Kinesiology

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Kinesiology is the study of the anatomy of movement with a focus on muscle recruitment strategies used in executing – and optimizing – functional tasks. Effective muscle action depends upon the status of brain function, somatosensory input, and postural control or stability maintaining functioning postures. Optimum muscle function occurs in the presence of optimum joint alignment and related muscle length and strength. [1]

Muscles serve upright maintenance and purposeful actions regardless of the existing functioning joint alignment – indeed, muscles are remarkably capable of meeting a functional need despite underlying bone and joint positional problems. When used tonically and for a long time in a faulty movement or balancing strategy, muscles adapt to use in shortened state by shortening. (See also Physiologic Adaptation, below.)

Sahrmann (2002 and 2010) addresses problems of muscle couple imbalances that result from movement system impairment syndromes. In muscle couple imbalance, one muscle (or group) dominates (eventually becoming shortened and overused) and its antagonist or synergist becomes dominated (long and underused). (See Movement System Analysis approach for more details.)

Demonstration

Walk with your lower limbs turned way out and notice that you use the hip adductor muscles – intended to draw the thighs together – rather than the hip flexor muscles – intended to swing the swing limb. Enhancing functioning joint alignment fosters purpose-related recruitment of kinesiologically correct muscles.

TheraTogs’ Role in Kinesiology

Rather than stretch the dominant (short) muscles, clinicians use TheraTogs to address the faulty underlying movement strategies – which provoke the imbalance – by:

  • Optimizing the functioning base of support – aligning the feet and knees in standing and the pelvis in sitting positions

  • Improving resting postures – the alignments from which the wearer initiates movements that are more developmentally and kinesiologically appropriate

  • Improving functioning alignment and stability in the trunk and hips or scapulae

  • Using strapping shorten underused muscles and letting them work in shortened state

  • Increasing the level of sensory awareness – and therefore, the recruitment – of underused muscles.

Maguire (2009) evaluated affected hip abductor muscle activity in adults with stroke while walking a) with a cane, and b) without the cane but wearing TheraTogs garments with hip abduction-assist strapping applied to the affected side. [2] Hip muscle activity diminished with cane use and increased significantly with the TheraTogs. The positive outcomes of this preliminary study have prompted a larger study that is now underway in Switzerland. [3]

Tip: TheraTogs are made of elastic fabrics. They are not capable of providing passive support to the torso. They cannot possibly produce limb motions. They provide flexible assistance to the wearer who functions in improved postural and joint alignment. It is common to find the wearer develop fatigue while undertaking routine activities in improved alignment. Antigravity muscles are being recruited in new ways and at shorter lengths. Caretakers can easily grant rest periods by loosening key straps temporarily.

Footnotes

  1. Sahrmann SA. 2010. Movement System Impairment Syndromes of the Extremities, Cervical and Thoracic Spines. St. Louis, MO: Elsevier Mosby.

  2. Maguire C, Seiben JM, et al. 2009. Hip abductor control in walking following stroke – the immediate effect of canes, taping and TheraTogs on gait. Clin Rehabil OnlineFirst, published on November 11, 2009 as doi:10.1177/0269215509342335.

  3. Maguire C et al. BMC Neurology 2012, 12 . http://www.biomedcentral.com/1471-2377/12/18

Additional References

Relevance to TheraTogs:

  • Joint alignment and muscle function influence each other.
  • Routine muscle use in joint malalignment leads to muscle imbalances, length changes, and loss of strength.
  • Routine muscle use in optimum joint alignment maintains joint integrity and muscle strength.
  • Foot and ankle alignment are essential to optimum body weight carriage and proximal limb and trunk function.
  • TheraTogs™ orthotic systems carry into daily life gains in functioning trunk alignment that the therapist achieves in treatment sessions.

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Kendall FP, McCreary EK, Provance PG, Rogers MM, Romani W. 2005. Muscles: Testing and Function with Posture and Pain. Fifth edition. Baltimore, MD: Lippincott, Williams & Wilkins

Mansfield PJ, Neumann DA: Essentials of Kinesiology for the Physical Therapist Assistant, Elsevier, third edition, 2019.

Neumann DA. 1999. Joint deformity and dysfunction: a basic review of underlying mechanisms. Arthritis Care Res. 12(2):139-51.

Neumann DA. 2010. Kinesiology of the hip: a focus on muscular actions. JOSPT. 40(2):82-94.

Neumann DA: Kinesiology of the Musculoskeletal System: Foundations for Rehabilitation (third edition), Elsevier, 2017.

Nguyen AD, Shultz SJ, Schmitz RJ, Luecht RM, Perrin DH. 2011. A preliminary multifactorial approach describing the relationships among lower extremity alignment, hip muscle activation, and lower extremity joint excursion. J Athletic Training. 46(3):246-56. Free article.

Nyland J, Kuzemchek S, Parks M, Caborn DN. 2004. Femoral anteversion influences vastus medialis and gluteus medius EMG amplitude: composite hip abductor EMG amplitude ratios during isometric combined hip abduction-external rotation. J Electromyogr Kinesiol. 14(2): 255-261.

Nyland J, Patton CM, Roberts CS. 2007. Progressive movement-related valgus knee impairments: clinical examination, classification, and treatment. Phys Ther Rev. 12(4):297-313.

Rose J, McGill KC.  2005. Neuromuscular activation and motor-unit firing characteristics in cerebral palsy. Dev Med Child Neurol. 47(5): 329-336.

Sahrmann SA. 2002. Diagnosis and Treatment of Movement Impairment Syndromes. St. Louis, MO: Mosby.

Sahrmann SA. 2010. Movement System Impairment Syndromes of the Extremities, Cervical and Thoracic Spines. St. Louis, MO: Elsevier Mosby.

Schmitz RJ, Riemann BL, Thompson T. 2002. Gluteus medius activity during isometric closed-chain hip rotation. Journal of Sport Rehabilitation. 11(3):179-88.

Snijders CJ, Hermans PF, Niesing R, Spoor CW, Stoeckart R. 2004. The influence of slouching and lumbar support on iliolumbar ligaments, intervertebral discs and sacroiliac joints. Clin Biomech (Bristol, Avon). 19(4): 323-329. 

Sykes K, Wong YM. 2003. Electrical activity of vastus medialis oblique muscle in straight leg raise exercise with different angles of hip rotation. Physiother. 89(7):423-30.

Ward SR, Winters TM, Blemker SS. 2010. The architectural design of the gluteal muscle group: implications for movement and rehabilitation. JOSPT. 40(2):95-102.

 

The typical TheraTogs client receives up to 10 hours of wearable therapy every day!