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UI PEP 300 - Range of Motion/Flexibility

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Name Lab Section Range of Motion/FlexibilityPurpose: To develop a greater understanding of the nature of flexibility and how it is measured.Dress: Shorts, t-shirtEquipment: Goniometer, lab handout, textbook.Readings: Chapter 5, pp. 125-134; Chapter 6, pp. 160-161Objectives: At the completion of this laboratory, you should be able to:1. Define the following terms:range of motion (ROM) active stretchingflexibility passive stretchingactive ROM static stretchingpassive ROM dynamic (ballistic) stretchingactive insufficiency proprioceptive neuromuscular facilitation (PNF)passive insufficiency static ROMdynamic ROM2. Determine active and passive ROM by means of orthopedic goniometry.3. Identify an average ROM of the shoulder, elbow, hip, knee, and ankle in the sagittal plane.4. Identify several methods for assessing joint ROM.5. Identify which stretching technique is most effective in increasing ROM. Background Information:Range of motion (ROM) is a description of how much movement exists at a joint.Rotation is the typical movement at a joint. This is called “angular” movement. Because the movement is angular, the unit “degree” is used when measuring ROM rather than inches or millimeters. ROM can be measured as either active or passive.Active ROM is created by the person contracting the muscles around that joint. Passive ROM is created by an external force pushing on the body around the joint (e.g., a partner, an opponent, a piece of equipment). Passive ROM is always greater than active ROM. Joint ROM can be assessed through a variety of methods. In PEP 201, you performed several field tests that are used to measure flexibility at different joints. The advantage of these field tests is that they can be easily administered to large groups of people with little equipment and training. However, as you learned in PEP 201, there are also limitations to these tests. To overcome these limitations,clinicians and researchers have developed a number of somewhat more sophisticated devices to measure ROM which provide greater accuracy with little increase in the complexity of the equipment and training required. These devices include goniometers (electro-, protractor, pendulum), inclinometers, and hygrometers. The most accurate techniques for measuring ROM (particularly dynamic ROM) include measurements of joint angles from arthrographs, radiographic images, photographs, and video (see figure to the left). However, these techniques require expensive, complex equipment and extensive training. In this lab, you will learn to measure ROM using a protractor goniometer, which is simply a protractor designed for use on the human body (see figure below to the right). There are 3 typical methods used today for flexibility training: static, dynamic (ballistic), and proprioceptive neuromuscular facilitation (PNF) stretching. Because temperature affects the extensibility of the soft tissues around the joint, completing 5 minutes of warm-up (light aerobic exercise) is recommended before performing flexibility exercises. Static and dynamic stretching are both effective means of increasing flexibility, but generally static stretching is considered safer and results in less soreness of muscles. Dynamic stretching recruits the muscle spindle to reflexively cause contraction just after the fast stretch. Thismay result in small muscle tears in themuscle due to a fast/forceful transition thatmay not be timed perfectly. The slow orstatic stretch also recruits the musclespindle, but at a lower response intensityso that tearing is minimized or eliminated.Holding a stretched position for 10-30 s isusually effective. PNF may be the most effective method that results in the least amount of post-stretching soreness. There are several methods of engaging in PNF. Two of these include contract-relax (CR) and contract-relax antagonist contract (CRAC). Use of PNF terminology and definitions is confusing in the literature, and a full understanding of PNF theory is yet to be developed. However, it is currently believed that suppression of the stretch reflex and enhancement of the Golgi tendonreflex work to make this method effective. Thus, the PNF technique is designed to capitalize on the neurological mechanisms in the muscle and joint.Procedures to be completed prior to the lab session:1. Read this lab handout and the textbook readings listed on p. 1 of this lab. 2. On a separate sheet of paper, use your textbook and this lab handout to write the definitions of the terms listed under objective #1 on the previous page.3. Answer the following question: According to your text, what are the factors that determine jointROM?Procedures to be completed during the lab session:1. Jog 10 laps around the gym. Then, work in groups of 3 to measure the ROM for the hip flexion and hipextension as described below. Measurements should be made for each person in the group. You should measure only the right side of the body for the purposes of this lab. [NOTE: Bilateral measurements should be taken in an actual measurement situation, since ROM is specific to the joint being measured.]Each measurement should be made 3 times, and the average of the two closest measures should be calculated.You should record your measurements in the space provided in your lab, and then transfer your average ROM to Table 1 of your lab.Follow the specific instructions provided on the following pages. At the endpoint of the joint ROM being measured, the axis of the goniometer should be place on the joint axis. The stationary arm of the goniometer should be aligned with the proximal point of the proximal segment, and the movable arm ofthe goniometer should be aligned with the distal point of the distal segment. The start position is anatomical position, which is always 0° unless otherwise indicated, therefore, you should use the scale on the goniometer that reads 0° in the start position. Use the specific landmarks as indicated for each measurement. Active ROM should created by the subject with his/her own muscle contraction. For passive ROM, one group member should apply an external force to the distal segment of the subject while the other group member measures ROM. When applying this external force, be very careful not to cause any injury to the subject. Apply the force slowly – the subject should tell you when to stop. You should then hold


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