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by: Mrs. Dixie Romaguera


Mrs. Dixie Romaguera

GPA 3.51

Loi Boulgarides

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About this Document

Loi Boulgarides
Class Notes
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This 37 page Class Notes was uploaded by Mrs. Dixie Romaguera on Monday October 5, 2015. The Class Notes belongs to KINS 157 at California State University - Sacramento taught by Loi Boulgarides in Fall. Since its upload, it has received 18 views. For similar materials see /class/218798/kins-157-california-state-university-sacramento in Kinesiology at California State University - Sacramento.




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Date Created: 10/05/15
KINS 157 Next 4 Weeks TREATMENTS TO IMPROVE FLEXIBILITY MOBILIZATION Treatment Goals ROM Stretch 0 Typical goals are to increase or maintain ROM stretch scar adhesion 0 Discuss What situations diagnoses focus on ROM Stretch for Strength Hypertonicityspasticity Decrease pain and or increase relaxation Improve circulation or joint lubrication CONTRAINDICATIONS PRECAUTIONS Bony block Acute infection 0 Beyond normal ROM of a joint 0 Prolonged immobilization 0 Severe tissue damage 0 Acute in ammation 0 Acute pain 0 Osteoporosis O Prolonged increased pain or soreness after treatment ugtmmltm EgtZ m OH ltOOZ ltgtZCgt ltmOIgtZOgt mmEn m me On ltOOZ Mechanical Passive ROM Passive ROM Self Passive ROM Manual Passive ROM Manual vs self passive ROM What are the advantages of manual vs self passive ROM Think of 34 situations that call for one or the other Manual vs Self Passive ROM Manual Passive ROM Self Passive ROM Control of vigor EffiCient Control of position Can be done Relaxation frequently at home Jointfracture Fosters independence protection Needs to be monitored ACTIVE RANGE OF MOTION Increases strength of weak muscles grade 3 or less Improve strength amp integrity of compromised tissues Maintains ROM gained by passive ROM Fosters normal patterns of coordinated movement ACTIVE ASSISTIVE ROM Increase ROM Increase Strength Gentle strengthening and stretching of injured compromised tissues STRETCHING ROM done at EROM Increase tissue lengthflexibility SELF STRETCH MANUAL STRETCH ACTIVE OR PASSIVE MUSCLE LENGTHENING Actin and Myosin slide into lengthened position 1 MUSCLE LENGTHENING Slack is taken out of the actinmyosin units Stretch occurs neXt in the noncontracile collagenous connective tissues in and around the myofibrils 1 Epimycium 2 Perimycium 3 Tendon 4 Fascia MUSCLE LENGTHENING O Prolonged stretch Causes production of more sarcomeres muscle cells to be added to the LENGTH of a muscle 0 Casting and splinting prolonged lengthening of muscles over days might result in increased cell production NonContractile Tissue Elastic Phase Wavy Collagen Fibers Straighten out WV 1 Wm NonContractile Tissue Elastic to Plastic Phase COLLAGEN FIBRIL BONDS BREAK AND REMODEL SITUETIHJ Y FORCE bond STRETCH break FORCE bond reibnns NonContractile Tissue Plastic Phase 0 FIBRILS AND FIBERS BREAK dc STRETCH FORCE jg STRETCH FORCE NONCONTRACTILE TISSUE PHASES OF STRETCH O Collagen Fibers Straighten out 0 Elastic Phase Tissue returns to original length 1 No Bonds Break 2 Heat is Released 3 Recovery is complete 0 Plastic Phase Tissue remains longer than prior to stretch 1 Bonds between fibers break and reform 2 Individual collagen fibers rupture 3 No complete recovery Deformation remains 0 Tissue failure FIND 3 PHASES ON YOUR PARTNER PHASE 1 You only straighten the wavy collagen fibers PHASE 2 elastic You will cause the bonds between the fibrils to be broken and reformed PHASE 3 plastic You will cause the bonds between collagen fibers to be broken and re formed You may cause collagen fibers to be broken AVOID PHASE 4 TISSUE FAILURE Discuss How can you perform ROMStretches to maximize lasting tissue changes What have you seen done in the clinictraining room to optimize flexibility Do you know the difference between prolonged stretch and static progressive stretch MAXIMIZE TISSUE CHANGES 1 2 1 2 INCREASE LOAD Stretch harder INCREASE TIME Stretch longed CYCLIC STRETCH Increase heat CPM Machine PROLONGED STRETCH Manual Mechanical STATIC PROGRESSIVE STRETCH WHAT TYPE OF ROMSTRETCH WOULD YOU RECOMMEND Prolonged or cyclic Active or passive Manual or mechanical Therapist or selfstretch 1 Acute inflamed ankle sprain 2Pain and Trigger point in the gastrocnemius 3Two days post elbow surgery 44 months post elbow surgery with elbow flexion contracture of 40 degrees of extension VIGOR How far39 in ro resistance The s rr39e rch is Taken Considerations 1 Tissue in regr39i ry S rage of healing 2 Inflammation presen r 3 Pain 4 Goal of Tr39ea rmen r Questionscommen rsexampIes Duration and Repetitions Share your personal stretch durationrepsfq What have you used or seen used for athletespatients Was there a difference in your practice and what you read in KC How should stretch duration change with age How should stretch duration change with adhesioncontractures DURATION and REPITITIONS HEALTHY OLDER ADULTS Comparing 15 30 and 60 sec s rre rch 60 sec s rre rch grea res r and longes rlas ring improvemen r HEALTHY YOUNG ADULTS 30 and 60 sec s rre rch more effec rive Than 15 sec Hams rrings 15 sec and 2 min s rre rch equal Adduc rors No benefi r pas r a 1 min hold 3 x 30 sec or 60 sec no more effec rive Than 1 x 30 or 60 sec If To ral dura rion equal cyclic and prolonged s rre rch are equally beneficial DURATION and REPITITIONS CHRONIC FIBROTIC CONTRACTURES Use of very prolonged s rre rch wi rh splin r cas r or s ra ric progressive s rre rch device may be necessary FREQUENCY HeaIThy AT easT 2 Times per39 week for39 gains in ROM SofT Tissue paThology More frequenle for39 gains in ROM 23 Time day may be necessary Based an individual39s r39esponse EXAMPLES MAINTENANCE Gains Ias r a week af rer39 s rr39e rching Main renance requires Use of new ROM in func rional ac rivi ries ANDOR a main renance s rr39e rch program DISCUSSION Wha r vigor of s rre rch would you use Tigh r hams rrings in normal ac rive individual no injury Ankle sprain wi rh swelling beginning The repair phase 2 mon rhs pos r knee surgery wi rh scarring S ruck a r 90 degrees flexion for 2 weeks RELATIONSHIP BETWEEN PAIN AND RESISTANCE Pain dominan r Pain limi rs mo rion Immedia rely af rer knee surgery Resis rance dominan r S riff wi rh pain a r The end S riff ankle af rer cas ring Pain and resis rance are closely rela red Shoulder capsuli ris Resis rance dominan r Tigh r Hams rring in normal persona rhle re What vigor repetitions duration should be used PROPRIOCEPTIVE NEUROMUSCULAR FACILTATION DEMONSTRATION IOEUEELPX gtZU Im O mZUOZ OWQgtZ ImO lt A 4 4 4 32002 chnrm gtgto01 ZNC10 4 4 4 HOLD RELAX CONTRACT RELAX AGONIST CONTRACT


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