when muscles are paralysed or inhibited. • A movement that an active and highly motivated person performs to compensate limitation of musculoskeletal system. Definition: • Trick movements are the substitute movements used by an individual to carry out desired movements when the prime movers are weak, fatigue, paralyzed or painful. • For example- the hitching of the shoulder by the trepezius muscle occur when supraspinatus muscle is inflamed or the deltoid is paralysed. Compensatory movements • Movement used habitually to achieve functional motor skills when a normal movement pattern has not been established or is unavailable (e.g., lateral trunk flexion and exaggerated weight shift to substitute for incomplete shoulder flexion while reaching aboveshoulder level or external rotation of the shoulder that extends the elbow if the triceps muscle is insufficient). Advantage:
• Trick movements occur where
prime movers are weak or paralysed and other muscles take over their function. • So person can do his work and disability is minimized. Disadvantage: • Trick movements may affect the normal function of prime movers when it recovers. • Can produced abnormal joint movement. • Excessive strain on muscle and ligament can occur. Types • There are two types of trick movements:- • 1. Direct trick movements. • 2. Indirect trick movements. 1. Direct trick movements.
• 1. By Alternate Prime Movers
• 2. By Fixators. • 3. By Alternating Position Of favorably placed muscle. • 4. By Making Use Of Whole Limb Pattern. DIRECT TRICK MOVEMENTS • 1. By Alternate Prime Movers • Here, the movement occurs due to action of another prime mover which produces the same movement in different direction.
• Example- In case of weak supinator muscle,
patient performs the movement with the help of biceps brachii but there will be associated elbow flexion • 2. By Fixators. • In this fixator muscle moves the origin of muscle to produce the action of prime mover. • Example- Patient with weak hip abductor will use lateral abdominal muscle to lift the pelvis and thus move his lower limb laterally to give appearance of hip abduction. • 3. By Alternating Position Of favorably placed muscle. • In this a favorable muscle may contract and place the joint in an alternate position, so that other muscle in alternate position can perform the desired movement. • Example- in patient with deltoid paralysis full abduction and elevation is possible by infraspinatus-(lateral rotators) which rotate the humerus laterally so that axis of shoulder joint moves out laterally and clavicular head of pectoralis major act as an abductor reinforced by long head of biceps and triceps which also cross the joint. • 4. By Making Use Of Whole Limb Pattern. • Here another muscles of limb contract to assist the weak muscle to perform the action. – Example- in patient with weak elbow flexors, whole upper limb muscles contract and thus assist in elbow flexion. INDIRECT TRICK MOVEMENTS • 1. By Tendon Action. • 2. By Rebound Phenomenon. • 3. By Assistance of Gravity. INDIRECT TRICK MOVEMENTS • 1. By Tendon Action. • In this antagonist of weak muscle contract to produce an opposite movement, there is shortening of the tendon which gives a stretch to weak muscles and produce movement with stretch reflex. This is due to the passive action of prime movers. It occurs in muscles which cross two joints and have normally a limited length. • Example- Patient with paralysis of long flexors of the fingers wrist hyper extension cause a tendon action at distal interphangeal joints. – 2. By Rebound Phenomenon. • When resistance is given to antagonist muscle contraction and if the resistance is suddenly removed or strong contraction of antagonist followed by gentle relaxation produces a sustained movement and a seeming contraction in agonist. • Example- If elbow extensors are weak, then resistance is given to elbow flexion movement and when this resistance is removed suddenly, the limb will move to and fro producing elbow flexion and extension. –3. By Assistance of Gravity. • In this patient alters the position of body, make use of gravity and assist weak muscles. • Example- Patient with triceps paralysis where elbow easily be extended by the help of gravity if shoulder is below 90° position. • http://www.oregonexercisetherapy.com/blog/ patellofemoral-pain-syndrome • https://www.us.elsevierhealth.com/media/us /samplechapters/9780702033803/978070203 3803.pdf