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Active Care Exam 2 > Stretching > Flashcards

Flashcards in Stretching Deck (111)
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1
Q

Ability of a tissue to return to it’s previous shape or size following the application of a force.

A

Elasticity

2
Q

Point of force beyond which tissue won’t return to former shape/size when force is removed.

A

Elastic Limit

3
Q

Deformation

A

Plastic Stretch

4
Q

Ability to deform without return to prior shape (can be normal property or secondary to damage)

A

Plasticity

5
Q

Resistance, tension, tightness, pain, non-specific term probably referring to shortened muscles which limit joint motion.

A

Stiffness

6
Q

Property of a fluid to resist loads that produce shear and flow.

A

Viscosity

7
Q

Faster Movement = _______ viscosity.

A

Lower

8
Q

Warming muscles increases viscosity (T/F)

A

False

9
Q

Phenomenon of gels/solids where mechanical vibrations causes change from gel/solid to liquid

e.g. Quicksand

A

Thixotrophy

10
Q

How does thixotrophy affect a muscle?

A

Muscle becomes stiff with disuse and more mobile with movement.

11
Q

Example of mobility stretch.

A

Hamstring Stretch

12
Q

Example of motor control stretch.

A

Hip Hinge, one legged balance

13
Q

Example of functional patterning.

A

Pick up bag, squat, going to bathroom

14
Q

What two things do our muscles/joints need?

A

Stability and Mobility

15
Q

What type of factors restrict motion?

A

Extrinsic, Intrinsic, Sedentary lifestyle and habitual faulty or asymmetric postures, paralysis, postural misalignment.

16
Q

Examples of extrinsic immobilization?

A

Casts, splints, skeletal traction

17
Q

Examples of intrinsic immobilization?

A

Pain, Joint inflammation, muscle/tendon/fascial disorders, skin disorder, bony block, vascular disorders

18
Q

Examples of sedentary/habitual immobilization?

A

Confinement to bed or wheelchair, occupation or work environment

19
Q

Examples of Paralysis immobilization?

A

CNS/PNS disorders

20
Q

Examples of postural misalignment immobilization?

A

Scoliosis, kyphosis

21
Q

What are the indications for stretching?

A

• When ROM is limited due to loss of extensibility
from adhesions, contractures, and scar tissue
causing functional limitations or disabilities
• When restricted motion may lead to structural
deformities that are otherwise preventable
• When muscle weakness and shortening of
opposing tissue have led to limited ROM
• As part of a total fitness program designed to
prevent or reduce the risk of MSK injury
• Prior to and after vigorous exercise to minimize
soreness

22
Q

What are the tight or overactive upper extremity muscles?

A
Pec Major/minor
Anterior deltoid
Subscapularis
Latissimus dorsi
Levator scapulae
Upper trap
Teres major
SCM
Scalenes
Rectus Capitis
23
Q

What are the weak or underactive upper extremity muscles?

A
Rhomboids
Lower Traps
Posterior	Delt
Teres minor
Infraspinatus
Serratus anterior
Longus coli 	
longus capitis
24
Q

What are common joint dysfunctions of the upper extremity?

A

Sternoclavicular joint
AC joint
Thoracic and Cervical Facet joints

25
Q

What are possible injuries of the upper extremities?

A
Rotator cuff
Shoulder	instability
Bicep tendonitis
TOS
Headaches
26
Q

What joints are prone to lose mobility? (stiff)

A
Ankle
Hip
Thoracic
Gleno-humeral
Upper Cervicals
27
Q

What joints are prone to decreased stability?

A

Knee
Lumbar
Scapula
Lower Cervicals

28
Q

What muscles are tight or overreactive in the lower extremities?

A
Fibularis
Lateral Gastroc
Soleus
IT Band
Lateral hamstring
Adductor
Psoas
29
Q

What muscles are weak or underreactive in the lower extremities?

A
Post. Tibialis
Flexor digitorum L.
Flexor hallucis L.
Ant.	Tibialis
Vastus Medialis
Pes Anserine
Gracilis
Sartorius
Semitendinosus
Gluteus Medius
Hip external rotators
Gluteus Maximus
Local lumbo-pelvic-hip stabilizers
30
Q

What are common joint dysfunctions of the lower extremities?

A
1st MTP joint
Subtalar joint
Talocrural joint
Prox. Tib/fib joint
SI Joint
Lumbar facet joints
31
Q

What are the possible injuries to the lower extremity?

A

Plantar fasciitis
Post. Tib tendonitis
Anterior knee pain
Low back pain

32
Q

What are the stretching contraindications?

A

• A bony block limits motion
• Recent fracture with non-union
• Acute inflammatory or infections process
• Soft-tissue healing could be disrupted due to stretch
• Sharp acute pain with jt movement or muscle elongation
• Hematoma or other tissue trauma indication
• Hypermobility already exists
• Shortened soft tissues provide support in stead of
neuromuscular control or normal structural stability
• Shortened soft tissues enable a paralyzed patient or one
with severe weakness to perform specific functional skills

33
Q

Stretching prior to a vertical leaping test may (increase/decrease) performance?

A

decreased

34
Q

Stretching prior to a bench press (increased/decreased) performance?

A

decreased

35
Q

Calf muscle strength was (increased/decreased) after 15 minutes of stretching?

A

decreased

36
Q

T/F Stretching causes an acute inhibition of maximal force produced by the muscle and this effect is more pronounced in activities performed at relatively slow velocities.

A

True

37
Q

T/F Minimal contraction of the muscle prior to static stretch minimizes stretch-induced strength loss.

A

False, maximum contraction does.

38
Q

What does static stretching without muscle activation do to performance?

A

Decreases

39
Q

What are the types of static stretching?

A
  1. ) Self Stretch (active)

2. ) Passive Stretch (partner)

40
Q

What are the types of dynamic stretching?

A
  1. ) Active Stretch

2. ) Ballistic Stretch

41
Q

What are the types of pre-contraction stretching?

A
  1. ) Proprioceptive Neuromuscular Facilitation (PNF)

2. ) PIR, PFS

42
Q

What are the types of static (active self stretches)?

A

Bands and stretch straps

43
Q

What type of static stretch is described: slow and constant, 15-30 seconds, 2-4 reps, position patient for relaxing, decrease intensity if painful, careful with hypermobile joints, avoid combination movements of the spine.

A

Passive Partner Stretch

44
Q

What is the acute increase in ROM immediately following a static stretch attributed to?

A

analgesic response

45
Q

In 30 seconds of stretching viscoelasticity increase until the ___ rep.

A

4th

46
Q

(T/F) A 30 second stretch per muscle group is
sufficient to increase ROM in most healthy
people, it is likely that longer periods or more
repetitions are required in some people, injuries,
and/or muscle groups.

A

True

47
Q

Is there an additional benefit seen with holding a stretch for 60 seconds?

A

NO. 30 seconds is sufficient.

48
Q

What is the downfall to stretching for 10 seconds?

A

It takes 10 weeks to reach plateau compared to 30 seconds takes 6-7 weeks to reach plateau.

49
Q
What type of stretching is:
Rapid alternating movements to end-range
– “Bouncing” at end range
– Increased injury risk
• Immobilized or disused tissue are weak
• Chronic contracture causes brittle tissue
– May be used for certain sports in healthy
athletes
• Gymnastics
• Martial arts
– Not for injury recovery
A

Ballistic Stretching (Dynamic Stretching)

50
Q
What type of stretching is:  Movement through a full range
– Start slow gradually pick up speed and
increase ROM
– Use sport / task-specific movements
– Preparation / warmup
A

Active Dynamic Stretching

51
Q

Who said it? “All human beings including those with disabilities, have untapped existing potential.”

A

KABAT, 1950

52
Q

What is the theory with PNF?

A

Stimulating distal segments increased proprioception of proximal segments.

53
Q

What type of patients did Herman Kabat use these techniques on?

A

Cerebral Palsy patients

54
Q

What are the facilitation techniques of PNF?

A
– Motor Control
– Increases excitability of the target
muscles
– Restore muscle function
– Increase ability to move
– Increase stability
– Facilitate coordinated movement
through timing
– Increase patient’s stamina to avoid
fatigue
55
Q

What are the inhibition techniques of PNF?

A
– Motor control
– Decrease motor
neuron excitability
– Reduction in
spasticity
– Improve motion
56
Q

What are the PNF spiral-diagonal plane movements? (3 components)

A
  1. ) Flexion-Extension
  2. ) Rotation
  3. ) Toward and Across Midline – Across and Away from Midline
57
Q

Stretching the hamstrings is an example of what plane stretch for PNF?

A

Single Plane

58
Q

T/F Single plane stretching (PNF) is just as effective as multi-plane stretching (PNF)?

A

False it is effective but not as functional as multi-plane

59
Q
• Form the basis for all movement
• Alternating agonist/antagonist control
• Multiple planes of movement
• Create control, with alternating mobility
and stability
A

PNF patterns

60
Q

Each extremity has ___ patterns of motion.

A

2

61
Q

The motions of the extremity are _____ _____ motions.

A

Mirror image

62
Q

Shoulder Flexion, external rotation, adduction

Forearm supination

Wrist Flexion

Finger Flexion

A

D1 Flexion

63
Q

Shoulder–Extension, Internal Rotation, Abduction

Forearm–Pronation

Wrist–Extension

Fingers–Extension

A

D1 Extension

64
Q

Shoulder–Flexion, External Rotation,
Abduction

Forearm–Supination

Wrist– Extension

Fingers—Extension

A

D2 Flexion

65
Q

Shoulder–Extension,
Internal Rotation,
Adduction

Forearm–Pronation

Wrist– Flexion

Fingers–Flexion

A

D2 Extension

66
Q

Grab Seat Belt to fasten seat belt.

A

D1

67
Q

Arm finishes in flexion, adduction and external rotation.

A

D1 Flexion

68
Q

Arm finishes in extension, abduction and internal rotation

A

D1 Extension

69
Q

Sword from the sheath to the air.

A

D2

70
Q

Arm finishes in flexion, abduction, and external rotation

A

D2 Flexion

71
Q

Arm finishes in extension,

adduction, and internal rotation

A

D2 Extension

72
Q

Soccer Kick

A

D1

73
Q

Leg finishes in
flexion, adduction, and
external rotation

A

D1 Flexion

74
Q

Leg finishes in
extension, abduction and
internal rotation

A

D1 Extension

75
Q

Snow Plow (up and out to down and in)

A

D2

76
Q

Leg finishes in
flexion, abduction, and
internal rotation

A

D2 Flexion

77
Q

Leg finishes in
extension, adduction and
external rotation

A

D2 Extension

78
Q
Hip--Flexion
Adduction
External Rotation
Foot--Dorsiflexion
Inversion
Toes--Extension
A

D1 Flexion

79
Q
Hip--Extension
Abduction
Internal Rotation
Foot--Plantar flexion
Eversion
Toes--Flexion
A

D1 Extension

80
Q
Hip--Flexion
Abduction
Internal Rotation
Foot--Dorsiflexion
Eversion
Toes--Extension
A

D2 Flexion

81
Q
Hip--Extension
Adduction
External Rotation
Foot--Plantar flexion
Inversion
Toes--Flexion
A

D2 Extension

82
Q

Spread of excitation in the central nervous
system that causes contraction of synergistic
muscles in a specific pattern”

A

Irradiation

-Surburg

83
Q

Contraction of the agonist simultaneously inhibits the action of the antagonist

A

Sherrington’s Law of Reciprocal Inhibition

84
Q

Technique that uses Sherrington’s Law?

A

CRAC

85
Q

Triceps is inhibited and Biceps Contracts

A

Reciprocal Inhibition

86
Q

After a muscle is contracted, it is automatically

in a relaxed state for a brief, latent period

A

Postcontraction inhibition

87
Q

Techniques that use postcontraction inhibition?

A

Hold Relax, Postisometric relaxation (PIR), and Postfaciliation stretch

88
Q

What are the facilitated PNF techniques?

A

– Rhythmic Stabilization
– Slow Reversal
– Fast Reversal

89
Q

What are the inhibited PNF techniques?

A

Hold Relax
– Contract Relax
– Contract Relax Agonist Contract (CRAC)

90
Q

Alternating between isometric actions of the

agonistic and antagonistic muscles

A

Rhythmic Stabilization

91
Q

Concentric action of the antagonist,
followed by a concentric action of the
agonist

A

Slow Reversal

92
Q

Concentric action of the antagonist,
followed by a concentric action of the
agonist (same but faster)

A

Fast Reversal

93
Q
  1. 10-15 seconds of stretch
  2. Isometric action of the antagonist for 6 seconds
  3. Followed by relaxation
  4. Passive stretching antagonist for 10-15 seconds
A

Hold Relax

94
Q
  1. Stretch for 10-15 seconds
  2. Maximal concentric action of the antagonist against resistance
  3. Followed by relaxation
  4. Stretch for another 10-15 seconds
  5. Repeat if needed
A

Contract Relax

95
Q

Utilizes reciprocal inhibition by having the agonist contract while
stretching the antagonist

A

CRAC (Contract Relax Agonist Contract)

96
Q

What are other techniques that use pre-contraction stretching?

A
  1. ) Post-isometric Relaxation (PIR)
  2. ) Post Facilitation Stretch
  3. ) Muscle Energy Techniques
  4. ) Active Isolated Stretching (Mattes Method)
97
Q

– Passively stretch mm to point of tension
– Contract mm (isometric) gently for ~10 sec
– Breathe out & relax mm
– Doctor feels for decrease resistance
– Gently stretch to next point of tension
– Repeat 3-5 reps

A

PIR (post-isometric relaxation)

98
Q

– Hold mm midway between neutral and point of tension
– Contract (isometric) with maximum or near maximum
effort for ~10 sec
– Relax completely
– Doctor feels for decreased resistance
– Move quickly to new point of tension (careful)
– Hold stretch for 20 seconds
– Move back to midrange and rest 20 – 30 seconds
– Repeat 3 – 5 times.

A

Post-Facilitation Stretch (PFS)

99
Q

– Stretching procedure involving voluntary
contraction of a muscle in precise and controlled
direction and variations in intensity

A

Muscle Energy Technique (MET)

100
Q

Uses include
– Lengthening a shortened muscle, contracture or
spastic muscles, strengthen weakened muscles,
reduce localized edema, mobilize joint
articulations with restricted mobility, TrP

A

Muscle Energy Technique (MET)

101
Q

Particularly helpful with postural muscles

A

MET (muscle energy technique)

102
Q
Helps strengthen muscles with isometric
actions
• Relaxes muscles, useful for spasms
• Regains muscle control through continual
use
• Reduce localized edema
A

MET (muscle energy technique)

103
Q

What is the protocol for MET?

A

Position of comfort, take muscle or movement to
the point of barrier. Should be pain free point when
stretch begins
– Ask pt. to contract muscle he feels the stretch, max
of 25%, while the Dr. matches effort with
resistance. May use less when patient is in early
stages of rehabilitation following injury
– After 10 seconds of action have patient relax and
within 3-5 seconds gently move to next barrier

104
Q

Who developed Active Isolated Stretching?

A

Aaron Mattes

105
Q

Takes advantage of the principle of reciprocal

inhibition

A

Active Isolated Stretching

106
Q
Stretch gently (1 pound of pressure) to prevent
activation of muscle spindles and Golgi bodies
A

Active Isolated Stretching

107
Q

• Lengthening with a gentle pressure at end range
to microscopically loosen scar tissue and allow
restoration of proper muscle length.

A

Active Isolated Stretching

108
Q

What is the protocol for active isolated stretching?

A
The patient positions the part in the
proper position and initiates voluntary
movement toward end range
• Doc applies a gradual tension of no more
than 1 pound of pressure to stretch
• Stretch for no more than 2 seconds
• Return to start position
• Repeat 8 to 10 reps
– more repetitions may lead to local ischemia
109
Q

T/F Older adults, 65 yrs and older, should

incorporate a static stretching into daily routine

A

True

110
Q

T/F Orthopedic patients only benefit from PNF types

of stretching

A

False, they may benefit from any type of stretching

111
Q

T/F Stretching may be beneficial in myofascial pain

management

A

True.