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41 Cards in this Set

  • Front
  • Back
Objective of neuromuscular control:
Integrate joint load sensation into coordinated movements.
Neuromuscular control activities are intended to:
Complement traditional rehabilitation protocols.
ABC's of Proprioception
A: Agility
B: Balance
C: Coordination
Agility, Balance and Coordination are in part determined by:
Flexibility, Strength, and
Four crucial elements for reestablishing neuromuscular control and functional stability:
Joint proprioception & Kinesthesia

Dynamic Stability

Preparatory & reactive muscle characteristics

Conscious & unconscious functional motor patterns.
Sensation of joint motion or acceleration.
Neuromuscular control:
Efferent (motor) response to sensory information.
Feed-Forward Neuromuscular Control:
Movements based on sensory information.
Feedback Process:
Continuously regulates motor control through reflex pathways.
Function by transducing mechanical deformation of tissue into frequency-modulated neural signals.
(QA) Receptors:
Quick Adapting Receptors that discontinue sending signals quickly after the onset of the stimulus. - Thought to provide conscious and unconscious kinesthetic sensations in response to joint movement or acceleration.
(SA) Receptors:
Slow Adapting Receptors continue to send signals as long as the stimulus is present. - Provides continuous feedback and proprioceptive information relative to joint position.
Process of maintaining the center of gravity (COG)
Postural Equalibrium:
Refers to the alignment of joint segments in an effort to maintain the center of gravity.
Balance is both Static and Dynamic
Musculotendinous unit's ability to elongate with application of a stretching force.
Range of Motion:
Amount of mobility of a joint.

Determined by the soft-tissue and body structures in the area
Connective Tissue Composition:
Collagen, provides tissue with strength & stiffness

Elastin, provides the structure with extensibility.

Ground substance reduce friction between fibers and maintain spacing between fibers to prevent excessive cross links.
Effects of Immobilization on Connective Tissue:
Connective tissue is continually replaced and reorganized as a art of normal body function.

Immobilization causes a loss of ground substance.
Effects of Immobilization of Articular Cartilage:
Cartilage becomes thinner

Necrosis of Articular cartilage.
Effects of Remobilization:
Movement causes a more rapid re-absorption of the hematoma, increase in tensile strength, improved myofibril regeneration and arrangement.

Less Articular cartilage degeneration occurs if both joint motion & weight bearing are allowed.
Effects of Immobilization on Muscle Tissue:
Reduction in muscle fibers size (seen after 2 weeks)

Decrease in myofibrils

Reduction in intramuscular capillary density.

Fatigue quickly

Unable to produce a strong contraction

Slower to respond.
Muscle Spindles:
Sensitive to a change in length.

Sensitive to velocity or rate of change of length.

Sensitive to duration of stretch.
Golgi Tendon Organ:
Not as sensitive to stretch changes but detect changes in tension.

Prolonged stimulus of the golgi tendon organ can cause an over-riding of the muscle spindle reflexive contraction.
Allows the connective tissue's length to change.

Ability of a substance to undergo a permanent change in size or shape after deforming force is applied.
Ability to return to normal length after an elongation force has been applied.
Structure to resist change in shape when an outside force is applied but an inability to completely return to its former state after changing its shape.
Effectiveness of Stretch:
Amount of collagen and elastin in the structure

Amount of force applied

Duration of stretch

Temperature of the tissue.
Elongation of tissue when a low level load is applied in the plastic range over an extended period of time.

-Time Dependant

-Effective when the tissue is warm
Creep Principle:
Low load over a period of time is effective in remodeling collagen and maintaining ROM.
Contraindications for Stretching:
Recent fractures

Bony block that restricts motion.

Infection in a joint

Acute inflammation in a joint.

Sharp pain
Fatigue Failure:
Load stress below the failure point is repeated for a cumulative effect.
Rehabilitation goals involve:
Increasing neuromuscular control and agility in addition to increasing strength and endurance.
Role of functional progressions:
Improve and complete the rehabilitation process.
Criteria for return to full activity:
1. Physician's release
2. Free of pain*
3. No Swelling
4. Normal ROM
5. Bilateral strength
6. Functional testing.
Strength and ROM do not always correlate to functional ability
Functional Testing: Specific and meaningful test should be:
1. Valid
2. Reliable
Basic Testing Measures:
1. Strength
2. Joint laxity
3. ROM, Flexibility
4. Swelling
5. Girth
Additional Basic Testing measures:
1. Motion
2. Balance
3. Stability
4. Control
Additional Basic Testing measures:
1. Motion
2. Balance
3. Stability
4. Control
Testing Criteria's:
1. Distance Reach
2. Time
3. Body position
4. Balance and Motion balance.