Pre-class Muscle length/flexibility

Question 1

Full ROM depends on what 2 components?

Answer 1

Joint ROM

Muscle length

Question 2

What two terms are used synonymously to describe the ability of a muscle to be lengthened to the end of the available ROM?

Answer 2

Muscle Length

Flexibility

Question 3

How is muscle length measured in the clinic?

Answer 3

Measured indirectly by determining the maximal PROM of the joint(s) crossed by the muscle

Question 4

What does muscle length/flexibility refer to?

Answer 4

The ability of a muscle crossing at the joint to lengthen, allowing one joint or a series of joints to move through available ROM

Question 5

In most cases, will joint ROM and muscle length be the same or different when passing over a single joint? Name an exception

Answer 5

Same

Exception: Pec major, which has clavicular or sternal fibers

Question 6

Which will be greater when a muscle passes over 2 or more joints: total joint ROM or muscle length/elongation? Name an exception

Answer 6

Muscle length/elongation

Question 7

What is static flexibility? How is it measured?

Answer 7

Defined as the PROM available to a joint or series of joints.

Measured using goniometer or by tests like toe touch, sit and reach.

Question 8

Decreased static flexibility indicates what?

Answer 8

A loss of motion

Question 9

What is dynamic flexibility? How is it measured?

Answer 9

The degree to which the force of a muscle contraction can move a joint.

Measured by determining muscle stiffness.

Question 10

What is stiffness?

Answer 10

A mechanical term defined as the resistance of a structure to deformation

Question 11

What can increase stiffness?

Answer 11

Strength training and immobilization

Question 12

What is muscle tightness?

Answer 12

Mild decrease in length of a muscle after sitting for short periods of time or following exercise

Question 13

What is adaptive shortening?

Answer 13

Loss of flexibility that develops in muscles that are maintained in a shortened position.

Question 14

What is contracture?

Answer 14

Marked decrease in the length of a muscle leading to a significant loss of ROM

Question 15

What is required to have a contracture?

Answer 15

A prolonged period of limited joint motion

Question 16

What factors influence muscle length/flexibility? (8)

Answer 16

1. Immobilization
2. Weakening of tissue
3. Sedentary living/inactivity
4. Corticosteroid use
5. Gender
6. Age
7. Injury
8. Temperature

Question 17

How does tissue weakening influence flexibility?

Answer 17

Secondary to collagen turnover and bond weakening, along with adhesion formation and disorganization of new collagen fibers

Question 18

How does sedentary lifestyle influence flexibility?

Answer 18

Leads to reduction in size and number of collagen fibers

Question 19

How does corticosteroid use influence flexibility?

Answer 19

Decrease in collagen fiber tensile strength

Question 20

How does gender influence flexibility?

Answer 20

Female generally more flexible than males

Question 21

How does age influence flexibility?

Answer 21

Leads to weakening of collagen fibers

Question 22

What happens as muscle temperature rises? What does this allow for?

Answer 22

Connective tissue becomes more pliable, allowing for more elongation

Question 23

How much can soft tissue temperature changes increase or decrease flexiblity?

Answer 23

By as much as 20%

Question 24

What is the optimal temperature for muscle elongation?

Answer 24

102-110 degrees F

Question 25

Because of the effect of increased temperature, what should be done before stretching?

Answer 25

A warm-up period

Question 26

In most cases, how is flexibility/muscle length assessed? What other ways can it be assessed?

Answer 26

Passively is most common.

Can be performed actively or as a composite assessment as well (sit and reach)

Question 27

What are indications for muscle length tests? (2)

Answer 27

Loss of ROM or flexibility

Soft tissue injury, overuse injury or disease

Question 28

What are contraindications for muscle length tests? (2)

Answer 28

Acute soft tissue or joint injury

Acute neurological trauma

Question 29

Passive ROM of a joint is influenced by what? (3)

Answer 29

1. Muscle length
2. Integrity of joint surfaces
3. Extensibility of capsule, ligaments, fascia and skin.

Question 30

True or false. Muscles can be categorized as either one, two, or multi-joint muscles.

Answer 30

False.

Muscles are categorized as either one- joint or mutli-joint muscles.

Question 31

What defines a one-joint muscle?

Answer 31

Crosses and influences the motion of one joint.

Question 32

What defines a multi-joint muscle?

Answer 32

Crosses and influences the mostion of two or more joints

Question 33

What is passive insufficiency?

Answer 33

When the length of an antagonistic muscle is NOT sufficient to allow the agonist to move the joint or joints through full ROM, even with a maximal contraction of the agonist.

Question 34

What type of testing is used to confirm the lack of excursion (or elongation) of an antagonist? Give an example.

Answer 34

Muscle length testing.

Thomas Test- used to determine if sufficient hip flexor (antagonist) muscle length is present to prevent the assessment of hip extensor (agonist) muscle strength

Question 35

What is the protocol for assessing muscle length? (5)

Answer 35

1. Patient placed in correct position
2. PT determines if test should be passive or active
3. Muscle being assessed is placed in fully lengthened position (focus on final, elongated position)
4. Palpate bony landmarks and measure with gonionmeter
5. Motion should not be blocked by support surface or pillow