Therapeutic Exam 2

stretching

any therapeutic maneuver designed to increase soft tissue 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 as unrestricted pain-free ROM

dynamic flexibility

active mobility or active ROM; the extent to which an active muscle contraction can rotate a joint through its available ROM

passive flexibility

passive mobility or passive ROM; the extent to which a joint can be passively rotated through its available ROM (depends on extensibility of soft tissues around a joint)

hypomobility

decreased mobility of restricted motion at a single joint or series of joints

contracture

adaptive shortening of muscular tendon unit

myostatic contracture

musculotendinous unit has adaptively shortened and there is significant loss of ROM, but no specific muscle pathology present

knee flexion contracture

cannot fully extend knee

pseudomyostatic contracture

impaired mobility and limited ROM may also be the result of hypertonicity associated with a central nervous system lesion

arthrogenic and periarticular contracture

result of intra-articular pathology; develops when connective tissues that cross or attach to a joint or the joint capsule lose extensibility, restricting normal arthrokinematic motion

fibrotic contracture and irreversible contracture

fibrous changes in the connective tissue of muscle and periarticular structures will limit tissue elasticity, create adhesions between joint tissues and result in a fibrotic contracture

self-stretching

stretch carried out independently (force applied by patient)

neuromuscular facilitation and inhibition techniques

decrease tension before/during stretch

muscular energy technique

manipulative procedures designed to lengthen muscle and mobilize joints (involve voluntary muscle contractions)

joint mobilization/manipulation

improve extensibility of soft tissue that limits mobility

neural tissue mobilization

neural pathway is mobilized through selective processes

elastic

a stretched soft tissue is ________ if it returns to its prestretch resting length after a short duration stretch force is removed

viscoelastic

a __________ tissue initially resists deformation, such as change in length, when a stretch force is applied but will slowly lengthen if the force is sustained (will return to normal when force is removed)

plasticity

______ is the tendency of soft tissue to assume a new and greater length because of alterations in structure and function after a stretch force is removed (adaptability)

stress

the force per unit area

strain

the amount of deformation

stress-strain curve

illustrates the mechanical strength of structures

tension

resistance to a force applied in a manner that will lengthen the tissue

compression

resistance to a force applied in a manner that approximates tissue

shear

resistance to two plus forces that are applied in opposing directions

muscle spindle

respond to stretch

golgi tendon organ

respond to tension

range of motion (ROM)

basic technique used for examination of movement and for initiating movement into a purposeful therapeutic intervention

functional excursion

distance a muscle is capable of shortening after it has been maximally elongated

ROM exercise

passive, assisted, or active movement of a body segment through the available ROM

passive ROM

motion produced by an external force, manual or mechanical (not synonymous with passive stretching)

active ROM

motion produced by active contraction of the muscles

active-assistive ROM

motion produced by a combination of external force and active muscle contraction (type of AROM)

disruptive

ROM should not be done when motion is _________ to the healing process

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

muscle performance

capacity of a muscle to do work (force*distance)

resistance exercise

activity in which dynamic or static muscle contraction is resisted by an outside force applied manually or mechanically

strength

force-producing capacity of the muscle (functional)

power

work produced by a muscle per unit of time (rate of performing muscle)

endurance

ability to perform repetitive or sustained activities for a prolonged period

overload principle

to improve muscle performance there must be a challenge to perform at a greater level than that to which it is accustomed

SAID principle (Specific Adaptation to Imposed Demands)

extension of Wolf’s law

Wolf’s Law

body systems adapt over time to the stress placed on them

cross-training (cross-education)

training on one side of the body promoted gains on the other side

decreases

although strength _________ with age weight training is effective to drive skeletal muscle adaptations in older adults

early gains

_____________ are likely due to nervous system adaptations

manual resistance

active-resistance exercise applied externally by an individual

mechanical resistance

active-resistance exercise applied externally by a machine or apparatus

isometric exercise (static)

muscle contracts and produces force without visible joint movement (no change in joint angle/muscle length)

pathological fracture

failure of bone already weakened by disease

manual resistance exercise

form of active exercise in which the resistance force is applied to a dynamic/static muscular action by the therapist

proprioceptive neuromuscular facilitation (PNF)

combines functionally based diagonal patterns of movement with techniques of neuromuscular facilitation to evoke muscular responses

mechanical resistance exercise

external resistance is applied by means of some type of exercise equipment

progressive resistance exercise (PRE)

what exercise you do most of the time

blood flow restriction (BFR)

use for patients weak from immobilization/unable to tolerate high load RE

physical activity

any bodily movement produced by the contraction of skeletal muscles that results in a substantial increase over resting energy expenditure

exercise

planned and structured physical activity designed to improve or maintain physical fitness

physical fitness

ability to perform physical work

maximum oxygen consumption (VO2 max)

body’s capacity to use oxygen

endurance

ability to work for prolonged periods of time and resist fatigue

aerobic exercise training

cardiorespiratory endurance; augmentation of the energy utilization of the muscle by means of an exercise program

adaptation

ability of the cardiovascular system and muscles to adapt to the training stimulus over time

myocardial oxygen consumption

oxygen consumed by the myocardial muscle

deconditioning

occurs with prolonged bedrest; seen in patients with an extended, acute illness or long-term chronic condition

phosphagen or ATP-PC system

used for 1RM; plyometrics

anaerobic glycolytic system

used for circuit training

aerobic system

used for cardio

type 1 muscle fibers

used for low resistance long duration exercise

type 2 muscle fibers

used for high resistance fast exercise

exercise efficiency

% of work output / work input * 100

3-5

inpatient cardio rehab lasts ______ days after surgery

balance (postural stability)

a dynamic process to maintain the body’s postural position in equilibrium

postural orientation

ability to maintain alignment of body segments

postural control

control of body position in space to maintain orientation and stability

center of mass (COM)

the point at which the body is in perfect equilibrium

center of gravity (COG)

the vertical projection of the COM to the ground

momentum

product of mass * velocity

base of support (BOS)

perimeter of the contract areas between the body and its support surface

limits of stability

sway boundaries to maintain equilibrium without changing BOS

ground reaction force

reaction from the ground to the body’s contact with the ground

Newton’s las of reatcion

for every action there is an equal and opposite reaction

center of pressure (COP)

location of the vertical projection of the ground reaction force

visual system

position of head relative to environment, movements

somatosensory system

position of the body parts to each other/surface

vestibular system

position of the head/body with respect to internal forces

steady-state balance control

balance at rest

reactive balance control

balance in response to unexpected perturbations

anticipatory balance control

maintain stability with voluntary movements

adaptive balance control

adapt; improve balance with experience

closed-loop

feedback (require sensory info)

open-loop

feedforward (too fast for sensory info)

ankle strategy (anteroposterior plane)

rotation around ankles

weight-shift strategy (lateral plane)

lateral shift across legs

suspension strategy

lowering body COM to maintain balance

hip strategy

rapid hip flexion/extension to move COM

stepping strategy

think a stumble, forward/backward step to regain balance

combined strategies

movement is complex, use combinations

BESTest

best balance evaluation systems test, tests 6 systems of balance control

internal focus of control

focus on body positions

external focus of control

focus on the external environment