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Movement Exam 3

Terms in this set (58)

limitations of ROM
-trauma of the joint or surrounding tissues
-disease of the joint or surrounding tissues
AROM
active range of motion
-what we see when we contract the muscles that control the motion that we want to perform
SROM
self range of motion
-when you or the client performs ROM on his or herself on the affected side using the unaffected side
AAROM
active assistive range of motion
-when the client or therapist provides some help during active range of motion, so that the client can move beyond where they can actively move alone
PROM
passive range of motion
-when the therapist moves the client through the given range
-normal to have more than active
discrepancy between AROM and PROM
-a tendon is not intact
-muscle weakness
-pain
-scar tissue
AROM and PROM affected
-bony block
-capsular tightness
-muscle tightness
-edema
-contractures
-extensive scar tissue
bony end feel
bone-to-bone
-movement stops as the bony surfaces meet such as elbow extension
capsular end feel
somewhat firm or leahtery but has some give, such as end range of shoulder external rotation
soft end feel
tissue approximation
-when soft tissue stops the movement, such as elbow flexion
spasm end feel
where the tissue responds with a harsh. movement in the opposite direction
empty end feel
where there is no "feel," but rather the patient asks to stop because of pain
springy end feel
where there is some rebound at the end ROM
edema
(swelling) possible consequences:
-decreased ROM
-pain
-decreased sensation
-impaired occupational performance
edema measurement
volumeter or tape measurement
volumeter
measures mass of a body part by looking at water displacement as measured by a graduated cylinder
-used to measure edema in an entire hand
tape measurement
-if we only wanted to measure one finger
-if someone had a recent surgery, had sutures and not able to submerge the body part into water
-make circumferential measurements, make sure we measure in exactly the same place each time we test (use anatomical landmarks)
strength measurement
-specific MMT
-gross MMT
-grip strength (Jamar dynamometer)
-pinch strength (tip, lateral or palmar pinch)
dexterity
refers to our ability to manipulate objects
-ROM
-strength
-sensation
conditions impacting endurance
-cardiac
-pulmonary
-prolonged bedrest
-loss of muscle function
-need for prosthesis or adaptive equipment
-borg perceived exertion scale
muscle fibers
the endurance and strength needed to perform an activity or exercise is dependent on many factors
-amount of motor units fired
-frequency of motor unit firing
-length-tension relationship
-muscle fiber types and sizes
type 1 muscle fibers
slow-twitch
type 2 muscle fibers
fast-twitch
concentric contraction
tension is created causing the muscle to shorten
eccentric contraction
lengthening of a muscle under tension
isometric contraction
internal and external forces are equal
aerobic exercise
rhythmic involves the use of large muscle groups and can be maintained
-muscle groups activated depend on aerobic metabolism to extract energy from carbs, amino acids, and fatty acids
-examples: dancing, cycling, swimming, hiking
anaerobic exercise
short bouts of intense physical activity
-muscles are fueled by the existing energy sources contained within the contracting muscle as as opposed to the energy that may be inhaled via oxygen intake
-examples: sprinting, powerlifting, high-intensity interval training
open-chain
the distal end of the extremity is not fixed to a stable surface
-non-fixed distal end is moved either to or away from the body
closed-chain
distal end is fixed
-body is being moved to or away from the stabilized extremity
exercise dosing
-clinical judgment
-standardized equipment or MMT
-1 repetition maximum (RM)
parameters
manipulated to increase strength
-volume
-rest
-velocity and type of contraction
-exercise frequency
volume
the number of reps and sets performed during one session multiplied by the resistance used
rest
heavy load and high reps = 3-4 minute rest

low load and low reps = 1-2 minute rest
exercise frequency
2-3 days a week initially
-increase to 3-5 days as the client's strength improves
active stretching
source of force originates from the contraction of the muscle opposite to the direction of limitation
-contract relax (CR)
contract relax
proprioceptive neuromuscular active stretching technique
passive stretching
an external force is applied
-two techniques: manual stretching and orthotics
-manual stretching considerations: environment, stabilization, movement, time, pain
isometric
muscle grade needed: 0
exercise: client contacts and holds the weak muscle as long as possible
reps: 10 times
dynamic assistive or active assistive range ROM
muscle grade needed: 2- or 3-
exercise: client moves their limb through their available ROM first, then therapists assists to complete the motion
dynamic active or active ROM
muscle grade needed: 2 or 3
exercise: client actively moves the limb through their full available ROM
repetitions: 3 sets of 10 reps with rest breaks taken between sets
dynamic active resistive or active resistive ROM
muscle grade needed: 2+, 3, 3+, 4, 4+
exercise: client actively moves the limb through their full available ROM against resistance
reps: 3 or 4 sets of 10 reps may be prescribed with rest breaks recommended between sets
strategies for improving endurance
-low intensity muscle contractions with a high or larger number of reps
-lift light to moderate loads
-greater than 15 reps
-less than 90 second rest periods
optimal motor performance
-absence of mechanical constraints
-adequate postural control
-kinesthetic understanding
-understanding of what constitutes success
-a match between individual abilities and task demands
-task analysis and praxis
joint mobility
if a joint has not moved through its full ROM due to weakness, spasticity, or an impairment of tone, motor planning or motor control, tissues can lose their distance ability
-scar tissue, tissue shortening, edema, and other factors
-PROM important
dissociation
the ability of the body segments to move independently of one another
-must have appropriate muscle length
postural alignment
poor postural alignment due to musculoskeletal imbalance can negatively affect balance, transfers, gait, and engagement in a variety of occupations as well as present a safety risk
praxis
ability to analyze the motor requirements of a task and determine the best solutions to potential problems that may arise when performing the task
task analysis
natural to analyze the task and environment in which it is to be performed in order to create an appropriate motor plan for the tasks
neural networks
allow us to plan for the task and to utilize feedforward control
feedforward
occurs before an individual makes contact
-allows us to make adjustments in the middle of a task and to be successful
stage 1 of brunnstroms stages of recovery
flaccid, no voluntary movement, no tone, reflexes absent
stage 2 of brunnstroms stages of recovery
reflexive synergies present, spasticity beginning
stage 3 of brunnstroms stages of recovery
voluntary movement in synergy can have significant spasticity
stage 4 of brunnstroms stages of recovery
spasticity is decreasing, beginning to be able to perform movements that slightly deviate from synergy
stage 5 of brunnstroms stages of recovery
isolated voluntary movements are increasingly independent of synergy
stage 6 of brunnstroms stages of recovery
minimal spasticity, isolated motor control
stage 7 of brunnstroms stages of recovery
typical speed and coordination
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