Module 2: Stretching and Flexibility

Which of the following is a true statement about a muscle's response to immobilization? - When a muscle is immobilized for a period of time, atrophy occurs more rapidly and extensively in fast-twitch fibers than in slow-twitch fibers. - As the immobilized muscle atrophies, an increase in fibrous and fatty tissue in the muscle occurs. - Atrophy of an immobilized muscle will begin after the first 30 days of inactivity, resulting in contractile weakness. - A muscle immobilized in a shortened position will have an increased ability to produce maximum tension at its resting length because of sarcomere absorption.

- As the immobilized muscle atrophies, an increase in fibrous and fatty tissue in the muscle occurs.

To achieve permanent lengthening of connective tissue: - The collagen fibers must line up in a parallel fashion. - The region of necking, or macrofailure, must be reached. - Bonds between collagen fibers must be remodeled in the lengthened position. - The ground substance between the fibers must be reduced.

- Bonds between collagen fibers must be remodeled in the lengthened position.

To achieve maximum elongation of the long head of the biceps brachii during passive stretching: - Extend the elbow with the forearm in pronation and then extend the shoulder. - Flex the shoulder overhead after extending the elbow with the forearm in supination. - Extend the elbow with the forearm in supination and then extend the shoulder. - Flex the shoulder overhead after extending the elbow with the forearm in pronation.

- Extend the elbow with the forearm in pronation and then extend the shoulder.

In a patient's medical record you see "knee flexion contracture." What does it mean? - The patient is unable to actively extend the knee through the full range of motion (ROM) despite full passive knee extension. - The quadriceps muscle group is tight and limits full, passive knee flexion. - Full, passive knee extension is not possible. - The patient cannot actively contract the hamstrings to flex the knee.

- Full, passive knee extension is not possible.

Which of the following is responsible for inhibiting a muscle when it perceives there is too much tension? -Muscle spindle -Golgi Tendon Organ -Collagen -Ground Substance

- Golgi Tendon Organ

The goal of this exercise is to increase the flexibility (extensibility) of the pectoralis major muscle. You teach the patient to stand facing a corner with the shoulders abducted to 90°, elbows flexed to 90°, and hands and forearms placed on the walls. You tell the patient to relax into the stretch (by leaning into the corner) for 30 seconds; push his forearms into the walls for a count of six; then relax and lean forward toward the corner again and hold for 30 seconds. The self-stretching technique the patient is using is: - Hold-relax (contract-relax). - Contract-relax-contract (hold-relax-agonist contraction). - Agonist contraction. - Static-progressive stretching.

- Hold-relax (contract-relax).

To increase terminal knee extension, you position the patient prone so the lower leg is not supported on the treatment table. The patient relaxes while the lower leg and foot "hang" off the end of the table. The therapist adds a cuff weight around the ankle. What type of stretching procedure is being applied? - Ballistic - Mechanical - Dynamic - Cyclic

- Mechanical

Which of the following terms best describes impaired extensibility of a muscle-tendon unit as the result of spasticity or rigidity from a lesion of the central nervous system? - Myostatic contracture - Fibrotic contracture - Pseudomyostatic contracture - Hypotonic contracture

- Pseudomyostatic contracture

Which of the following descriptions of stretching procedures performed for several repetitions during a single treatment session and repeated over a series of stretching sessions represents the safest and most comfortable process to achieve soft tissue lengthening? - In an end-range position, apply several high-intensity, rapid-velocity stretch forces. - Slowly apply a low-load force; maintain the end-range position for an extended time period and release the stretch force slowly. - ply an end-range, high-load force slowly, maintain the end-range stretch for an extended time period, and release the stretch quickly. - In an end-range position, apply several low-intensity, rapid-velocity stretch forces.

- Slowly apply a low-load force; maintain the end-range position for an extended time period and release the stretch force slowly.

To maintain gains in ROM achieved as the result of a stretching program, it is recommended to: - Use the stretch-induced gains in ROM during functional activities as soon as able on a regular basis. - Perform daily resistance training of the muscle group opposite the stretched muscle. - Apply heat on a daily basis to the lengthened muscle groups. - Perform daily resistance training of the stretched muscle.

- Use the stretch-induced gains in ROM during functional activities as soon as able on a regular basis.

Ballistic stretching: - Should be used with elderly patients or patients with long-standing contractures. - utilizes quick bouncing movements during the stretching maneuver, resulting in an increased chance for tissue trauma and muscle soreness. - Is effective only if done concurrently with joint-mobilization techniques. - Can be very effective because the rapid force has greater chance of reaching the plastic range, leading to tissue remodeling.

- Utilizes quick bouncing movements during the stretching maneuver, resulting in an increased chance for tissue trauma and muscle soreness.

Each of the following is a contraindication to stretching adaptively shortened tissues except: - Sharp, acute pain during ROM. - When ROM is limited because scar tissue has reduced soft tissue extensibility. - A bony block. - When tight (shortened) soft tissues provide functional stability of a body segment affected by paralysis.

- When ROM is limited because scar tissue has reduced soft tissue extensibility.

Explain the three types of stress: tension, compression, and shear forces, and give an example of each. - Tension

Tension- Resistance to force applied that will lengthen a tissue. Example- Static stretching

Explain the three types of stress: tension, compression, and shear forces, and give an example of each. - Compression

Compression- Resistance to force applied that will approximate the tissue. Example- Weight bearing through a joint

Stretching is indicated for someone who is hypermobile. -True -False

False

When applying a stretch, you first feel some resistance; as you maintain the stretch, you feel as though you can move into a greater range using the same amount of force. This describes what mechanical property of connective tissue? - Stress relaxation - Tissue failure - Elastic limit - Creep

Creep

Which PNF technique is most appropriate for someone who is experiencing pain? - Hold Relax - Contract Relax - Agonist Contraction - None of the above

Hold Relax

Which of the following is not a contributing factor to loss of flexibility? - Aging - Immobilization - Muscle Disuse - Muscle Hypertrophy

Muscle Hypertrophy

reciprocal inhibition

Muscles on one side of a joint relax to allow muscles on the other side to contract.

Explain the three types of stress: tension, compression, and shear forces, and give an example of each. - Shear

Shear - Two or more forces that are applied in opposing directions. Example- In the spine where one vertebrae is going to left and another, either above or below it is going to the right.

autogenic inhibition is often seen during

static stretching ( low force long duration)

autogenic inhibition

The process by which neural impulses that sense tension are greater than the impulses that cause muscles to contract, providing an inhibitory effect to the muscle spindles.

Autogentic Inhibition

relaxation of antagonist muscle during contraction

relative stiffness

the most flexible parts of the body will move first - Path of least resistance.