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Chapters 3-9
Contracture
the adaptive shortening of the muscle-tendon unit and other soft tissues that cross or surround a joint, resulting in significant resistance to passive or active stretch and limited ROM.
Myostatic Contracture
although the musculotendinous unit has adaptively shortened and there is a significant loss of ROM, there is no specific muscle pathology present.
Pseudomyostatic Contracture
Impaired mobility and limited ROM may also be the result of hypertonicity associated with a central nervous system lesion, such as a cerebrovascular accident, a spinal cord injury, or traumatic brain injury.
Arthrogenic & Periarticular Contracture
The result of intra-articular pathology including adhesion, synovial proliferation, joint effusion, irregularities in articular cartilage, or osteophyte formation.
Collagen Fibers
responsible for the strength and stiffness of tissue and resist tensile deformation
Elastin Fibers
Provide extensibility; show a great deal of elongation with small loads and fail abruptly without deformation at higher loads
Ground Substance
organic gel containing water and is made up of proteoglycans and glycoprotiens; hydrate the matrix, stabilize the collagen networks, and resist compressive forces-especially important in cartilage and intervertebral discs
Stress
force per unit area; the internal reaction or resistance to an externally applied load
Strain
the amount of deformation or lengthening that occurs when an external load is applied to a structure
muscle strength
a broad term that refers to the extent that the contractile elements of muscle produce force.
functional strength
the ability of the neuromuscular system to produce the appropriate amount of force, during functional activities in a smooth and coordinated manner.
muscle power
related to the strength and speed of movement and is defined as the (force x work) produced by a muscle per unit of time (force x distance x time).
endurance
broad term that refers to the ability to perform repetitive or sustained activities against an external load, generate and sustain tension, and resist fatigue over an extended period of time.
overload principle
foundational element that guides the use of resistance exercise in improving muscle performance; if muscle performance is to improve, a resistance load that exceeds the metabolic capacity of the muscle must be applied
ROM
a basic technique used for the examination of movement and for initiating movement into a program of therapeutic intervention
active insufficiency
it is too short to produce much tension
passive insufficiency
when it is fully lengthened and limits motion at onr of the joints it crosses
Passive ROM
movement of a segment within the unrestricted ROM that is produced entirely by an external force; there is little to no muscle contraction
Active ROM
movement of a segment within unrestricted ROM that is produced by active contraction of the muscle crossing that joint
Active-assistive ROM
a type of ROM in which assistance is provided manually or mechanically by an outside force because the prime mover muscles need assistance to complete the motion
Continuous Passive Motion (CPM)
passive motion that is performed by a mechanical device that moves a joint slowly and continuously through a preset, controlled ROM
Stretching
any therapeutic maneuver designed to increase soft tisssue extensibility and subsequently improve flexibility and ROM by elongating structures that have adaptively shortened and have become hypermobile
Flexibility
the ability to rotate a single joint or series of joints smoothly and easily through an unrestricted, pain-free ROM
Factors Contributing to Restricted Motion
Prolonged immobilization: extrinsic/intrinsic factors - casts, pain, inflammation, muscle or tendon disorders, bony blocks; sedentary lifestyles or asymmetrical postures; paralysis or muscle imbalances; and postural malalignment
Selective Stretching
a process whereby the overall function of a patient may be improved by applying stretching techniques to some muscles and joints while allowing motion limitations to develop in other muscle or joints
overstretching
a stretch well beyond the normal length of muscle and ROM of a joint and the surrounding soft tissues, resulting in hypermobility
stress-strain curve
stress is the force per unit area; strain is the amount of deformation/lengthening
shear
resistance to two+ forces that applied in opposing directions
Hold-Relax and Contract-Relax
the range limiting target muscle is first lengthened to the point of tissue resistance or to the extent that is comfortable for the patient, then actively performs a prestretch, end-range, isometric contraction of the range-limiting target muscle against manual resistance applied by the clinician.
Agonist Contraction
the patient concentrically contracts the muscle opposite the range-limiting muscle and then holds the end-range position for at least several seconds.
Hold-Relax with Agonist Contraction
move the limb to the point that tissue resistance is felt in the range-limiting target muscle; then have the patient perform a resisted, prestretch isometric contraction of the range-limiting muscle, followed by voluntary relaxation of that muscle and an immediate concentric contraction of the muscle opposite the range-limiting muscle.
PNF stretching
integrates active muscle contractions into stretching to inhibit or facilitate muscle activation and to increase the likelihood that the muscle to be lengthened remains as relaxed as possible as it is stretched.
Specific Adaptation to Imposed Demands (SAID) Principle
refers to the concept that to improve a specific muscle performance element, the resistance program should be matched to that elements constructs.
Specificity of Training
concept suggesting that the adaptive effects of training, such as improvement of strength, power, and endurance, are highly specific to the training method employed.
Cross-Training Effect
can occur from an exercised limb to a nonexercised, contralateral limb in a resistance training program that has been shown to have transfer effect by moderatley improving muscular endurance.
Reversibility Principle
adaptive changes in the body’s systems in response to a resistance exercise program are transient unless training-induced improvements are regularly used for functionial activities or unless an individual participates in a maintenance program of resistance exercises.
detraining
reductions in muscle performance, begins a week or two after the cessation of resistance exercises and continues until training effects are lost.
Psychological and Cognitive Factors
Array of psychological factors can influence muscle performance and how easily, vigorously, or cautiously a person moves
Attention
A patient must be able to focus on a given task to learn how to perofrm it correctly; the ability to process relevant data while screening out irrelevant information from the environment and to respond to internal cues from the body.
Motivation & Feedback
Patient must be willing to put forth and maintain sufficient effort and adhere to the program over time
