Muscle Energy and Articulatory Principles & LAB

Question 1

Define Muscle Energy technique

Answer 1

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

Question 2

Who came up with muscle energy?

Answer 2

Fred L. Mitchell, Sr., DO Almost didn’t become a thing

Question 3

What is Eccentric contraction?

Answer 3

muscle tension allows the origin and insertion to separate, in effect to lengthen the muscle

Question 4

What is concentric contraction?

Answer 4

contraction of a muscle resulting in the approximation of the origin and insertion , to shorten the muscle

Question 5

What is a Isotonic contraction

Answer 5

: a concentric or eccentric contraction against a steady but yielding counterforce, allowing a constant tone (constant weight)

Question 6

What is Isokinetic contraction

Answer 6

a concentric contraction in which the joint motion is at a constant rate/speed (weight can vary)

Question 7

What is Isolytic contraction

Answer 7

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

Question 8

What is Isometric contraction

Answer 8

the distance between the origin and the insertion of the muscle is maintained at a constant length (neither eccentric nor concentric)

Question 9

Post-isometric Relaxation Idea

Answer 9

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.

Question 10

Force of contraction in isometric contraction

Answer 10

Sustained gentle pressure (10-20 lbs

Question 11

Reciprocal inhibition MOA

Answer 11

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

Question 12

Crossed Extensor Reflex MOA

Answer 12

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

Question 13

Oculocephalogyric Reflex MOA

Answer 13

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

Question 14

Respiratory Assistance MOA

Answer 14

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.

Question 15

Isolytic Lengthening MOA

Answer 15

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

Question 16

Isokinetic Strengthening MOA

Answer 16

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.

Question 17

Joint mobilization using muscle force

Answer 17

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.

Question 18

Indications of MET

Answer 18

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

Question 19

Contraindications of MET

Answer 19

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

Question 20

Indications of ART

Answer 20

Arthritic patients
Elderly or frail
Critically ill or post-operative patients
Infants or very young patients
Patients unable to cooperate with instructions

Question 21

Contraindications of ART

Answer 21

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 disorders

Question 22

What levels of the spine can you use the head as a lever?

Answer 22

T1-T6

Question 23

At what point do you move the back for a back somatic dysfunction?

Answer 23

T6-T12

Question 24

You go over 1 bicep for which type of dysfunction?

Answer 24

Type 1

Question 25

You go over 2 biceps for which type of dysfunction?

Answer 25

Type 2

Question 26

Seated low thoracic has which hand placed on the neck?

Answer 26

The hand on the side of the PTP

Question 27

For a lower thoracic seated technique, the doctor stands on which side of the patient?

Answer 27

Opposite of the PTP

Question 28

What position do you set up a patient with a seated lumbar dysfunction for MET/ART?

Answer 28

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!

Question 29

What position do you set up a patient with a lateral recumbent lumbar dysfunction for MET/ART?

Answer 29

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.