ROM and Stretching Flashcards by Tori Chatman

Fuctional Excursion

-entire length of a muscle
-max elongation

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Range of Motion

-used for examination of movement

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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

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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

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ROM Contraindications

-disruptive to healing process (precautions)
-response or condition is life threatening

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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

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Patient Preparation for ROM

-decribe
-free the area/drape
-position pt and PT

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Application of Techniques of ROM

-control movement
-support areas of poor structural integrity
-move segment through pain free range
-smooth and slow
-repetitions

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Self-Assisted ROM

-pt can determine level of assistance

Equipment:
-wantd, wall climbing, ball rolling, overhead pulleys, skateboard, reciprocal exercise (bike)

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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

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Functional Patterns

-asssits teaching ADLs and IADLs
-help realize value and purpose
-motor patterns
-meaningful exercises

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Acute ROM

PROM
-3-5 reps w/in pain tolerance
-several times a day

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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

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Chronic/Functional ROM

-AROM
->30 reps for maintenance of ROM
-stretching to gain ROM

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Stretching

-therapeutic maneuver to move soft tissues
-improve ROM of hypomobility

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Dynamic Flexibility

-flexibility of muscle due to active mmt
-how high you can kick your leg

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Passive Flexibility

-flexibility of muscle due to a passsive force
-PROM usually greater
-how far someone can bend your leg

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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