ROM and Stretching Flashcards
Fuctional Excursion
-entire length of a muscle
-max elongation
Range of Motion
-used for examination of movement
PROM
-motion produced by external force (PT)
-no active contraction
-motion only through pain free range
Indication:
-Don’t disrupt repair
-pain
-neurological inability to activate muscles
Goals:
-avoid stiffness
-mainstain mobility
-mitigate pain
-avoid contracture
AROM and A-AROM
-motion produced by active contraction or a combination
-demonstrate using PROM
-movement in pain free range
Indication:
-move against gravity
Goals:
-restore AROM
Limitations:
-not enough to sustain strength
ROM Contraindications
-disruptive to healing process (precautions)
-response or condition is life threatening
Exam, Eval, Treatment of ROM
-level of ROM present
-safe amount of motion
-pattern of motion that meets goals
-pt response
-document
-re-eval and modify
Patient Preparation for ROM
-decribe
-free the area/drape
-position pt and PT
Application of Techniques of ROM
-control movement
-support areas of poor structural integrity
-move segment through pain free range
-smooth and slow
-repetitions
Self-Assisted ROM
-pt can determine level of assistance
Equipment:
-wantd, wall climbing, ball rolling, overhead pulleys, skateboard, reciprocal exercise (bike)
Continuous PROM
-CPM
-mechanical device that moves joint slowly and continuously through controlled ROM
-for pt unable to move themselves
Benefits:
-prevents contractures
-stimulates healing structures
-increases synovial fluid lube
-prevents degrading from immobilization
-quicker return of ROM
-decreases postop pain
Functional Patterns
-asssits teaching ADLs and IADLs
-help realize value and purpose
-motor patterns
-meaningful exercises
Acute ROM
PROM
-3-5 reps w/in pain tolerance
-several times a day
Subacute ROM
-PROM to AAROM to AROM
-gravity eliminated to antigravity
10-15 reps with brief hold w/in pain free range
-2-3x per day
Chronic/Functional ROM
-AROM
->30 reps for maintenance of ROM
-stretching to gain ROM
Stretching
-therapeutic maneuver to move soft tissues
-improve ROM of hypomobility
Dynamic Flexibility
-flexibility of muscle due to active mmt
-how high you can kick your leg
Passive Flexibility
-flexibility of muscle due to a passsive force
-PROM usually greater
-how far someone can bend your leg
Hypomobility
-limited arthrokinematic mmt of a joint
-motion you can feel
Arthrokinematics
-movement at the joint
-can be improved to improve osteokinematics
-can treat glides not rolls
Active Insufficiency
-muscle comprimises movement from being too contracted to produce movement
Ex: triceps in full ext and shoulder hyperext
Passive Insufficiency
-muscle comprimsies movement from being too lengetthend to produce movement
ex: finger extensors in full wrist flexion
Convave on Convex
-concave moving on convex
-roll and glide move in same direction
-tibia on femur during open chain kick
Convex on Concave
-convex moving on concave
-roll and glide happen in opposite direction
-femur moving on tibia in closed chain squat
Roll
-direction bone moves farthest from joint
-rotational
Glide
-direct bone movement closest to joint
-linear: forward/backward
Contractures
-joint or muscle stuck in place
-designation by location and position joint is stuck in
Myostatic Contracture
-MT unitt is adaptively shortended
Pseudomyostatic Contracture
-hypertonicity due to CNS lesion
Arthrogenic and Periarticular Contractures
-adhesions, synovial proliferation, joint effusion, osteophytes
Fibrotic and Irreversible Contractures
-fibrous changes in connective tissue leads to adhesions
-difficult to re-establish normal tissue length
Selective Stretching
-purposeful stretch certain muscles and joints while letting others become hypomobile to improve function
Overstretching/Hypermobility
-purposefully overstretch certain muscles or joint to increase function
Interventions to Increase Mobility
Manual Stretching
-external force to perform a passive stretch
Passive Stretching
-no active contraction of contractile unit
Assisted Stretching
-patient assistance by themselves, machine or another person
-self stretching
Neuromuscular Fasciltation and Inhibition
-PNF
-increase or decrease msucle tone
Muscle Energy Techniques
-hold-relax-repositon techniques
Joint Mobilization/Manipulation
-passive techniques to restore arthrokinematics
Soft Tissue Mobiliation
Neural Tissue Mobilization
Indications for Stretching
-adhesions, scars, scar tissue limit ROM
-potential deformity due to ROM limitations
-muscle weakness, shortening
-part of training
-pre/post exercise
Contraindications for Stretching
-bony block
-non-union fracture
-acute inflammation
-infection
-sharp pain
-hematoma or tissue trauma
-hypermobility
-hypomobility provides stability or control
Mechanical behaviors: toe region
-Laxity in tissue/collagen begins to straighten
Mechanical behaviors: elastic region
Can return to original shape and size after being deformed
Mechanical behaviors: elastic limit/yield point
Following elastic region, the yield point signals, the point of no return for the tissue
Mechanical behaviors: plastic range
Residual deformations of the tissues will be permanent
Mechanical behaviors: failure point
Tear or break of tissues
Mechanical behaviors: Necking
-ultimate strength
-warning for failure
Creep
-load applied for extended time to elongate
-PROM
Stress-Relaxation
-load is applied for extended time with tissue at constant length
-AROM
PNF Types
-Propriocetive Neuromuscular Facilitation
Hold-Relax and contract- Relax
Agonist Contraction
Hold- Relax with agonist contraction
