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Terms in this set (100)
What is an examination?
a clinician seeks information containing the SINS of a patients injury.
What is in the subjective part of an examination?
Demographic, hx of the current injury and hx of other prior injuries, and other important questions.
Why is the importance of flexibility?
for restoration and improvement in normal pre- injury ROM.
What is flexibility?
Ability of neuromuscular system to allow for efficient movement of a joint or series of joints through a full, non-restricted pain free range of motion
What are some anatomical features that are impacted with flexibility?
muscles, connective tissue, bony structure, adipose, skin, and neural tissue.
What is so important about flexibility?
Aside from bone structure, age and gender all other flexibility limiting factors can be modified and altered to increase range of motion.
What is AROM?
Active Range Of Motion
joint movement via muscle contraction
ability to move a joint with little resistance.
What is PROM?
Passive Range Of Motion
Motion of joint to end points without muscle contraction
How can you measure ROM?
What are some stretching techniques?
Ballistic, static stretching, PNF, Myofascial and neural tissue stretching
Antagonist Vs. Agonist
Bouncing movement in which repetitive contractions of agonist work to stretch antagonist muscle
* Possible soreness due to uncontrolled forces within muscle created by bouncing
* Passively stretching given antagonist
*6-8 second hold in maximal position of stretch
*point of discomfort and back of slightly
Progressive Velocity Flexibility Program (PVFP)
Stretches that incorporate increased velocity and range lengthening
What are the 3 techniques in the the PVFP technique?
Slow reversal hold relax, contract relax, and then hold relax.
Moves body passively into agonist pattern
contract antagonist isotonically against resistance
Athete then relaxes allowing the AT to push further
Hold Relax (HR)
Isometric contraction of antagonist followed by concentric contraction of agonist with light pressure
Effective when muscle tension is on one side of joint
Isotonic contraction of agonist
Follow with isometric contraction of antagonist
Useful to stretch antagonist**
Ballistic stretching is recommended for athletes engaged in what?
Relaxation of antagonist during contraction
During relaxation phase, antagonist is placed under stretch but assisted by agonist contraction to pull further into stretch
Contraction elicits additional relaxation of antagonist (protect against injury
Physical lengthening of muscle occurs due to what?
Stretches that are sustained long enough (autogenic inhibition) result in what and plastic changes in collagen and what
What allow slow deformation and imperfect recovery (not permanent)?
Greater Velocity equals what?
greater chance for exceeding tissue capacity (viscoelastic and plastic)
Joint hypomobility can cause?
Faulty posture, Muscular imbalance, and Abnormal neuromuscular control
Why is it important to stretch prior to warming up?
Intramuscular temperature should be increased, Enhances reflexive relaxation associated with golgi tendon organs
To increase = low intensity, warm-up type exercise or modalities
What are some guidelines and precautions when you are stretching?
don't over stretch, Overload or stretch beyond normal range, Use caution when stretching around painful joints, Avoid overstretching, should be performed 3 times a week, and for greater gains 5-6 times a week is ideal.
Surrounds all tissue, superficial layer, deep layer. Contains elastin, collagen, and cellular components. high tensil strength can be deformed
Results from chronic or acute deformation forces. Alters function. May cause pain, deformity, loss of motion, reduced function. Increases risk of injury.
What are the myofascial release techniques?
J-stroke, oscillation, wringing, stripping , arm/leg pull, and longitudinal release.
What is a trigger point?
focus of hypomobility that refers pain and occasional autonomic reaction.
What are trigger point treatments?
Ice or spray and stretch, Ischemic compression. Followed by gentle stretches.
What is Joint mobility?
Used to modulate pain , Used to increase ROM, and Used to treat joint dysfunctions that limit ROM by specifically addressing altered joint mechanics
What does mobilization mean?
passive joint movement for increasing ROM or decreasing pain.
What does manipulation mean?
passive joint movement for increasing joint mobility.
concurrent application of a sustained accessory mobilization applied by a therapist & an active physiologic movement to end range applied by the patient.
what is Physiologic Movements?
Movements of the bone, movements that are common too such as flexion, extension, abductions, and rotation
Whats Accessory Movements?
movements within the joint & surrounding tissues that are necessary for normal ROM, BUT can not be actively performed by the patient.
What is Component motions?
motions that accompany active motion, but are not under voluntary control.
What is joint play?
motions that occur within the joint.
What is Arthrokinematics?
- motions of bone surfaces within the joi
What are the 5 motions of Arthrokinematics?
Spinning, rolling, sliding, compression, and distraction.
What is muscle energy?
use an active contraction of deep muscles that attach near the joint & whose line of pull can cause the desired accessory motion.
What is thrust?
high-velocity, short-amplitude motion that the patient can not prevent.
What is the difference between Cancave and convex
Concave: hollowed or rounded inward
convex: curved or rounded outward
What are the basic concepts of joint mobility?
Joint shapes and types of joint motion
What are two joint shapes?
Ovoid and sellar (saddle)
What is the Ovoid shape?
one surface is convex, other surface is concave
Ex: condyle joint.
Whats a sellar (saddle) joint?
one surface is concave in one direction & convex in the other, with the opposing surface convex & concave respectively. Ex: metacarpal
What are the 3 components of a joint mobility?
roll, spin, and slide
What is a roll?
A series of points on one articulating surface come into contact with a series of points on another surface.
* Roll occurs in direction of movement.
What is a spin?
Occurs when one bone rotates around a stationary longitudinal mechanical axis. Ex: shoulder extesion/flexion.
What is a slide?
Specific point on one surface comes into contact with a series of points on another surface. surfaces are congruent.
What is the Convex-Concave Rule?
convex joint surfaces slide in the OPPOSITE direction of the bone movement (concave is STABLE).
What is the Concave-convex rule?
What are the effects of Joint Mobilization?
Neurophysiological effects, Nutritional effects , and Mechanical effects.
What are some contrainindications for Joint mobility?
Inflammatory arthritis, Malignancy, Tuberculosis, Osteoporosis, Ligamentous rupture, Herniated disks.
What are some Precautions for Joint Mobility?
Pregnancy, flu, poor health, scoliosis, joint replacement, oseoarthritis.
What is a grade 1 Joint mobile?
Small amplitude rhythmic oscillating movement at the beginning of range of movement. Manage pain and spasm.
What is a grade 2 joint mobile?
Large amplitude rhythmic oscillating movement within midrange of movement.
Grade 3 joint Mob?
Large amplitude rhythmic oscillating movement up to point of limitation (PL) in range of movement; Used to gain motion within the joint; Stretches capsule & CT structures.
Grade 4 joint mob?
Small amplitude rhythmic oscillating movement at very end range of movement, Used to gain motion within the joint.
Grade 5 joint mob?
Small amplitude, quick thrust at end of range; Accompanied by popping sound (manipulation) ; Velocity vs. force; Requires training.
What are indications of Mobility?
Grades I and II - primarily used for pain; Grades III and IV - primarily used to increase motion.
What are the joint postions?
resting position, lose- pack, and closed-packed
What is resting position?
Maximum joint play- joint capsule and ligaments are the most relaxed. Evaluation and treatment position utilized with hypomobile joints
What is lose-packed?
Articulating surfaces are maximally separated, Joint will exhibit greatest amount of joint play, Position used for both traction and joint mobilization.
What are close-pack?
Joint surfaces are in maximal contact to each other.
Why is regaining strength, endurance and power essential to the rehabilitation process?
Critical to maintain and improve in each area in order to achieve competitive fitness levels and return athlete to functional level following injury.
What is muscular endurance?
Ability to perform repetitive muscular contractions against some resistance.
What is power?
Ability to generate force quickly, Combination of strength and speed, and Performance is limited without power.
What are the Types of Skeletal Muscle Contraction?
Isometric contraction, Concentric contraction, Eccentric Contraction, Econcentric contraction, and
Whats isometric contraction?
Contraction that produces muscle tension but no change in muscle length.
What is Concentric contraction?
Contraction that causes muscle shortening while tension increases to overcome some resistance.
What is Eccentric Contraction?
Resistance is greater than the muscular force being produced and muscle lengthens while producing tension.
What is Econcentric contraction?
Controlled concentric and eccentric contraction of same muscle over 2 separate joints.
What factors determine the level of strength, endurance, and power?
size of muscle, Number of Muscle Fibers, Neuromuscular Efficiency, Age, Biomechanical Considerations, and Overtraining.
What is slow-twitch fibers?
Type I or slow oxidative, Resistant to fatigue, Time required to generate force is greater in slow twitch fibers, and Primarily associated with long duration, aerobic type activities.
What is Fast -twitch Fibers?
Type IIa (fast oxidative glycolytic) IIb (fast glycolytic, Type IIx - fatigue resistant with force capacity (a<x<b, and Produce quick, forceful contractions by tendency to fatigue.
What is the overload principle?
To improve strength, muscle must be worked at a level higher than it is accustomed to.
Capable of increasing muscle strength at specific joint angles, Widely used in rehabilitation, Contractions should be held for 10 seconds at frequency of 10 or more per hour, Utilized to enhance lift or activity at "sticking point".
Progressive Resistive Exercise
Most popular and commonly used, Exercises that work through a full range of motion, Isotonic or isodynamic contractions, Concentric vs. Eccentric.
What are some techniques of Progressive Resisive Exercise?
Repetitions, Repetition maximum (RM), Set, Intensity, Intensity, Recovery period, Frequency.
What areas must you consider when recommending Progressive Resistive Exercise?
Amount of weight to be used, Number of repetitions, Number of sets, Frequency of training.
What is closed kinetic chain?
Foot or hand is weight bearing, Useful in rehabilitation,
What is open kinetic chain?
Foot or hand not in contact with ground or some other surface.
Whats the difference between strength vs. endurance?
Strength: Heavier weight and low repetitions
Endurance: Lighter weight and heavier repetition
What impacts balance?
Muscular weakness, Proprioceptive deficits, and ROM deficits.
What are the components of Postural Control System?
Sensory detection of body motions, Integration of sensorimotor information within the CNS, and Execution of musculoskeletal responses.
Body position in relation to gravity is sensed by?
Visual, Vestibular, and Somatosensory inputs
Balance movements involve a number of what joints?
ankle, knee, hip, and coordinated momevment along kinetic chain
What is proprioception?
Body's ability to correctly transmit and interpret position information and to respond to a stimulus.
What are your proprioceptors?
Cutaneous, Muscles, Tendons, and Joints.
What is the 3 component series of Balance?
Vestibular, Oculomotor, and Proprioception.
How to you test balance?
Romberg Test and the stork stand
What are the classifications of Balance Exercises
Static, Semi-dynamic, Dynamic, Functional.
What Is Agility?
Ability to control body activity during rapid, complex, and skillful activities.
What are the components of Agility?
Flexibility, Strength, Speed, Power, and Coordination.
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