UE Muscle Energy Principles

Question 1

Post-Isometric Relaxation

Answer 1

Goal: Direct Muscle relaxation
Physiology: after isometric contraction, neuromuscular apparatus goes into refractory state wherein passive stretch can be performed w/o encountering strong myotonic reflex opposition
Contraction: sustained gentle force from ounces to about 20lbs
Example: hamstrings placed on stretch followed w/ pt contracting these muscles for 3-5 sec

Question 2

Joint Mobilization Using Muscle Force

Answer 2

Goal: restoration of joint motion for an articular dysfunction
Physiology: distortion of articular relationships w/ alteration in muscle tone activity (tight and/or weak)
Contraction: between 30-50lbs

Question 3

Respiratory Assistance

Answer 3

Goal: releasing muscle tension and improve respiratory and circulatory activities
Physiology: activity of breathing uses significant muscle groups that are contiguous w/ entire body, motion generated enhances tissue release and improves respiratory and circulatory needs
Contraction: exaggerated respiratory motion

Question 4

Oculocephalogyric Reflex

Answer 4

Goal: use of reflex muscle activity in head and neck related to eye muscle movements
Physiology: voluntary eye movements reflexively affect cervical and truncal musclulature as body attempts to follow lead of provided by eye movement, very gentle post isometric or reciprocal inhibition can be produced w/ this effort
Contraction: gentle eye movement

Question 5

Reciprocal Inhibition

Answer 5

Goal: to lengthen muscle shortened by ramp or acute spasm
Physiology: a mild contraction effort exerted in agonist muscle causing a reflex relaxation in that muscle’s antagonist muscle group
Contraction: ounces and not pounds
Example: cramping in biceps countered w/ pt attempting to extend extended elbow to reciprocally inhibit biceps

Question 6

Crossed Extensor Reflex

Answer 6

Goal: used in extremities where muscle requires treatment too injured or immobilized to permit manipulative treatment
Physiology: utilizes learned cross pattern locomotion reflexes engraved into CNS, when flexor muscle in 1 extremity contracted voluntarily, flexor muscle in contralateral extremity relaxes and extensor contracts
Contraction: ounces and not pounds

Question 7

Isometric contraction

Answer 7

most common forms of contraction used in muscle energy technique, origin and insertion of muscle and maintained in a stationary position while muscle is contracted against resistance

Question 8

Isotonic contraction

Answer 8

basic principle is applied to join restriction by activating a specific muscle while fixing only one end of muscular attachment w/ goal of restoring normal mechanics, can be concentric shortening or eccentric lengthening

Question 9

Isolytic contraction

Answer 9

used for treatment of fibrotic or chronically shortened myofascial tissues, applied counterforce greater than patient force, resulting in lengthening of myofascial tissues

Question 10

Goals of Treatment (Muscle Energy)

Answer 10

improve neural communication to tissues
reduce intramuscular pressure and fascial tension to improve muscle balance
improve joint surface apposition to normalize neural communication to myofascial structures affected by these joints
improve oxygenation and nutrients flow to tissues
reduce congestive edema and secondary effects of this process
reduce increased sensitivity in all tissues
reduce adaptive responses that result w/ increased energy demand
improve overall health and recover of patient

Question 11

Hypoxia Effect on Nociceptors and Muscle Spindles

Answer 11

hypoxia sensitizes nociceptors (pain generating afferent fibers) and also reduces discharges in muscle spindles which can silence spindles, prolonged hypoxia can have damaging effect on muscle spindle receptors

impairs muscle spindle influence on muscle tension (stretch reflex) and CNS control on motor coordination, alters quality of movement

injured muscle fibers typically become more inhibited through reduced gamma and alpha motor input to these fibers

hypoxia an therefore lead to: 1) muscle pain and tenderness by exciting or sensitizing free nerve endings and 2) altered motor coordination of muscle spindles

Question 12

Hypoxia/Ischemia

Answer 12

reduces muscle length

increases sensitivity in tissues

Reduces muscle spindle activity and therefore alters CNS coordination of muscle movement patterns.