Question 1

Multiple potential benefits and outcomes are speculated to result from stretching programs.Which of the following is strongly supported by evidence and research?

Accepted Answer

Improved flexibility and increased ROM by restoring extensibility of the muscle-tendon unit with specific stretching techniques is strongly supported by evidence and research. The benefits of stretching in reducing soft tissue injury risk or reducing muscle soreness are less conclusive, and pre-event stretching may actually impair physical performance.

Question 2

Which of the following is an incorrect statement about hypomobility?

Accepted Answer

Hypomobility is usually associated with joint stability rather than instability. It is a decreased range of motion, and may be caused by muscle imbalance, weakness, tissue trauma or may occur without tissue trauma. It may also be associated with loss of passive or dynamic flexibility.

Question 3

During a stretching maneuver, you apply a 30-second stretch of a shortened muscle group just up to the point of tissue resistance.After this maneuver, rather than relaxing with the patient and returning the body segment to a neutral position, you move the body segment into the newly gained range to apply another stretch of the same muscle group and hold the stretch for an additional 30 seconds.What term best describes this type of stretching?

Accepted Answer

This type of stretching is known as static-progressive stretching, where the muscle group is stretched statically and then moved into the newly gained range for an additional stretch, progressively increasing the range of motion.

Question 4

Which of the following is a true statement about a muscle's response to stretch?

Accepted Answer

The connective tissue, such as the fascia and tendons, provide the main resistance to passive stretch of a muscle. The muscle spindle is a sensory receptor that detects changes in muscle length, but it does not protect the sarcomeres from stretch. Sarcomere give is a phenomenon that occurs over a longer period of slow, sustained stretch, not a quick stretch. The Golgi tendon organ is involved in inhibiting muscle contraction in response to tension, not facilitating it.

Question 5

In a patient's medical record you see "knee flexion contracture." What does it mean?

Accepted Answer

Knee flexion contracture refers to the inability to fully extend the knee, which means that full, passive knee extension is not possible. This can be due to a variety of reasons, such as soft tissue or joint capsule tightness.

Question 6

What is the safest and most effective way of stretching the multijoint flexor digitorum profundus?

Accepted Answer

This method ensures that the stretch is applied gradually and safely across all joints involved, minimizing the risk of injury while effectively stretching the flexor digitorum profundus.

Question 7

Each of the following is a true statement about self-stretching procedures except:

Accepted Answer

This statement is not true. Self-stretching can also be effective when the proximal segment is stabilized and the distal segment moves.

Question 8

You are teaching a client total-body relaxation techniques as part of a pain management program.Each of the following is an indicator of relaxation except:

Accepted Answer

Decreased skin temperature in the extremities is not an indicator of relaxation. Instead, relaxation techniques such as deep breathing, progressive muscle relaxation, and meditation typically lead to increased blood flow to the extremities, which might increase skin temperature rather than decrease it. Lowered heart and respiratory rates, a flat facial expression, and decreased muscle tension are all indicators of relaxation.

Question 9

Which of the following descriptions of stretching procedures performed for several repetitions during a single treatment session and repeated over a series of stretching sessions represents the safest and most comfortable process to achieve soft tissue lengthening?

Accepted Answer

Slowly applying a low-load force and maintaining the end-range position for an extended period of time is the safest and most comfortable way to achieve soft tissue lengthening. This approach allows the tissues to gradually adapt and elongate without causing excessive stress or injury. Rapid-velocity stretch forces (options A and D) may be too aggressive and can lead to tissue damage or pain. Applying a high-load force (option C) also carries a higher risk of injury and discomfort.

Question 10

The most effective means of stretching the latissimus dorsi in order to increase flexion of the shoulder is to:

Accepted Answer

Flexing the shoulder while stabilizing the pelvis helps to effectively stretch the latissimus dorsi, which is a shoulder extensor and internal rotator.

Question 11

To maintain gains in ROM achieved as the result of a stretching program, it is recommended to:

Accepted Answer

Using the stretch-induced gains in ROM during functional activities on a regular basis is the most effective way to maintain the flexibility gained through stretching. Continuing to stretch regularly will also help maintain flexibility, but performing daily resistance training of the stretched muscle or the muscle group opposite the stretched muscle is not necessary for maintaining gains in ROM. Applying heat on a daily basis may temporarily increase flexibility but will not contribute to maintaining gains in ROM in the long term.

Question 12

To achieve maximum elongation of the long head of the biceps brachii during passive stretching:

Accepted Answer

The long head of the biceps brachii is maximally stretched by extending the elbow, pronating the forearm, and extending the shoulder, as this position lengthens the muscle across both the shoulder and elbow joints.

Question 13

The goal of this exercise is to increase the flexibility (extensibility) of the pectoralis major muscle.You teach the patient to stand facing a corner with the shoulders abducted to 90°, elbows flexed to 90°, and hands and forearms placed on the walls.You tell the patient to relax into the stretch (by leaning into the corner) for 30 seconds; push his forearms into the walls for a count of six; then relax and lean forward toward the corner again and hold for 30 seconds.The self-stretching technique the patient is using is:

Accepted Answer

This technique is known as "hold-relax" or "contract-relax," which is a form of proprioceptive neuromuscular facilitation (PNF) stretching. It involves an isometric contraction of the muscle being stretched (in this case, the pectoralis major), followed by a relaxation phase where the muscle is stretched further.

Question 14

To increase terminal knee extension, you position the patient prone so the lower leg is not supported on the treatment table.The patient relaxes while the lower leg and foot "hang" off the end of the table.The therapist adds a cuff weight around the ankle.What type of stretching procedure is being applied?

Accepted Answer

The procedure described is a mechanical stretch as it uses a weight to provide a sustained force to increase range of motion. Ballistic stretches involve rapid, bouncing movements, while dynamic stretches involve controlled movements through a range of motion. Cyclic stretches alternate between stretching and relaxing the muscle.

Question 15

Which of the following terms best describes impaired extensibility of a muscle-tendon unit as the result of spasticity or rigidity from a lesion of the central nervous system?

Accepted Answer

Pseudomyostatic contracture is the term that best describes impaired extensibility of a muscle-tendon unit resulting from spasticity or rigidity due to a lesion of the central nervous system. This condition is characterized by a constant state of contraction that mimics muscle shortening, despite the absence of actual changes in the muscle's physical length.

Question 16

Each of the following is a contraindication to stretching adaptively shortened tissues except:

Accepted Answer

Scar tissue reducing soft tissue extensibility is a condition where stretching adaptively shortened tissues can be beneficial, as it helps in improving flexibility and range of motion. The other options (A, C, D) are contraindications to stretching because they involve conditions where stretching could cause harm or exacerbate the issue.

Question 17

Ballistic stretching:

Accepted Answer

Ballistic stretching involves quick, bouncing movements which can increase the risk of tissue trauma and muscle soreness due to the forceful nature of the stretches. It is generally not recommended for most populations because of the high risk of injury.

Question 18

Based on the neurophysiological properties of the contractile components of muscle, a high-intensity, quick stretch of a muscle-tendon unit is believed to create phasic elevation of tension in the stretched muscle by:

Accepted Answer

A quick stretch of a muscle-tendon unit stimulates the primary (Ia) afferents, which in turn stimulate the extrafusal fibers of the muscle. This leads to a phasic elevation of tension in the muscle. The activation of the muscle spindle via the Ib fibers and facilitation of GTO can also contribute to the tensile response, but the primary mechanism is the activation of the Ia afferents. Inhibiting the secondary (II) afferents would not lead to muscle activation, as these afferents do not directly stimulate the extrafusal fibers of the muscle.

Question 19

Which is the safest (for protection of the long arch of the foot) and most effective way to apply a long-duration self-stretch of the gastrocnemius-soleus muscle group?

Accepted Answer

The answer of Which is the safest (for protection of...

Question 20

Which of the following is categorized as an extrinsic factor contributing to limited ROM?

Accepted Answer

Cast immobilization after a fracture is considered an extrinsic factor because it is an external factor limiting the range of motion (ROM), unlike the other options which are intrinsic to the body's own tissues or conditions.

Quiz 4: Stretching for Improved Mobility