Muscle Energy and Articulatory Principles & LAB Flashcards
Define Muscle Energy technique
The patients muscles are actively used on request, from a precisely controlled position, in a specific direction, against a distinctly executed physician counterforce
Who came up with muscle energy?
Fred L. Mitchell, Sr., DO Almost didn’t become a thing
What is Eccentric contraction?
muscle tension allows the origin and insertion to separate, in effect to lengthen the muscle
What is concentric contraction?
contraction of a muscle resulting in the approximation of the origin and insertion , to shorten the muscle
What is a Isotonic contraction
: a concentric or eccentric contraction against a steady but yielding counterforce, allowing a constant tone (constant weight)
What is Isokinetic contraction
a concentric contraction in which the joint motion is at a constant rate/speed (weight can vary)
What is Isolytic contraction
a type of eccentric contraction in which the muscle’s concentric contraction is overpowered by a stronger counterforce (weight is greater than maximal effort) leading to a lengthening of the muscle
What is Isometric contraction
the distance between the origin and the insertion of the muscle is maintained at a constant length (neither eccentric nor concentric)
Post-isometric Relaxation Idea
Immediately after an isometric contraction the neuromuscular apparatus is in a refractory state during which passive stretching may be performed without encountering strong myotatic reflex opposition.
Force of contraction in isometric contraction
Sustained gentle pressure (10-20 lbs
Reciprocal inhibition MOA
When a gentle contraction is initiated in the agonist muscle, there is a reflexive relaxation of that muscle’s antagonistic group
Example: Cramping hamstring(agonist), contraction of quad(antagonist)
DONE WITH OUNCES OF COUNTER PRESSURE
Crossed Extensor Reflex MOA
This form of muscle energy technique uses the learned “cross pattern locomotion reflexes”(walking) in the central nervous system. When the flexor muscle in one extremity(left hamstring) is contracted voluntarily, the flexor muscle in the contralateral extremity(right hamstring) relaxes and the extensor(right quad) contracts.
Example: right hypertonic hamstring
OUNCES of pressure. DONE BECAUSE EFFETED LEG IS SO BADLY INJURED
Oculocephalogyric Reflex MOA
The eye movements reflexively affect the cervical and truncal musculature as the body attempts to follow the lead provided by eye motion
Respiratory Assistance MOA
Goal: Improve body physiology with the patient’s voluntary respiratory motions
The muscular forces involved in these techniques are generated by the simple act of breathing. This may involve the direct use of the respiratory muscles themselves, or motion transmitted to the spine, pelvis, and extremities in response to ventilation motions. The physician usually applies a fulcrum against which the respiratory forces can work.
Isolytic Lengthening MOA
It is postulated that the vibration used here has some effect on the myotatic units in addition to mechanical and circulatory effects [11].Example: Contracture of the bicep
Isokinetic Strengthening MOA
asymmetry of range of motion exists, there is also the potential for asymmetry in muscle strength.
Further restoration of strength can be accomplished through the use of an Isokinetic contraction. In Isokinetic contractions, the length change occurs at a constant velocity. Typically concentric contractions are used, where the muscle is permitted to shorten, but at a controlled slow rate.
Joint mobilization using muscle force
Hypertonicity of musculature across a joint can cause distortion of articular relationships and motion loss.
This increase in muscle tone tends to compress the joint surfaces, and results in thinning of the intervening layer of synovial fluid and adherence of the joint surfaces.
Restoration of motion to the articulation results in a gapping, or reseating of the distorted joint relations with reflex relaxation of the previously hypertonic musculature.
Indications of MET
balance muscle tone
strengthen reflexively weakened musculature
improve symmetry of articular motion
enhance the circulation of body fluids (blood, lymph, and interstitial fluid)
Lengthen a shortened, contractured, or spastic muscle group
Contraindications of MET
Local fracture
Local dislocation
Moderate-to-severe segmental instability in the cervical spine
Evocation of neurologic symptoms or signs on rotation of the neck.
Low vitality
Situations that could be worsened by muscle activity
Post-surgical patient - internal bleeding may be caused
Immediately following myocardial infarction
Recent eye-surgery – use of Oculocephalogyric reflex
Indications of ART
Arthritic patients
Elderly or frail
Critically ill or post-operative patients
Infants or very young patients
Patients unable to cooperate with instructions
Contraindications of ART
Relative
Vertebral artery compromise
Avoid combination of rotation and extension in
the cervical spine
Absolute
Local fracture or dislocation
Neurologic entrapment syndromes
Serious vascular compromise
Local malignancy
Local infection (e.g., cellulitis, abscess, septic arthritis, osteomyelitis)
Bleeding disordersWhat levels of the spine can you use the head as a lever?
T1-T6
At what point do you move the back for a back somatic dysfunction?
T6-T12
You go over 1 bicep for which type of dysfunction?
Type 1
You go over 2 biceps for which type of dysfunction?
Type 2
Seated low thoracic has which hand placed on the neck?
The hand on the side of the PTP
For a lower thoracic seated technique, the doctor stands on which side of the patient?
Opposite of the PTP
What position do you set up a patient with a seated lumbar dysfunction for MET/ART?
Same as thoracic.
Instruct the patient to sit on the treatment table with their ipsilateral hand to the PTP clasped behind their neck and holding that elbow with their other hand. Step away from the PTP!
What position do you set up a patient with a lateral recumbent lumbar dysfunction for MET/ART?
PTP down on the table. Physician facing pt. for neutral, have the top leg flexed and lowered off the edge of the table. for type 2, extend or flex the hip on the bottom leg (this is the treatment movement). and flex the top leg and rest on top of the popliteal fossa. Then move the arm up or down to get the right sidebending. then have the top arm make a hook that your cephalad hand can go through while you caudle hand is on the hip.
