Functional stability

Question 1

Concept of functional stability

Answer 1

The bodys ability to hold itself together with regards to external forces

There can be static factors and dynamic factors that play a role:
– static factors- bony congruity, ligamentous structures, interosseous structures, syndesmotic structures, joint capsules- they dont have contractile qualities, they control the movement around them. Convex and concave structures mean they can work better together

– Dynamic structures:
– muscular control, joint proprioception, feedback loop (visual, balance and proprioception)

Neuroplasticity also will play a role:
– it is the quality of the nervous system to respond to activity and provide feedback to make improvements/alterations
– there is an interaction between the CNS and PNS

Question 2

Hypermobility vs instability

Answer 2

Hypermobility:
– where there is an increased ROM more than the normal within a joint
– multiple joints involved
– visceral symptoms
– chronic pain for 3 months or more
– recurring episodes of pain in the same area
– exercises can improve or exacerbate pain

Instability:
– where there is a weakening in the structures around the joint (tendon, ligaments, muscles etc), leading to weakness and instability at a joint
– there is usually only a single joint involved
– pain may resolve in a few days
– there are no visceral symptoms
– can be caused by relaxin during pregnancy

Question 3

Concept of core stability

Answer 3

Capacity of the muscles of the torso to assist maintenance of a good posture, balance especially during movement

The key muscles involved:
– thoracic diaphragm
– transversus
– multifidis
– pelvic floor
– internal/external obliques
– rectus abdominal

The supporting structures :
– thoracolumbar fascia
– linea alba
– semilunaris

In order to be able to move safely, all the muscles above need to contract and maintain internal pressure in the trunk to stabilise and allow movement

Question 4

joint hypermobility spectrum

Answer 4

A condition which most individuals’ synovial move beyond the normal limits taking into consideration the age, gender, and ethnic background of the individual

Characterised by:
– joint hyper mobility
– chronic MSK pain

Epidemiology:
– 10-25% of the population
– female more common
– more prevelant in African and asian countries
– extreme variants:
—- Ehlers danlos and marfans syndrome

Beightons scale for assessment:
1) bring pinkie back further than usual
2) can you pull thumb down to your arm
3) elbow overextending
4) toes
5) bending over and touching your toes

Pathogenesis:
– Type 1 collagen- has high tensile strength and is normally abundant in connective tissue
– Type 2 collagen- found mainly in hyaline cartilage
– Type 3 collagen- found in the same tissues as type 1 but in lesser amounts. its thin and elastic and found in high amounts in extensive connective tissues like the vascular system and the lungs

Laxity and fragility of connective tissue coupled with decreased proprioceptive acuity and altered neuromuscular reflexes may be the cause of predisposition to damage and injury