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Contents
Movement
Joint stability – The ability of a person to control and maintain the joint position or movement
Joint mobility – This is the amount (range) of uninhibited movement around a body segment or joint
Arthrokinematics – This is motor output and sensory input based on physiological and neurological systems. It also includes joint mechanics.
The length/tension relationship
- Actin and myosin as contractile proteins
The force/couple relationship
- The prime movers
Neural control
- Reciprocal inhibition: This is the reflex inhibition of antagonistic motor neurons during the time that agonist muscles are contracting.
- Synergistic dominance: This happens when synergistic muscles carry out the primary movements/functions of an inhibited/weakened prime mover
The first phase: Stability and mobility training
The first phase is meant to restore good levels of mobility and stability within the client’s body
Slow twitch muscle fibers: Improve the muscular endurance of stabilizer muscles
- Allows joint stabilization for prolonged periods of time with minimal fatigue
Stretching
- Static stretching, self-myofascial release (SMR), PNF, dynamic and ballistic stretching
Proximal stability (core activation)
- Help to promote lumbar spine stability by bettering the core musculature reflex function
- The innermost layer of core
- The vertebral discs/bones and ligaments of the spine on both the back and front of the spinal column
The three stages
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- Core function
- Static balance
- Dynamic balance
The proximal stability (core function)
- The supine draw in exercise (centering)
- The quadrupled draw in exercise with added movement of the extremities
Proximal mobility (thoracic spine and hips)
Helps to improve the mobility of both the joints that are adjacent to the lumbar spine
Helps in avoiding compensated or undesirable movement patterns
Monoarticulate: When muscle crosses one joint
Biarticulated: When a muscle crosses to joints
Different exercises:
Pelvic Tilts
- Modified dead bug + reverse knee marches, supine bent knee marches
Cat/camel
Mobility for hip flexors
- The half kneeling triplanar stretch
- hip flexor stretch (lying)
Hamstring mobility exercises
- Lying hamstring stretch
Hip mobilization + glute activation
- Glue to bridge/shoulder bridge
- Supine 90/90 hip rotator stretch
T-spine (thoracic) mobilization exercises
- Spinal twists and spinal extension
Posterior mobilization
- Rocking quadriceps
Proximal stability (around the shoulder)
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For bettering the stability in the scapulothoracic area during pushing and pulling type movements
Glenohumeral joint mobility
Requirements for improving stability in the scapulothoracic area
- Thoracic mobility
- Extensibility of tissue by passive and active structures
- Self-myofascial release, posterior capsule stretches, inferior capsule stretch, superior capsule stretch and anterior capsule stretch (for pecs).
- Healthy muscle functions of the rotator cuffs
- Good muscle balance in the parascapular muscles
- The ability to resist an upward gliding motion and impingement of the coracoacromial arch during shoulder movements
CKC (closed chain kinetic) movements
- The distal segment stays more fixed while moving
- Compress and load joints
- Increased proprioception and kinesthetic awareness
- Exercises:
- External and internal humeral rotation, shoulder packing, reverse flies with 90/90, diagonals, CKC weight shifts, prone arm lifts
Distal mobility
Static balance
The variables of training:
- 2 to 3 sessions per week
- Perform at the beginning of the routine
- One set of between two and four repetitions. Each for between five and 10 seconds
Training conditions:
- Narrow BOS
- Raise COG
- Shift LOG
- Sensory alteration
- Sensory removal
Dynamic balance
When one’s body needs to react to a changing surface
Standing patterns on one leg
Imbalance identification
Exercises
- Single leg static balance
- Single leg stands
The second phase: Movement training for ADL’s
Valgus – This is an internal rotation between the tibia and femur where the knees move inward
Bend and lift
The hip hinge
The alignment of the lower extremity
Figure 4 position
Single Leg
Half kneeling lunge rise
The lunge matrix and lunges
Pushing
Unilateral and bilateral pressing
Thoracic matrix
The overhead press
Pulling
Unilateral and bilateral rowing
Rotational exercises
Hay bailers
Wood shops
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Can i crack ace cpt exam by reading your guide?????…….bcoz i can’t understand the language in books
Hey Patel,
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