7. Flexibility training

Question 1

Define flexibility

Answer 1

Refers to the amount of ROM about a joint or multiple joints at any age

Question 2

The greatest decline in ROM with age is observed in:

Answer 2

Spinal extension

Question 3

Define range of motion (ROM)

Answer 3

Total excursion possible at a joint from the beginning of movement to the end of itB

Question 4

Between 20-70 yo, spinal extension will decline by ___

Answer 4

50%

Question 5

Between 20-70 yo, hip extension will decline by ____

Answer 5

20%

Question 6

Between 20-70 yo, knee flexion will decline by ___

Answer 6

2%

Question 7

On average, is the ↓ROM greater in lower or upper extremity?

Answer 7

Lower extremity

Question 8

Hamstring flexibility will ↓ in both genders by ___ per decade!

Answer 8

14% +/-

Question 9

Clinical definition of joint stiffness

Answer 9

Sensation of difficulty moving a joint or the apparent loss of ROM. It often accompanies joint pain and swelling.

Question 10

What is one of the most common complaints of older adults?

Answer 10

Joint stiffness

Question 11

Steps from joint pain —- _____ —- _____ —- Joint stiffness (cycle)

Answer 11

Joint pain
Joint movement
Disuse atrophy
Joint stiffness

Question 12

How to breakdown this cycle of joint pain? Steps leading to maintain function

Answer 12

Joint pain
Maintain joint movement
No or limited disuse atrophy
No or limited joint stiffness
Maintain function

Question 13

With age = ↓ muscle mass due to ↓ in ____

Answer 13

number of muscle fibers

Question 14

With age, ↑ or ↓ connective tissue surrounding and within muscle

Answer 14

INCREASE

Question 15

Name the connective tissues involved in mobility: (4)

Answer 15

tendons
ligaments
fascia
joint capsules

Question 16

With age, change in the chemical composition of the connective tissue matrix & collagen - 2 consequences

Answer 16

• loss of water content
• connective tissue more resistance to being deformed and less extensible

Question 17

Is pain directly coming from the breakdown of articular cartilage?

Answer 17

No P! receptors are located in the connective tissues + bones

Question 18

By the age of 75 years old, ____% have osteoarthritic changes

Answer 18

85

Question 19

Is putting clothes a BADL or an IADL?

Answer 19

BADL

Question 20

Increase in number of functional limitations leads to:

Answer 20

loss of independence

Question 21

Basic ADLs(BADLs) consists of self-care tasks: give some examples

Answer 21

Bathing and showering
Bowel and bladder management
Dressing
Eating
Feeding themselves
Functional mobility (moving from one place to another)
Personal hygiene and grooming
Toilet hygiene

Question 22

What is the mnemonic that some consider useful? Define

Answer 22

DEATH
Dressing/bathing, Eating, Ambulating, Toileting, Hygiene

Question 23

IADLs are not necessary for fundamental functioning, but they let an individual live independently in a community. Give examples

Answer 23

Housework
Taking medications as prescribed
Managing money
Shopping for groceries or clothing
Use of telephone or other form of communication
Using technology
Transportation within the community

Question 24

What is the useful mnemonic for IADLs?

Answer 24

SHAFT
Shopping, Housekeeping, Accounting, Food preparation/meds, telephone/transportation

Question 25

When OA improve flexibility, they typically improve on ___

Answer 25

muscular strength

Question 26

Explain the mechanism of how working on flexibility is linked with improved strength

Answer 26

Effort to gain ROM will challenge the surrounding musculature and slightly increase strength

Question 27

Define critical ranges

Answer 27

Absolute minimum ROM required to perform a certain activity

Question 28

Special considerations after knee/hip surgery

Answer 28

Knee replacement: - rarely flex past 110 Hip replacement: - no hip flexion past 90 - no internal rotation of the hip - no hip adduction past midline (no leg crossing)

Question 29

Critical ranges of flexibility: Putting on clothes overhead

Answer 29

90 elevation (flexion and ABD) 45 external rotation

Question 30

Critical ranges of flexibility: fastening or unfastening clothes in back

Answer 30

45 abduction 70 internal rotation 10 extension

Question 31

Which activity requires the greatest extension at the hip, knee, and ankle?

Answer 31

Getting down onto & up from floor, in & out of tub 120 hip flexion 135 knee flexion 10 dorsiflexion

Question 32

Can OA with ROM deficits improve their flexibility?

Answer 32

Yes

Question 33

4 modes of flexibility training for OA

Answer 33

- Traditional stretching exercises - Dance - Tai chi - Aquatic exercise

Question 34

What is the most important when working on flexibility exercises?

Answer 34

Stressing the end-ROM of a joint

Question 35

Very safe type of stretching

Answer 35

Static stretching

Question 36

Type of stretching that is more functional to ADLs

Answer 36

Dynamic stretching

Question 37

Static vs PNF: YA respond better to C-R PNF while OA benefit more from ____

Answer 37

Static stretching

Question 38

What are the breathing guidelines when stretching? (3)

Answer 38

1) inhale before the start of the stretch 2) exhale during the stretch 3) breathe evenly while holding the stretch

Question 39

What are the general flexibility guidelines? (3)

Answer 39

- emphasize joints that have a significant decrease in joint ROM - stretch to a point of gentle tension, but not pain - do not jerk, bounce, or force a stretch