2.3 Stretching

Question 1

What is the decreased mobility or restricted motion at a single joint or series of joints

Answer 1

Hypomobility

Question 2

What is the overall function of a pt may be improved by applying stretching techniques to some muscles & joints while allowing motion limitations to develop in other muscles or joints

Answer 2

Selective Stretching

Question 3

What is the lengthening of muscle and other joints soft tissues well beyond their normal length by exceeding the normal ROM of a joint

Answer 3

Overstretching & Hypermobility

Question 4

What muucslotendionous unit has adaptively shortened with a loss of ROM but no specific muscle pathology is present

Answer 4

Myostatic contracture

Question 5

What is it called when the result of hypertonicity associated with a central nervous system lesion, such as a cerebrovascular accident, a spinal cord injury, or traumatic brain injury

Answer 5

Psedumyostatic contracture

Question 6

What is it called when the contracture is a result of intra-articular pathology that limits arthrokinematics motion with changes that may include adhesions, synovial proliferation, joint effusion, irregularities in articular cartilage, or osteophyte formation

Answer 6

Arthrogenic & periarticular contracture

Question 7

What is the name of the contracture that has fibrous changes in the connective tissue of muscle & periarticular structures that limit tissue elasticity, create adhesions between joint tissues, & result in fibrotic contracture

Answer 7

Fibrotic & irreversible contracture

Question 8

Why should an individual stretch?

Answer 8

• adhesions, contractures, scar tissue, limiting ROM
• weakness secondary to shortened muscle length
• part of total fitness program
• post-exercise

Question 9

What are these goals for?
- increased flexibility & ROM
- general fitness
- injury prevention
- enhanced performance

Answer 9

Stretching

Question 10

What do these factors affect?

• joint structure
• age & gender
• muscle & connective tissue
• stretch tolerance

Answer 10

Flexibility

Question 11

What is this intervention?

Elongating shortened muscle-tendon units and/or periarticular connective tissues when a restricted joint is rotated just beyond its available ROM

Answer 11

Stretching (manual, mechanical, assisted)

Question 12

What is this intervention?

Carried out independently by the patient at the end of available ROM for the purpose of elongating hypomobile soft tissues

Answer 12

Self-stretching

Question 13

What is this intervention?

The use of inhibition or facilitation techniques known as proprioceptive neuromuscular facilitation (PNF) to assist with muscle elongation

Answer 13

Neuromuscular Facilitation & Inhibition

Question 14

What is this intervention?

Manipulative procedures that employ voluntary muscle contractions by the patient in a precisely controlled direction and intensity against a counterforce applied by the practitioner to lengthen muscle & fascia and to mobilize joints

Answer 14

Muscle Energy

Question 15

What is this intervention?

Skilled manual therapy interventions specifically applied to joint structures by the clinician with the intent of modulating pain and treating joint impairments that limit ROM

Answer 15

Joint Mobilization/Manipulation

Question 16

What is this intervention?

To improve the extensibility of any soft tissues that limits mobility (friction massage, myofascial release, acupressure, trigger point therapy, & Instrument-assisted soft tissue mobilization)

Answer 16

Soft Tissue Mobilization/Manipulation

Question 17

What is this intervention?

Used to improve or restore nerve tissue mobility that may have become restricted by tissue adhesions or scar tissue following trauma or surgical procedures

Answer 17

Neural Tissue Mobilization

Question 18

What type of stretch is this?

Soft tissues are elongated just beyond the point of tissue resistance & then held in the lengthened position with a sustained stretch force over a period of time

Answer 18

Static stretching

Question 19

What type of stretch is this?

A high velocity and high intensity stretch characterized by fast joint movement that quickly elongated the targeted soft tissues

Answer 19

Ballistic Stretching

Question 20

What type of stretch is this?

A low velocity, low intensity stretch often used before athletic activities or for general fitness or rehabilitation programs

Answer 20

Dynamic stretching

Question 21

What type of stretch is this?

• involves active muscle contractions
• traditional explanation - reciprocal inhibition
• modern explanation - sensorimotor processing and visco-elastic adaptation of the muscle tendon unit

Answer 21

Proprioceptive Neuromuscular Feedback (PNF) Stretching

Question 22

What is this non-contractile tissue called?

Fibers responsible for the strength and stiffness of tissue & resist tensile deformation with multiple levels of fiber composition arranged in an organized relationship

Answer 22

Collagen

Question 23

What is this non-contractile tissue called?

Fibers that elongate with small loads and fail abruptly without deformation at higher loads, providing extensibility and flexibility to tissue

Answer 23

Elastin

Question 24

What is this non-contractile tissue called?

Fibers that provide tissue with bulk

Answer 24

Reticulin

Question 25

What is this non-contractile tissue called? An organic gel containing water and consists of proteoglycan and glycoproteins which function to hydrate the matrix, stabilize the collagen networks, & resist compressive forces in connective tissues

Answer 25

Ground Substance

Question 26

What is this? - major sensory organ and is sensitive to quick and sustained stretch - detects and conveys information about changes in muscle length and velocity changes - small, encapsulated receptors composed of afferent sensory fiber endings, efferent motor fiber endings, and specialized muscle fibers called intrafusal fibers

Answer 26

Muscle Spindle

Question 27

What is this? - quick sustained stretch force applied to a muslce-tendon unit, the primary and secondary afferent of intrafusal muscle fibers sense these length changes - afferent signals synapse with alpa motor neurons in the spinal cord to activate extrafusal muscle fibers - results in an increase or facilitation of active tension in the muscle being stretched; this increased tension resists lengthening and is though to compromise the effectiveness of the stretching procedure

Answer 27

Stretch Reflex

Question 28

What is this? - sensory organ located near the musculotendinous juntions of extrafusal muscle fibers that monitors changes in tension of muscle-tendon units - nerve endings are woven among collagen strands of a tendon and detect changes of tension on a muscle-tendon unit - activated signals will inhibit alpha motorneuron activity and decrease tension in muscle-tendon unit

Answer 28

Golgi Tendon Organ (GTO)

Question 29

What is this? - inhibition of the contractile components of muscle by the GTO is thought to contribute to reflexive muscle reflective muscle relaxation during an applied stretch - low-intensity, slow stretch force is applied to muscle, the stretch reflex is less likely to be activated as the GTO fires and inhibits tension in the muscle

Answer 29

Autogenic Inhibition

Question 30

What is the non-contractile tissue? Constant load applied over time results in increased tissue length until equilibrium is reached

Answer 30

Creep

Question 31

What is this non-contratcile tissue? Load applied with the tissue kept at a constant length that results in decreased internal tension (stress) in the tissue until equilibrium is reached

Answer 31

Stress-relaxation

Question 32

What is this non-contractile tissue? Repetitive loading of tissue within a short duration of time increases heat production and may cause failure at strain levels lower than what is needed for a single load

Answer 32

Cyclic Loading

Question 33

What is this non-contractile tissue? Greater the repetitive loads, the fewer number of cycles needed to reach failure

Answer 33

Connective Tissue Fatigue