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CORE SKILLS 2 > 2) Mobilising Reduced ROM theory > Flashcards

2) Mobilising Reduced ROM theory Flashcards

1
Q

What does normal movement depend on

What does reduced movement impact on

A

*Ligaments
*Capsule
*Cartilage *connective tissues
*Tendons
*Fascia
Synovium
Muscles
Skin
Bone
Subcutaneous tissue
Neurological control

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2
Q

Intra-articular

A

Capsule

Synovium

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3
Q

Periarticular

A

Surrounds joint

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4
Q

Extra articular

A

Outside joint

Muscle skin

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5
Q

Abnormal joint movement

X3 categories

A

1) Reduced range of movement
• ROM passive movement

  • stiffness/hypomobility contracture
  • reduced ROM

2)Hypermobility
• Increased range of passive/active movement

  • Desirable pathological or incidental
  • Without sufficient muscle control= joint instability

3)Insufficient neurological control

  • Muscle tone and/or controller on joints or abnormal
  • Pathological
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6
Q

Contracture

A

Irreversible lack of range of passive movement

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7
Q

Connective tissue

A

See core skills 1

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8
Q

What determines joint range of movement

A

a) Arthrology have a joint
b) Resistance within the joint – low co-efficient friction

c)Properties of each joint structure
•Interarticular – Cartlidge
•Periarticular – joint capsule
•Extra-articular – muscle tendon units

d)By external forces are transmitted by articular soft tissue
•Function of passive viscoelasticity

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9
Q

Viscoelasticity

A

Elastic and water content

Ability to stretch is stress dependent and time dependent

Viscoelasticity depends on numbers of

  • elastin
  • Collagen
  • Proteoglycans- lubracin chemical lubricator
  • Water
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10
Q

Mechanical properties of articular connective tissue

A
  1. Dense connective tissues very strong
  2. Organise structure
  3. Resistance to tensile stress
  4. Strongly resistant rope like along lines of stress -one direction but not the other
  5. Collagen fibre crimping
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11
Q

What is stiffness

What’s is the stiffest structure

A

Ability to resist tensile stress

Tendon > ligament > joint capsule strength

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12
Q

Collagen crimping

A

Small force initiate large elongation

When the barbers straight no elongation is directly proportional to the force applied due to elastic properties

Up until a point then Microfailure occurs - small tissue tares can result in permanent damage

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13
Q

What is a small tissue tare that results in permanent change in length

A

Plasticdeformation

If force continues to increase rupture will occur of structure

Rapid high force applied

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14
Q

What is tissue elongation subject to

A

Time and stress

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15
Q

Causes of reduced ROM

A

Trauma

Chronic diseases

Immobility

See diagram

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16
Q

Effects of reduced range of movement

A

1) Function

  • UL– reduced independent e.g. getting dressed
  • LL- poor gait and functional mobility falls
  • Time off work
  • Quality of life

2) pain
3) muscle weakness
4) vicious cycle of inactivity

17
Q

Physiological changes of mobility

connective tissue

A

Immobility = stress deprivation = remodelling

See diagram

18
Q

Physiological changes of mobility

Intra articular

Cartilage

A

Reduced water content

Reduced GAGS

Reduced nutrients from synovial fluid

Thinning of extracellular matrix

Fibrofatty connective-tissue proliferation

Adherence of synoviocytes and protein deposits

19
Q

Physiological changes of mobility

Intra articular

Synovium

A

Reduced number of synoivosytes

Reduced synovial fluid volume

Reduced synovial fluid movement - loss of
( sweep & squeeze)

Reduced lubricin

Adhesions between microfilms in synovial membrane

20
Q

Physiological changes of mobility

Bone

A

Increased reabsorption of cancellous and compact bone (eight weeks)

Decreased bone mineral density

Decreased ability to withstand stress

Increased risk of fracture

21
Q

Physiological changes of mobility

Muscle

A

Atrophy

Sarcomeres lost from end of myofibrils = shortening

connective tissue proliferation

= increase collagen within endomysium perimysuim and epimysium

= adaptive shortening

CORE SKILLS 2 (9 decks)

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