Muscle Energy and Articulatory Principles Flashcards
Isokinetic strengthening
Goal: reestablish normal tone and strength in a muscle weakened by hypertonicity of the opposing mm group.
If there is asymmetry in motion it could be due to tight muscles in one side that don’t allow for full motion in the opposite direction, or it could be due to lack of strength in a set of muscles due to lack of use from thight opposite mm.
If neck muscles in left are weak pull neck to right and have patient pull neck to left slowly.
Joint mobilization using muscle force
Goal: restore joint motion in articular dysfunction.
Hypertonicity of musculature across a joint can cause distortion of articular relationships and motion loss.
The increase in muscle tone compresses joint surfaces and restoration of motion to the articulation results in gapping or re setting of distorted joint with reflexive relaxation of hypertonic muscle. Results in popping of joint
Using mm force to move another region of the body to achieve movement of another bone or region.
Goal: treat somatic dysfxn
Hold one side of muscle and allow patient to contract. For example while stabilizing the superior attachment of SCM, the distal attachment of the muscle pulls superiorly on the clavicle, alleviating somatic dysfunction.
When is muscle energy used?
balance muscle tone, strengthen reflexively weakend muscles, improve symmetry of articular motion, enhance circulation of body fluids, lengthen a shortened contractured or spastic muscle group
What can go wrong with muslce energy?
Contract too hard, contract in wrong direction, sustain contraction for too short of time, not giving accurate directions include direction to push and amount of force to use as well as how long to sustain force, also moving a joint to a position too soon after a patient stops contracting. Relaxation is important.
When to not use muslce energy?
Local fracture, local dislocation, moderate to severe segmental instability in C spine, low vitality, or unable to follow directions
Situations that can be worsened by this:
post surgical patient, following MI, recent eye surgery,
Artiuculatory Approach
AKA: sprining, low velocity/high amplitude, slow movement/long distance
It is a passive and direct technique. Move towards restricted barrier consistently. Can be used on single or entire region.
Used in: arthritic patients, elderly or frail, critically ill or post operative patients, infants or young patients, patients unable to follow instructions.
The patient is comfortable and relaxed and the anatomic barrier to joint motion is never exceeded. Gentle firm force applied by carrying body part shortly past restrictive barrier. rhythmic force 1-2 seconds forward and back
Articulatory technique condtaindications?
Vertebral artery compromise,
local fracture or dislocation, neurologic entrapment syndromes(tingling), serious vascular compromise, local malignancy, local infection, bleeding disorders
Compare mm energy vs artriular technique:
Mm energy: direct technique activating force is patient muscle contraction, patient cooperation is required as it is active technique, goal is to alleviate somatic dysfxn.
Articular technique: direct technique, activating force is repetitive physician directed motions, patient cooperation is relaxation as it is passive, goal is to alleviate somatic dysfxn.
Physiological principles?
- Post isometric relaxation
- Reciprocal inhibition
- Crossed extensor reflex
- Respiratory assistance
- Oculocephalogyric reflex
- Isokinetic strengthening
- Isolytic lengthening
- Joint mobilization using mm force
- Using mm force to move one region of body to achieve movement of another region or bone.
Post isometric relaxation
MOST COMMON form of muscle energy used.
Goal is to relax the muscle.
Immediately after an isometric contraction the neuromuscular apparatus goes into a refractory state where passive stretching can be performed without strong opposition. The 1b nerve in the golgi tendon organ sends signals to inhibit the alpha motor neuron to inhibit the active muscles contraction.
Move patient passively into restrictive barrier (direct technique) and then have paatient contract away from the barrier (indirect technique), Dr. resists the contraction towards the barrier (direct) for 3-5 seconds. No muscle movement as Dr holds origin and insertion same distance. Relax 1-2 seconds and move to next restrictive barrier
Reciprocal inhibition
Goal is to lengthen a muscle shortened by cramp or acute spasm. When a gentle contraction is initiated in the agonist muscle there is reflexive relaxation of that muscles antagonist group.
Ex: cramping hamstring (agonist), contract the quads(antagonist) using ounces of force
Passive movement into the restrictive barrier (direct) and have the patient contract towards the barrier (direct), physician resists the contration toward the barrier for 3-5 seconds resulting in origin and insertion remaining at same length. Relax and after complete relaxation move to next barrier.
Crossed extensor relfex
Goal is to treat an area severely injured such as fractures or burns, or an area that cant be manipulated or accessed such as casted. This uses learned cross pattern locomotion reflexes (seen in walking). When the flexor muscle in one leg is contracted voluntarily the the other flexor in the contralateral leg relaxes and extensor contracts.
Oculocephalogyric Reflex
Goal: affect reflex muscle contractions using eye motion, the eye movements reflexively affect the cervical and truncal muscles as the body attempts to follow the lead provided by eye motion, use gentle contraction.
Respiratory assistance
Goal is to improve body physiology using patients voluntary respiration motions.
The muscle forces involved in these techniques are generated by breathing, this can involve direct use of respiratory muscles or the motion transmitted to the spine pelvis and extremities in response to ventilation motions.
The force of contraction is exaggerated breathing
