Muscle Energy Flashcards
Describe the general MET exercise using PIR in an acute context (according to lewitt).
- Patient’s joint positioned at the point at which resistance is first perceived
- Pt uses no more than 20 % of their available strength to slowly, isometrically contract their agonist muscles (the muscles being stretched) for 7- 10 seconds
- Practitioner uses only a small amount of force to resist
- Pt relaxes their muscles slowly with the muscle maintained at the movement barrier
- Move the Pt’s joint into the new resistance barrier
- Repeat as needed
In PIR, when may the patient inhale and exhale to focus contraction and relaxation (according to lewitt)?
- Inhale during contraction
- Exhale during relaxation
How long is the latency “window” during which the patient may be moved into a new resting position in PIR (according to lewitt)?
10 - 20 seconds
What is the ‘neurological model’ of PIR?
- The golgi tendon is loaded to influence the intrafusal fibers of muscles spindles that inhibits muscle tone
How is a chronic patient, or a patient with muscle fibrosis treated differently using PIR?
- The patient is treated more vigorously with a more aggressive stretch
How is the Janda approach of ‘post-facilitation stretch different from that of a standard PIR?
- Contraction is done at mid-range position instead of end range
- The tissues are stretched IMMEDIATELY following contraction
- Stretch is held for at least 10 seconds
- 30 second rest periods
Describe the modified Janda approach.
- Pt moved into mid position
- Contraction of 20 - 35 % held for 7 - 10 seconds
- Rest period of 2 - 3 seconds for relaxation
- Move joint into a position JUST BEYOND the resistance barrier (patient may assist this movement)
- Hold for 30 seconds
- Repeat until no further gains can be made
Why may the patient assist the practitioner in moving the joint into it’s new position?
- The antagonists are activated preventing a stretch reflex
How many PIR stretches can typically be performed until no more length gain is made?
2 - 3
What are the 3 major differences between Janda’s and Lewitt’s approaches to PIR?
- Janda’s uses stronger and longer` contraction
- Janda’s approach moves the patient PAST the resistance barrier
- ## Lewitt begins at the restriction barrier
What type of impairments/ injuries is reciprocal inhibition used for?
- Acute where the tissue cannot be contracted without pain
Why is the muscle contracted short of the resistance barrier in reciprocal inhibition?
- Contractions are easier to perform from mid-range
- The muscle has less of a chance of cramping from the mid-range position
What are 5 common patients errors when contracting a muscle in MET?
- Contracting too strong
- Contracting in the wrong direction
- Patient contracts too hastily (should be a slow build up)
- The patient doesn’t contract for long enough
- The individual doesn’t relax completely after the contraction
What suggestion can be given to the patient if they do not relax completely after contraction?
- Release, and relax
- Inhale and exhale once or twice
- “Now relax completely”
What error is commonly made with respect of the position of the joint by the practitioner in MET? How can this be fixed?
- Inaccurate or uncontrolled positioning
- Can be fixed with: Palpation and visualization of the joint and structures
