Theory and Concepts Flashcards
(110 cards)
0
Q
What is meant by the term co-contraction ?
A
A phenomenon that occurs because of delayed local stabilizer recruitment.
When recruitment is delayed the joint gets stability from surrounding global mobilizers
1
Q
What is proprioception ?
A
Perphiral input to the brain
It can be visual, physical, auditory etc
2
Q
In which range/s can an isomeric contraction be held?
A
Inner, middle and outer ranges
3
Q
What muscle type is responsible for joint stability and the ‘neutral zone’ ?
A
Local stabilizers
4
Q
What causes faulty movement ?
A
- Imbalance of both muscle length/strength
- lack of joint stability
- an inability to dissociate movement
5
Q
What process can be used to describe the metabolic process used by global mobilizers ?
A
Glycolysis
6
Q
What motor units are Sensitive and have easily activated recruitment thresholds ?
A
Slow motor unit
7
Q
These muscles do not shorten when they contract
A
Local stabilizers
8
Q
What muscle type is dominated by FMU fibres
A
Global mobilizers
9
Q
These muscles usually have a rotatory component in there movement
A
Global stabilizers
10
Q
These muscles prevent translational movements at joints
A
Local stabilizers
11
Q
What Motor unit Fatigues easily ?
A
Fast motor unit
12
Q
These muscles give concentric action to go through a particular ROM
A
Gobal Stabilizers
13
Q
These muscles provide an isometric hold in the inner range
A
Global stabilizers
14
Q
Factors that define ideal movement ?
A
- plane of movement
- range of movement
- dissociation of movement
15
Q
What is a motor unit ?
A
A motor neurone and the muscle fibres that it innervates
16
Q
What motor units are Insensitive and require more stimulation to be activated ?
A
Fast motor unit
17
Q
What constitutes a ‘loaded’ movement ?
A
Either speed or resistance or a combination
18
Q
Which muscle type is recruited for loaded movements ?
A
Gobal mobilizers
19
Q
High load activity and strength training is a result of which motor unit recruitment ?
A
Both slow and fast motor units
20
Q
What muscle consists of predominately SMU fibres ?
A
Local stabilizers
21
Q
What motor units are highly resistant to fatigue ?
A
Slow motor unit
22
Q
This motor unit is used for rapid/ accelerated and high load activity
A
Fast motor unit
23
Q
What muscle has many muscle fibres per motor unit?
A
Course coordination muscles
24
In what muscle type is the distribution of SMU and FMU 50/50?
Global stabilizers
25
At what speed are stabilizer muscle tested?
Slowly
26
What is meant by the term high recruitment threshold ?
```
The motor units in this muscle need a higher amount of stimulus in order to be effectively recruited. They are not as 'easily' activated
Examples of stimulus/load
- speed
- resistance
- combination of the above
```
27
What is the main difference between recruitment and hypertrophy ?
Recruitment - no structural change modulated by CNS and influenced by afferent proprioception system
Hypertrophy - structural change with neural adaptation of CNS - result of overload training
28
How can slow motor unit recruitment be optimized ?
Low load training and exercise
29
What would be the first consideration taken during evaluation of pain or dysfunction ?
Check local stabilizers are correctly setting a joint in the neutral zone
30
Two joint muscles are classified as what kind of muscle ?
Global mobilizers
31
Continual faulty movement causes ?
Pain and dysfunction
33
What motor units have a high Contraction speed ?
Fast motor unit
34
What does dissociation of movement mean ?
Having the ability to differentiate between movements at a particular joint and with reference the joints above, below or adjacent to the joint in question
35
What is considered 'good' dissociation ?
An ability to completely isolate a pure movement at a joint. No undesirable trick movements occur.
36
What is considered 'bad' dissociation ?
An inability to isolate a particular movement at a joint. Trick Movements are observed as the patient uses joints above, below or adjacent to 'acquire' additional ROM
37
What is the only joint in the body that doesn't have a local stabilizer
The ankle joint
38
What common adaptations can be expected if a joint is not in the neutral zone?
- muscles shorten adaptively
- muscles lengthen and weaken adaptively
- extra load is placed on cartilage, articular surfaces and ligaments. Extra load causes structure ms to degenerate
39
What are the key differences in function between local stabilizers, global stabilizers and global mobilizers ?
Local stabilizers - function to keep joints stable by keeping them in the neutral zone before movement occurs
Global stabilizers - function so as to facilitate rotational movements
Global mobilizers - function so as to produce force and gross ROM in a joint
40
Which muscle type has the most sustainable energy source ? What type of storage is used ?
Local stabilizers
| They use stored ATP (of which there is an abundance in the body)
41
Why are local stabilizers fatigue resistant?
Their muscle metabolism is the most sustainable
42
Which muscle type uses phosphotylation of ADP and CP as a source of energy ? Comment on sustainability ?
Global stabilizers
| This source is less sustainable than using stored ATP but more sustainable than Glycolysis
43
In what muscle type will Latic acid formation be the most prevalent ?
Global Mobilizers
44
Is glycolysis a sustainable source of energy ? Are they're any implications because of it's sustainability ?
Not sustainable relative to other sources of energy
Implications
-Muscles that use this form of energy are prone to fatigue
-The Glycolysis process creates lactic acid
45
What is mean by the term a low recruitment threshold ?
The motor units in this muscle sensitive. They require minimal stimulus to be activated - this they are 'easily activated'
Examples stimulus
- a thought
- unloaded movements
48
What is the most important principle that applies when local stabilizers are evaluated ?
There is no movement
52
What will arise when proprioception is not present?
Movement dysfunction due to lack of external environment information to the brain
55
These muscles provide eccentric control from the inner range back to the neutral position
Global stabilizers
56
Which muscle type uses the oxford grading system and why ?
Global mobilizers
The oxford system tests ROM and ability to withstand external resistance
Global mobilizers are characterized by their ability to produce force and ROM
57
Do recruitment patterns return to normal after pain dissipates ?
No, rehab has to take place in order to restore correct recruitment patterns
58
What motor unit has a fast Contraction speed ?
Fast motor unit
59
What is ideal local stabilizer function ?
They activate in anticipation of movement and prevent joint translation
60
How are muscles physically altered if recruitment patterns are abnormal ?
LS - will weaken and atrophy
| GM - will become over active
61
What does 'low or high threshold' imply in terms of stimulus required?
Minimal stimulus is required to optimally recruit low threshold muscles; higher stimulus needed for optimal recruitment of high threshold muscles
62
How will low threshold muscles be tested and rehabilitated
Slow
Static
Sustained
63
How will high threshold muscles be tested and rehabilitated?
Fast
| Fatiguing
64
What tendencies do stabilizers have in the presence of pain ?
Tendancies includes
Exhibit excessive flexibility
Laxity and weak
65
What Tendency to mobilizers have in the presence of pain ?
They become over active
| They hypertrophy in order to cope with demand being placed on it
66
If pain, pathology and decreased proprioception are present describe the effect that will play out on the Stabilizers
1) recruitment delayed
2) threshold increase because sensitivity has decreased
3) activation of the muscle this require a higher stimulus
4) reaction time slows down
5) long term - stabilizers stop responding to load movements and start loaded movements, rapid acceleration and larger shifts in gravity
67
If pain, pathology and decreased proprioception are present in mobilizers what are the effect? What are the implications?
1) recruit early than that should
2) threshold decreases
3) sensitivity to stimuli increases
4) more reactive to low load movement
A) fatigue easily - react muscle spasm
B) over active and they loss their extensibility
C) hypertrophy
68
What motor unit has a Low % of recruitment of Motor Units ?
Slow Motor Unit
69
What motor unit Controls dynamic functional posture and normal low load/unloaded movements ?
Slow motor units
69
What kind of muscle has fewer muscle fibres per motor unit ?
Fine coordination muscles - e.g. Hand
69
Which muscle type doesn't shorten when it contracts ?
Local stabilizers
69
What is the most important principle that applies when global mobilizers are evaluated ?
The length of the muscle
69
What causes a muscle to become hypertrophic ? Describe a hypertrophic muscle
Hypertrophy occurs as a result of overload training. The muscle becomes bigger and strong to cope with the demand it is being placed under
69
1) Motor control
2) Muscle structure
On which of the two will pain and dysfunction have constant effect ?
Motor control.
| Pain and dysfunction have no direct effect on muscle structure
69
_______ provides efficiency of movement by creating a stable joint
Strong local stabilizers
69
How does the perception of pain influence the recruitment of SMU?
When pain is perceived, SMU's need more propreoceptive input to be recruited. Over time the recruitment threshold becomes desensitized
69
How does the perception of pain alter the ideal firing sequence of SMU and FMU in local stabilizers and global mobilizers? What is the effect of altered firing sequence on these two muscle types ?
If Pain is perceived
1) Global mobilizers(mostly FMU) are activated and fixated before Local stabilizers(mostly SMU) are recruited
2) Global stabilizers become over active. Local stabilizers are recruited too late to prevent translation -> effectively the 'damage' is done.
69
What are the clinical implications for stabilizers due to changes caused by pain, pathology and decreased proprioception ?
- uncontrolled segmental translation(LS)
- increased recruitment threshold (both)
- recruitment timing deficit (both)
- muscle atrophy (GS) and laxity (LS)
69
What are the clinical implication for global mobilizers due to changes caused by pain, pathology and decreased proprioception ?
- Length associated changes than change muscle efficiency
- Imbalance in low threshold recruitment between synergist and antagonist
- Direction dependent relative stiffness and flexibility (trick movements)
- Bracing and co contraction
70
Which motor unit does the presence of pain have a a greater influence on?
Slow motor unit
71
Efficient recruitment of slow motor units result in what 3 phenomenon ?
Optimized postural holding
Anti gravity holding
And stability function
72
Efficient recruitment of the fast motor units result in what two phenomenon ?
Optimized rapid/accelerated movement
| The production of high force/power
73
Dysfacilitation ?
Relates to utilization of altered motor control strategies
74
What are muscle spindles sensitive to ?
Changes in length and force in a muscle
75
What information do muscle spindles send to the CNS ?
They have a primary role in proprioceptive and afferent feedback for motor control
76
How do muscle spindles contribute to segmental stability ?
The regulate and control muscle 'stiffness' and thus give segmental stability
77
What is the difference between clinical and biomechanical stiffness ?
Clinical stiffness relates to a loss of function or motion - intrinsic muscle stiffness
Biomechanical stiffness relaes to a process of providing stability and support - reflex mediated stiffness
78
What is the sense of effort (CNS) ?
A metal challenge in which the brain passes a judgement on the effort required to produce a force
79
What is the sense of effort (PNS)?
Awareness of the sensation of a force in a muscle contraction
80
What is perceived effort (CNS and PNS)?
A combination of the AWARENESS of the sensation of a FORCE and the sensation of EFFORT
81
What is the difference between peripheral and central fatigue?
Peripheral - muscle can't maintain contraction die to peripheral factors (no fuel) CNS may increase neural discharge but no response - improved by strength training
Central - alterations in the way that the CNS drives motor neurons. Muscle has ability and fuel but there is inadequate neural stimulus - motor control issue
82
Which ability to multi joint, long lever muscles have a particular aptitude for?
The ability to produce ROM during concentric shortening
| Not good at preventing excessive movement during eccentric lengthening
83
What ability do one joint, short lever muscles have a particular aptitude for?
They have better control with Eccentric lengthening to limit excessive movement
Not good at producing movement during concentric shortening
84
Very short lever muscles are best at ?
Controlling intersegmental translation
85
What critical factors play a role in rehabilitation ?
```
Neutral alignment
Local stability
Proprioception
Dissociation
Joint ROM
Muscle control through ROM
Speed, Power and load
```
86
What factors influence neutral alignment ?
Non-muscular joint stability
Joint health
Muscle length
87
How do local stabilizers contribute to joint ROM ?
They need to recruit at the correct time in order to give stability to a joint and prevent translation before and during gross movement (that produces ROM) occurs
88
How do global stabilizers contribute to joint ROM ?
They function over a long lever and when they contract produce the visible force, movement and ROM at a joint
89
What is a homunculus ?
The brain's sensory and motor representation of the body
90
What is the effect seem on a joint if global stabilizers can not control eccentric movement ?
Degeneration will be noted on the periphery of the joint structure
91
What is the effect on a joint if local stabilizers do not recruit timeously ?
Joint translation will occurs. Over time the joint structure will sustain extra load and begin to degenerate. Joints will search for stability in other muscles - co contraction and rigidity will occur. GM will become over active
92
What prevents full passive ROM of motion at a joint ?
Joint pathology/pain/restriction
| Length of Antagonist muscle
93
For which form of contraction is there never a trick movement or compensation ?
Eccentric control
94
In what range are global mobilizers and stabilizers first rehabilitated ?
Middle range
95
Why is proprioception important for correct recruitment training in local stabilizers ?
Decreased proprioception results in an increased sense of effort. When sense of effort is increased low load activities are harder to perform
96
What causes the sensation of effort to be increased whilst performing low loaded tasks
Recruitment dysfunction
| Muscle atrophy/disuse
97
Which muscle system is associated with a postural holding role that involves eccentrically decelerating or residing momentum (especially in axial/rotation plane)
The stabilizers
98
Which muscle system has unidirectional fibres and a repetitive and rapid movement role ?
The mobilizers
99
What are four consequences of local muscle dysfunction as a result of pain, pathology and decreased proprioception ?
Uncontrolled segmental translation
Atrophy
Increased recruitment threshold
Motor recruitment timing deficit
100
What are 4 consequences of global muscle dysfunction as a result of pain, pathology and decreased proprioception ?
Length associated change affecting muscle
Imbalance in low threshold recruitment between synergist a and antagonist
Direction dependent - relative stiffness and relative flexibility
Bracing
101
What is inhibition ?
A process of neural discharge beig actively discharged by a another neural influence
102
At altered length what occurs to the the actin and myosin bridge building
The ability to build bridges decreases and the muscle becomes weaker if the length tension relationship functions at an later length
103
What are the characteristics of co contraction ?
-Respiratory changes with stability muscle activation
Excessive global muscle contraction
- eliminated rotation isometrically
- inability to sustain stability muscle contraction with trunk rotation/ passive breathing
104
What are the characteristics of good motor control?
- stability muscles activated without respiratory changes
- rotation is eccentrically controlled
- the patient had the ability to sustain a stability muscle contraction during passive rotation or normal breathing
105
What are the 'ingredients' that constitute rehabilitation ?
```
Neutral alignment
Local stability
Speed, load and power
Joint ROM
Muscle control through ROM
Dissociation
Proprioception
```
106
What factors influence normal full ROM in a joint
Joint play
Biomechanical Muscle stiffness that prevent joint translation
Normal muscle strength to control full concentric and eccentric range
Normal muscle length to allow for normal movement
107
Why is proprioception used in rehabilitation and with what inputs can it be used?
Proprioception is very important in retaining the patient to have the ability to recognize and correct joint alignment
Proprioception can be tactile, visual and cognitive
