Stretching For Impaired Mobility

Front 1

Cycle of Immobility

Back 1

1. Pain or immobility

2. Decreased Loading

3. Progressive adaptive shortening

4. Decreased mobility and function

5. Disuse/substitution

Front 2

Stretching

Back 2

Any therapeutic maneuver designed to increase mobility of soft tissues and improve ROM by elongating structures that have adaptively shortened and have become hypomobile over time

Front 3

Flexibility

Back 3

The ability to move a single joint or series of joints smoothly and easily through an unrestricted ROM

Front 4

Dynamic flexibility

Back 4

the degree to which an active muscle contraction moves a body segment through the available ROM of a joint

Front 5

Passive flexibility

Back 5

degree to which a body segment can be passively moved through the available ROM and is dependent on the extensibility of muscles and connective tissues

Front 6

Hypomobility

Back 6

decreased mobility (usually 1 joint)

Front 7

Contracture

Back 7

adaptive shortening of soft tissue surrounding joints hat resuts in a significant decrease in joint ROM

Front 8

How is a contracture described?

Back 8

By identifying the action of the shortened muscle

EX: elbow flexion contracture

Front 9

Myostatic Contracture

Back 9

Tendon is shortened

Front 10

Pseudomyostatic contracture

Back 10

hypertonicity from TBI or SCI

Front 11

Arthrogenic and periarticular contracture

Back 11

cartilage or things in joint

Front 12

Fibrotic contracture

Back 12

muscle tissue has developed scar tissue

Front 13

Selective stretching

Back 13

applying stretching techniques selectively to some muscles and joints but allowing limitation of motion to develop in other muscles or joints

Front 14

Overstretching

Back 14

stretch well beyond the normal lenggth of muscle and ROM of a joint and the surrounding soft tissues

Front 15

Hypermobility

Back 15

excessive mobility (DONT STRETCH)

Front 16

Manual or Mechanical stretch

Back 16

a sustain or intermitten external, end-range stretch force applied with overpressure and by manual contact or mechanical device

Front 17

Passive stretching

Back 17

No patient assistance

Front 18

Assisted stretching

Back 18

Pt. helping you with a stretch

Front 19

Self-stretching

Back 19

patient performs the stretch.

Front 20

Neuromuscular facilitation and inhibition

Back 20

Neuromuscular facilitation and inhibition procedures are purported to relax tension in shortened muslces during muscle elongation

(PNF)

Front 21

Muscle Energy Techniques definition

Back 21

manipulative procedures that are designed to lengthen muscle and fascia and to mobilize joints

Front 22

How does muscle energy technique work?

Back 22

Voluntary muscle contractions by the patient in a controlled direction and intensity against a counterforce applied by PT

Front 23

Soft tissue mobilization/manipulation

Back 23

designed to improve muscle extensibility and involve the application of specific and progressive manual force

Front 24

Indications for Stretching

Back 24

1. adhesions, contractures, scar tissue

2. Potential for structural deformity due to limited ROM

3. muscle weakness and shortening

4. part of a total fitness program

5. pre and post vigorous exercise

Front 25

Contraindications for stretching

Back 25

1. bony block

2. Non union fracture

3. acute inflammation or infection

4. sharp or acute pain with elongation

5. hematoma or tissue trauma

6. hypermobility

7. when hypomobility provides stability or neuromuscular control

Front 26

Benefits from Stretching Exercises

Back 26

1. Increased flexibility and ROM

2. General fitness

3. Injury prevention

4. Enhanced performance

5. reduced postexercise muscle soreness

Front 27

Elasticity

Back 27

ability of soft tissue to return to its prestretch resting length direction after stretch has been removed

Front 28

Viscoelasticity

Back 28

time dependent property of soft tissue that initially resists deformation but will gradually lengthen before returning to prestretch position

Front 29

Plasticity

Back 29

tendency of soft tissue to assume a new and greater length after the stretch force has been removed

Front 30

Sarcomere give

Back 30

when actin slides apart leading to abrupt lengthening of sarcomeres

Front 31

What happens during immobilization to muscle?

Back 31

1. decay or contractile protein

2. decrease in muscle fiber diameter, # of myofibrils

3 Increase in fatty tissue and fibrous units

Front 32

Sarcomere absorption

Back 32

sarcomers become reabsorbed=atrophy

Front 33

Muscle spindle

Back 33

Respond to changes in length and velocity

Front 34

Golgi tendon organ

Back 34

Respond to tension

Front 35

Reciprocal inhibition

Back 35

decrease of activity on opposide side (antagonist)

Front 36

Autogenic inhibition

Back 36

decrease of muscle tension with sustained stretch

Front 37

Types of Connective Tissue

Back 37

1. ligaments

2. tendons

3. joint capsules

4. fasciae

5. skin

6. non contractile tissue in muscles

Front 38

Collagen fiber placement in tendons?

Back 38

parallel

Front 39

Collagen fiber placement in ligaments

Back 39

vary

Front 40

Collagen fiber placement in skin

Back 40

random

Front 41

Toe region

Back 41

considerable deformation without the use of much force

Front 42

Elastic region

Back 42

continued stretching and elongation. Strain is proportional to force

Front 43

Yield point

Back 43

Beyond the tissue does not return to its pre stretch length

Front 44

Plastic region

Back 44

permanent deformation.

Front 45

Failure point

Back 45

rupture of tissues

Front 46

Grade 1 Ligament injuries

Back 46

microfailure, few fibers rupture

Front 47

Grade 2 Ligament Injuries

Back 47

Macrofailure, partial tear

Front 48

Grade 3 Ligament Injuries

Back 48

Complete rupture

Front 49

Precautions for Stretching

Back 49

1. nonselective or poorly balanced stretching activities

2. insufficient warm-up

3. ineffective stabilization

4. uSe of ballistic stretching

5. Excessive intensity

6. Abnormal biomechanics

7. Insufficient information about age-related differences