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Therapeutic Exercise > Stretching > Flashcards

Stretching Flashcards

1
Q

Flexibility

A

ability to move through an unrestricted, pain-free ROM

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2
Q

Flexibility includes

A

extensibility, arthrokinematics, deformation

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3
Q

Stretching

A

any therapeutic maneuver used to lengthen soft tissue structure & thereby increase ROM

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4
Q

Stretching includes

A

passive, active/dynamic, active inhibition, selective stretching

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5
Q

soft tissue fibers include

A

collagen, elastin, reticulin, ground substance

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6
Q

collagen

A

responsible for strength & stiffness

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7
Q

Elastin

A

provides extensibility

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8
Q

reticulin

A

provides bulk

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9
Q

Ground substance

A

reduces friction between fibers

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10
Q

soft connective tissue include

A

tendons, ligaments, joint capsule, fascia, skin

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11
Q

tendon fibers are

A

parallel

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12
Q

ligaments fibers

A

vary between parallel & random

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13
Q

joint capsule fibers

A

vary between parallel & random

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14
Q

Fascia fibers

A

vary between parallel and random

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15
Q

Skin fiber

A

are random

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16
Q

properties of connective tissue

A

elasticity & plasticity

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17
Q

Elasticity

A

the ability to return to resting length

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18
Q

Plasticity

A

ability to assume a new & greater length

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19
Q

muscles are primarily what type of tissue

A

contractile

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20
Q

Muscles attach to what and interwoven with ?

A

attached to tendon & interwoven with (fascia) non-contractile tissue

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21
Q

what is the primary source of resistance to passive elongation of muscle

A

non-contractile components of muscle

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22
Q

what are the mechanical response to stretch

A
  • lengthening occurs in the elastic component of the muscle & tension rises
  • When stretch is released, the sarcomere return to their resting length (elasticity)
  • after a point, mechanical disruption of the cross bridges with lengthening of the sarcomeres
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23
Q

what happens during a quick stretch

A
  • muscle spindle triggers a m monosynaptic stretch reflex
  • stim of alpha motor neurons
  • contraction of the extrafusal muscle fibers
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24
Q

what happens during a slow stretch

A
  • GTO fires & inhibits alpha motor neurons
  • tension decreases
  • sacromeres and muscle lengthen
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25
Q

what are the mechanical properties of non-contractile tissue

A

material strength
stress
strain

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26
Q

Material strength of non contractile tissue

A

the ability to resist a load or stress

27
Q

Stress of non contractile tissue

A

The force per unit area.

28
Q

mechanical stress

A

internal reaction or resistance to an external load

29
Q

examples of stress

A

tension
compression
shear

30
Q

strain

A

the amt. of deformation that occurs when a load (stress) is applied

31
Q

factors affecting stress strain response

A
  • immobilzation, inactivity
  • age
  • corticosteroids
  • Prior injury
  • Other conditions
32
Q

immobilization, inactivity causes weakening of tissues by

A

collagen turnover, weak bonding

33
Q

immobilization, inactivity causes adhesion formation by

A

greater cross-linking & diminished effectiveness of ground substance

34
Q

How does age affect stress-strain response

A
  • decrease in max tensile strength
  • decrease in elastin
  • decrease in rate of adaptation to stress
35
Q

what are indications to stretching

A
  • limited joint ROM, restricted motion
  • Adhesions, contractures, scars
  • muscle weakness with shortening of opposing tissue
36
Q

Contraindications/ precautions for stretching

A
  • bony block
  • recent fx, union is incomplete
  • inflammtion, infection, hematoma
  • sharp/acute pain
  • shortened tissue provides stability to allows function
  • hypermobility
37
Q

effects of stretching

A
  • injury prevention

- muscle function

38
Q

the lower the intensity of stretch

A

the longer it is tolerated and the longer the CT can be held in a lengthened position

39
Q

Longer total duration of passive stretch yield

A

longer lasting decreases in muscle -tendon stiffness

40
Q

how long do you hold duration stretches to improve flexibility

A

30 s

41
Q

permanent stretch-induced gains can only be achieved by

A

maintaining a stretching program and/or using the new ROM in functional activities

42
Q

application of passive stretching

A
  • stretching should be preceded by some low intensity active exercise or therapeutic heat
  • patient should be as relaxed as possible
43
Q

factors to be controlled by passive stretching

A
  • direction
  • intensity
  • duration
  • speed
44
Q

Dynamic stretching uses?

A

speed of movement, momentum and active muscular effort to bring about a stretch

45
Q

when do some therapist use dynamic stretching

A

warm up

46
Q

low load prolonged stretch (LLPS)

A

low intensity external force (5-15 lbs or 5-10% BW) usually with equipment

47
Q

Duration of LLPS

A

at least 20 minutes

48
Q

Examples of LLPS

A

splinting, serial casting, weighted traction or pulleys, positioning

49
Q

Advantages of LLPS

A

time management, patient comfort

50
Q

Disadvantages of LLPS

A

skin breakdown, requires frequent reassessment of joint & soft tissue, imposes mobility restrictions

51
Q

Ballistic stretching

A
  • high potential for rupturing weak structures
  • increased susceptibility to microtrauma
  • facilitation of increased muscle tension & stretch reflex
52
Q

cycle (intermittent) stretching

A

short duration stretch applied slowly and gradually, released and reapplied

53
Q

Proprioceptive neuromuscular facilitano (PNF) stretching

A

an active muscle stretching approach that uses the principles of autogenic and reciprocal inhibition to promote muscle length

54
Q

PNF stretching Techniques

A
  • Hold relax
  • contract relax
  • agonist contraction
  • hold relax - agonist contraction
55
Q

hold relax

A

End-range isometric contraction of the muscle to be passively lengthened

56
Q

What is the hypothesis of hold relax

A

contraction will cause the muscle to relax thru “autogenic inhibition”

57
Q

contract relax

A

end range isotonic contraction of the muscle to be passively lengthen

58
Q

agonist contraction

A

isotonic contraction of the muscle opposite the tight muscle, against resistance

59
Q

hypothesis to agonist contraction

A

reciprocal inhibition of the tight muscle

60
Q

when is agonist contraction effective

A

when tight muscle is painful,

61
Q

when is agonist contraction least effective

A

when pt has close to normal ROM

62
Q

Hold relax with agonist contraction

A

isometric contraction of the tight muscle, followed by concentric, isotonic contraction of the muscle opposite the tight muscle

63
Q

how to improve function with stretching

A
  • use gain in ROM during functional activities
  • stretch induced gains can be maintained through routine stretching
  • strengthen muscle that have been stretched

Therapeutic Exercise (6 decks)

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