Stretching & PNF Flashcards
Difference between ROM, Mobility & Flexibility
ROM - distance & direction a joint can move (goni)
Mobility - ability to move to allow for functional activities
Flexibility - extensibility of the soft tissues that surround a joint that allow it to go through full, nonrestricted pain-free ROM
Myostatic Contracture
-defn, end feel
shortening of the muscle fibers & decrease in the number of sarcomeres + decrease in length of sarcomere
- springy, firm end feel
Periarticular Contracture
-defn
decrease in mobility in the surrounding connective tissues
AKA loss in joint play - will feel when assessing accessory motions
Arthrogenic Contracture
-defn, end feel
intra-articular pathology that limits motion
- i.e. osteophyte, adhesions, joint effusion, irregularities in articular cartilage
- hard end feel
Pseudomysotatic Contracture
-defn
increased hypertonicity that directly affects muscle due to pathology in the CNS
i.e. spasticity or tone
Fibrotic & Irreversible Contracture
-defn
when connective tissue around a joint has been replaced by fibrotic (scar) tissue
Principles of Muscle Stretching
- stress/strain curve
- muscle tension relationship
- neurophysiological
- Elastic region - no deformation, return to original length;
Plastic region - microruptures in muscles will stimulate sarcomeres to grow & cause deformation aka muscle lengthening;
Necking - tissue is overstretched & becomes weak; easy to tear - muscle length should be in mid-range to allow for optimal development of tension
- Golgi tendon organ is located in tendon & protects the muscle from being over-stretched
Contraindications to Stretching
& precautions
- Bone is the limiting factor in ROM
- Hypermobility
- Recent fracture/trauma
- acute inflammatory process/infection
- Sharp or acute pain to elongation
Be cautions w/ OP, prolonged bed rest, age, prolonged use of steroids & nearly united fractures
Determinants of Stretching Interventions
- frequency, intensity, mode, technique
- alignment & stabilization to avoid compensations
- LOW & comfortable intensity & SLOW speed
- Frequency depends on severity, age & tissue healing
- 2-5sessions/week; OR if early perform every hour w/ very short sessions - Mode - self-stretching, mechanical (equipment for prolonged stretch) OR manual (by therapist)
Global Postural Reeducation
-defn & concept
global stretching of anti-gravity muscles in a muscle kinetic chain
- antigravity are those that are responsible to maintain upright posture
Concept is that compensations are not allowed
Muscles involved in Posterior kinetic chain
Erector spinae
deep pelvic, trochanteric, gluteal muscles
hamstrings
triceps surae
Muscles involved in Anterior kinetic chain
STM & scalenes anterior fascial tissues of the thoracic spine diaphragm psoas adductors soleus muscle
Proprioceptive Neuromuscular Facilitation
-defn & principles
stimulating the prioprioceptors in order to get a muscular response
Principles
- 2 applications: strengthening & stretching
- based on every day movements, in diagonals, multiple planes of motion, rhythmic & reversing
UE D1 Flexion & Extension
- position & functional implication
Flexion - Scapular elevation & protraction Shoulder flexion, ADD & ER Elbow flexion & supination Wrist & fingers flexed
Extension - Scapular depression & retraction Shoulder extension, ABD, & IR Elbow extension & pronation Wrist & fingers extended
Functional implication: bringing something to your face for ADL’s
UE D2 Flexion & Extension
-position & functional implication
Flexion - Scapular elevation & retraction Shoulder flexion, ABD, & ER Forearm supinated Wrist & fingers extended
Extension - Scapular depression & protraction Shoulder extension, ADD, & IR Forearm pronated Wrist & fingers flexed
Functional implication - reaching out, lifting
VERY good for someone w/ Parkinson’s & kyphotic posture to do this bilaterally
LE D1 Flexion & Extension
- foot & ankle only, functional implication
Flexion
DF & inversion
Extension
PF & eversion
functional implication - stance phase
LE D2 Flexion & Extension
- foot & ankle only, functional implication
Flexion
DF & eversion
Extension
PF & inversion
functional implication - swing phase b/c DF & inversion w/ hip adduction
Hold-Relax Technique
- used when it is painful to contract the agonist (muscle being stretched)
- Take muscle to endpoint
- Perform isometric contraction INTO direction of the stretch to contract the antagonistic muscle
Rationale: recipricol inhibition
Contract-Relax Technique
- used when the tight muscle being stretched is NOT painful to contract; more effective method
- Take muscle to endpoint
- Perform isometric contraction in OPPOSITE direction of the stretch to contract the agonist muscle
Rationale: autogenic inhibition
