Stretching

Question 1

myostatic

Answer 1

• no specific muscle patho present, can be resolved quickly w stretching exercises
  
  • contracture d/t prolonged posture

Question 2

pseudomyostatic

Answer 2

result of hypertonicity, mm spasm, or guarding; full passive elongation possible w neuromuscular inhibition techniques

Question 3

fibrotic/irreversible

Answer 3

result of fibrous changes in CT of muscle d/t immobilization/trauma, difficult to reestablish tissue length non-surgically

Question 3

arthogenic/prearticular

Answer 3

result of intra-articular OR prearticular pathology

Question 4

reduced functional motion
- d/t adaptive shortening or decreased extensibility in soft tissue

Answer 4

hypomobility

Question 5

factors that influence hypomobility x7

Answer 5

prolonged immobilization
sedentary lifestyle
postural malalignment
tissue trauma
impaired mm performance
age-related decreases in tissue extensibility
congenital or acquired deformities

Question 6

hypermobility/overstretching

Answer 6

excessive mobility
creates detrimental joint instability
normal in healthy active patients that require extensive flexibility

Question 7

flexibility

Answer 7

ability to rotate 1 jt smoothly & easily through unrestricted, pain-free ROM

Question 8

Dynamic flexibility

Answer 8

• active muscle contraction rotating a joint through its available ROM
  
  • depends on: mm ability to contract & degree of tissue extensibility

Question 9

Passive flexibility

Answer 9

• joint passively rotated through available ROM
  
  • depends on: tissue extensibility
  • prerequisite for dynamic flexibility

Question 10

precautions x8

Answer 10

• do not stretch beyond normal ROM
• extra caution w pt’s w osteoporosis
• protect newly united fx’s
• torque → point of force application
  
  • long lever arm = more torque
• vigorous stretching of previously immobilized tissue
• progress dosage gradually
• edematous tissue
• overstretching weak mm’s

Question 11

contraindications x8

Answer 11

• bony block limits movement
• recent fx’s w incomplete union
• acute inflammatory/infectious process
• necessary healing can be disrupted
• sharp, acute pain w stretching
• hematoma /tissue trauma
• joint hypermobility
• shortened ST provides stability

Question 12

modes of stretching x8

Answer 12

ballistic
manual
mechanical
PNF
static
self
cyclic/intermittent
selective

Question 13

ballistic stretching

Answer 13

• rapid, forceful intermittent stretch
• high velocity, high-intensity stretch
• fast joint movement that quickly elongates the targeted soft tissue

Question 14

manual stretching

Answer 14

• clinician applies external force
• early stages of program
• most appropriate if pt lacks NM control of body segment & can’t self-stretch

Question 15

mechanical stretching

Answer 15

• device applies low-intensity, prolonged stretch
• PT’s role to recommend type of device
• pt/PTA’s role to teach pts how to safely use

Question 16

PNF: proprioceptive NM facilitation

Answer 16

• performed w synergistic mm groups in diagonal pattern
• types:
  
  • hold-relax or contract-relax
  • agonist contraction
  • hold-relax with agonist contraction

Question 17

static stretching

Answer 17

• held in lengthened position over period of time
• manual/self: 5 seconds to 5 minutes
• mechanical: 1 hour to several days/weeks
• used to increase flexibility/ROM

Question 18

self stretching

Answer 18

• independently complete after instructions
• integral component of HEP
• typically 30-60 seconds

Question 19

cyclic/intermittent stretching

Answer 19

• short duration
• repeatedly but gradually applied, released, & reapplied
• similar to static stretching repeated multiple times

Question 20

selective stretching

Answer 20

applying stretching techniques to some muscles and joints while allowing motion limitations to develop another muscles or joints

Question 21

proper alignment for stretching

Answer 21

• patient comfort & stability
• influences baseline amount of tension
• one joint vs two joint
• maximized distance bt origin & insertion

Question 22

adjunct to stretching x7

Answer 22

het
cold
massage
joint traction
biofeedback
relax techniques
ST mobilization

Question 23

Ability of body structure or segment to move so ROM for functional activity is allowed

or

ability of an individual to initiate control or sustain active movements of the body to perform motor task

Answer 23

mobility

Question 24

Increase soft tissue extensibility to improve flexibility in ROM by elongating adaptively shortened and hypomobile structures

Answer 24

Stretching

Question 25

Around the tissue (ligaments)

Answer 25

Prearticular

Question 26

adaptive shortening of a muscle tendon unit /soft tissue surrounding a joints

Answer 26

contracture

Question 27

Contractors are due to: x4

Answer 27

prolonged joint positioning neurological conditions trauma burns

Question 28

t/f: Contractors are long term

Answer 28

true - Hypermobility, muscle tightness, shortening = short term

Question 29

Interventions to increase mobility of soft tissues x7

Answer 29

Stretching self-stretching neuromuscular facilitation/inhibition muscle energy joint mobilization soft tissue mobilization neural tissue mobilization

Question 30

Indications for stretching x5

Answer 30

- Limited ROM due to soft tissues - restricted motion leads to structural deformities that are otherwise preventable - muscle weakness slash shortening have led to limited ROM - as part of fitness/sports specific program to reduce risk of injury - part of warm-up/cooldown from vigorous exercise

Question 31

returns to pre-stretch resting length after a short-duration stretch force is removed

Answer 31

elasticity

Question 32

initially resists deformation when stretch force is applied, but will slowly lengthen if force is sustained

Answer 32

viscoelasticity

Question 33

tendency of soft tissue to assume a new/greater length after stretch is removed

Answer 33

plasticity

Question 34

properties of oft tissue x3

Answer 34

elasticity viscoelasticity plasticity

Question 35

force per unit area (load)

Answer 35

stress

Question 36

amount of deformation

Answer 36

strain

Question 37

lengthening of wavy collagen fibers

Answer 37

toe region

Question 38

direct relationship between stress/strain

Answer 38

elastic range

Question 39

point beyond which tissue does not return to its original shape/size

Answer 39

elastic limit

Question 40

permanent tissue deformation

Answer 40

plastic range

Question 41

MAX strain the tissue can sustain

Answer 41

ultimate strength

Question 42

considerable weakening of the tissue

Answer 42

necking

Question 43

tissue ruptures

Answer 43

failure

Question 44

Steepness of curve depends on rate at which load is applied

Answer 44

rate dependence

Question 45

Continuous, slow elongation with maintained stretch

Answer 45

creep

Question 46

Gradual decrease in force required to maintain deformation with constant load applied

Answer 46

stress-relaxation

Question 47

Repetitive loading may cause failure at lower strain levels

Answer 47

Cyclic Loading & CT Fatigue

Question 48

total time from all cycles Lack of agreement on optimal duration/rep

Answer 48

Total elongation time

Question 49

static, sustained, maintained, prolonged

Answer 49

Long duration stretching

Question 50

cyclic, intermittent, ballistic

Answer 50

Short duration stretching

Question 51

single cycle

Answer 51

duration - Period of time stretch is applied and tissues are held in lengthened position