Biomechanics and Kinematic Chain

Question 1

Closed chain vs Open Chain

Answer 1

• CKC== Inter-dependence of motion, think stance phase, action on one joint affects another (moves UP the chain)
• OKC= NON-interdependent, think swing phase, what is happening at the jt wont affect other jts so much

Question 2

HypOmob at 1 jt can lead to _ @ another
and ex?

Answer 2

HypERmob @ another!
Ex. lower LS hypO usually will see upper TS hypER (bending over)

Question 3

Hypomob @ 1 jt leads to hypERmob @ another

Excessive PF example

Answer 3

David wears his high heels all over NY
- excess PF==knee hyperEXT (PE class)
- THEN we see LS lordosis + Ant pelvic tilt + TS kyphosis

Closed-chain—- compensations work UP THE CHAIN!

Question 4

ConCAVE vs ConVEX Rule

Key stuff

Answer 4

• Roll follows long bone
• Sliding (what jt does)/Gliding (what PT does, mobs)
• Vex on Cave== OPP
• Cave on Vex== SAME

Question 5

Convex/Concave Rule
GOLD!!!

Answer 5

• Vex on cave= opp (ex. shoulder)
• Cave on vex= same (ex. tibia on femur)
• every other joint this changes!!! Start proximal
• Ex. UE–> Shoulder-vex on cave-opp, Elbow-cave on vex-same, prox RU-vex on cave-opp, dist RU-cave on vex-same, wrist-vex on cave-opp
• Ex. LE–> Hip-vex on cave-opp, knee-cave on vex-same, ankle-vex on cave-same, toes-cave on vex-same

Question 6

PROnation vs SUPination

Answer 6

OPEN Chain!
- Pronation= Eversion + DF + ABDuction (P. DEAB)
- Supination= Inversion + PF + ADDuction (IPAD)

Question 7

Ex. ‘Topic

Limitations in ROM
when determining best area for intervention, READ THE INFORMATION GIVEN!!!

Answer 7

!!!!!!!!

Question 8

Limitations in ROM
when determining best area for intervention, READ THE INFORMATION GIVEN!!!
Ex. questions

Answer 8

Pt presens to OP clinic w/ shoulder pain. He demos limtd A/PROM of shoudler and INCREASED PAIN with both motions
Key word: PAIN**

They use the word PAIN twice…..so create intervention for pain

Ex answer: Grade I/II mobs

Question 9

Limitations in ROM
when determining best area for intervention, READ THE INFORMATION GIVEN!!!
Ex questions

Answer 9

Pt presents w/ limitations in shoudler A/PROM that are pain free*
*Best INITIAL intervention
question similar to last (pain question) but emphasis is on pain-free and highly on ROM limits—likely a jt restriction

Ex answer: Grade III/IV mobs

Question 10

Jt mob grades

See pic

Answer 10

Finger trick– D1 very small (small amp), D2 bigger than D1 (lg amp), D3 even bigger (lg amp), D4 smaller than D3 (small amp), D5 smallest (small amp)
**get closer and closer to END ROM (limit of avail motion and tissue resistance) as grades INC

Grade I/II- pain Grade III/IV- ROM, Grade V- adhesions

Question 11

Pt demos painful ROM in ABD during ROM of shoulder. Jt mob MOST approp?

Answer 11

Lg amp oscillations within avail ROM inferiorly
aka Grade II

Question 12

Janda’s Crossed Syndrome
Inhibited vs Facilitated

Answer 12

Inhibited= Weak (think inhibited, not able to do its job bc its too weak)
Facilitated= Tight

See pic

Question 13

Upper Crossed Syndrome
Inhibited (weak) vs Facilitated (tight)

Answer 13

• Inhibited== Deep CS flexors + Lower trpz/Serratus ant (go across)
• Facilitated== Upper trpz/Levator scap + SCM/Pec minor (go across)

Question 14

Lower Crossed Syndrome
Inhibited (weak) vs Facilitated (tight)

Answer 14

• Inhibited== Abs + Glute min/med/max
• Facilitated== Thoracolumbar ext’s + Rec fem/iliopsoas

NOTE w/ Lower Crossed—> Ant pelvic tilit

Question 15

Long Sitting (Supine to Sit) Test
Purpose: ?

Answer 15

ID’s SI jt dysfunctionthat may be cause of LLD

Question 16

Always ____ BEFORE ____

Answer 16

STRETCH BEFORE STRENGTHEN!!!

Question 17

PT exam reveals PSIS is LOW on Left; ASIS is HIGH on LEFT. Interventions should MOST likely include

Answer 17

L. pelvis rotated inom. posterior
- STRETCHING L hip ext’s to correct L post rotated inom
- Stretch BEFORE strenghten

Rationale: Bc HS’s/Glute max are TIGHT and posteriorly rotating pelvis
NPTE likes stretching first–quicker, more efficient

Question 18

Weak hip ABD’s causing hip drop in stance
What nerve supplies glute med?

Answer 18

Superior gluteal
NOTE: Glute max==Inferior gluteal N.

Question 19

Pt in OP c/o hip probs. You see drop of L hip during R MSt. Most approp tx?

Answer 19

Address the weak R. ABDs
Stand on R leg and ABD L leg
- closed chain is better for strengthening!
- Stick to you plane, this is asking about a frontal plane prob so answer of ABD’ing L leg will address this–causes more time under tension (SLS) on RLE

Question 20

What is better for strengthening overall?
OKC vs CCK?

Answer 20

CLOSED CHAIN!!!!!

Question 21

Muscle Action (contractions)

Iso vs Conc vs Ecc

Answer 21

• Isometric: MM torque = Load torque (no JRF)
• Conc: MM torque > Load torque
• Ecc: MM torque < Load torque (aka Deceleration, slowing us down)

Question 22

Eval baseball player, PT concludes insuff deceleration (ecc) of shoulder during throwing. Most effective strengthening tech?

Answer 22

ECC ex’s of teres minor and infrasp (both ER’s that must slow down the throw)
Need Ecc control of ERs
**Anything “deceleration” think ECC !!

Question 23

PT analyzing gait of pt who suffered CVA. 3 HS mm’s contract eccentrically during which phase of gait?

Answer 23

TSw
as we prepare to land (aka leg is straightening back out)
*think ecc knee ext==> HS’s *