STRETCHING

Question 1

In the presence of hematoma or other indication of tissue trauma, can you apply stretching techniques?

Answer 1

Not recommended

Question 2

A patient has a hip extension contracture. What muscles are short?

Answer 2

Hip extensors are short

Question 3

What is a pseudomyostatic contracture?

Answer 3

Limited ROM may be due to a CNS lession:

• CVA, SC injury, or TBI
• Hypertonicity: spasticity or rigidity.

Also:
-Muscle spasm or guarding and pain.

In both cases: excessive resistance to passive stretch.

Question 4

What is a DYNAMIC muscle contraction?

Answer 4

-Eccentric or concentric muscle contraction

Question 5

If a patient has knee flexion contracture, what muscle are short?

Answer 5

Patient has has shortened HAMSTRINGS and cannot extend knee fully

Question 6

In what type of CONTRACTURE the patient has an adaptive shortening of musculotendinous unit without specific muscle pathology present. Can usually be resolved with stretching
exercises within a short period of time.

Answer 6

Myostatic contracture (myogenic contracture)

Question 7

When a patient cannot fully abduct the leg because of shortened adductors of the hip, he or she is said to have an…

Answer 7

adduction contracture of the hip.

Question 8

If a patient has shortened ankle plantar flexors and cannot fully dorsiflex the ankle, he or she is said to have a…?

Answer 8

Ankle plantarflexion contracture

Question 9

Impaired mobility and limited ROM may also be the result of hypertonicity (i.e., spasticity or rigidity) associated with a central nervous system lesion, such as a cerebrovascular accident, a spinal cord injury, or traumatic brain injury.
What type of contracture?

Answer 9

Pseudomyostatic

Question 10

In what type of contracture adhesions, synovial proliferation, joint effusion, irregularities in articular cartilage, or osteophyte formation may be the cause?

Answer 10

Arthrogenic contracture.

Question 11

This type of contracture develops when connective tissues that cross or attach to a joint or the joint capsule lose mobility, thus restricting normal arthrokinematic motion.

Answer 11

periarticular contracture

Question 12

Fibrous changes in the connective tissue of muscle and periarticular structures can cause adherence of these tissues and subsequent development of: (type of contracture)

Answer 12

a fibrotic contracture.

Question 13

This type of contracture will not respond to non-surgical interventions. Results from muscle & connective tissue being replaced with a large amount of relatively nonextensible fibrotic adhesions, scar tissue or heterotopic bone.

Answer 13

Irreversible contracture.

Question 14

Atrophy after inmobilization can begin within as little as… (Time)?

Answer 14

a few days to a week.

Question 15

What is AUTOGENIC INHIBITION?

Answer 15

• Autogenic inhibition reflex is a sudden relaxation of muscle upon development of high tension. It is a self-induced, inhibitory, negative feedback lengthening reaction that protects against muscle tear.
• Golgi tendon organs are receptors for the reflex.

Question 16

What happens if a muscle is stretched too fast?

Answer 16

muscle spindle is activated → stretch reflex → contraction of the muscle being stretched

Question 17

What happens if a muscle is stretched too fast?

Answer 17

muscle spindle is activated → stretch reflex → contraction of the muscle being stretched

Question 18

What type of fibers resist tensile deformation and are responsible for strength and stiffness of tissue?

-As tension increases, fibers stiffen to resist deformation

Answer 18

Collagen fibers

Question 19

What type of tissue fibers provide extensibility and elongate significantly with light loads?

Answer 19

Elastin fibers

Question 20

How are collagen fibers arranged in the skin?

Answer 20

Random and weakest in resisting tension

Question 21

How are collagen fibers arranged in tendons?

Answer 21

In parallel, and can resist the greatest load

Question 22

How are collagen fibers arranged in ligaments, joint capsules and fascia?

Answer 22

Vary between random and parallel

Question 23

How long is each repetition of a static stretching?

Answer 23

30 seconds

Question 24

A physical therapist is slowly applying and releasing the force applied during a stretch. Each cycle of stretch id held for 7 seconds. What type of stretching is this therapist using?

Answer 24

Cyclic stretching

Each cycle of stretch: 5-10 seconds in some studies

Question 25

What do you do after a stretching session with a patient?

Answer 25

• Have the patient PROM or strength train the new ROM gained
• Apply cold, best in lengthened position.
• Advise the patient of post-exercise soreness.

Question 26

Indications for stretching:

Answer 26

Limited ROM resulting from loss of extensibility of soft tissue due to adhesions, contractures & scar tissue formation which lead to functional limitations or disabilities

When restricted motion may lead to structural deformities

In the presence of muscle weakness & shortening of opposing tissue

As part of a total fitness program designed to prevent musculoskeletal injuries

Prior to and after vigorous exercise to potentially minimize post-exercise muscle soreness

Question 27

CONTRAINDICATIONS TO STRETCHING

Answer 27

When a bony block limits joint motion

After a recent fracture before bony union is complete

If soft tissue healing could be disrupted in the tight tissues and surrounding region

When there is evidence of acute inflammation or infection

When joint movement or muscle elongation elicits a sharp, acute pain