Stretching/ROM Flashcards
what is flexibility and what characteristics contribute to it?
ability to move a joint smoothly and easily through pain free ROM
-muscle length
-joint integrity
-extensibility of periarticular soft tissue
what are potential causes for a decrease in flexibility?
prolonged immobilization or sedentary lifestyle
postural malalignment and muscle imbalance
weakness caused by MSK or neuro disorders
tissue trauma>inflammation and pain
deformity (congenital or acquired)
Describe the MOA for how immobilization contributes to decreased flexibility.
breakdown of contractile protein
decrease in fiber diameter
decrease in myofibrils
decrease in intramuscular capillary density
During atrophy of immobilized muscle, the is an increase in ____ and ____tissue that produces weakness and restricted ROM.
fibrous and fatty tissue
How does the position of immobilization impact strength and/or ROM?
shortened>decreases strength bc its unable to produce max tension
lengthened> increases ROM but it could potentially result in reinjury
What is the functional difference between ROM and stretching? When do we care?
ROM-keeping what they have vs Stretch increases it
we care when it comes to hypermobility and/or surgical precautions.
list and describe the 3 types of ROM. Same categories apply for stretching.
PROM-completely externally controlled within unrestricted range
AAROM-manual or mechanical ext assistance
AROM- active contraction of muscles produce movement in unrestricted range
when is PROM indicated?
acute, inflamed tissue
pt is nuable or not suppoed to actively contract
what are the goals of PROM
maintain joint mobility and mechanical elasticity of muscle
minimize contractures
assist circulation
lubricate the joint
decrease pain
assist healing process
what are the limitations of PROM
prevent atrophy
increase strength or endurance
assist circulation as much as AROM
what are indications for AAROM?
pt can actively contract and then move w/ or w/o assistance
often above and below immobilized segments
pt weakness (esp vs gravity) through desired range
what are the goals of AAROM?
PROM goals +
maintain eslasticity and contractility
sensory feedback from contraction
stimulate bone and joint integrity
increase circulation
develop coordination + motor skill
what are the limitations of AROM
no maintenance or strength gains
ONLY develops skill and coordination in movement patterns used
what kinds of stretching are most appropriate early in rehab? later?
manual stretching. and joint mobes; self-stretching and mobilization
For longer lasting (plastic) length increase to be permanent, stretch force must be ______.
maintained over an extended period of time
what types of movement are muscle spindles sensitive to? what is their related reflex?
they are sensitive to quick and sustained stretch. they react by increasing tension in the muscle being stretched and produce reciprocal inhibition in the opposing muscle group. slow and low intensity stretch prevents this.
what types of movement are golgi tendon organs sensitive to? what is their related reflex?
sensitive to slight changes of tension on unit. they react by decreasing tension via autogenic inhibition (basically, it gives in)
what are the 6 contraindications for stretch/ROM?
hard end feel
recent fracture
when the shortened tissue enable function
acute inflammation
hemotoma
hypermobility
what are the 4 broad categories of stretching exercises?
static stretching
cyclic stretching
ballistic stretch
proprioceptive neuromuscular facilitation (PNF)
what are the 8 parameters of stretching we should consider?
alignment
stabilization during stretch)
intensity
duration
frequency
speed
mode (type)
integrations of neuromusc inhibitioncor faciliatation
what is the optimal intensity/duration relationship for improving ROM?
low load, long duration; if there isn’t time and ability to do so in the clinic, educate the pt for their HEP
Ballistic stretching is beneficial to what population? Who is is contraindicated for?
athletes; elderly, sedentary, or pts w/ msk pathology
what are some examples of stretching modes?
manual, mechanical, self, active,assisted
Describe scenarios for when PNF stretching is appropriate vs inappropriate.
appropriate when muscle spasms are the limiting factor, inappropriate for long standing fibrotic contractures
