Mobility training

Mobility training

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  MOBILITY TRAINING - NITHINNAIR (MPT -1) UNDER GUIDANCE OF Dr. SHRUTI NAIR (PT)
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  LEARNING OBJECTIVES Define MobilityTraining Enumerate Pre-requisites for Mobility Training Enumerate Rationale & Contraindications for Mobility Training Recall step-wise protocol for Mobility Training Demonstrate / Practice Mobility Training on Models After this session, the students will be able to:
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  WHAT IS MOBILITYTRAINING ? Mobility is the ability of structures or segments of the body to move or be moved to allow the presence of ROM for functional activities. Mobility is defined as the ability of an individual to initiate, control, or sustain active movements of the body to perform simple to complex motor skills. Muscle energy techniques: A manual medicine treatment procedure that involves the voluntary contraction of muscles in a controlled direction, at varying levels of intensity, against a counterforce applied by the operator (Greenman 1996)
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  RATIONALE Whenever somatic dysfunctionis present and /or whenever there is need to • Normalize abnormal neuromuscular relationships. • Improve local circulation • Lengthen and / or normalize restricted / hypertonic muscle or fascia • Movement restricted due to muscle tightness • Muscle weakness • Myofascial restrictions, muscle imbalance
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  CONTRAINDICATIONS • Healing /Recent Fracture • Active infections • Severe sprain • Severe strain • Open wounds • Metabolic bone or other disease e.g. Osteoporosis
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  PRE-REQUISITE Assess ROM (Active/ Passive – end feel) Assess Tightness (grades- mild/moderate/severe)
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  HOW TO STARTMOBILITY TRAINING ? HOT PACKS/ COLD PACKS ACTIVE / PASSIVE MOVEMENTS MASSAGE / MYOFASCIAL RELEASE STRETCHING MUSCLE ENERGY TECHIQUES (PNF STRETCHING TECHNIQUES)
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  PROTOCOL FOR MUSCLEENERGY TECHNIQUES  Muscle / limb is moved until a barrier of resistance is reached.  Muscle contraction is performed and held for 5 - 10 secs  The muscle is then allowed to fully relax (this can also take a few secs)  Passive overpressure is then applied to stretch the muscle / limb until a new barrier of resistance is reached.  The entire cycle is repeated (3-5 reps)
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  PNF STRETCHING TECHNIQUES TECHNIQUEMUSCLE GROUP TARGETED MUSCLE WORK NEUROPHYSIOLOGICAL PRINCIPLES HOLD RELAX ANTAGONIST (Range Limiting Muscle) ISOMETRIC AUTOGENIC INHIBITION CONTRACT RELAX ANTAGONIST (Range Limiting Muscle) ISOTONIC (Concentric) AUTOGENIC INHIBITION AGONIST CONTRACTION AGONIST ISOTONIC (Concentric) RECIPROCAL INHIBITION
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  AUTOGENIC INHIBITION • GTO,located at the musculotendinous junction of Extrafusal fibers – senses (monitors) increased tension when the muscle contracts or stretches. • When the muscle contracts, the GTO is activated and responds by inhibiting this contraction (reflex inhibition) and thereby contracts the opposing (Antagonist) muscle group. Also known as Inverse stretch reflex (inverse myotatic reflex) AGONIST MUSCLE ANTAGONIST MUSCLE AUTOGENIC INHIBITION RELAXATION CONTRACTION
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  RECIPROCAL INHIBITION • Themuscle spindle is located within the muscle belly and stretches along with the muscle itself. • When this occurs, the muscle spindle is activated and causes reflexive contraction in agonist muscle (stretch reflex) and relaxation of antagonist muscle. AGONIST MUSCLE ANTAGONIST MUSCLE RECIPROCAL INHIBITION CONTRACTION RELAXATION
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  REFERENCES • Therapeutic exercise– Kisner (6th ed) • Muscle Energy Techniques – Leon Chaitow (3rd ed) • Textbook of Therapeutic Exercises – Lakshmi Narayan (1st ed) • Principles of Exercise in Physiotherapy – C Sivaram (1st ed)
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  PRACTICAL SESSION