Introduction Information

Occupations

Everyday activities that bring meaning and purpose to life

Occupational Performance

Act of completing meaningful activities

Functional Mobility

Moving from one place to another

Activity Analysis

Identification and evaluation of performance skills and patterns that facilitate or inhibit occupational performance

Movement

• Basic human drive

• Allows for communication, survival, and engagement

• Must move efficiently (energy-conserving ways)

• Created by our muscular, skeletal, and neuromuscular systems

Neuromuscular components of movement

• Muscles cannot move without nerve innervations

• CNS and PNS make up nervous system

Cardiovascular components of movement

• Muscles need oxygen and nutrients provided by lungs and blood to survive

• Muscles also help expand the lungs and return blood to heart

Skeletal components of movement

• Provides framework of body

• Protects vital organs

• Series of bones connected at joints

Muscular components of movement

• Skeletal muscles provide movement and stability

• Strength is determined by number of muscle fibers, size of muscle fibers and size of axon innervating nerves

Isometric Contraction

• Muscle length DOES NOT change → tension increases

• No movement at joint

• Ex: holding squat for 30 seconds, survivor challenge, etc.

Isotonic Contraction

• Causes MOVEMENT at joint

• Muscle tension maintained throughout movement

Isotonic Contraction: Eccentric Movement

• Muscle lengthening

• Putting something down lengthens bicep muscle

Isotonic Contraction: Concentric Movement

• Muscle Shortening

• Picking something up causes bicep muscle to get shorter

Insufficiency

Muscle is not able to work to its fullest potential

Active Insufficiency

• Muscle is TOO SHORTENED over multiple joints

  • Bending wrist forwards when making a fist

Passive Insufficiency

• Muscle is TOO STRETCHED over multiple joints

  • Make a fist and bend wrist backwards

Agonist (Prime Mover)

Generates the most force in a group of muscles

Antagonist

• The muscles of the contrary movement

  • These muscles need to relax in order to allow agonist muscles to move

Fixator

Stabilize the origin of a muscle’s contraction

Synergists

Muscles that assist the prime movers (agonists)

Push

Compression and approximation

• pushing against wall compresses shoulder → approximates it to body

Pull

Tension (tensile force) and distraction

Friction

Force acting against movement

• pressure sores/bed sores

Effort (force)

• Has magnitude and direction

• Directions:

  • LINEAR

  • ROTARY

    • All features of force in the body tend to be more rotary

Axis

Joint

Resistance

Force of weight of a limb, object, or gravity

Lever

Pulley system that provide mechanical advantage and generate motion

Torque

Downward force on one end causes upwards force at the other end

• Steering wheel

• Seesaw

First Class Lever

• Effort , Axis, Resitance

  • EAR (your ear is right by your C1→ head pulled down and chin elevates)

• Axis always in the middle

Second Class Levers

• Axis, Resistance, Effort (ARE)

• MOST MECHANICAL ADVANTAGE

Third Class Lever

• Axis, Effort, Resistance (AER)

• MOST COMMON

Stress

The amount of applied force per area

Strain

The amount of material displacement under an amount of stress

Load Rate

How quickly a force is applied to a tissue

• happening at same rate (hydraulic push example)

Yield Point

Maximum stress that can be sustained before tissue failure

• bone has high yield point

Load to failure

Force exceeds the capability of tissue elasticity

Ipsilateral

Same side of body

Contralateral

Opposite side of body

Kinematic Chain

Cooperative, independent movement of the segments and joints of the body

Closed-Chain

• PROMOTES STABILITY OVER MOBILITY

• Functional movement involved the proximal joints moving in relation to a fixed distal segment

• Ex: Push-up, squat

Open Chain

• PROMOTES MOBILITY OVER STABILITY

• Motions involve free movement of distal body segments in space, allowing joints to move together or independently of others

• Ex: waving

Precautions

• Hypermobility

• Recent soft tissue injury or fracture

• Active inflammation/pain at or near join

• Some pain medications/muscle relaxers

• Post-op restrictions

• Osteoporosis or conditions that cause weakness of the bone

Contraindications (reasons to avoid)

• Acute soft tissues injury or fracture

• Joint instability/subluxation

• Post-op restrictions limiting all ROM

• Myositis ossificans or ectopic ossification

Hypermobility

Greater mobility than normal

• Congenital, occupation based, laxity of ligaments

Hypomobility

Less mobility than normal

• Edema, scars, pain, shortening, muscle weakness, hypertrophy, tone, excess tissue

Environmental considerations

• Time of day

• Noise

• Temperature

• Preparatory activities (stretching, heat, medications, etc.)

Psychosocial Considerations

• Fear of pain or re-injury

• Stress/anxiety

• Depression

Functional Range of Motion (FROM)

Amount of active motion necessary to complete a specific functional task

Active Range of Motion (AROM)

Motion that a patient is able to generate independently

Passive Range of Motion (PROM)

Motion produced externally by OT, or patient (by using their opposite arm)

Active-Assist Range of Motion (AAROM)

Combination of clinician and patient effort

End-feel

The way the joint feels to the hands of the clinician at the end of the movement