Rehabilitation Anatomy: Training of the Abdominal Muscle Group and Kinetic Chain Exercises - Assignment Example

REHABILITATION ANATOMY …………………………………………………………. NAME …………………………………………………………… INSTITUITION ………………………………………………………… LECTURER …………………………….. DATE …………………………………. REHABILITATION ANATOMY Qn.1. Explain the role of the central nervous system in the control of the movement and posture? The cerebellum part of the brain receives input signals through a system of nervous sensory receptors about a certain movement and posture it interprets it and in turn issues message to the target muscle or muscle group via extrapyramidal and the pyramidal systems about the immediate need and it responds accordingly either to movement, posture or balancing (Highten ,2004) Qn.2. Describe the Structure and training of the abdominal muscle group and the functional importance of the core stability? The abdominal muscle group consists of Transversus Abdominis (TA) Internal Oblique (IO), Multifidus (MF), deep trunk muscles, pelvis floor, and Para-spinal which actively support lumbar spine. The procedure of intensifying the deep trunk which is a “stabilisers” producing static contractions its function has to be clearly analyzed and should be specified to task needed for. Hence, the specific training has to ensure that the kind of contraction, needed the type of the muscle and the required anatomical position is met. These muscles need to be well coordinated, work continuously, and maintain the neutral position of the lumbar spine. This neutral position of the spine forms the ‘S’ curve naturally needed following well aligned pelvis. Therefore abdominal muscle training is the process of muscle stability and fitness along the torso following a specified form of exercises such as the crunches, sit-ups with aim of muscle building and enlargement low back health improvement ,and lowering the overall abdominal fat. The core stability ensures that the muscles of the deep trunk are working together and correctly controlling the lumbar spine incase of any dynamic movement.) (Miller, 2007). Qn.3. Describe the different between open and closed kinetic chain exercises and give examples of them and the uses of each? Open kinetic exercises (OKC) lead to shearing forces as they do concentrate on one muscle in this case the foot or the hand can move freely, the (OCK) exercise do not bear weight as in the case of (CKC) weight is applied in the limbs distal portion and movement is only realized in the knee or the elbow joint. Closed kinetic chains these are physical exercise are performed with the foot or the hand fixed on the surface used for squatting and jumping. CKC uses more than one joint and muscles and hence promotes compressive forces. The weight involved can be either external weight or body weight. Open exercise are considered unsafe and less functional as compared to (CKC). Examples of (OKC) leg press and bench press and (CKC) push ups, lunges, squats, deadlifts both the OKC and CKC serve the same purpose of rehabilitation and strengthening (Miller ,2007). Qn. 4. How exercises such as sit-ups may contribute to neck and back pain? Sit ups leads to back pains and neck pains. This usually happens following weak abdominal muscles, poor balancing and instability during the sit up exercises. They do put high amount of stress in the weaker area of the lower back (Miller 2007) Qn.5. Explain the stretch shortening cycle and describe how this is utilized in movement patterns 5-9 Stretch shortening cycle (SSC) is carried out by three muscle type action. It starts with an eccentric action then isometric static action follows this leads to storage of potential energy while a concentric action of the same group of muscles leads to kinetic energy storage. This kind of muscle wave communication; following their elasticity exerts a great power leading to movement. Such cycle is usually used in sports like bob-down movement a kind of movement performed before jumping, before a throw, a wind –up movement is done. (Miller 2007) Qn.6. Explain the desired changes in neuromuscular system during stretch shortening cycle During SSC the stiffness changes in the leg spring is determined first in the joint then the behavior of the triceps muscle is noted. Movement like hoping is achieved by movement in the mult-joint of submaximal. This amplitude movement is shown to positively affect work. The modification of amplitude can be done with knee flexion which there after affects the stretching magnitude in both the triceps and quadriceps femoris muscles. The changes in functioning of this muscles following neuromuscular behavior is also noted. The electromyography (EMG) rate is usually higher before the activity while meantime energy gained during potential period is of importance to resist the impacts of forces to the muscles during the eccentric phase. The neuromuscular coordination limits the speed of the muscle movement. (Miller 2007) 7. Describe the safety guidelines and training progressions using the stretch shortening cycle During the SSC some safety measures have to be deployed to the motor units and muscle fibers, fiber recruitment increases with exercise, muscle adaptation continues to improve with more SSC, kinesiology of strength training the exercises leads to bone hardening and strengthening, resistance training principles, training duration starts at a low phase per week ands increases with time and frequency and progression resistance overload training. The general physiological formula used in training is: muscle hypertrophy plus neuromuscular equals to muscular strength. (Miller 2007) Qn.8. Describe the safe number of foot contacts in a training session for a beginner, intermediate and experienced athlete In plyometric training 90-140 foot contact are termed as the safest for any trainee. Qn.9. Name poor or contraindicated exercise movements and the possible damage they may cause anatomical structures in the body. E.G. pec deck leg extensions sit ups. Sit ups leads to lower back pains following spine curving ore people with weak low backs and neck pains yet they are termed as the best for tummy trimming. Powerlifting as kind of a sport doesn’t mean the most energetic person is always declared a winner but how any one displays the skills of strength and power but is an accurate measure of power and strength. (Miller, 2007). Qn.10. Describe the shoulder joint mechanics-force couples and functions The shoulder comprises of the scapula, clavicle and humerus this enables it to obtain stability and mobility which is enhanced by the intricate muscle force in the arm. As compared to other shoulder bone the clavicle bone moves the least. Its functions are to provide stability. This function is promoted by its ability to resist compressions and acts as a path of transmitting stress. The scapula which is irregular in shape increases the hand space area this is done by varying the proximal positions of the humerus and also provides stability during hand activities. Humerus being a long bone is used to provide strength for the upper extremity and a greater area for hand replacement. This bone alignment coupled with a great muscle attachment provides rotation and hand movement along the shoulder region. (Weltman, 2008) Qn.11. Name the rotator cuff muscles and scapula stabilizers The scapula stabilizers are lats; mid/ lower traps rhomboids while the rotator cuff muscles include the infraspinatus, minor teres, and the subscapularis. (Weltman, 2008) 12. Describe the strengthening of the rotator cuff muscles and scapula stabilizers A 12 -25 rep range is kept so that local muscles development is achieved with little or no strain and growth stimulation. Eccentric portion low tempo is encouraged and full contraction tempo at 1-2 seconds. Exercise like stability, ball cobras, band row, elevated and external rotators, scapular isometric, rotator cuff excises, lat stretch chest stretch and empty band are employed.(Weltman , 2008) Qn.13. Explain the use of sports equipment such as the bicycle-ergo meter, treadmill, mini-treadmill, and ski (pro) fitter in a rehabilitation setting. Bicycle ergo meter are designed and used in controlling the speed, resistance, effort amount and hence for physiological testing. Treadmills give an opportunity for the client either to run or walk at a certain pace while still a central position is maintained and are used for training and testing. Ski (pro) fitters are mostly used for aerobic exercises training since they are designed to give low impact. (Trees, 2005) Qn.14. What is the mid-tendon Achilles Tendinopathy? 14 15 Mid –tendon Achilles’ tendinopharthy is a syndrome clinical in nature that is often associated with tendon inflammation, pain and results into altered functioning and performance of the tendons. (Trees, 2005) Qn.15. Describe the activities that would be suitable to include into different stages of rehabilitation program for someone who suffering mid-tendon Achilles tendinopathy, calf muscle and hamstring strain. Rehabilitation exercise to cuff: muscles includes gentle stretching, light strengthening on the set rather than the reps .Achilles rehabilitation involves stretching and strengthening of the tendons either inwardly or outwardly, picking up light object like a small stone with the toes. In hamstring strain eccentric strength and neuromuscular training control exercises are incorporated like balancing and weight bearing exercises. Second step will be to regain flexibility and, strength increase demanding exercises are incorporated with recovery, improvement in function and pain disappearance finally on recovery with which period differs on the severity the subject can return to his full day calendar activities (Trees, 2005) Qn.16. Explain the criteria that have to be met before a person can return to sport following rehabilitation of a meniscal injury. Be able to warm the ankle by riding a stationery bicycle, rise the with ease while lying on the stomach, rotate the knees up to 90 degrees while diving in chest deep waters without complaining pain, be able to handle risk position, stand on one leg with good balance, do the 3-D lunge and matrix hope. (Trees, 2005) Qn.17. Describe the suitable exercises following an anterior crucial ligament ACL knee reconstruction at 5-8, 8-12, and 16 weeks. At 5-8 weeks the ACL knee reconstruction- exercise such as motion of 0 -130 degrees range ,hamstring open and closed chains beginning weight at 40% , proggramme of gym like stationary bike ,weights treadmill , and swimming .Strength training and proximal stability , use of wall slides lunges , squats as weight bearing in active closed chain exercises At 8-12 weeks of post operative exercises training on the agility and strength continues in the gym, lunges and squats , treadmill jogging down slopes and on flat surface progresses to running levels , eccentric and concentric hamstring open chain exercises ,to 60%of the weight of the body. Using gym machines for resistance and balancing upper body training. 16 weeks patients is examined and its progress isokinetic test is done as from low speed of 30 degrees to a higher speed of 120 degrees this level isokinetic programme addresses residual deficit, sports specified drills are carried out, interval training, advanced plyometric drills, agility and running, Pilates strengthening exercises and core stability on all equipment is done to increase endurance (Trees, 2005) Qn.18. Describe the exercises that would be suitable to use for training spinal stability in the early stages of a discogenic back injury. .Practice Out of bed stress free exercises and strain less are advised, taking a slow walk, soft standing, and sitting for short session .resting, avoid bending exercises or flexing and sleep on a flat firm bed or mattress(Trees ,2005) 19. Describe the Resistance Training for children and older adults with a focus on developing and implementing safe and effective training outcomes. Resistance training can be defined as a physical form of specialized conditioning that enhances the ability of the athletes to either resist force or exert force and its effect is felt on the musculoskeletal strength development this resistance training according to National Strength and conditioning association (NSCA) of America illustrates that a well defined resistance training should foster children and the elderly safety ,increase their strength ,improve their performance ,their health and their physiological well being and prevent injuries , NSCA guidelines for effective and safe resistance training programmes (RTP) states that RTP must be based on principles which are scientifically accepted for training ,should be periodical within the year calendar ,all client should receive sporting procedures ,training ,and the exercise techniques , a qualified coach should supervise the training ,as strength increases increase the resistance a and perform or use the right technique to perform all the excise(Trees ,2005) Qn 20. Describe the steps involved in the pyramid of performance and the benefit of using this system when training others. Consist of three levels Level 1the foundation .in this level the coaches evaluates the stability of the subject and his mobility Level 2performance level involves movement efficiency evaluation is carried on gross athleticism (power) Level 3participation the skills gained are evaluated with specific attention to competition statistics. This pyramid helps the coaches to understand the capability of its trainees and the level of full recruitments to sports. (Trees, 2005) Qn.21. Define the terms pronation and supination of the subtalar joint, varus and valgus and the effects of over-pronation on lower limb function. Pronation is the movement of the foot that is allowed by the substalar joint away from the body this may lead to bow legged or valgus is in excess and the supination is the movement towards the center of the body and this may lead to varus or knock –knees If in excess. Over pronation is the abnormal pronation. (Trees, 2005) Qn22. Describe the proprioceptive training Proprioceptive training (PT) is used by soccer coaches to lower the rates of ACL injuries. The PT can either be used with or without equipment. Incase of equipment only of simple make used like fitness bands, wobble boards, and balance pads. These exercises can as well be used to fasten return of athlete to sports after injury they too foster a positive neurological and physical changes. (Trees, 2005) Qn23. Define the term proprioception and the benefits and training progressions/use of equipment in proprioceptive training. Proprioception is the third sense different from the others. It provides information only about the internal status of the body in terms of body movement effort whether is adequate, and information about the location of body parts as related to the rest. . (Trees, 2005) Qn24. Define the possible causes of patellofemoral pain syndrome (PFPS). PFPS is the commonest of knee pain which may be dull mostly felt when standing down stairs walking etc. in both under and around the kneecap mostly caused by overuse of the knee like in hikers, cyclist, runners and knee under use like the office sitter workers., . (Trees, 2005) Qn25. Describe the safe and effective quadriceps strengthening with a person with pattellofemoral PE. Backward running / walking ,lateral steps downs /ups ,high seat and low resistance bicycle cycling ,backward stair climbing, 0 -30 degrees squats and leg presses this exercises allows for flexibility and strengthening of the hip and foot muscles. (Trees, 2005) Section B Qn1. Explain the Hip Clearance technique. It is the process of pelvis realignment in the area of distortion of sacroiliac joint by a misalignment. This process encompasses working first on the less painful leg by checking and increasing the movement if possible. This movement includes prone extension and abduction, side abduction and adduction, adduction, abduction extension, hip flexion, internal and external rotations and Adduction. Other assessments are also carried out which are forward bending and high ileum while seated, high ileum and forward bending while standing, Anterior Superior Iliac Spine (ASIS) versus Posterior Superior Iliac Spine (PSIS) height difference is checked and therapist gets the information required towards the client sacroiliac joint and pelvis alignment treatment.. (Braman et al.2009). Qn2. The hip flexion, medial rotation, lateral rotation, abduction, and adduction The hip flexion takes place when there are is a decrease in the angle between the thigh and the torso as the knee is brought towards the chest. Hip’s Medial rotation is the opposite of the lateral rotation the femur‘s anterior surface rotating on its axis moves inwardly towards the body. Lateral rotation is the movement of the hip caused by the femur when it moves outwardly or away from the body in its anterior surface. As femur moves outwards and sideways (thighs apart) then results to abduction hip movement of the femur to midline position or crossing the other leg is termed as the hip adduction (Miller 2007) see appendix (I) 3. Popliteal angle /hamstrings The popliteal angle is used in identification of children with cerebral palsy following hamstring length muscle assessment this muscle is more prone to injuries in sporting activities and there fore popliteal angle is used to assess its flexibility and maturation the more flexible it is the less prone it is to injuries. With the hip flexed at 90degrees and extending the knee tightly popliteal angle is taken that is formed by tibia being in a parallel line to femur from the foot. The decrease in hamstring flexibility is said to be a risk of developing hamstring injury or strain, patellofemoral and tendinoparthy. (Trees, 2005) appendix (ii) Qn4. Adduction with mild extension/.TFL and ITB Gluteus Medius, Gluteus Maximus and Tensor Fascia Lata (TFL) forms the fiber band origin of the Illotibial Band (ITB).Gluteus Maximus contributes to 80% of the ITB if in any case is not well functioning the abductor work load is left to ITB tendinous and TFL originating from the hip therefore the ITB and TFL portion becomes strained ITB stabilizes the pelvis and, hip flexion and abduction. Adduction muscles controls the leg midline position like when walking, running. Weakening of these muscles of TFL, gluteus medius which works together with ITB overloads the ITB then leads to dysfunction and pain. (Miller 2007) appendix (iii) Qn5. Hip extension with bent leg /rectus femoris Sartorius and rectus femoris originate from the pelvis and are involved in hip flexion and knee extension. With bent leg the rectus femoris produces a strong reflexer and is sufficient to its movement activity. (Miller 2007)See appendix (IV) Qn6. Hip extension with straight leg / iliopsoas Hip joint flexion is carried by Iliopsoas muscle group like when one is doing sit ups in a supine position its flexion flexes the femur’s trunk. (Miller 2007)See appendix (v) Qn7. Describe the spring test for upper trapezius, pectoralis major, external rotators, internal rotator, Latissimus Dorsi The LSST (lateral scapular slide test) is used in determining the position of the scapular with the abducted arm this is done at bilateral scapular distances of 0, 45 and 90 degrees The scapula can move in a three dimension if no any abnormality with ease during shoulder elevation. During this process the scapula rotates externally, upwards and can tilt posteriorly. Incase of imp-pigmentation problem there is decreased posterior tilt and upward rotation. Clients showing glen humeral shoulder instability; a decreased upward with increased internal rotations’ of the scapular is demonstrated .a slight internal rotation increase in the scapular flexion and plane abduction in the arm elevation in early rage it could be normal (Weltman, 2008) (see appendix vi) Qn8. Describe the assessment for scapula and shoulder Strength testing is used to measure the trapezius. The subject is requested to shrug the shoulder without or with resistance. To measure pectoralis major let the subject lie in a hook position; abduct the shoulder to 135 degrees in external rotated position. If the subject arch’s the low back the arm should be adducted and measure the angle of the shoulder. Use the same test for the clavular part with the arm abducted to 90 degrees. Latissimus dorsi let the subject lie in a hook position and raise both arms; with the back maintained in a flat plane like a table the arms should be raised to a position of full flexion. Bring the arm back to a point where the subject doesn’t raise his lower back such that it remains s flat and then, use the goniometer to measure the shoulder angle. External and internal rotators the subject should lie in a supine position, arms abducted at 90 degrees, and elbow flexed at 90 degrees, the goniometer’s stationary arm is aligned to the forearm which lies on the table perpendicular to it in this case parallel to it. The goniometers moveable arm is moved together with the forearm and uses the ulna’s styloid process as reference. Make sure no compensation done by the girdle of the shoulder during movement external rotation normal range is 90 degrees and internal rotation 70 degrees (Weltman, 2008) (see appendix vi) 1. References 2. Heighten S.M, Fay R.R, Popper eds. 2004. The vestibular system. Berlin: Springer ISBN 0-387-98314-7 3. Miller J. P.and Croce 2007.”Analysis of Isokinetic and Closed Chain Movement for Hamstring” Reciprocal Coactivation journal of sport rehabilitation, (16):319-325. 4. Trees A .H .Howe T.E, and Dixon J 2005 Exercise for treating isolated anterior cruciate ligament injuries in adults .Cochrane Database of systemic Reviews: issue 4.Art.No.cd005316 DOI: 101002/1461858.CD005316pub2. 5. Ludewig P.M and Reynolds J.F 2009. The association of scapular kinematics and glenohumeral joint pathologies Sports Phys ther. 39:90-104 6. Weltman A, Gaersser G.A, Prokopy M.P et al 2008. Closed Kinetic Chain upper body training improves throwing performance of NCAA Division soft ball players Strength Cond Res Nov; 22(6); 1790-8 Appendix (I) Posterior view of several hip muscles Anterior view of several hip muscles Posterior view of Gluteus maximus and Gluteus medius Appendix(ii) Measurement of the hamstring-popliteal angle for the assessment of hamstring tightness. Appendix(iii) Appendix (iv) Rectus Femoris Muscle Appendix (v) Appendix(vi) Read More