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Active and Passive
Insufficiency
Dr Jitendra Sharma * Insufficiency is the term used for describing the inability of a muscle
to generate adequate force bring out a desired action / movement.
* In absence of disease process, muscle insufficiency is seen when the
length tension relation is altered.
* Muscle lengthened = Passive insufficiency
* Muscle shortened = Active insufficiency
* Active and Passive insufficiency is seen only in two joint or multi-joint
muscles. Passive
* Active insufficiency occurs when < soma
multi-joint muscle shortens over
BOTH joints simultaneously, and
hence, creates so much slack, tha’ _
muscle tension is almost
completely lost. It cannot
maintain or generate active
tension.
* Passive insufficiency occurs when
the multi-joint muscle
is lengthened to its fullest extent
at both joints, but also preventing
Passive
the full ROM of each joint it 7 = ineuticiency
of sao
crosses. The muscle cannot
elongate further. * Rectus femoris causes Hip flexion and Knee extension. It cannot cause
full ROM together of hip flexion and knee extension....this is active
insufficiency.
+ Similarly, Flexor Digitorum Profundus loses capability to make a tight
fist when the wrist is flexed.......active insufficiency.
* When the hip is fully flexed, the knee cannot be extended to fullest
without pain or damage..............passive insufficiency. ‘A. OversStretched Actin’Myosin Fibers:
‘Cannot langtven furher witout damgage(mico-ears) Cross bridges
Cannot reach Acin fers, therefor have nothing to pul on. Cannot
guneat any actual wort landing fo moverwnt er aton PASSIVE INSUFFICIENCY
in Fiber 2 Gs sin Fer
7 LTP Actin Fiber ANN
ovis Brges
8 Balanced Acta yesin Fibers
Maximum Range of shortening orlengthering avaiable.
Cross brdges Tuy avalabe to generate force & wor.
_/ ky NORMAL
C. Overontacted ActiniMyosin Fibers:
Cross bikges have no where fo go. Cannot shorten, therefore can geneeate “forcat ACTIVE INSUFFICIENCY
but na werk ing fo movwmant er measurable Seton, only etemal ésoring fore
Points of myosh ters are
armed aganst each ater
LT
Cross Bridges exert ratcheting acon deaving actin &
‘myosin foes together, creating muscular contraction
Copy igh © 2008-2011 David Sect Lynn Length Tension Relationship
Passive Insufficiency
=" Active force ~ Ee
Sarcomere length
Active Insuffciency Relationship between Active and Passive
Insufficiency?
* When the agonist is trying to contract, the antagonist is relaxing/
lengthening.
* The extensibility of the antagonist therefore is a factor in limiting
capability of the agonist......passive insufficiency.
* Therefore, the agonist becomes:
+ Actively insufficient when it is placed in shortened position.
* Passively insufficient if the antagonist is tight. QUESTIONS??
