Professional Documents
Culture Documents
flexion.
3) Patient is instructed to extend th elbow with as much effort as
possible, perhaps several pounds.
4) The operator provides a yielding counterforce that allows the elbow
to lowly but steadily extend throughout its maximal range.
5) Operator returns elbow to full flexion and the patient repeats the
contraction of the triceps to extend the elbow, but this time the
operator provides increasing resistance to elbow extension.
6) Several repetitive efforts are accomplished with the operator
providing increasing resistance each time and with the patient
endeavoring to take the elbow through full extension with each effort.
7) Approximately three or five repetitions are usually necessary to
achieve full elbow extension.
In any of these muscle energy procedures, it is important to accurately
assess the resistant barrier. With an isometric technique, the first
barrier sensed must be the point where the careful joint position is
held by the operator. If the operator "crashes into" the muscle
resistant barrier in positioning the joint, an increase in the muscle hyp
ertonicity will result, just the opposite of the desired therapeutic effort.
Second, when using these procedures in a joint with multiple planes of
movement available, each motion barrier must be engaged in the
same fashion. In the vertebral column with motion restriction around
and along three different axes, precision in the engagement of the
restrictive barrier is essential for therapeutic effectiveness.