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41 Cards in this Set

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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
Endurance
Four crucial elements for reestablishing neuromuscular control and functional stability:
Joint proprioception & Kinesthesia

Dynamic Stability

Preparatory & reactive muscle characteristics

Conscious & unconscious functional motor patterns.
Kinesthesia:
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.
Mechanicoreceptors:
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.
Balance:
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.
STATEMENT:
Balance is both Static and Dynamic
Flexability:
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.
Plasticity:
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.
Elasticity:
Ability to return to normal length after an elongation force has been applied.
Viscoelasticity:
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.
Creep:
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.
STATEMENT
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.