STRETCHING

通報

問題一覧

Ability of body structures or segments to move so that ROM for functional activities is allowed

Mobility

Ability of an individual to initiate, control, or sustain active movements of the body to perform motor tasks

Mobility

Supported by a requisite level of muscle function

Mobility

MOBILITY

Strength, Endurance, Neuromuscular control

Ability to rotate a single joint or series of joinys smoothly and easily through an unrestricted, pain-free ROM

Flexibility

Maximized when the muscle-tendon units that cross a joint havr adequate extensibility to deform and yield to a stretch force

Flexibility

Determinants of flexibility

Muscle length, Joint integrity, Periarticular soft tissue extensibility, Arthrokinematics

Extent to which an active muscle contraction can rotate a single joint through its available ROM

Dynamic flexibility or AROM

Ability of a muscle to contract through the ROM

Dynamic flexibility or AROM

Degree and quality of tissue extensibility

Dynamic flexibility or AROM

Extent to which a joint can be passively rotated theough its available ROM

Passive flexibility or PROM

Extensibility of soft tissues that cross and surround a joint

Passive flexibility or PROM

Decreased mobility or restricted motion at a single joint or series of joints

Hypomobility

Adaptive shortening of the muscle-tendon unit and other soft tissues that cross or surround a joint

Contracture

Types of contracture

Myostatic or myogenic, Pseudomyostatic, Arthrogenic and periarticular, Fibrotic and irreversible

Shortening of musculotendinous unit and significant loss of ROM but no specific muscle pathology

Myostatic or myogenic

Managable

Myostatic or myogenic

Involved muscles appear to be in a constant state of contracture, giving rise to excessive resistance to passive stretch

Pseudomyostatic

Increased spasticity

Pseudomyostatic

Result of intra-articular parhology that caused when connective tissues that cross or attach to a joint/joint capsule lose mobility

Arthrogenic and periartciular

Has restriction joint infusion

Arthrogenic and periartciular

Changes in the connective tissue of muscle and periarticular structures can cause adherence of these tissues and subsequent

Fibrous and irreversible

Process whereby the overall function of a patient may be improved by applying stretching techniques to some muscles and joint while allowing motion limitations to develop in other muscles or joints

Selective stretching

A stretch well beyond the normal length of muscle and ROM of a joint and the surrounding tussyes, resulting in

Hypermobility

Limited ROM

indication

Loss of soft tissue extensibility

indication

Muscle weakness and shortening of opposing tissue

indication

Retricted motion leading to structural deformities

indication

May be a component of a total fitness or sport-specific conditioning program

indication

Bony block limits joint motion

contraindication

Recent fracture and/or bony union is incomplete

contraindication

Acute inflammatory or swelling

contraindication

Sharp, acute pain with joint movement or muscle elongation

contraindication

Hematoma or other indication of tissue trauma is observed

contraindication

Joint hypermobility already exists

contraindication

Shortened soft tissues provide necessary joint stability in lieu of normal structural stability or neuromuscular control

contraindication

Shortened soft tissues enable a patient with paralysis or severe muscle weakness to perform specific functional skills otherwise not possible

contraindication

Increased flexibility and ROM

potential benefits and outcomes

General fitness

potential benefits and outcomes

Injury prevention and reduced post-exercise muscle soreness/DOMS

potential benefits and outcomes

Enhanced performance

potential benefits and outcomes

Responsible for the strength and stiffness of tissue and resist tensile deformation

Collagen fibers

Provides extensibility

Elastin fibers

Great deal of elongation with small loads and fail abruptly without deformation at higher loads

Elastin fibers

Stable

Collagen fibers

Provide tissue with bulk

Reticulin fibers

Organic gel containing water and is made up of proteoglycans and glycoproteins

Ground substance

Reduce friction between fibers, transport nutrients and metabolites within the tissue, and maintain space between fibers

Ground substance

Composed of connective tissues (Collagen, Elastin, Reticulin, Ground substance)

Mechanical properties of noncontractile soft tissues

Determines by the proportion of collagen and elastin fibers, the proportion of PGs, and by rhe structural orientation of the fibers

Mechanical behavior of noncontractile soft tissues

Collagen fibers are parallel and can resist the greatest tensile load

Tendons

Collagen fibers have a random orientation and so are limited in resisting higher levels of tension

Skin

collagen fiber alignment varues so that they can resist multi directional forces

Ligaments, joint capsules and fascia

Absorb load

Tendon

Illustrates the mechanical strength of structures and is used to interpret what is happening to connective tissue under stress from an externally applied load

Stress-strain curve

Microfailure

Grade 1

Rupture of some fibers after deformation into the early part of the plastic range

Grade 1

Macrofailure

Grade 2

Rupture of an increased number of fibers and partial failure after deformation into the later part of the plastic range

Grade 2

Complete rupture or tissue failure after deformation beyond the plastic range

Grade 3

Least painful

Grade 3

Force or load per unit area

Stress

The internal reaction or resistance to an externally applied load

Stress

Has 3 types: tension; compression and shear

Stress

The amount of deformation or lengthening that occurs when an external load such as a stretch force is applied to a structure

Strain

Resistance to a force applied in a manner that will lengthen the tissue

tension

Resistance to a force applied in a manner that approximates tissue

compression

Resistance to two or more forces that are applied in opposing directions

shear

Major sensory organ of muscle and is sensitive to quick and sustained (tonic) stretch

Muscle spindle

Main function of these is to detect and convey information about muscle length changes and velocity of those changes

Muscle spindle

Function is to monitor changes in tension of muscle-tendon units

Golgi tendon organ

Sensitive to even slight changes of tension on a muscle-tendon unit brought on by passive stretch or active muscle contractions during normal movement

Golgi tendon organ

Stretch

Muscle spindle

Mechanoreceptors tension

Golgi tendon organ

Determinants of stretching interventions

Alignment and stabilization, Intensity of stretch, Duration of stretch, Speed of stretch, Frequency of stretch, Mode of stretch

Positioning a limb or the body such that the stretch force is directed to the appropriate muscle group

Alignment

Fixation of a bony segment that has an attachment of the muscle to be stretched

Stabilization

Magnitude of the stretch force applied

Intensity of stretch

Length of time the stretch force is applied during a stretch cycle

Duration of stretch

Rate of initial application of the stretch force

Speed of stretch

Number of stretching sessions per day or week

Frequency of stretch

Form or manner in which the stretch force is applied, degree of patient participation or the source of the stretch force

Mode of stretch

Stretching should be applied at a low intensity by means of low load

True

Maximize muscle activation during stretching and reduce the risk of injury to tissues and post stretch muscle soreness

False

2-5 sessions per week with time in between sessions for tissue healing and maximize DOMS

False

Soft tissues are elongated just beyond the point of tissue resistance and then held in the lengthened position with a sustained stretch force over a period of time

Static stretching

Effective method to increase flexibility and ROM

Static stretching

Relatively short-duration stretch force that is repeatedly but gradually applied, released, and then reapplied multiple times during a single treatment session

Intermittent or cylic stretching

A rapid, forceful intermittent stretch— that is, a high velocity and high intensity stretch

Ballistic stretching

Not recommended for elderly or sedentary individuals or patients with musculoskeletal pathology or chronic contractures

Ballistic stretching

Integrate active muscle contractions into stretching

PNF stretching

Apply a very low intensity stretch force over a prolonged period of tume to create relatively permanent lengthening of soft tissues, presumably due to plastic deformation

Mechanicsl stretching

Type of stretching procedure done independently by the patient after careful instruction and supervised practice

Self stretching

Enables the patient to maintain or increase the extensibility gained as the result of direct intervention by a therapist

Self stretching

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