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Why must you protract the scapula before doing upper extremity ROM?
in order to get full ROM
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What is the normal humeral-scapular rhythm?
2o humeral 1o scapular rhythm
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If the humerus moves through an ARC of 90o, how many degrees must the scapula move?
30o scapula, 60o humerus
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Identify two upper extremity movements which are not under voluntary control.
- Inferior glide of the glenohumeral joint
- MC glide
- AC/SC joint movement
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Identify two lower extremity movements which are not under voluntary control
- Screw home at knee joint
- MT glide
- Patella movements
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During knee flexion the patella glides...
inferior
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During knee extension the patella glides...
superior
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If the patient has stricted hip abduction, substitution will be by...
- Trunk lateral flexion on the same side
- Hip hiking on the same side
- Hip lateral rotation
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Decreased range in hip extension is substituted for by...
- Trunk extension (lumbar)
- Anterior pelvic tilt
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Decreased forearm spination is substituted for by...
Lateral rotation of glenohumeral joint
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The person with restricted glenohumeral range in abduction will substitute by...
- Trunk lateral flexion away
- Scapular elevation
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The person with restricted glenohumeral range in flexion will substitute by...
- Trunk extension
- Scapular elevation
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A decrease in trunk flexion is substituted for by...
- Hip flexion/ anterior pelvic tilt
- Scapular protraction
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Positional stretch
the body part is positioned in such a way as to stretch a paticular muscle or muscle group. Gravity is often used to assist in the stretch
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Stretch with weights
a weight is used to increase the effects of gravity on the muscle stretch - hold for 8 seconds
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Manual stretch
a partner is used to assist the subject by applying an outside manual force to the body part being stretched - hold 30 seconds
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Contract or Hold-relax
a PNF technique where the shortened muscle is taken to its maximal length, the subject maximally isometrically contracts the shortened muscle, the subject then relaxes the muscle and attempts to move the joint into a new range
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What must occur in order to stretch a muscle?
about 30 seconds, maybe more for older adults
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Why is stretching important?
- Normal biomechanics length/tension curve
- ADLs ROM
- Can decrease performance (i.e. jumping)
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When is stretching important?
After exercise, stretch warm muscles
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What are stretching guidelines including intensity, duration, and frequency?
- Stretch to discomfort
- About 30 seconds (duration)
- Depends on pathology - normally, PROM 3-4 times per day (frequency)
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Why is the position of the weight or the partner's hand in manual resistance important?
Lever arm
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When doing stretching with weights, how do you determine the correct amount of weight to use?
Stretch to discomfort
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When performing manual muscle stretching exercises you should...
- Move slowly
- Stabilize
- Go to patient of discomfort
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How do you know when to stop stretching?
- Patient reaction
- Substitutions
- No more increase ROM
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What is the significance of a major decrease in range at the next treatment session?
Have they done their exercise - not doing them, doing it too much, & doing them wrong
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How do you maintain the newly gained range of motion?
- Home stretching program
- stretch muscles in new range (can only pick one - antigonist) - agonist and antigonist
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Normal range - shoulder abduction
180o
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Normal range - wrist radial deviation
20o
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Normal range - wrist ulnar deviation
30o
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Normal range - hip IR
45o
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Normal range - hip ER
45o
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Normal range - ankle inversion
15o
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Normal range - ankle eversion
5o
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Normal range - hip abduction
45o
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Normal range - hip extension
30o
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Shoulder flexion innervation
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Scapular protraction innveration
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Forearm pronation innervation
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Thumb opposition innervation
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Hip abduction innervation
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Hip extension innervation
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Ankle dorsiflexion innervation
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