Range of Motion (ROM): the basic technique used for the examination of mvmt and for initiating mvmt into a program of therex.
Functional excursion: the distance that a muscle is capable of shortening after it has been elongated to its maximum.
Upper Hand or Top Hand: PTA hand → pts. head.
Bottom Hand or Lower Hand: PTA hand → pts. foot.
Active insufficiency: shortening a muscle across two joints = too short to produce much tension. (-Power)
Passive insufficiency: lengthening a muscle across two joints = too long to produce much motion. (-ROM)
Passive ROM (PROM): ROM produced w/external force, no voluntary muscle contraction.
Indications for PROM: pt. in acute stage w/inflamed tissue (approx. 2-6 days)
PROM DOES NOT: prevent muscle atrophy, increase strength or endurance of a muscle.
Continuous passive motion (CPM): passive motion performed by a mechanical device that moves a joint slowly and continuously through controlled ROM.
Active ROM (AROM): ROM produced w/internal force, by active contraction of the muscles.
Active-assistive ROM (AAROM): type of AROM that uses manual or mechanical external forces to assist with AROM.
Indications for AROM/AAROM: pt. has weak musculature and is unable to move against gravity.
AROM/AAROM DOES NOT: for strong muscles, does not maintain or increase strength.
Self-Assisted ROM: pt. uses a contralateral hand or object to assist with ROM.
Wand or T-Bar: the pt. has voluntary muscle control but needs motivation/guidance to complete ROM.
Finger ladder, wall climbing, ball rolling: provides objective reinforcement = and motivation via markings.
Pulleys: set up directly over the joint that is moving = line of pull.
Pulleys: can be easily misused → compression of the humerus vs. acromion process.
Skateboard/powder board: friction-free surface to promote mvmt w/o resistance of gravity.
Reciprocal exercise devices: bicycle, UE, or LE ergometer to provide flex & ext.
Functional ROM: motion through functional patterns used in ADLs.
Mobility: the ability of body structures or segments to move so that ROM for functional activities is allowed (functional ROM) → rel. joint integrity & soft tissue flexibility.
Flexibility: the ability to rotate a single joint or series of joints smoothly and easily through an unrestricted, pain-free ROM.
Dynamic: active mobility/AROM.
Passive: passive mobility/PROM.
Functional mobility: the ability of an individual to initiate, control, or sustain active mvmt’s of the body to perform motor tasks.
Elastic: stretched soft tissue, returns to pre-stretched resting length after the short-duration stretch force is removed.
Viscoelasticity: the time-dependent property of soft tissue. Initially resists deformation but will slowly lengthen if force is sustained. Gradually return.
Plasticity: soft tissue assumes a new and greater length. (30-sec hold or 3x10 secs)
Hypomobility: reduced functional motion, adaptive shortening, or decreased extensibility in soft tissues.
Contracture: adaptive shortening of the muscle tendon that surrounds a joint. (Almost complete loss of ROM)
Myostatic: type of contracture w/no specific muscle pathology present, maybe a reduction in # of sarcomere BUT NO decrease in individual sarcomere length. Can be Resolved in a relatively short time w/stretching.
Pseudomyostatic (apparent): muscles in a constant state of contraction = excessive resistance to passive stretch. Hypertonicity contracture.
Arthrogenic & Periarticular: a contracture resulting from intra-articular pathology. Adhesions, synovial proliferation, joint effusion.
Fibrotic: fibrous changes, contracture possible to stretch and +ROM
Irreversible: permanent loss of soft tissue extensibility, a contracture that cannot be reversed with nonsurgical intervention.
Stretching: any therapeutic maneuver designed to increase soft tissue extensibility to +flexibility and ROM.
Selective Stretching: apply stretching techniques to some muscles and joints while allowing motion limitations to develop in other muscles or joints.
Overstretching: stretching well beyond the normal length of muscle and ROM of a joint and surrounding tissue → hypermobility. (can lead to instability)
Passive stretching: pt is as relaxed as possible during the stretch.
Dynamic stretching: type of stretch that is controlled through AROM for each joint → enhanced performance (>90secs)
Static stretching: stretching the soft tissues just beyond the point of tissue resistance and then holding in the lengthened position w/ a sustained stretch force over time.
Cyclic (Intermittent) Stretching: short-duration stretch force that is repeatedly but gradually applied, released, and then reapplied multiple times.
Ballistic stretching: rapid, forceful intermittent stretch, high velocity, and high intensity. Fast joint mvmt. CREATES GREATER TRAUMA & > residual muscle soreness than static stretching.
Assisted stretching: pt. assists the contralateral limb in moving the joint through a greater range during the stretch.
Self-stretching: independently performed stretch by a pt after instruction and Supervised by PT.
PNF stretching: reflexively decreasing tension in shortened muscles prior to or during the stretch.
Hold-relax (HR): pt. actively performs; prestretch, end-range, isometric contraction against manual resistance by PTA. Contraction held for 5 sec, then voluntary relaxation.
Agonist contraction (AC): agonist = muscle opposite the range-limiting target muscle vs. antagonist = range-limiting muscle. (ie: short muscle (antagonist) preventing the prime mover (agonist).
HR-AC: PTA moves limb to end feel, pt. performs a resisted, pre-stretch isometric contraction of the range-limiting muscle, followed by voluntary relaxationand immediate concentric contraction of the muscle opposite the range-limiting muscle.
Muscle energy: or post isometric relaxation, an osteopathic medicine designed to lengthen muscle and fascia and mobilize joints.
Joint mobilization/manipulation: applied to joint structures to modulate pain and Rx joint impairments.
Soft tissue mobilization/manipulation: improves the extensibility of soft tissue that limits ROM. Ex: Friction massage, myofascial release, acupressure, trigger point, etc.
Neural Tissue Mobilization: improves or restores nerve tissue mobility caused by tissue adhesions or scar tissue.
Collagen: strength and stiffness of tissue and resist tensile deformation.
Elastin: extensibility, elongate w/small loads and fail abruptly w/o deformation at higher loads.
Reticulin: bulk in tissues
Relaxation training: pts learn to relieve or reduce pain, muscle tension, anxiety or stress, etc. Purpose = reduce muscle tension in the entire body or painful or restricted region using conscious effort and thought.
Autogenic training: Schultz and Luthe and Eagle, conscious relaxation through autosuggestion and a progression of exercises as well as meditation.
Progressive relaxation: Jacobson, systematic, distal-to-proximal progression of voluntary contraction and relaxation of muscles. (used in childbirth education)
Awareness through movement: Feldenkrais, sensory awareness, movements of the limbs and trunk, deep breathing, conscious relaxation procedures, and self-massage to remediate muscle tension and pain by altering muscle imbalances and abnormal postural alignment.