KEMA (Kinetic Ergocise based in Movement Analysis)

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KEMA (Kinetic Ergocise based in Movement
Analysis)

• Introduction course
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Movement Impairment Syndromes
Impairment of movement
Tissue adaptation that Reinforces the motion
Tissue injury
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Movement Impairment Syndromes
Treatment is directed at correcting the movement
and the tissue adaptations that are contributing
to the vicious cycle of
Impairment of movement
Tissue injury
Tissue adaptation that Reinforces the motion
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Key Concepts
Tissue Adaptation Movement Patterns
Alteration
Repeated Movements Sustained Postures
Directional Susceptible to Movement (DSM)
The DSM is the cause of the pain because of the
microtrauma produced by stress or movement in the
specific direction
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Key Concepts

• Impairments
• Muscle Performance
• Motor Control
• Biomechanics

• Examination
• Standardized
• Qualitative Quantitative
• Alignment
• Movement

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Structure of a Skeletal Muscle
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Structure of a Skeletal Muscle
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Structure of a Skeletal Muscle
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Structure of a Skeletal Muscle

• Non contractile elements such as titin
• Contractile elements- actin, myosin

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Parallel EC Series EC
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Base Element ImpairmentsMuscular System

1. Muscle Strength Atrophy, Strain, Hypertrophy
2. Muscle Length - Length associated changes
3. Dissociated length changes of synergistic
4. Stiffness-muscle and joint
5. Shortness

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Decreased muscle strength caused by Atrophy

• Loss of contractile elements (primary sarcomeres
  in parallel)
• Decreased actin and myosin filament
• Muscle is not painful when palpated or
  contracting against resistance
• Reducing the number of sarcomeres in parallel
• Decreasing the amount of connective tissue

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Decreased muscle strength caused by Strain

• Stain can from excessive stretching for short
  duration or prolonged load, an injurious tension
• Disruption of series elastic components (intra
  and extracellular connective tissue proteins and
  cross-bridge) Forces within the body that exert
  an injurious tension
• Muscles that are strained are usually painful
  when palpated or when contractracting

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Increased muscle strength caused by Hypertrophy

• Increased muscle force
• Increased passive tension of the muscle and
  connective tissues
• The cross-sectional of muscle is correlated with
  the stiffness of the muscle through the range as
  it is elongated, rather than at the end of its
  range.

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Muscle Length-Prolonged elongated position

• Bed rest or inactivity
• Poor Alignment and posture increased resting
  muscle length
• MMT weak throughout the range

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Muscle Length- Injurious strain

• Disruption of Z-line of the sacremere thus
  detaching the actin and myosin filaments and
  disrupting tension generating ability
• Healing process is more readily if the muscle is
  not subjected to contraction or constant tension

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Muscle Length- Sustained stretching

• Sustained stretching added sacromeres
• Elongated muscles tested weak at a shortened
  length
• MMT give initially then able to hold

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Sustained stretching added sacromeres

• Sacromere length and tension

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Muscle Length- Immobilization with muscle
shorteded

• Fixation of muscle in a shortened position causes
  a decrease (up to 40) in the number of
  sarcomeres.
• rapid loss of sacromeres, primarily in
  series(2-4weeks)
• The adaptation in muscle length occurs in
  conjunction with an increase in the sacromeres
  length.
• Muscle change or adaptation is more pronounced
  when a muscle is shortened than when it is
  lengthened

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Muscle Length- Immobilization with muscle
shorteded

• Creep property viscoelastic
• - can explain short-term, reversible changes in
  muscle length
• Fails to explain the long-term, permanent change.
• Permanent increase in range of motion that is
  observed after a stretching program due to
  adding sarcomers in series, allowing further
  excursion
• Adding more sarcomere need myofibrillognesis

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Dissociated Length Changes in Synergistic

• Difference in the length of two synergistic
  muscle
• compensatory motion (rotation)
• development of movement impairment syndromes.

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Muscle and Soft-tissue stiffness

• Stiffness change in tension per unit change in
  length
• Muscle and soft tissue is believed to be a major
  contributor movement patterns and movement
  impairment syndrome
• Refers to the resistance present during the
  passive elongation of muscle and connective
  tissue, not during active muscle contraction or
  at the end of the range motion
• Stiffness of muscle is similar to springs

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Muscle and Soft-tissue stiffness

• Non contractile elements such as titin
• Contractile elements- actin, myosin

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Muscle and Soft-tissue stiffness

• Thixotrophy
• Defined as the property of various gels that
  become fluid when disturbed (by shaking)
• Source of resistance to passive stretching
• Which is the property of a substance that, when
  static for a period of time, become stiff and
  resists flow.

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Muscle and Soft-tissue stiffness

• Variation in the stiffness of muscles can be a
  factor in the development of compensatory motion
  in contiguous joints and can contribute to
  musculoskeletal pain syndrome

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Base Element ImpairmentsMuscular System

1. Muscle Strength Atrophy, Strain, Hypertrophy
2. Muscle Length - Length associated changes
3. Dissociated length changes of synergistic
4. Stiffness-muscle and joint
5. Shortness

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Any Other Questions??