Therapeutic Exercise

Question 1

What are the general categories used for therapeutic exercise?

Answer 1

• pain control
• ROM/stretching
• Strengthening/endurance
• balance/proprioception

Question 2

Mechanoreceptors - types

Answer 2

• muscle spindle
• golgi tendon organs
• joint receptors

Question 3

Muscle spindle

Answer 3

• monitors length of the muscle
• stimulates 1A afferent fibers that synapses with an alpha motor neuron to cause a contraction
• in parallel with the muscle

Question 4

Golgi tendon organs

Answer 4

• monitors tension from a muscle (force production)
• in series with the muscle found in the tendons
• stimulates 1B afferent fibers to the alpha motor neuron to inhibit contraction

Question 5

Joint receptors type 1 and type 2

Answer 5

• both: monitors position of a joint and stimulated with grade 1/2 mobs

type 1:
- senses movement in the early range
- nothing is stretched

type 2:
- monitors joint position and activated in mid range

Question 6

Therapeutic exercises/interventions for pain control

Answer 6

• rocking/rhythmic: take in open pack position and rock slightly to stimulate joint mechanoreceptors
• mobilizations grade 1/2
• release of endogenous analgesic substances (endorphins/serotonin/neurtophins)
• stressing the body for 20min-1hour can stimulate endorphins to be released
• release of anti-inflammatory cytokines as well

Question 7

what are the 4 types of contractures

Answer 7

• myostatic
• pseudomyostatic
• arthrogenic/periarticular
• irreversible

Question 8

myostatic Contracture

Answer 8

• adaptive shortening of a muscle
• if someone does not use muscle through full ROM it can cause it to shorten
• apply tension on muscle to try to fix

Question 9

Pseudomystatic Contracture

Answer 9

• hypertonicity (CNS injury)
• spasm
• looks like a myostatic Contracture
• muscle did not physical shorten
• Golgi tendon organ can inhibit it from moving

Question 10

• arthrogenic/periarticular Contracture

Answer 10

• due to the joint istelf (ligament/capsule)
• results from intra-articular pathology
• tissues crossing joint become restricted

Question 11

Irreversible Contracture

Answer 11

• fibrous change in muscle or periarticular structures
• can be due to adhesions, trauma, surgery
• longer present, more difficult
• limitations in a joint for longer than a year may be more difficult to treat but can still try

Question 12

How does a muscle get shorter and what can be done about it

Answer 12

• reduction in sarcomeres
• can stretch to stimulate more sacromeres to be made in series

Question 13

Principles with stretching a muscle

Answer 13

• warm up tissue/increase blood flow
• LLPS/TERT
• Dont bounce - muscle spindle
• time? - 30 sec hold for 1+ set about 2 minutes total
• collagen straightening: when you stretch you are uncrimping the collagen must stretch beyond this a little to get more sarcomere production
• exercise actively into new range (be persistent)

Question 14

Principles for elongating capsule/ligaments

Answer 14

• LLPS(TERT)
• creep into plastic range
• remodleing tissue (break/reform cross links
• time = 2 minutes