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PTRS 745 Exam 2 > Stretching > Flashcards

Stretching Flashcards

1
Q

Term: ability of structures or segments of the body to move or be moved to allow the presence of ROM for functional activities

A

Mobility

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2
Q

Term: ability to move a single joint or a series of joints smoothly and easily through an unrestricted pain-free ROM

A

Flexibility

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3
Q

Q: What does flexibility depend on?

A

Extensiblity of soft tissues that cross/surround the joint (muscles, tendons, fascia, joint capsules, ligaments

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4
Q

Term: Decreased mobility or restricted motion

A

Hypomobility

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5
Q

Q: What is one of the causes of hypomobility?

A

Contractures

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6
Q

Term: adaptive shortening of the muscle-tendon uint and other soft tissues that cross/surround the joint and results in significant resistance to PROM or AROM and limited ROM

A

Contracture

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7
Q

Content: 5 types of contractures

A
  1. Myostatic
  2. Periarticular
  3. Arthrogenic
  4. Pseudomyostatic
  5. Fibrotic/Irreversible
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8
Q

Term: adaptive muscle shortening with reduction in the number of sarcomeres units in series, individual sarcomere length is also shortened

A

Myostatic contracture

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9
Q

Term: loss of mobility in the connective tissues that cross or attach to a joint or joint capsule (restriction of the arthrokinematic)

A

Periarticular contracture

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10
Q

Term: result from intra-articular pathology (adhesions, synovial proliferation, joint effusion, irregularities in the articular cartilage or osteophyte formation

A

Arthrogenic contracture

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11
Q

Term: limited ROM due to hypertonicity (i.e., spasticity and rigidity) associated with the central nervous system

A

Pseudomyostatic contracture

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12
Q

Term: the connective tissues are replaced by great amount of non-extensible tissue: fibrotic adhesions, scar tissue, and heterotopic bone

A

Fibrotic/Irreversible contracture

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13
Q

Content: Interventions to increase flexibility (6)

A
  1. Manual
  2. Self-stretching
  3. PNF
  4. MET
  5. Mobilization/manipulation
  6. Neural tissue mobilization
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14
Q

Q: What are the two components of muscle stretching (2)

A
  1. Contractile tissue (sacromere, myofibril, myofilament)
  2. Non-contractile tissue (epi, peri, endomysium)
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15
Q

Diagram: Soft tissue response to stretch

A

Regions: Toe, Elastic, Plastic, Failure

  • past elastic region doesn’t return to resting position
  • In plastic range some fibers fail/microruptures
  • Necking - when tissue becomes very weak just before failure
  • In elastic range not pushing the muscle thus requires a longer hold
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16
Q

Diagram: Muscle neurophysiological properties

A

Get the structures to work for you

If you stretch too fast the structures will work against you

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17
Q

Content: changes affecting flexibility (5)

A
  1. Injuries (tendon, ligaments, mm, bone, n., joint cap, etc.)
  2. Immobilization
  3. Inactivity
  4. Aging
  5. Postural patterns (scoliosis, kyphosis, etc)
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18
Q

Content: Indication for use of stretching (5)

A
  1. Decreased ROM
  2. Restricted motion
  3. Postural deviations (weakness vs. shortening)
  4. Preventing musculoskeletal injuries (before - not plastic changes)
  5. Minimize post exercise soreness (after)
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19
Q

Content: Contraindications to stretching (6)

A
  1. Bone block limits joint motions
  2. Recent fx - incomplete union
  3. Acute inflammatory or infection processes
  4. Sharp or actue pain to elongation
  5. Hypermobility
  6. Shortened soft tissue that is necessary for stability or neuromuscular control
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20
Q

Content: Determinants of stretching interventions (6)

A
  1. Alignment and stabilization
  2. Intensity of stretch
  3. Duration of stretch
  4. Speed of stretch
  5. Frequency of stretch
  6. Mode of stretch
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21
Q

Content: Alignment and stabilization

A

Avoid compensation

22
Q

Content: Intensity of stretch (4)

A
  1. Low intensity (low load)
  2. Comfortable
  3. Minimize voluntary/involuntary muscle guarding
  4. Avoid risk of injuries
23
Q

Content: Duration of stretch (2)

A
  1. Static stretching
  2. Cyclic stretching
24
Q

Content: Static stretching (4)

A
  1. Progressive or not
  2. 30-60 sec, 1-3 times (could be 5 times)
  3. Noncontractile soft tissues yield more readily to low intensity continuous applied stretch force
  4. GTO inhibits tension during stretch
25
Q

Content: Cyclic stretching (like ballistic stretch) (2)

A
  1. Low velocity, low intensity
  2. Held between 5 to 10 seconds several times
26
Q

Q: What is the typical speed of stretch?

A

Low

27
Q

Q: What is another type of speed of stretch?

A

Ballistic stretching

28
Q

Term: Quick, bouncing movements that create momentum to carry the body segment through the ROM

A

Ballistic stretching

29
Q

Q: Who is ballistic stretching contraindicated for?

A

older people

30
Q

Content: Frequency of strecth depends on (4)

A
  1. Impaired mobility
  2. Tissues healing
  3. Severity of contracture
  4. Age
31
Q

Content: Frequency of stretching (2)

A
  1. 2-5 sessions a week
  2. Be aware of breakdown of tissues
32
Q

Content: Mode of stretch (6)

A
  1. Manual
  2. Mechanical
  3. Self stretching
  4. Passive
  5. Assisted
  6. Active
33
Q

Content: Mode of stretching indications - Manual (4)

A
  1. Early stages
  2. Patient cannot perform
  3. Stabilize compensations
  4. Applying “proprioceptive” techniques
34
Q

Content: Mode of stretching indications - Self-stretching

A

Maintain of increase ROM gained by PT (HEP)

35
Q

Content: Mode of stretching indications - Mechanical

A

Prolonged time, 30 min to 10 hours

36
Q

Content: Examination and evaluation of the patient (4)

A
  1. Determine available ROM (passive or active)
  2. Soft tissue sources of impaired mobility (end feel and muscle length)
  3. Evaluate irritability of involved tissue (healing)
  4. Determine outcome goals pt. wants to achieve (realistic?)
37
Q

Content: Application of manual stretching procedures (11)

A
  1. Move slowly through the free range to the point of restriction
  2. Grasp the areas proximal and distal to the joint (use broad surfaces of you hand)
  3. Stabilize the proximal segment and move the distal
  4. For the multijoint muscle, stabilizes segment to which the range-limiting muscle attaches.
  5. Consider using “proprioceptive” techniques.
  6. Avoid joint compression, apply gentle distraction
  7. Apply low intensity stretching in a low, sustained manner. Increase tension gradually
  8. Maintain position for 30 sec. or longer tension in the tissues should decrease, then move a little further.
  9. Gradually release the stretch force while maintaining the range-limiting tissues in a comfortable elongated position
  10. If the patient can’t tolerate, use very low, gentle, intermittent stretches.
  11. If appropriated apply selected soft tissues mobilization near the sites of adhesion during the stretch
38
Q

Content: Precautions for Stretching (4)

A
  1. Osteoporosis, prolonged bed rest, age, or prolonged use of steroids.
  2. Protect nearly united fractures
  3. Avoid vigorous stretching of muscles and connective tissue that have been immobilized for an extended period of time.
  4. Progress the dosage gradually (watch pain and soreness)
39
Q

Content: Adjuncts to stretching intervention (5)

A
  1. Relaxation training
  2. Heat
  3. Massage (friction, myofascial release/massage)
  4. Biofeedback
  5. Joint traction or oscillation
40
Q

Term: PT method basedon the global stretching of anti-gravitational muscles and the stretching of muscles that are organized on muscle kinetic chains

A

Global Postural Reeducation (GPR)

41
Q

T/F: With GPR compensations are allowed

A

False, not allowed

42
Q

Content: Basic Principle of GPR (2)

A
  1. Antigravity muscles
  2. Muscle assisted by gravity
43
Q

Content: Anti-Gravity muscles (2)

A
  1. Posture maintenance
  2. Became tight and then weak
44
Q

Content: Muscles assisted by gravity (2)

A
  1. Locomotion
  2. Susceptible to atrophy and then weakness
45
Q

Term: Connecting several joints and overlapping withouth interruptionin the linkage

A

Muscular chain

46
Q

Content: Posterior muscular chain (4)

A

Erector spinae > deep pelvic trochanter mm > hamstrings > triceps surae

47
Q

Diagram: Posterior muscular chain

A
48
Q

Cotent: Anterior Muscular Chain (6)

A

Sternocleidomastoid/scalenes > anterior fascial tissues of the thoracic spine > diaphragm > psoas > adductors > soleus (NOT anterior tib like you may want to think)

49
Q

Diagram: Anterior Muscular Chain

A
50
Q

Content: Treating postures (4)

A

Hold postures for 30-60 minutes

  1. Opening hips, arms down
  2. Opening hips, arms up
  3. Closing hips, arms down
  4. Closing hips, arms up

PTRS 745 Exam 2 (12 decks)

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