towards table

Question 13

post isometric relaxation

Answer 13

goal is muscle relaxation

passive stretch after isometric contraction

physician moves patient into restrictive barrier, patient contracts away from barrier while physician resists contraction toward barrier

Question 14

reciprocal inhibition

Answer 14

goal to lengthen muscle that is shortened by cramp or acute spasm

w/ gentle contraction in agonist muscle, there is reflexive relaxation of that muscle’s antagonistic group

cramping hamstring (agonist) w/ contraction of quad (antagonist)

Question 15

crossed extensor reflex

Answer 15

goal is use in extremities where muscle that needs treatment is in area severely injured that it cannot be manipulated/accessed

form of muscle energy technique uses cross pattern locomotion reflexes in CNS

flexor muscle in 1 extremity is contracted voluntarily, flexor muscle in contra-lateral extremity relaxes & extensor contracts

Question 16

reciprocal inhibition v crossed extensor reflex

Answer 16

reciprocal is ipsilateral (same side)

crossed extensor is contralateral (opp side)

Question 17

oculocephalogyric reflex

Answer 17

goal to affect reflex muscle contractions using eye motion

eye movements reflexively affect cervical & truncal musculature as body attempts to follow lead provided by eye motion

Question 18

respiratory assistance

Answer 18

improve body physiology w/ patient’s voluntary respiratory motions

muscular forces generated just by breathing

used for sacral dysfunction (exaggerated respiratory motions)

Question 19

isolytic lengthening

Answer 19

lengthen a muscle shortened by contracture & fibrosis

contracture of bicep (max contraction that can be resisted by physician)

Question 20

isokinetic strengthening

Answer 20

goal to re-establish normal tone & strength in muscle weakened by reflex hyper-tonicity of opposing muscle group

asymmetry in ROM, asymmetry in muscle strength

use isokinetic contraction so length change occurs @ constant velocity (muscle can shorten but @ slow rate)

Question 21

joint mobilization using muscle force

Answer 21

goal to restore joint motion in articular dysfunction

hypertonic muscles across joint can cause thinning of synovial fluid/adherence of joint surfaces

example of anterior rotated pelvis

Question 22

to treat somatic dysfunction…

Answer 22

use muscle force to move 1 region of body to achieve movement of another bone or region

muscular force used to move 1st structure & that body part’s response to the muscle force transmitted to another part of the body

sustained, gentle pressure

Question 23

Indications of muscle energy

Answer 23

balance muscle tone
strengthen reflexively weakened vasculature
improve symmetry of articular motion
enhance circulation of body fluids
lengthen a shortened, contracted, or spastic muscle group

Question 24

Factors that impact success of muscle energy

Answer 24

contract too hard
contract in wrong direction
sustain contraction
do not relax following contraction
not giving correct instructions
move to new joint position too soon

Question 25

Contraindications of muscle energy

Answer 25

local fracture
local dislocation
instability of cervical spine
neuro symptoms/signs in neck
low vitality
situations when more muscle activity worsens
can't follow verbal commands

Question 26

Articulatory Approach

Answer 26

springing techniques

low velocity/high amplitude (slow movement/long distance)

passive & direct

Question 27

When to use articulatory approach

Answer 27

arthritic patients
elderly or frail
critically ill or post op patients
young/infantile patients
patients who unable to coop w/ instructions

Question 28

Articulation Technique

Answer 28

patient is comfortable & relaxed

do not exceed anatomic barrier

w/ response to technique, restrictive barrier will shift position w/ in physiological range of motion

Question 29

Contraindications of Articulatory Technique

Answer 29

vertebral artery compromise (relative)

absolute:
local fracture/dislocation
neuro syndromes
serious vascular compromise
local malignancy/infection
bleeding disorders

Question 30

what is common between MET & ART

Answer 30

direct techniques, alleviate somatic dysfunction

Question 31

what is different between MET & ART

Answer 31

MET-patient muscle contract 3-5 times & need patient coop (active)

ART-repetitive physician directed motions & need patient relaxation (passive)