Chapter 11 : designing programs for flexibility and low back pain

Question 1

Is a systematic program of stretching exercises designed to progressively increase the ROM of joints overtime

Answer 1

Flexibility training

Question 2

T or F: stretching improves flexibility & ROM

Answer 2

True

Question 3

Flexibility programs should be individualized to address a client’s: (4)

Answer 3

Goals
Needs
Abilities
Physical activity interests

Question 4

Elasticity

Answer 4

Is the property that enables a tissue to return to its original shape or size when a force is removed

Question 5

Plasticity

Answer 5

Is the property of a material to permanently deform when it is loaded beyond its elastic range

Question 6

Stress

Answer 6

Is defined as the force per unit area of a material ( = force/cross sectional area)

Question 7

Strain

Answer 7

• Is the change in length or amount of deformation caused by the applied force
• Is defined as extension per unit length

Question 8

Stiffness

Answer 8

• Is the ratio of stress or strain, or force to deformation.

- Is the ratio of the change in force to the change in length

Question 9

Viscosity

Answer 9

Is the property of materials to resist loads that produce shear & flow
Is resistance to flow
An apparent force that prevents fluids from flowing easily

Question 10

Viscoelasticity

Answer 10

Also known as anelasticity, is the study of materials that exhibit both viscous and elastic characteristics when undergoing deformation
Is defined as a combination of viscous & elastic properties exhibited by biological tissues

Question 11

What is the viscoelastic stress relaxation response?

Answer 11

• Is a time-dependent mechanical property of soft tissues
• Is the gradual decrease in stress in a material stretched & held at a constant length
• Is the decrease in tension in the MTU when the joint is held at a constant angle

Question 12

What is the viscoelastic creep?

Answer 12

Is a time-dependent mechanical property of soft tissues.
A slow, progressive deformation of a material under constant stress.
Is a small increase in joint angle due to the elongation of the MTU during constant-torque static stretching.
The lengthening that occurs when a constant force or load is applied to a muscle.

Question 13

Name the spinal reflexes

Answer 13

Stretch reflex (muscle spindles)
Inverse stretch reflex (golgi tendons organs)

Question 14

What is stretch tolerance?

Answer 14

A measure of the amount of resistive force to stretch within target muscles that can be tolerated before experiencing pain

Question 15

What are the 6 steps for designing a flexibility program?

Answer 15

1. Assess the clients flexibility
2. Identify the joints and muscles needing improvement
3. Select an appropriate stretching method
4. Select specific exercises for the exercise prescription
5. Follow the guidelines for designing flexibility programs
6. Follow the guidelines for desinging a stetching program

Question 16

Which training principles are applied to the development of flexibility programs

Answer 16

• Overload
• Specificity
• Progressing
• Inter-individual variability

Question 17

What are the 4 stretching methods (modes) used to increase ROM?

Answer 17

• Slow static stretching
• Ballistic stretching
• Dynamic stretching
• Proprioceptive neuromuscular facilitation (PNF)

Question 18

What are the classifications of the stretching techniques?

Answer 18

• Active stretching
• Passive stretching
• Active-assisted stretching

Question 19

Which of these stretching methods produces the highest or lowest resistance to stretch?

Answer 19

• Highest: ballistic

- Lowest: slow static

Question 20

which of these 4 stetching methods activate the stretch reflex the most or the least?

Answer 20

Most: ballistic
Least: slow static

Question 21

What is constant-angle static stretching?

Answer 21

• Joint angle does not change
• Exhibits the viscoelastic stress relaxation response
• Changes both viscosity and elasticity of MTU

Question 22

What is constant-torque stretching?

Answer 22

• Joint angle increases during stretching because the constant pressure applied to the MTU causes it to elongate
• Exhibits viscoelastic creep
• Changes both viscosity and elasticity of MTU

Question 23

According to Herda et al. (2011), which type of static stretching (constant-angle or constant-torque) decreases muscle-tendon unit stiffness?

Answer 23

Constant-torque static stretching

Question 24

What are the commonly used PNF stretching techniques?

Answer 24

• Contract relax technique (CR)

- Contract relax agonist contract technique (CRAC)

Question 25

What are the general recommendations for performing PNF stretches?

Answer 25

- Stretch the TMG by moving the joint to the end of its ROM - Isometrically contract the stretched muscle group against an immoveable resistance for 5-10s - Relax the TMR as you can stretch it actively or passively to a new point of limitation - CRAC technique: contract the opposing muscle group submaximally for 5-6s to facilitate stretching of TMG

Question 26

What are the physiological mechanisms underlying the increased ROM produced by the PNF stretching method?

Answer 26

- Autogenic inhibition - Reciprocal Inhibition - Viscoelastic Stress relaxation - Gate control theory of pain modulation

Question 27

Which sensory receptors mediate the stretch reflex and inverse stretch reflex?

Answer 27

Muscle spindles and golgi tendon organs (GTO)

Question 28

Where are the muscle spindles and Golgi tendon organs located?

Answer 28

- Muscle spindles: Muscle belly | - GTO: Muscle tendon

Question 29

What is sensed by the muscle spindles and the Golgi tendon organs?

Answer 29

Muscle tension

Question 30

What is autogenic inhibition?

Answer 30

- A reduction in the excitability of the targeted muscle because of the inhibitory signals sent from the GTO during an isometric contraction - Relaxation due to increased tension

Question 31

What is reciprocal inhibition?

Answer 31

As the opposing muscle group is voluntarily contracted, the TMG is reflexively inhibited

Question 32

What is the viscoelastic hypothesis?

Answer 32

Based on viscous and elastic properties

Question 33

What is the gate control theory of pain modulation?

Answer 33

- A neurophysiological theory that explains what happens when stimuli such as pain and stretch activate their respective receptors simultaneously - May explain ability to tolerate stretching and increases in stretch tolerance following PNF stretching

Question 34

Which exercises are contraindicated for a flexibility program?

Answer 34

- Neck extension - Headthrows in a crunch - Unsupported hip/trunk flexion - The Plow - Swan lifts - Vsits - Leg lifts with trunk hyperextended - Hamstring stretch- leg on bar - Hurdlers stretch - Squats and deep knee bends - Lunges with knee forward of supporting foot - Fast twists/jump twists

Question 35

Which exercises are recommended for a flexibility program

Answer 35

Dynamic stretching

Question 36

Does stretching affect maximal muscle performance?

Answer 36

- Dynamic stretching: improvement | - Static and PNF: reduction

Question 37

Does stretching prior to physical activity prevent injury?

Answer 37

need more research, cant tell

Question 38

Which factors decrease ROM with age?

Answer 38

- Disuse - Changes in tissue viscoelasticity - Diseases such as arthritis

Question 39

What are the client guidelines for stretching programs?

Answer 39

- perform a WU before stretching to increase body temp - stretch all major muscle and opposing muscle groups - focus on target muscles involved in the stretch, relax them, and minimize movement of other body parts - hold stretch for 10-30s, 30-60s for older individuals - stretch to the limit of movement, not pain - normal breathing - stretch TMG in different planes to improve overall ROM - include stretching after the active WU and CD

Question 40

What is the CSEP-PATH's (2019) FITT for flexibility?

Answer 40

- F: 2-7days/week - I: Below pain threshold - T: Static: 10-30s/muscle stretch 2-4reps/stretch total: 60s PNF: 5-6 isometric contraction, 10-30s assisted slow static stretching - T: Static & PNF - At least 1 exercise for each major muscle group performed after a general WU - NO BOUNCING, stretch slowly and smoothly