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| when doing a pedalum exercise for the shoulder, what happens when giving a pt a weight to hold? | it increases momentum and causes distraction at the glenohumeral joint
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| when would we let someone use a weight during a pendulum exerise? | if they have grinding in their shoulder
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| how could we give more resistance for a pendulum exercise? | make the pt stand up straight
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| whats one way to get more knee extension? | get more hip extension!
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| if the knee is bent in prone to measure knee extension,are the quads passive or actively insufficient? | passive insufficiency
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| where is more muscle force going to occur? | midrange
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| if a muscle is to short and we are trying to generate FORCE, is it active or passively insufficient? | actively insufficient
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| if a muscle is to long and we are trying to generate FORCE is it active or passive insufficiency? | passively insufficient
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| can u have an active insufficient ROM issue? | NO!active insufficiency is only about force generation..
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| can passive insufficiency be a ROM issue and FORCE generation issue? | yes. it can be both
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| is lombards paradox a close or open chain | closed
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| whats the first question we should ask ourselves? | is it strength,length or control problem?
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| where would decreased hip extensor strength be most vulnerable during gait cycle? | midstance
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| where would weak quad strenth be vulnerable in gate cycle? | initial contact...because the ground reaction force creates knee flexion so quads have to counteract the knee extension moment
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| does coming from sit to stand create a lombards paradox? | yes...its due to hamstrings and quads concentrically contracting
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| what is functional excursion? | distance a mm is capable of shortening after it has been elongated to its maximum
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| how is the range of the brachialis mm limited? | limited by the range aavailable at the elbow joint.
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| what is an example of active insufficiency? | when biceps brachii contract and moves the elbow into flexion and the forearm into supination while simultaneously moving the shoulder into flexion, it shortens to a point of active insufficiency
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| what is an example of passive insufficiency? | when biceps brachii is lengthened full range by extending the elbow, pronating the forearm and simultaneously extending the shoulder. when its fully elongated its passively insufficient
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| why are rom acitivies administered? | to maintain joint and soft tissue mobility to minimize loss of tissue flexibility and contracture formation
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| what is passive rom? | movement of a segment within the unrestricted rom thts produced entirely by an external force
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| what is active rom? | movement of a segment within the unrestricted rom thts produced by active contraction of the mm's crossing tht joint
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| what is active-assistive rom? | type of AROM in which assistance is provided manually or mechanically by an outside force because the prime mover mm's need assistanct to complete the motion
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| in a region where there is acute, inflamed tissue would prom or arom be more beneficial? | passive rom. active would be detrimental to the healing process
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| when is there an indication to use arom? | when a pt can contract mm's actively and move a segment with or without then arom is used.
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| when is there an indication to use aarom? | whena pt has weak musculature and is unable to move a joint through the desired rom. aarom is used to provide enough assistance to the mm in a controlled manner so mm can function at maximum level and b strengthened
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| true or false..arom does not maintain or increase strenth. it also does not develop skill or coordination except in the movement patterns used. | TRUE
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| what does CPM stand for? | continuous passive motion.
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| what does hypomobile mean? | decreased mobility or restricted motions.
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| what is a contracture? | adaptive shortening of the muscle-tendon unit and other soft tissues tht cross or surround a joint tht results in significant resistance to passive or active stretch and limitation of rom.
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| when could we use a wand (T-Bar), cane, wooden stick, or dowel rod to provide assistance? | when a pt has voluntary mm control in am involved upper extremity but needs guidance or motivation to complete the rom in the shoulder or elbow
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| what are some forms of self-assisted rom? | manual..equipment: wand or tbar, finger ladder, wall climbing, ball rolling, pulleys. skate board, reciprocal exercise devices
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| can a pt begin self-assited rom when they have weaknes or paralysis? | yes! they can learn how to move the involved part within safe parameters.
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| is self assisted rom used after surgery or a traumatic injury? | yes! used to protext the healing tissues whenmore intensive mm contractin is contraindicated.
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| when a pt is using self-asstance, how does gravity effect their rom? | effects of gravity change with positioning so when lift the part against gravity, gravity provides a resistive force against the prime motion and therefore the prime mover requires assistance.
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| when a pt is using self assistance and thier extremity moves downward, what causes tht motion? | gravity causes the motion and the antagonsists need assistance to control the motion eccentrically.
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| what are some substitutes when a pt is using wall cominin for shoulder elevation? | trunk side bending, toe raising or shoulder shrugging
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| why would we use wall climbing? | to provide the pt with objective reinforcement and motivation for performing shoulder rom.
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| what can we use overhead pullys for? | can be effectively used to assist an involved extremity in performing rom.
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| true or false..overhead pulleys should be used only when mm activity is desired.. | TRUE
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| if a pt misuses a assistive pulley activities for the shoulder, what can result? | compression of the humerus against the acromion process.
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| what are the most common motions done when using a skate board/powder board? | abduction/adduction of the hip while supine and horizontal abduction/adduction of the shoulder while sitting.
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| what does pnf stand for? | proprioceptive neuromusclular facilitation
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| how are contractures described? | described by identifying the action of the shortened mm.
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| what are some types of contractures? | myostatic contracture, pseudomyostatic contracture, arthrogenic and periarticular, fibrotic and irreversible contractures
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| what is a myostatic contracture? | the musculotendinous unit has adaptively shortened and there is a significant loss of rom. there is no specific mm pathology present.
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| how can we resolve a myostatic contracture? | in a relatively short time with stretching exercises
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| what can cause a pseudomyostatic contracture? | hypertonicity associated with a cns lesion such as serebral vasucular sccident, spinal cord injury, or TBI. mm spasm or guarding and pain may also cause it.
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| what is an arthrogenic contracture a result of? | result of intra-articular pathology. these changes may include adhesions, synovial proliferation, joint effusion, irregularities in artivular cartilage or osteophyte formation.
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| when does a periarticular contracture develop? | develops when connective tissues tht cross or attach to a joint or the joint capsule lose mobility, thus restricting normal arthrokinematic motion.
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| what can cause a fibrotic contracture? | fibrous changes in the conective tissue of mm and periarticular structures can cause adherence of these tissues and subsequent development of a fibrotic contracture.
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| is it possible to stretch a fibrotic contracture and increase rom.? | yes. it is possible to strech a fibrotic contracture and ecentually increase rom , however it is often difficult to re-establish optimal tissue length
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| how does a irreversible contracture happen? | the longer a fibrotic contracture exists or the greater the replacement of normal mm and conectiv tissue with nonextensible adhesions and scar tissue or bone, the more difficult it becomes to regain optimal mobility of soft tissues.
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