Card Set Information
What are some effects of prolonged bed rest?
muscle atrophy from disuse
pressure necrosis-> ischemia-> tissue death
phlebothrombosis (formation of cloth adhering to wall of a vein (+) homans sign)
hypostatic pneumonia-in secretion in lungs at night
How do you test for a homans sign?
force foot into DF
if they have a sharp pain in their leg, probably positive for homans (dvt)
What happens when a body is immoblized for any length of time?
CT becomes dense/hard and loses its properties
What are some factors promoting formation of dense fibrosis (decreased ROM)?
Joint restrictions may be present secondary to what?
congential anomaly (birth defect)
prolonged m. contraction (spasticity, contracture)
What is the therapeutic technique to lengthen (pathophysiology) shortened soft tissue?
What is the ability of a m. to relax and yield to a stretch force?
What is plasticity?
muscle keeps some of the new gained length
What is elasticity?
muscle must recoil after stretch
What does normal ROM involve?
mobility and flexibility of soft tissues that surround a jt (muscles, CT, skin), and joint play (laxity)
Full ROM is not possible without what?
What are the goals for stretching?
regain normal ROM of joints and soft tissue mobility
prevent irreversible contractures
increase general flexibility prior to exers
prevent/minimize risk of muscle/tendon injuries in sports
What are some indications for stretching?
limitation of motion secondary to contractures, adhesions, scar tissue
when limitations may lead to structural deformities
when contractures interfere with normal ADLs
muscle weakness and opposing tissue tightness is present
What are contraindications of stretching?
bony blocks limiting motion
acute inflammatory process(RA, fibromyalgia)
when the contracture benefits the pt
after recent fracture
sharp pain with mvmt
when you have no orders
if theyre hypermobile
What are precautions for stretching?
prolonges disuse, paralysis, anesthesia
stretching of tight jts, not just tight mm.
post op pts in ICU (can do PROM)
very young pts
do not force beyond normal ROM
prolonged use of steroids
How should you apply a stretch to a pt?
stabilize on each side of jt
apply force in precise direction to produce tension in right muscles
use gentle and low intensity stretching so the pt can relax
hold at least 20 seconds
What is static stretching?
what we want
soft tissues are lengthened just past point of tissue resistance and held for extended period of time
What is ballistic stretching?
bouncing, rapid, forceful, high speed mvmts
doesnt elongate, initates m. contraction, doesnt increase flexibility
What is the active stretching contract-relax technique?
move extremity to comfortable lengthed position
isometrically contract tight m. 6 seconds
lengthens m. passively moving into gained range
What active stretching technique uses sherringtons law of autogenic inhibition?
contract-relax (hold relax)
m. can relax more fully after a contraction occurs....max resistance, max relaxation of same m.
What active stretching technique uses sherringtons law of reciprocal approach?
contract relax contract (hold relax contract)
contracting the antagonist allows the tight agonist to relax
What is the active stretching technique of contract relax contract?
move extremity to comfortable stretch
isometrically contract tight m. 6 seconds
pt isotonically contracts the antagonist of the tight muscle and actively moves thru gained range
How is reciprocal inhibition performed?
move extremity to comfortable position of stretch
isotonic contraction of antagonist of tight muscle against mild resistance
elongation is achieved with relaxation of agonist (tight muscle)
What is passive stretching?
pt is relaxed or the muscle is an an external force is applied manually or mechanically to lengthen soft tissues
What type of stretching does the therapist applies external force and controls the speed, direction, intensity, and duration of stretch?
manual passive stretch
force applied 20-30 seconds, repeated 2-3 times
intensity and duration depends on pt tolerance
How is prolonged mechanical passive stretching performed?
weight applied for prolonged period of time or splints, casts, or pulley system used
15-30 mins (depends)
What type of stretch has the pt allowing their body weight or gravity to lengthen soft tissues (20-30ish minutes daily)?
positioning for static stretch
do not do on elbows, itll cause myositis ossificans
What can happen if motion is not maintained in the presence of inflammation?
What are some things to remember while performing mobility exers?
focus pts attention of what theyre doing
make sure theyre doing it right
they have good posture
modalities may help facilitate desired effect (best to have pt stretch with heat on)
What does stretching the muscle prior to mvmt help do?
recruit more motor fibers and prepare the muscle to work
What is the spray and stretch technique?
evaporative cooling...draws moisture out of the muscle so its easier to stretch
rapid cooling, m. less sensitive to stretch, decreased pain and nerve conduction
What are the 2 types of spray and stretch?
What are some uses and advantages of spray and stretch?
local anesthetic, trigger point therapy, M/S pain due to trigger points
simple and effective, enhances stretch by decreasing pain, immediate results
What are some precautions/disadvantages of spray and cool?
loss of pain response
more expensive than traditional forms
effects of freezing
do not inhale fumes, use in ventilated area
no more than 3 times per muscle
may need 2 clinicians
How should you explain the feeling of spray and stretch to a pt?
transient and CBAN
1-2 feet from body part
2-3 times over same muscle
1/4-1" apart from origin to insertion
go in same direction (4"/sec)
spray as you stretch