🔹Contract relax→Autogenic inhibition.

🔹Antagonist contraction→ Reciprocal inhibition.

🔹Hold relax contract→ Both

In MET :-

مع العضله اللي هي agonist ) weak) تفضل تعمل reciprocal inhibition علشان تنقل ال firing impulses للعضله دي بعد ما تاخد ال impulses دي بشكل أكبر من الانتاجونست لان ال spinal cord ما بيديش impulses لعضلتين بياخد من ال antagonist اللي عندها spasm ويدي للاجونست ال weak.

لكن مع العضله اللي هي عندها spasm أو over contracted بالنسبه للانتاجونست يفضل تعمل autogenic inhibitions.

يفضل مع ال spasm انك تستخدم ال MET و مع ال tightness تفضل تستخدم ال stretch اللي احنا عارفينه و يفضل تبدأ برده ال process دي بال MET قبل ما تعمل ال stretch لأنه ما بيبقاش painful.

In MET :-

Errors

Individual doesn’t relax completely after contraction.

Not waiting for refractory period following an isometric contraction before muscle can be stretched to a new resting length.

Not maintaining stretch position for appropriate
period of time.

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★ After sustained but light contraction, a momentary pause should occur.

★ Isotonic contractions requires forceful contraction.

This Antagonist inhibition is specially effective if muscle spasm is the cause of tightness.
علي أساس أن ال antagonist بيعتمد علي ال reciprocal inhibition.

ايو ما هو أنا بقول أن ال spinal cord هيبدا ياخد ال impulses من العضله دي و يوديها العضله ال week علشان هي اللي تنقبض.


ال MET و ال Stretch مش واحد و مختلفين تماما.

وده بيعتمد علي انك فاهم مين اللي حصلت tightness و restriction يعني عاده بتلاقي أن ال antagonist بتشير لل spasm or tightness و هي اللي عمله limit لل motion تمام

كمان متنساش أن مثلاً لو ال tightness في ال triceps ف ال restriction هيبقي في elbow flexion علي الرغم أن ال triceps بتعمل extension.

نقاط مجمعة من نظري الـ
Muscle energy technique (MET).

سهلت عليا جدًا فهم النقط دي فيه لأن أنا عارفة أنها بتلغبط إلى حد ما، فـ لعل وعسي تفيد حد فيكم وبالتوفيق ليكم جميعًا❤️.
#Therapeutic_2

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تدريب مستشفى السعودى الألماني فى القاهرة لطلاب صيدله و علاج طبيعى و بشرى

Training areas :
Pharmacy
- Lab -Quality
- Infection Control
- Physiotherapy
- Radiology (Only Medical Applied Science Graduates)
- Radiation Therapy (Only Medical Applied Science & Science Biophysics Graduates)

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https://forms.gle/pBMtF33Zj6228YTm8

https://forms.gle/BCutjsYmBBJCRH8F8 (TENS)

https://forms.gle/v7j7scXeLVxzWMNfA (HVPC)

#Electro_2

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عشان تحكم على ال frequency هل هو High ولا low لازم :

(1) اشوف الزمن بتاع ال phase بتاعته هل هو كبير و لا صغير.

(2) الـ pulse interval بتاعته كل ما تكبر كل ما تقل ال intensity.



فـ بكده من 1 و 2

أن مش معنى ال frequency يبقى عالي القيمه يبقى هو كده عالي التأثير في انه يوصل deep او لا.. انا بحكم على كده من زمن ال phase و ال pulse interval


عندنا مثلا ال HVPC اللي ال wave form بتاعه Twin peak هنلاقي ان ال duty cycle بتاعته وقت ال on فيها صغير جدا بالنسبه لوقت ال off بمعنى أن زمن ال phase صغير جدا بالنسبه لـ زمن ال pulse interval

فـ بكده استنتج انه low frequency (منخفض التأثير) ف ميوصلش deep فـ استخدمه في ال wound healing.. و نتيجه لـ ده ال capacitive reactance هتبقى High فـ ميوصلش deep و يعمل strike superficial و ساعتها تعرف.. انه عرف يخترق ال tissues و يتغلب على ال resistance بالرغم ان ال average بتاعه صغير لأن سواء زمن ال phase او pulse interval فـ هما الاتنين بالميكرو و لكن عرفت اعمل strike superficial لأني عليت الفولت بتاعه اللي هو من 100 لـ 150 و قدرت ازود ال average بتاع ال HVPC.

★Large electrode is the dispersive electrode.

★High current denisity close the neural structure is better as you can do it with least amount of current.

★Electrode placement is probably one of the biggest causes of poor results from electrical therapy.

★Pulse width=pulse duration.

★Inteapulse interval=interphase.



★يفضل انك تستخدم الالكترود الأصغر عند ال motor point و الأكبر بعيد عنه و ده هيجيب أكبر تأثير.

🟡 Current used with* chronic and acute pain*
💥Interfrential current
💥HVPS
💥Tens
💥MES

🟡 Current used with* Chronic and acute inflammation*
💥MES
💥 iontophoresis

⚡️⚡️⚡️ acute and chronic inflammation is contraindicated for *faradic current*

🔻Muscle strenght
▪️faradic
▪️tens(acupuncture like tens)
▪️Russiun & Aussie
▪️IFC
▪️DD (MF)
--------------
🔻Muscle re education
▪️faradic
▪️HVPS
▪️IFC
--------------
🔻Muscle spasm
▪️DF
▪️HVPS >chronic spasm
▪️IFC

Subsensory level:-
Stimulation occurs within the output interval between the point at which the output intensity rises from 0 to the point at which the patient receive a discrete electrical sensation.
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Sensory Level:-
Stimulation describes an output that stimulates only sensory nerves.
This level is found by increasing the output to the point at which a slight muscle twitch is seen and then decreasing the output by approximately 10%
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Motor level:-
Stimulation describes an intensity that produces a visible contraction without causing pain.
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Noxious Level:-
Current applied at an intensity that stimulates pain fibers.

Neuropraxia
Mild degree blockage
Local conduction block
No wallerian degeneration
Reversible
Axon isn't disrupted
No muscle waste
Decrease(loss) of strength
Absence of tendon reflex (below the level of lesion)
Slightly sensory loss
No sympathetic change
Class l.......
Recovery weeks to months

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Axonotmesis
Second degree
The axon only disrupted
Loss of nerve conduction
Wallerian degeneration occurs
Arreflxia occurs
Axon degeneration occurs at rate 1-8 mm/day
Occurs due to (profound nature compression, traction, prolonged friction, percussion injury,closed crush, injection and operation)
Class ll
Recovery may occur

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Neurotmesis
Greatest degree
Complete disruption
Wallerian degeneration occurs
Regeneration may occur
Disruption of axon
Paralysis of denervated muscle
Loss of nerve conduction
Sensory disruption
Vasomotor disruption
May occur due to (stap would,high velocity projectiles and nerve traction disrupting the connective tissue of the nerve with complete transaction of nerve trunk)
Class lll
Regeneration may occur

What is the functional goal of loading response?

-- Weight acceptance
#gait

What are the two phases analyzed in the gait cycle?

Stance Phase
--60% of cycle

Swing Phase
--40% of cycle

stance and swing phase differ in

--speed increases in running

--Running the swing phase is greater than the stance phase.

What is the hip flexion requirement for normal gait?

0-30 degrees