S1_L3-4: ROM, Stretching, & Flexibility Flashcards
(1) ____ is when a muscle contracts on both joints that it crosses to the point where it cannot be shortened anymore.
- Active insufficiency
Name the 6 structure that can affect ROM.
- Muscle
- Joint structure (synovial fluid & capsule)
- Ligament
- Fascia
- Nerve
- Vessels
This is also known as the range of muscle
Functional excursion
TRUE OR FALSE: PROM may prevent muscle atrophy that is why itβs used in early stages of healing.
False.
PROM does not prevent muscle atrophy.
TRUE OR FALSE: AROM & AAROM prevents thrombus formation
True.
In wall climbing, proper posture must be taught to avoid (1) ___, (2) ____, (3) ____.
- trunk side bending
- toe reaching
- shoulder shrugging
Continuous Passive Motion must initially start at (1) ____ degrees then progress (2) ____ degrees per day as tolerated.
- 20-30
- 10-15
TRUE OR FALSE: Gravity provides resistive force against the prime motion, therefore, prime mover
requires assistance.
False.
Gravity provides assistive force.
Functional activities require assistance when muscle grade is ___
below 3/5
TRUE OR FALSE: PROM prevents muscle atrophy.
False
TRUE OR FALSE: PROM is indicated when a patient is in a comatose.
True
____ is dependent on the amount of muscle contraction
and tissue resistance
Dynamic Flexibility (Active Mobility / AROM)
What 6 factors contribute to hypomobility?
5&6 from Kisner 7th ed.
- Prolonged Immobilization
- Sedentary lifestyle/habitual postures
- Postural malalignment (congenital/acquired) / muscle
- Paralysis / weakness
- Tissue trauma resulting in inflammation and pain
- Congenital or acquired deformities
TRUE OR FALSE: Pseudomyostatic contracture occurs on shortened musculotendinous unit.
False.
Myostatic contracture occurs on shortened musculotendinous unit.
_____ contracture develops when connective tissue that
attaches to a joint capsule becomes stiff
Periarticular
TRUE OR FALSE: PROM is used to prevent cartilage degeneration & decrease pain.
True.
____ is a time-dependent property of non-contractile connective tissues that allows change in length when sustained.
Viscoelasticity
5 factors that cause changes in collagen, thereby affected stress-strain response
- immobility
- inactivity
- age
- corticosteroids
- injury
Autogenic inhibition is the inhibition of the contractile components of the muscle by the ____
golgi tendon organ
Name the 7 contraindications for stretching
- Bony block
- Recent fracture or incomplete bony union
- Acute inflammatory or infectious process
- Sharp, acute pain with joint movement or muscle elongation
- Hematoma or tissue trauma
- Hypermobility
- Contractures or shortened tissues
TRUE OR FALSE: Lengthening of opposing tissue is indicated for stretching
False.
Stretching is only indicated for shortening of opposing tissue.
TRUE OR FALSE: Low intensity stretching is recommended to minimize muscle guarding.
True
Which statement is correct?
- Cryotherapy is used to minimize post-stretch muscle soreness.
- Cryotherapy is used before stretching muscles to prevent soreness.
Only the 1st statement is correct.
Stabilization is the fixation of the body segment that has an (1) ____ to the muscle that is to be (2) ____.
- attachment
- stretched
TRUE OR FALSE: Ballistic stretching is indicated for stroke patients
False.
Ballistic stretching is avoided.
Increased tension resists (1)____ & is thought to compromise the effectiveness of the stretching procedure.
- lengthening
____ may be the adaptive shortening of other soft tissues that cross or surround a joint
Contracture
TRUE OR FALSE: Muscle range is describe with terms such as flexion, extension, abduction, adduction, or rotation.
False.
Joint range is describe with terms such as flexion, extension, abduction, adduction, or rotation. Conversely, muscle range is related to the functional excursion of the muscles.
Functional excursion is (1)___ influenced by the joint it (2)___.
- Directly
- Crosses
Source: Kisner 7th ed. pg. 61
TRUE OR FALSE: A skateboard or a power board is a friction-free surface that encourages movement without the resistance of gravity of friction.
True.
Source: Kisner 7th ed. page 78
TRUE OR FALSE: For two-joint or multi-joint muscles, their range goes beyond the limits of any one joint they cross.
True
(1) ____ happens when a muscle is too short to produce much tension. (2) ____ is when a muscle is fully lengthened and limits motion at one of the joints
it crosses.
- Active insufficiency
- Passive Insufficiency
TRUE OR FALSE: When the extremity moves downward, gravity causes the motion, and the antagonists need assistance to control the motion eccentrically.
True
2 ways to perform shoulder internal & external rotation using wand (t-bar) exercise
- The patientβs arms are at the sides, and the elbows are flexed 90Β°. Patient moves the wand from
side to side across the trunk while maintaining the elbows at the side. - The patientβs shoulders are abducted 90Β°, and the
elbows are flexed 90Β°. For external rotation, the wand is
moved toward the patientβs head; for internal rotation, the wand is moved toward the waistline.
How to perform shoulder horizontal adduction & abduction using wand (t-bar) exercise
The wand is lifted to 90Β° shoulder flexion. Keeping the elbows extended, the patient pushes and pulls the wand back and forth across the chest through the available range.
____, or reduced functional motion, is often caused by adaptive shortening or decreased extensibility in soft tissues
Hypomobility
____ is a rapid, forceful intermittent stretchβthat is, a high-velocity and high-intensity stretchβ and characterized by fast joint movement that quickly elongates the targeted soft tissues
Ballistic stretching
TRUE OR FALSE: Ballistic stretching safely increases ROM in young, healthy subjects participating in a conditioning program.
True
TRUE OR FALSE: Ballistic stretching is recommended for elderly or sedentary individuals or patients with musculoskeletal pathology or chronic contractures.
False.
If ballistic stretching is done on elderly or sedentary individuals, tissues weakened by immobilization or disuse are easily injured& dense connective tissue found in chronic contractures becomes more brittle and tears more readily as it does not yield easily with high-intensity, short-duration stretch.
Source: Kisner 7th ed. page 99
TRUE OR FALSE: Stretching should be preceded by either low-intensity active exercise or therapeutic heat to warm the tissues that are to be lengthened.
True
Source: Kisner 7th ed. page 100
TRUE OR FALSE: PROM is used to demonstrate a desire motion, but is not done before passive stretching.
False.
PROM is often used preceding passive stretching techniques.
Source: Kisner 7th ed.
PROM is done when a condition is ___
Acute
TRUE OR FALSE: AROM is used for aerobic conditioning programs.
True
This type of ROM is used when a patient has weak musculature.
AAROM
What is the desired progression?
AAROM β> (1)____ β> (2)____
- AROM
- Resistance Exercise
This kind of ROM prevents thrombus formation.
AROM & AAROM
On what conditions should ROM exercises be carefully monitored?
- Myocardial Infarction (MI)
- Coronary Artery Bypass Graft (CABG)
- Percutaneous Transluminal Coronary Angioplasty (PTCA)
TRUE OR FALSE: Muscle range of elongation is antagonistic to the line of pull of the muscle
True
What is the recommended number of smooth & rhythmical repetitions of ROM?
5-10 reps
When is assistance allowed during AROM?
- At the beginning or end of AROM
- When effect of gravity has greatest movement arm (torque)
What are the 5 equipments that may be used in S-AROM?
- Wand (T-Bar)
- Finger Ladder
- Overhead Pulleys
- Skateboard/ Power Board
- Reciprocal Exercise Unit
The Wand (T-Bar) equipment is used for the (1)___ extremity & is done in (2)___ position when maximum protection is needed.
- Upper
- Supine
This equipment is used for shoulder flexion & abduction
Finger Ladder
TRUE OR FALSE: Overhead Pulleys must only be used when muscle activity is desired.
True
TRUE OR FALSE: A power board may be done for hip abduction & adduction.
True
Duration of CPM usage
Minimum of 1 week
Rate of motion of CPM
1 cycle/45 seconds or 2 minutes
TRUE OR FALSE: Passive flexibility is a prerequisite for dynamic flexibility.
True
A bony block is considered an ___ factor that contributes to hypomobility
Intrinsic
____ is the adaptive shortening of muscle-tendon unit & can result in complete LOM
Contractures
A (1)____ contracture is when no specific muscle pathology is present, while a (2)___ contracture has hypertonicity associated with CNS lesions, muscles spasm & muscle guarding.
- Myostatic/ myogenic
- Pseudomyostatic
What are the 4 types of contractures:
- Myostatic
- Pseudomyostatic
- Arthrogenic & periarticular
- Fibrotic & irreversible
When a patient is relaxed as possible during the stretch, it is called ____
Passive stretching
If the patient assists in moving the joint through a greater range, it is called ____
Assisted stretching
Muscle Energy Technique (MET) is also known as
Post Isometric Relaxation
____ is used to improve or restore nerve tissue mobility
Neural Tissue Mobilization/ Neuromeningeal Mobilization
What is the primary cause of LOM?
Decreased extensibility of connective tissue
TRUE OR FALSE: Both contractile & non-contractile tissues have a viscoelastic property.
False
Only non-contractile tissues have a viscoelastic property
____ allows a soft tissue to assume a new & greater length even when a force has been removed.
Plastic Deformation/ Plasticity
____ are responsible for the strength & stiffness of tissue, along with resisting tensile deformation
Collagen fibers.
High amounts of elastin leads to ___
Greater flexibility
Tissues that withstand high tensile loads are high in (1)____, while tissues that withstand greater compressive loads have greater concentrations of (2)____
- Collagen fibers
- Proteoglycans (PGs)
Region in the stress strain curve where most functional activity normally occurs
Toe Region
Source: Kisner & Colby 7th ed.
GR.II ligament injury in a stress strain curve means that the tissue has reached ___
Macro failure
Corticosteroids decreased the (1)___ strength of the mechanical properties of (2)___
- Tensile
- Collagen
Inactivity decreases the (1)___ & (2)___ of collagen fibers
- Size
- Amount
TRUE OR FALSE: A longer lever arm creates a greater torque at a joint
True
Number of seconds in a cyclic (intermittent) stretching
5-10 seconds