lecture 2: ROM and stretching Flashcards by sophia carrasco

what is functional excursion

Distance a muscle is capable of shortening after it’s been maximally elongated

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what is the difference between active and passive insuffiecny

active is when agonist is over shortened over a joint and passive is when a multi joint mm is lengthen to his full extent n

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what kind of motion is ROM

osteokinematic

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when is the difference between active , passive and active assisted ROM

passive is when you move them , active is when they move them selves (mm contraction) and active assisted is u move them and they move themselves

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when are the 2 reasons ROM should not be done

when the motion is disruptive to the healing process and when the patient response or condition is life threatening

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what are the 7 benefits of CPM

• Prevents development of adhesions, contractures
• Stimulates healing of tendons, ligaments
• Enhances healing of incisions
• Increases synovial fluid lubrication
• Prevents degrading effects of immobilization
• Quicker return of ROM
• Decreases postoperati

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when is CPM device applied

immediately after sx

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what is the purpose for doing ROM through functional patterns

helps patient realize purpose and value of ROM exercises and assists in developing motor patterns

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what is the general ROM exercise for acute tissue healing

PROM 3-5 reps within pain tolerance , several times per day

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what is the general ROM exercise for subacute tissue healing

PROM > AAROM> AROM for 10-15 reps with brief hold periods (3-5 seconds) within pain free range; 2-3 times per day

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what is the general ROM exercise for chronic tissue healing

AROM: >30 reps for mm re education , maintenance of ROM , stretching to gain ROM

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what is the purpose of stretching

increase mobility of soft tissue , improve ROM by enlow acting structures that have adaptively shortened and have become hypo mobile over time

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what is the difference between dynamic and passive flexibility

dynamic is flexibility due to active movement and passive is due to a passive force

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what is hypo mobility

limited arthrokinematic movement of a joint

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how can u gain ROM from arthrokinematics

can make the joint glide which will improve the roll and u will gain ROM

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what is contractures designated by

location and position the joint is “stuck in:

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what is myostatic contracture

MT unit is adaptively shortened

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what is Pseudomyostatic contracture:

Hypertonicity due to CNS lesions: CVA, TBI, SCI

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what is Arthrogenic and periarticular contractures:

Adhesions, synovial proliferation, joint effusion, osteophytes

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what is Fibrotic contracture and irreversible contractures:

• Fibrous changes in connective tissue leads to adhesions
• Difficult to re-establish normal tissue length

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what is Purposefully stretch or mobilize certain muscles and joints while letting others become hypomobile to improve function

Selective Stretching

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what is the purpose of overstretching and hypermobility

increase function

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what are 8 interventions to increase mobility of soft tissues

-manual or mechanical stretching
-passive stretching
-assisted stretching
-neuromuscular facilitation and inhibition
-muscle energy techniques
-joint mobilization/ manipulation
- soft tissue mobilization and manipulation
-neural tissue mobilization

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what type of intervention to increase mobility of soft tissues Utilizes an external force to perform a passive stretch

manual or mechanical stretching

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what type of intervention to increase mobility of soft tissue is there No active contraction of the contractile unit

passive stretching

what type of intervention to increase mobility of soft tissue does the Patient assistance by themselves, machine or another person

assisted stretching

neuromuscular facilitation and inhibition for interventions to increase mobility of soft tissues does what 2 tings

• PNF • Increases or decrease in muscle tone

what type of intervention to increase mobility of soft tissue uses Passive techniques to restore arthrokinematics

oint Mobilization/Manipulation:

what are indications for stretching exercises

• Adhesions, Contractures, Scar Tissue Limit ROM • Potential for Structural Deformity due to limited ROM • Muscle Weakness, Shortening of Muscles • Part of a Total Fitness Program • Pre and Post Vigorous Exercise

what are the 7 contraindications for stretching exercises

• Bony Block • Non-Union Fracture • Acute Inflammation or Infection • Sharp or Acute Pain With Elongation • Hematoma or Tissue Trauma • Hypermobility • Hypomobility Provides Stability or Neuro-muscular Control

what are the 3 Potential Benefits and Outcomes for Stretching exercises

• Increased Flexibility and ROM • General Fitness • Other Potential Benefits • Injury prevention (evidence not shown for passive stretching techniques) • Reduced post-exercise soreness • Enhanced performance

what is the temporary change in tissue length then return to previous length once force is removed

elasticity

viscoelsaticity is only what kind of connective tissue

non contractile

what kind of connective tissue initially resist stress and strain

non contractile

what is the permanent change in tissue length

plasticity

the contractiles tissue response to stretch is determines by what 3 things

velocity , duration and amount of force applied

what type of contractile tissue is Facilitory (Ia afferent)

muscle spindle

what type of contractile tissue is inhibitory (Ib afferent)

glogi tendon organ

Neurophysiological Response of Muscle to Stretch is based on what

velocity, duration and amount of force applied

what are the 6 types of connective tissue

• Ligaments • Tendons • Joint Capsules • Fasciae • Non-Contractile Tissue in Muscles • Skin

what is the composition of connective tissue

-collagen fibers -elastin fibers -reticulum fibers -ground substance

what do elastin fibers allow for

elastic properties of connective tissue

what type of ribs is a type 3 collagen that forms a fibrous mesh or scaffold for other connective tissue types

reticulin fibers

what are the 4 ground substances

GAGs, water, glucosamine, chondroitin sulfate

what is the stress and strain curve used for

interpreting mechanical behavior of connective tissue

what are the 4 things from stress and strain

• Tension • Compression • Shear • Strain

what are the 7 regions of the stress strain curve

- toe region -elastic range -elastic limit -plastic range -ultimate strength (necking) -failure -structural stiffness

what region of the stress strain curve is before the stretch begins and it is “straightening of the collagen fibrils”

toe region

what region int he stress strain surge is the linear phase where if u let go of the stretch it will go back to the length

elastic range

what is the elastic limit int he stress strain surve

transient increase then return to previous length

what region of the stress strain curve will there be permanent increase in length and there is no going back

plastic range

what is the necking region on the stress strain curve mean

warning shock before failure

what part of the stress strain curve does stress (load) increase the most

elastic range

what is creep

load is applied for an extended time to elongate tissue

what kind of load is creep

low load , long duration

what is load is applied for extended time with tissue at constant length

stress relaxation

tissue creep grows from ___ load to ___ load

low to high

stress relaxation goes from ___ load to ___ load

high to low

what is changes in collagen affecting stress strains response

• Effects of immobilization • Effects of inactivity (decrease of normal activity) • Effects of age • Effects of corticosteroids • Effects of injury • Other conditions affecting collagen

what are the determinants and types of stretching exercises

-alignment and stabilization -intensity of stretch -duration of stretch -speed of stretch -frequency of stretch

what are the modes of stretch

• Manual Stretching • Self-Stretching • Mechanical Stretching

what are the 3 different types of PNF stretching

• Hold–relax and contract–relax • Agonist contraction • Hold–relax with agonist contraction

what is a method of warm up

heat

what is useful for UMN lesions to promote relaxation prior to stretch

cold

what is beneficial after stretch to decrease pain and muscle spasm

cold

what Promotes relaxation of muscles being stretched

biofeedback

what does Joint Traction or Oscillation do

• Inhibits pain • Promotes muscle relaxation • Increased inhibitory mechanoreceptor activity

what are the 3 manual stretching techniques in anatomical planes of motion for UE anf LE stretching

• Hand placement • Patient position • Procedure

what are the 3 manual stretching techniques in anatomical planes of motion for UE anf LE stretching

• Hand placement • Patient position • Procedure