Exam 3- Pain, Neuromuscular Control and Biofeedback

5 stages of response to terminal illness

Denial, anger, bargaining, depression acceptance

TRUE or FALSE

The 5 stages of response to terminal illness are applicable to sport injury

FALSE

Model state that Rennes to injury depends on understanding of the injury

Cognitive Appraisal Model

When talking about injuries to patients you must be aware of?

Emotional and physiological factors that are involved with an injury

Ability to cope with injury is influenced by

Family friends co workers team mates, stress level etc.

Purpose of pain

Warns of injury

Essential for survival

Protection

Says something is wrong

Limits further injury

Chiropractors reduce pain by

Removing subluxations

Using EPAs

Most common use of therapeutic modalities it to/

Reduce pain levels

Transmission of pain can occur at what levels

Periphery

Spinal level

Ascending pathway

Supraspinatus level

Descending pathway

Process of changing energy of nociception into electrical action potential in the neuron

Transduction

Nociceptors have a ________ threshold

High

Nocicepors are classified as? Function?

Free nerve endings that detect pain

First order afferent nerves synapse? Have cell bodies?

Cell body in dorsal root ganglia

Synapse in spinal cord

What things affect the nerve velocity

Diameter

Degree of myelination

Function of the nerve

A-beta fibers carry

Light touch, vibration

A beta fibers

Large diathermy with lots of myelin

A-delta fibers carry

Discomfort, war and cold, pressure

A-delta fibers

Medium diameter ,some myelin

C fibers carry

Pain

C fibers

Small diameter, no myelin

Smallest peripheral nerves that are associated with pain

C fibers

Where do ascending pain fibers from the body synapse

VPL of the thalamus

Modulation phase has what role in new impulses

Excitatory or inhibitory role

Network of messages and activation of brain centers may exacerbate the painful event and lead to wind up

Modulation phase

-if that wind up occurs thats how shock happens

How does ice decrease pain

Increased threshold

Decrease effects of chemical mediators

Decrease speed of transition

How does ice increase the threshold for pain

More difficult to stimulate

Fewer pain impulses transmitted to the spinal cord

Gate theory

Because a-beta fibers transmit faster than C fibers, we can't get the signals of pain from the C fibers and why we "shake it off" after injury

Ways of motor pain modulation

Low frequency, high intensity stimulation (Motor TENS and IFC/premod)

Descending endogenous opiate system

Inhibitor effect on lower pain pathways

Electrical stimulation of C fibers in the injury area

Noxious pain modulation

Also with ice stimulation of __________ during burning and aching sensation

C fibers

Decreased pain sensation during physical activity

Exercise induced hypoalgesia

Why does exercise induced hypoalgeisa happen

Increased endogenous opioids (endorphins) and catecholamines (epinephrine/norepinephrine)

What intensity must you be at for exercise induced hypoaglesia to occur

70% of VO2 max

Neuromuscular control consists of what 3 components

Consciously controlled muscle contraction

Reflex responses

Complex movement patterns

Quick and efficient voluntary contractions are desired with? Injury can lead to inhibition

Conscious muscle contraction

Reflex response of muscle to stress and strain

Reflex responses

How does reflex responses work

Damage to ligaments, capsule, tends interrupts afferent singles meaning loss of proprioception

Difficult to reflexively contract muscle to control balance

Unconscious movement patterns that take over after practicing

Complex movement patterns

Injury leads to loss of

Complex movement patterns

Joint effusion (swelling) leads to

Inhibition of muscles around that joint

-stretch receptors in the joint capsule of the knee monitor the fluid

What have been shown to have been affected with injury

Balance

Protective reflexes

Force output

Joint stability

Position sense

Restoring neuromuscular control

Active rehabilitation

The use of information to bring physiological energy to conscious awareness in the patient

Biofeedback

What is the best biofeedback

Patient feels it themselves

What are the 2nd best ways of biofeedback

Mirror

Videotape

Biofeedback with measuring stress

Heart rate

Skin conductivity

Skin temp

Needles are good for

Specific portion of muscle

Surface electrodes are food for

Whole muscles or muscle groups

Clinical applications of EMG

Inhabit muscles form injury

Positive feedback

Reduce trial and error

Reduce patient frustration