TherEx Test #2

Muscle endurance

the ability of a muscle of a muscle group to perform repeated contractions against a less-than maximal load.

Agility

the ability to control the direction of the body or a body segment during rapid movement.

Proprioception

the body's ability to transmit position sense, interpret the information, and respond consciously or subconscously to stimulation through appropriate execution of posture and movement

General Myofascial Techniques

J-stroke Oscillation Wringing Stripping Arm or Leg Pull

Normal attributes of normal tissue during palpation

no tenderness springy end-feel when pressure is released In myofascially restricted tissue, pain occurs with palpation, and restriction with a loss of springiness is palpated by the clinician When the treatment is effective, the clinician feels tissue release during the treatment

Irritability or excitability

of the motor unit determines the amount of stimulation required to initiate the response of a muscle fiber. Irritability is an electrochemical property of skeletal muscle that occurs when a muscle responds to a stimulus by producing tension or movement.

What are the 5 parts of application of muscle energy

1. Assessment of the problem 2. Specific joint position 3. Precise active contraction by the patient 4. Appropriate counterforce 5. Stretch force

Strain-Counterstrain Treatment Steps

1. Locate tender point 2. Place in a position of comfort 3.Position is held 90 s 4. Joint is returned to neutral position 5. Reassess tender point

9 Principles of Application of PNF

1. The clinician's hand placement is important for providing appropriate facilitation of the deep-touch and pressure receptors 2.Verbal cues are given in a moderate tone if the patient is providing a maximal output 3. The technique should not be bainful 4. Proper instruction on the PNF pattern before the start of exercise is important if the muscles are to receive optimal facilitation 5. Providing traction to separate the joint surfaces and approximation to compress the joint surfaces stimulates the joint's proprioceptive nerve endings to ultimately improve muscle response 6. A quick stretch applied immediately before the beginning of the movement pattern uses the stretch reflex to help the muscle to produce a stronger initial response 7. Rotation is an important component of the diagonal motion 8. The motions are performed precisely and through a smooth range of motion 9. the clinician must use good body mechanics

What is a barrier?

A barrier is not the end of the existing range of motion but a resistance that is felt when a part is moved through its passive range of motion

Closed Kinetic Chain

A kinetic chain is closed when the distal segment is weight bearing

Outline a progression of four plyometric exercises for either a lower or an upper extremity program

A lower-extremity plyometric exercise progression for a basketball player might begin with a two-foot ankle hop and progress to a single-foot ankle hop, side-to-side hops, standing jump-and-reach, long jump with lateral sprint, and box depth jumps

Identify the elements of a motor unit

A motor unit consists of a umber of muscle fibers and the nerve that innervates the fibers. When stimulated, a motor unit behaves according to the all-or-none law in that all muscle fibers of the motor unit contract.

Discuss the spray-and-stretch trigger point release theory

According to the gate control theory of pain, the sudden, brief application of cold inhibits the pain-spasm cycle and provides muscle relaxation and pain relief, especially when accompanied by a stretch

Muscle Structure

Actin Myosin Myofibril Sarcoplasm Sarcolemma Muscle Fiber Endomysium Fasciculus Perimysium Epimysium Muscle Belly Tendon

ABCs of proprioception

Agility Balance Coordination

Engram

An engram is an effect or performance that is impressed upon the CNS through repetition.

Extensibility

As a muscle stretches, it becomes more extensible because it connective tissue is heated and stretched with the activity.

Overload principle

As a muscle's strength adapts to a resistance, the muscle must be additionally overloaded to continue making strength gains

Identify the systems that control balance

Balance is influenced by three systems: the vestibular, oculomotor, and proprioceptive systems. These all deliver input to the CNS to provide both static and dynamic balance.

Discuss the difference between basic and advanced functional activities

Basic exercises begin early in the therapeutic exercise program to assist in achieving flexibility, strength, endurance, and proprioception. Advanced exercises, however, include more complex functional performance exercises that prepare the patient for performance-specific exercises.

Convex-on-concave rule

Bone and surface move in opposite directions

Concave-on-convex rule

Bone and surface move in the same direction

Identify the contributions of functional and performance-specific exercise to a therapeutic exercise program

Both exercises are used to ready the patient physically for the stresses and demands of his or her activity and to prepare the patient mentally. The effects of successful execution of functional and performance-specific activities come through the patient's discovery that the injured segment can withstand normal stresses.

Explain the characteristic differences between fast-twitch and slow-twitch muscle fibers.

Compared to fast-tqitch of Type II fibers, the slow-twitch, Type I fibers are smaller, are red, have a slower conduction velocity, have a lower recruitment threshold, have lower minimum and maximum firing rates, have slower-acting myosin ATPase, have a greater number of mitochondria, and function in endurance activities rather than in rapid, brief bursts of activities

2 types of Accessory motion

Component: not capsular but accompanies physiological motion. Joint Play: occurs within the joint and is determined by the joint capsule's laxity

What is isotinic divided into?

Concentric Eccentric

Describe the neural acquisition involved in developing coordination

Coordination includes the process of perceiving an activity, getting feedback from the CNS about the result of the activity, and correcting the activity through a series of repetitions and alterations until the activity is performed correctly and without the need for cerebral cortex input

Identify four principles of strengthening exercises

Development of a theraputic exercise program must address the SNAP guidelines: specific exercise, no pain, attainable goals, and progressive overload

Identify the various types of dynamic activity

Dynamic activity includes muscle tension with movement. Dynamic activity is divided into isotonic and isokinetic activity. Isotonic activity is further divided into concetric and eccentric activity.

What are the Swedish massage strokes?

Effleurage Petrissage Friction Tapotement

Muscle Energy

Essentially, muscle energy is the use of muscle contraction to correct a joint's malalignment.

Describe the factors involved in plyometric program design

Every plyometric exercise includes three aspects - the lengthening or eccentric phase, the amortixation phase, and the contracting or concentric phase. The lengthening phase prepares the muscles for the rapid change, or amortization, and allows a greater contraction to produce greater results.

T/F: Inhibition can be trained directly

F

T/F: When using effleurage or petrissage, the pressure of the massage strokes should be away from the heart

F: they should be toward the heart, and the hands should not lose contact with the skin. On the return stroke, continue lightly touching the part

T/F: You should move from deeper structures to superficial structures

F: you should move from superficial structures to deeper structures to avoid a mistake in identifying the structure or tissue that is restricted. Techniques should be applied with the least amount of force that is appropriate for achieving the established goals

Resisted Range of Motion

Falls into the broad category of dynamic exercises

Type II

Fast twitch

Explain the difference between functional exercise and performance-specific exercise

Functional exercises are used in a therapeutic exercise program from its early stages to its final stages. Functional exercises are activities that precede performance-specific exercises in a rehabilitation program. They commonly involve mutliplanar activities and provide increased stresses and demands greater on performance muscle groups than strength exercises to prepare the patient for more advanced skill activities. In later rehabilitation stages, performance-specific exercises prepare the patient to return normal activities by mimicking the stresses and skills required of the patient during those activities. Final testing uses activities of drills that are specific to the patient's sport or work demands and activities that mimic the maneuvers and movements that will be required when the patient returns to full participation. This testing assesses whether the patient is ready to reume normal activities.

List factors that can be varied in a progression of functional and performance-specific activities

Functional exercises proceed from slot to fast, simple to complex, low force to high force, short distance to long distance, and bilateral support to unilateral support. A progression of functional exercises includes a steady change to allow for SAID principle advancement. Functional exercises include some characteristics unique to functional exercises and some characteristics common to most exercises.

Discuss the direction of glide and traction in relation to the treatment plane.

Glide movement during mobilization should be parallel to the treatment plane, and traction is perpendicular to the treatment plane.

What kind resistance and repititions of exercise causes hypertrophy of Type II fibers?

High resistance Low repetition

PNF Techniques for Gaining Flexibility

Hold-relax: An extremity is brought to end motion in agonist pattern, isometric of tight muscle (antagonist), relax, passive motion to new end range in agonist pattern (to stretch tight muscle) Contract-relax: Extremity is brought to end motion of agonist, isotonic contraction of antagonist (tight muscle), relax, passive movement to end range in agonist pattern (to stretch tight muscle) Slow reversal-hold-relax: Limb starts in the shortened position of the agonist (opposing muscle). The antagonist (tight muscle) contracts concentrically to move to its shortened position (bringing tight muscle to its end range), isometric contraction of tight muscle, relax, stretch by unopposed concentric contraction of agonist (opposing) muscle

Precautions and Contraindications for Joint Mobilization

Hypermobile joints Malignancy Tuberculosis Osteomyelitis Osteoporosis Recent Fractures Ligamentous rupture Herniated discs with nerve compression Joint effusion Osteoartheritis Pregnancy Flu Total joint replacement Severe scoliosis Poor general health Inability to relax Precautions should also be taken when treating hypermobile joints using the pain relieving grades

What are the grades of movement?

I II III IV V - manipulation

Absolute refractory period

If a muscle fiber is stimulated for about 1 ms, the membrane depolarizes and cannot be immediately restimulated

What are the neurological effects or massage?

Improved neurological effects result in a combination of pain reduction and muscle spasm relaxation. There is evidence that massage reduces neuromuscular excitability so that muscles with injury-related spasm can relax. Additionally, research indicates that pain subsides because massage facilitates the release of beta-endorphines, thereby affecting the gate-control mechanism of pain

Discuss how PNF can be used to improve flexibility and strength

Improvement in either flexibility or strength is accomplished using PNF because this technique uses optimal relaxation during stretching exercises and optimal muscle recruitment during strengthening exercises to make the changes. It does this through increased neural recruitment by afferent stimulation of the central nervous system. To achieve increased flexibility, the CNS is stimulated to optimize muscle relaxation to produce motion fains. During strengthening activities, increased CNS stimulation results in greater stimulation of its muscle fibers with reduced facilitation of its GTOs to allow for greater muscle output.

What kind of muscle contraction is used in Muscle Energy?

Isometric It should be sustained for 5 to 10s

Explain the concave-on-convex and convex-on-concave rules.

Joint mobilization techniques are based on these rules. The concave-convex rule states that concave joint surfaces slide in the same direction as the bone movement, and the convex-on-concave rule states that the convex joint surface slides in the opposite direction of the bone movement

Indications for Joint Mobilization

Joint pain - grade I and II oscillations relieve pain A hypomobile joint, which is determined by a capsular pattern of joint motion and less mobility than the contralateral join. - Grades III and IV improve joint mobility.

What are the contraindications for massage?

Massage is contraindicated when the technique may aggrivate the condition or cause additional harm to the patient infection malignancies skin disease blood clots and irritations or lesions that may spread with direct contact.

What are the mechanical benefits of massage?

Mechanical benefits include improvements in the tissue's ability to move because of reduced adhesions, changes in the range of motion of the joints, increased mobility of the muscle tissue, and reduction in tissue stiffness. Mechanical effects improve blood and lymph flow, promote the mobilization of fluid, and stretch and break down adhesions to ultimately help reduce edema and improve tissue mobility

Difference between Mobilization and Manipulation

Mobilization is commonly performed by rehabilitation clinicians, but manipulation is not. Manipulation is most commonly performed during chiropractic applications

MWMS

Mobilization with movement are intended to relieve pain and increase joint motion This application uses a combination of passive accessory mobilization and simultaneous active motion.

What resistance and repetitions cause more genral hypertrophy in Type I and II fibers

Moderate resistance higher repitition

Define joint mobilization grades of movement

Movements in joint mobilization are divided into four grades. Grade I is small-amplitude movement in the beginning range of motion, grade II is large-amplitude movement in the middle of the nonrestricted range of motion, grade III is large-amplitude movement to the restricted range of motion, and grade IV is a small-amplitude movement to the restricted range of motion

Discuss the relationship between muscle strength, endurance, and power

Muscle function includes strength, endurance, and power. Athletic activity involves all these factors to different degrees, depending on its specific demands. Muscle strength and endurance are closely related. Strength is the ability to produce force, and endurance is the ability to produce less forceful activities over a longer periods; power is the strength output related to time.

What are the primary afferent receptors of muscles and tendons

Muscle spindles Golgi Tendon Organs

Identify the various grades of manual muscle testing

Muscle strength is rated from 5 (normal) to 0 (no function). A grade 4 muscle is one that offers some resistance beyond gravity but not normal resistance; grade 3 muscle can lift the limb against gravity but cannot offer any additional strength; a grade 2 muscle can move the limb through a fill range of motion in gravity-eliminated position; and a grade 1 muscle provides some voluntary activity but cannot move the segment through a full range of motion. A 0 grade indicates that there is no palpable or observable activity in the muscle.

Explain the progression of myofacial restriction after an injury.

Myofascial restriction occurs after an injury when secondary effects such as scar tissue forms and adhesions occur between the newly formed tissue and adjacent structures. Immobilization after an injury can also lead to myofascial restriction and loss of tissue mobility.

Contraindications for myofascial techniques

Myofascial technique contraindications include malignancy, hypermobile joints, recent fractures, hemorrhages, sutures, osteoporosis, local infections, and acute inflammations

NAGS

Natural apophyseal glides are passive oscillations applied betweenthe middle and end range of available motion to relieve pain and increase motion, and they are used primarily in the cervical region of the spine. This technique is used for cervical spine levels 2 through 7

Active Range of Motion

Occurs when the patient can produce motion of the segment with no assistance. No resistance is applied.

Position of Comfort

Once the tender point is located, some pressure is applied to it and the joint is passively placed in a shortened position where tenderness to pressure over the tender point is relieved. This position is known as a position of comfort and is often fine-tuned by the clinician until the patient has no pain or discomfort

What are the psychological effects of massage?

One of the psychological effects of massage is relaxation. Another psychological benefit of massage.

Discuss the difference between open and closed kinetic chain activity

Open kinetic chain activity occurs when the sital aspects of the limb is not fixed and joints inn the chain can move independently of each other; closed kinetic chain activity occurs when the distal aspect is fixed or anchored so movement of one joint affects the motion of the others in the chain.

Proprioceptive Neuromuscular Facilitation

PNF incorporates impulses from the afferent receptors of skin, muscle, tendon, visual, and auditory neurons to facilitate a response from motor neurons, which produce desired actions

Nociceptors

Pain receptors

Discuss the grades of muscle activity

Passive motion is performed by an outside force without voluntary muscle activity, active assistive motion is motion that occurs through a combination of voluntary and assistive mechanisms, active motion occurs without the aid of any outside mechanism; and resistive motion occurs through a range of motion within which resistance to that motion is present

What are the 2 types of joint motion?

Physiological: movement that the patient can do voluntarily, such as flexion and abduction. Accessory: is necessary for normal joint motion but cannot be voluntarily performed or controlled

Manual Therapy principles to keep in mind

Place the patient in a comfortable position Place yourself in a comfortable position Always use good mechanics Obtain feedback from the patient throughout the treatment so you can apply the technique properly with appropriate pressure Your fingernails should be clean and trimmed. As a general rule, the nail should not extend beyond the end of the fingertip Before you apply the technique, explain what will be done and what sensations to expect. Warn the patient in advance about any potential discomfort, and ask her to tell you when she was less pressure or discomfort during the treatment. Assess the patient's condition before, during, and at the conclusion of the treatment The appropriate manual therapy techniques must be correctly applied for a successful result Always respect precautions and contraindications

Identify the mechanical and neurological components of the neuromuscular principles involved in plyometrics

Plyometrics involves the technique of first lengthening, then shortening the muscle to produce an increased power output. This type of exercise is based on stretch-shortening principles. It is believed that a muscle's increased power during plyometric exercise training may result from a combination of an increased level of muscle elasticity and the adaptions that occur in the muscle spindle and GTO.

List the precautions and contraindications for plyometrics

Precautions include factors such as the amount of time involved in plyometrics and the possibility of delayed onset muscle soreness postexercise. Contraindications include an acute inflammation, recent postoperative conditions, and instability.

List the locations of afferent receptor involved in proprioception

Proprioception, an important target of therapeutic exercise programs, is based on the input of afferent receptors in skin, muscles, tendons, and joints

Explain the theoretical basis for proprioceptive neuromuscular facilitation.

Proproceptive neuromuscular facilitation incorporates the inhibitory and excitatory impulses from the afferent receptors of skin, muscle, tendon, visual, and auditory neurons that facilitate a response from the motor neurons, resulting in a desired action

Commonly Seen Trigger Points

Rotator Cuff Gluteus Medius Gluteus Minimus Cervical muscles

What is the smallest contractile element of a muscle fiber?

Sarcomere

What are the Physiological effects of massage?

Several physiological effects result from massage application. Blood flow to the area increases along with an increase in localized skin temperature. Even muscle temperature improved up to cm deep after massage, indicating an increase in muscular blood flow. Other physiological effects include increased parasympathetic activity; this is evident through physical changes after massage such as a reduction in heart rate and blood pressure. Massage also has been shown to reduce the production of cortisol

Type I

Slow-twitch

Identify precautions for functional and performance-specific exercises

Some precautions are those discussed in prior chapters and include explaining the exercise to the patient, avoiding pain and swelling, considering tissue integrity when designing exercises, knowing the patient's confidence level, and being aware of the patient's progression tolerance.

SAID principle

Specific Adaptions to Imposed Demands This means that the muscle will adapt and perform according to the demands placed on it

A Strengthening program is designed according to four principles: SNAP

Specific exercises No pain Attainable goals Progressive overload

Stiffness

Stiffness is the resistance of tissue or a structure to deformation or change in shape or length

Discuss the techniques for myofascial release

The primary techniques for myofascial release are J-stroke, oscillation, wringing, stripping, and arm of leg pull.

SNAGS

Sustained natural apophyseal glides are used to treat the cervical, thoracic, and lumbar spines. It is also used to treat ribs and the sacroiliac joints. SNAGS is used both to relieve pain and to improve mobility

Examples of Popular Massage Techniques

Swedish Shiatsu Reflexology Thai Hot Stone Sport

T/F: Most manual therapy techniques are aimed at altering pain and function by affecting the body neurologically and mechanically

T

Discuss the ABCs or proprioception

The ABC's of proprioception are agility, balance, and coordination. Balance is fundemental to coordination and agility. A patient must have good balance, coordination, and agility to fully meet the demands of his or her sport. Specific exercises are used to restore these functions. These exercises can be initiated early in a program with simple activities and progressed to more complex activities as the patient advances in the therapeutic exercise program. Agility requires good coordination; coordintation requires good balance; and balance requires functioning afferent input from three sources, one of which is proprioceptors

Identify the CNS sites that relay propreioceptive information to the motor system

The afferent receptors transmit information to one of three CNS sites: the spinal cord, the brain stem, or the cerebral cortex. The most rapid reflexes involve quick transmission and response from the spinal cord. The slowest responses are sent from the cerebral cortex, where conscious execution of the response is initiated

Describe the sarcomere and its function in muscle activity

The contractile element of a muscle fiber is the sarcomere. Actin and myosin filaments and their relationship to each other via cross-bridges determine the length of the sarcomere and its activity status. A complex system of biomechanical processes and the stimulation of an action potential produce muscle activity through the release of calcium and ATP to cause a sliding of actin and myosin over each other, shortening the sarcomere's length

Contraction phase

The contraction phase of mechanical response of actin and myosin follows a 10% latency period and occurs through the next 20% of the cycle.

Open Kinetic Chain

The kinetic chain is open when the distal segment moves freely

Discuss the three techniques of message and their indications, precautions, and contraindications.

The massage used most commonly in rehabilitation include effleurage, or stroking; petrissage, or kneading; and friction. They relieve pain, relax muscles, reduce swelling, and mobilize adherent scar tissue. Tapotement is a type of massage used in cases where fluids need to be dislodged. Massage should be avoided in the presence of infection, malignance, skin disease, blood clots, and any irritations or lesions that may spread with direct contact. Precautions include having clean hands and body surface to be treated, explaining the procedure before application, removing jewelry that may interfere with the application, using warm hands and massage media, and draping the body part appropriately.

Mobile Point

The mobile point is the position into which the patient is passively placed and is the point of maximum ease; this is a position from which any change produces an increased tissue tension that a clinician can palpate

Length-Tension Relationship

The muscle produces the most force at its resting length

What are contractile components>

The myofibrils (actin and myosin)

Refractory period

The refractory period includes a latent period during which there is a momentary cessation of activity as the muscle fiber prepares to fire

Explain how an action potential is transmitted

The sarcoplasmic reticulum releases calcium to the muscle fibers through its T-tubules to the Z-discs, where the calcium binds to the troponi on the actin filaments. This causes the topomyosin on the actin filaments to shift and allow the head of the myosin cross-bridge to attach to the actin, shortening the sarcomere. The ATPase on the cross-bridge breaks down ATP for energy to allow the cross-bridge to recock and continue muscle activity. As long as calcium is present, the activity can continue

Outlie a sample of a progression of function to performance-specific exercise for either the lower of the upper extremity

The specific progression and selection of exercises depend on the patient's specific task demands, especially as he of she nears the final stages of the program. A lower-extremity program may include a progression from non-weight-bearing use of the BAPS board that can start early in the therapeutic exercise program. As the patient becomes full weight bearing, stork standing first with eyes open and then with eyes closed and finally with eyes open and head rotation left to right can begin. a progression of this activity can go from using the floor to using either a trampoline or a 1/2 foam roller or balance board to combining the activity with another activity such as ball catching. Stork-standing activities can then progress to dynamic movement activities such as lunges, step-ups and step-downs, walking, and jogging. Running activities begin with a forward jog on a flat surface, proceed to increased speed and distance, and then to lateral runs and cuts and sudden changes in direction.

Plyometrics

The use of a quick movement of eccentric activity followed by a burst of concentric activity to produce a powerful output from a muscle

Describe a progression of proprioceptive exercises for the lower or upper quarter

Therapeutic exercise for proprioception progresses from easy to difficult, from static to dynamic, from slow to fast, and from simple to complex. As a rehabilitation clinician you must understand the complexity and requirements of the patient's sport or work to be able to include appropriate proprioception exercises that will eventually permit the patient to return to full sport and normal participation

Explain the leading hypotheses for the mechanism of myofascial trigger points

Three hypotheses explain myofascial trigger points and focus on histopathology, neuroelectropathology, and a combination of these two. The histopathological hypothesis indicates that during contraction of a normal muscle fiber, calcium that is stored in the fiber's sarcoplasmic reticulum is rapidly released when the contraction begins is triggered by a brief nerve impulse called an action potential. A contraction is the result of the shortening of the sarcomere when its cross-bridges pull the actin and myosin filaments over each other. If an injured muscle fiber's sarcoplasmic reticulum is damaged, its calcium is released, stimulating the sarcomere to produce a sustained contraction. This sustained calcium release and sarcomere contraction create an energy crisis because of the ischemia that results. Ischemia occurs because the muscle fibers' sustained contraction limits capillary blood flow in the region, causing oxygen deficiency within the muscle cells so they cannot provide enough ATP to relax the contraction. Without sufficient ATP, the sarcomere's filaments cannot release from each other, and therefore they remain fixed in their contracted position. The second hypothesis is based on neuroelectrical pathology. It uses concepts of the Cinderella hypothesis, which refers to the fact the Type I fibers are normally recruited first, remain activated for a prolonged time, and are afforded short recovery times; hence, these fibers are susceptible to pain and damage. Studies have demonstrated that low-level activation after as little as 30 min causes trigger point pain in muscles. Previous studies have shown spontaneous electrical activity in trigger point muscle fibers but not in adjacent or surrounding normal muscle fibers. It is believed that repetitive low-level muscle stress provides just enough stimulation that acetylcholine leaks out of the motor nerve terminal to trigger a depolarization of the synaptic membrane. This facilitation opens the sodium channels to produce sustained activation of very localized muscle fibers. The third hypothesis is the integrated theory, which is a combination of the other two hypotheses. This hypothesis indicates that a dysfunctional motor end plate provides sustained contraction of isolated muscle fibers, as is presented in the neuroelectrical theory. Sustained muscle fiber contraction creates a combination of localized ischemia and increased metabolic needs, which together create a sustained energy crisis. Lacking sufficient energy to an inability to reduce acetylcholine quantities, the muscle cells remain locked in contraction. It is thought that ischemia and the ensuing local hypoxia trigger the release of chemical neural sensitizers that facilitate local nociceptors to produce pain. Input into the central nervous system from these nociceptors within the muscle may result in functional changes in the central nervous system, creating referred pain.

Since movement around a joint is rotational, the force produced is

Torque

Trigger Points

Trigger points are a common cause of muscle pain "focus of hyperirritability in a tissue that, when compressed, is locally tender, and, if sufficiently hypersensitive, gives rise to referred pain and tenderness, and sometimes to referred autonomic phenomena and distortion of proprioception

Precautions for myofacial techniques

Use cautiously on new scars Use care on patients with complex regional pain syndrome (CRPS) or reflex sypathetic dystrophy (RSD) Avoid bruising (results in additional scar tissue) Warn the patient before treatment that sensations of pain, tingling, burning, and warmth may occur and are normal with this technique Also instruct the patient to tell you of any sensations experienced during the treatment

List three considerations for plyometric program execution

When designing a plyometric program, one must consider the patient's physical condition and the sport's demands. Specifically, the patient should have adequate flexibility, strength, and proprioception before beginning a plyometric program. Special considerations also include factors such as the patient's age, weight, level of competition, footwear, the surface, proper technique, progression, and goals

Capsular patterns

When loss of motion results from restriction in the joint capsule, specific characteristic chanes occur in the joint's pattern of motion and are referred to as capsular patterns

Fatigue

a decrease in a muscle's maximal ability to produce force or power.

Palpation

a fundamental in myofascial release

Tetany

a sustained maximal contraction

Name the two extrafusal fibers

actin myosin

What is the excitatory impulse that stimulates a motor unit?

an Action Potential

Passive Range of Motion

an activity that requires no active work on the part of the muscle

Tetanus

an intermittent contraction that is a noted by a fibrillating tremor

Manual Therapy Direct techniques

are maneuvers that load or bind tissues and structures. The techniques direct the treatment force at the point where tissue mobility is lization, trigger point release, and Rolfing fall into this category. The goal of these techniques is to move the point of restriction closer to the normal range of motion.

Tender Points

are small areas of tenderness about the size of a dime or smaller that are located in subcutaneous, muscle, tendon, ligament, or fascial tissue

Manual Therapy Indirect techniques

are the opposite of direct techniques. These techniques apply treatment forces to move the tissue away from the direction of limitation. Some techniques refer to this point of limitation as the barrier.

Contracture

failure of a muscle to relax

Myofascial release

involoves manual contact with the patient and uses the sense of touch in evaluating the problem and the effectivness of the treatment, just as massage does. Massage and myofascial release also both include the use of pressure and tissue stretch to produce soft-tissue results.

Fascia

is a continuous structure that surrounds and integrates tissues and structures throughout the body. Fascia varies in density and thickness and is interconnected with the structures is surrounds Divided into three layers: Superficial Deep Subserous

Jump Sign

is also a reflex response but is a reaction of wincing or withdrawal

Loose-packed position

is any position that is not packed. The articular surfaces are not completley congruent, and some portions of the capsule are lax. Both examinations and early mobilization techniques are performed with a joint in its maximum loose-packed position. This position is a joint's resting position

An active trigger point

is one that is always tender and produces referred pain whether the muscle is active or inactive. The muscle also displays weakness and reduced motion.

A latent trigger point

is painful only when it is palpated. Like active trigger points, it has a taut band that demonstrates a twitch response when manually examined. Normal muscles do not have these areas of tenderness or pathology

Active Assistive Range of Motion

is performed either when the muscle is incapable of producing the full motion without assistance, or when it is desirable for the patient to perform limited voluntary activity with assistace from an outside source to achieve the objective of the exercise

Manual Therapy

is the application of skilled hands-on techniques to treat and improve the status of neuromusculoskeletal conditions Manual therapy techniques address soft tissue and more specifically the collagen of soft tissue and more specifically the collagen of soft tissue

Massage

is the systematic and scientific manipulation of soft tissue for remedial or restorative purposes

Static activity is Dynamic activity is

isometric isotonic and isokinetic

Interoreceptors

provide information about the body's internal environment

Exteroreceptors

provide information on the external environment

Arthrokinematics

refers to the motions between the bones that form a joint.

The 5 types of arthrokinematics

roll - when a new point of one surfave meets a new point of the opposing surface slide - one point of one surface contacts new points on the opposing surface spin - one bone rotates around a stationary axis compression - two surfaces are pressed together distraction - two surfaces are pulled apart

Ammortization Phase

simply defined as the amount of time it takes to change from eccentric to concentric motion

Mechanoreceptors

specialized afferent nerve endings that respond to mechanical stimulation such as pressure, tension, and vibration

Power

strength applied over a distance for a specific amount of time. Fxd/t

What is plyometrics also called?

stretch-shortening exercise

Coordination

the complex process by which a smooth pattern of activity is produced through a combination of muscles acting together with appropriate intensity and timing. Several muscles are involved in a coordinated activity.

Viscosity

the internal resistance that limits the rate of muscle contraction

Close-packed position

the joint surfaces are most congruent with each other The convex surface of one bone is at its maximum congruence with the opposing concave surface of the other bone. The ligaments and capsule are taut, and joint surfaces cannot be easily separated with traction. Joints are not usually mobilized in a close-packed position, but this position can be used to stabilize an adjacent joint before applying mobilization forces to another joint

Strength

the maximum force that a muscle or muscle group can exert.

Threshold stimulation

the minimum amount of stimulation required to cause a response

Elasticity

the muscle's ability to recover its normal shape or length after a stretch force is removed.

Kinesthesia

the sensation of limb movement and position

Relative refractory period

when the membrane becomes partially repolarized and can respond if the stimulus is greater than the normal threshold levle

Muscle spasm

which is a prolonged reflex muscle contraction