Therapeutic Exercise - Lecture 2

Question 1

define flexibility:

Answer 1

refers to the mobility of muscles and the length to which they can extend

Question 2

define hypomobility

Answer 2

restricted ROM

Question 3

define hypermobility:

Answer 3

excessive ROM

Question 4

define contracture:

Answer 4

adaptive shortening of the muscle-tendon unit and soft tissues surrounding joint

Question 5

flexibility is a measure of __

Answer 5

ROM

Question 6

flexibility has 2 components…

Answer 6

static and dynamic

Question 7

static flexibility occurs during __

Answer 7

passive movement

Question 8

dynamic flexibilty occurs during:

Answer 8

available ROM during active movements

Question 9

define ROM

Answer 9

amount of mobility of a joint

Question 10

determinants of ROM/flexibility:

Answer 10

1. mechanical response of contractile tissue,
2. neruphysiologic properties of contractile tissue,
3. mechanical characteristics of non-contractile soft tissue,
4. structure limitation of the joint,
5. pain threshold

Question 11

contractile tissue is individual __, __ and __

Answer 11

muscle fibres, myofibrils and sarcomeres

Question 12

contractile tissues response to stress is ..

Answer 12

initial resistance to stretch followed by relaxation

Question 13

chronic stretching of contractile tissue results in __

Answer 13

sarcomere addition

Question 14

what is contractile tissues response to immobilization?

Answer 14

atrophy, loss of sarcomeres, increase in connective tissue

Question 15

what does the muscle spindle trigger in accordance with the velocity and duration of a stretch?

Answer 15

muscle contraction in response to stretch

Question 16

the golgi tendon organ is ___ to muscle tension

Answer 16

sensitive

Question 17

what does the golgi tendon organ do in response to tension

Answer 17

relax muscle

Question 18

does the golgi tendon organ have a low or high threshold during passive stretching

Answer 18

high

Question 19

the __ reflex is a protective meachnism

Answer 19

stretch reflex

Question 20

the stretch reflex increases __ in the muscle and provides resistance to __

Answer 20

increases tension in the muscle and provides resistance to lengthening

Question 21

what is autogenic inhibition?

Answer 21

stretch applied is slow, low intensity, the muscle relaxes and there is reciprocal inhibition *** check to see if makes sense

Question 22

list the types of connective tissue

Answer 22

collagen, elastin, reticulin and ground substance

Question 23

what type of connective tissue has the highest tensile strength and transmits forces?

Answer 23

tendons

Question 24

what type of connective tissue has properties that vary with location and provide intermediate strength?

Answer 24

ligaments

Question 25

what type of connective tissue holds things together and is the weakest?

Answer 25

fascia

Question 26

define elasticity:

Answer 26

ability to return to normal length after elongation

Question 27

define plasticity:

Answer 27

ability of a substance to undergoe permanent change in size or shae

Question 28

define viscoelasticity:

Answer 28

ability to resist change of shape when an outside force is applied, inability to completely return to shape

Question 29

changes in collagen: immobilization

Answer 29

weakening of collage matrix as a result of turnover, slow to recover

Question 30

changes in collagen: inactivity

Answer 30

decrease in size and amount of collagen, weakening

Question 31

changes in collagen: age

Answer 31

loss of strength and elasticity, | slower adaptation and healing

Question 32

changes in collagen: corticosteroids

Answer 32

loss of collagen and weakening

Question 33

changes in collagen: injury

Answer 33

initiated by week 3, type III to type I remodelling

Question 34

why stretch?

Answer 34

hypomobility, muscle tightness, muscle contracture, decrease muscle spasm

Question 35

list the causes of hypomobility:

Answer 35

1. extrinsic - casts - splints - traction, 2. intrinsic - pain - swelling - muscle tendon fascial disorders, 3. lifestyle, 4. paralysis, 5. congenital or acquired disease

Question 36

list interventions for hypomobility

Answer 36

``` passive or assisted stretching, self-stretching, facilitated stretching. Joint mobilization, soft tissue mobilization, nerual tissue mobilization ```

Question 37

after an injury, the architecture is less capable of withstanding ___ loads so you have to be mindful of the degree of __ that is used.

Answer 37

tensile, stretching

Question 38

during which stage is scar tissue forming (primarily collagen) and thus the area is still fragile?

Answer 38

repair and remodelling stage

Question 39

what will stretching of scar tissue help to do?

Answer 39

help convert the inelastic tissue into a more pliable, elastic tissue

Question 40

what are some things stretching could be used to help achieve?

Answer 40

``` increase ROM, increase flexibility, enhance recovery, prevent injury, increase performance ```

Question 41

stetching principles: alignment

Answer 41

positioning critical

Question 42

stretching principles: stabilization

Answer 42

proximal or distal fixation

Question 43

stretching principles: intensity

Answer 43

lower intensities generlly preferred

Question 44

stretching principles: speed

Answer 44

dependent on injury state

Question 45

stretching principles: duration

Answer 45

much debate, 15s-2 min

Question 46

stretching principles: repetitions

Answer 46

much debate, 1-3

Question 47

stretching principles: frequency

Answer 47

dependent on severity

Question 48

guidelines for prescription:

Answer 48

Examine patient – swelling, pain, stage Assess ROM – pre-test with muscle function Establish goals – therapist and patient Select appropriate techniques, modalities and principles Warm-up the tissues Inform patient of procedures Ensure patient comfortImplement the stretching prescription

Question 49

stretching techniques:

Answer 49

``` StaticHold-relax Contract-relax Slow reversal Agonist reversal Slow reversal hold Ballistic stretching Active isolated stretc ```

Question 50

special considerations: elderly

Answer 50

Loss of balance and coordination Increased stiffness, decreased elasticity Muscle weakness Bone weakness

Question 51

special considerations: children

Answer 51

Often quite flexible Very elastic Muscle weakness Overstretching can easily result in hypermobility

Question 52

why warm up?

Answer 52

Increased core temperature Increased mental preparedness Increased neural conduction Improved muscle elasticity and contractility Increased metabolic rate Unregulated cardiovascular and respiratory systems Rehearsal of motor patterns

Question 53

types of warm up:

Answer 53

``` General Increase core temp Large muscle group repetitive exercise Specific Enhance neural activity, coordination, prep specific muscle groups Movements that are part of the activity Passive Dependent on sport and demands ```

Question 54

dynamic flexibility: sport specific stretching

Answer 54

Flexibility speed Flexibility strength Flexibility endurance

Question 55

how should you initiate dynamic stretching?

Answer 55

slow initiation, then gradual increase in speed, ROM

Question 56

with regard to dynamic flexibility you should avoid __ and movements should be __ not __

Answer 56

avoid fatigue and movements should be controlled not jerky

Question 57

what is the catch 22 with regard to dynamic flexibility?

Answer 57

the muscle is not relaxing but is active through the ROM which is specific to the movements that occur in sport

Question 58

dynamic vs static stretching which is better?

Answer 58

strong evidence to suggest that acutely, static stretching may limit human performance when compared to dynamic stretching

Question 59

how do you maintain a warm-up?

Answer 59

``` Initial thorough warm-up Short sport-specific warm-up if idle for >45min Maintain mental focus Avoid chronic postures Use vigorous shaking or massage Appropriate clothing ```

Question 60

Why should we cool down?

Answer 60

- Reduce muscle fatigue and soreness - Facilitate muscle relaxation - Aid muscle recovery - Best time to enhance flexibility - Mental review

Question 61

basic cool down tips:

Answer 61

Sport specific <50% max intensity Up to 20min, Include mild dynamic and static stretching