Anatomy of Upper Limb by Sameh Doss

By Sameh Doss

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For example, a patient with neuro­ Both the direction of resistance and the angle at which it is applied will influence the response. The use of logical dysfunction may demonstrate an increase in unwanted tonal patterns or nonfunctional synergistic movements if resistance is increased or if too difficult a posture is attempted; patients with cardiovascu­ lar-pulmonary involvement may demonstrate an in­ crease in physiological stress, including increases in heart rate and blood pressure; for those with muscu­ loskeletal involvement, excessive resistance may be inconsistent with the goal of tissue healing.

9 Muscle stability is a prerequisite to postural stability, which occurs when weight-bearing positions are maintained. Endurance is improved as the person contracts against the resistance of gravity with the same intensity but for longer durations. 42,48 This contraction should be maintained for a prolonged du­ ration, for example, from 20 seconds to 1 minute, al­ though the duration will vary among individuals. The type I, slow-twitch, oxidative fibers needed to improve stability and endurance are activated by this low-intensity, long-duration contraction.

When uni­ lateral arm movements are performed, increased weight bearing on and through the supporting limb occurs. The neck extensors are positioned in mid range, rather than the shortened range that occurs in pivot prone. 19 This slight stretch facilitates contraction of the short and long neck extensors and flexors. The position of the upper arm will influence the amount of activity in the shoulder musculature: if the elbows are positioned directly under the shoulders, the posi­ tion is mechanically stable and little shoulder activity is needed; resistance applied anteriorly, posteriorly, or laterally will require increased proximal muscle activation to maintain the posture.

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