Chapter 7 Flashcards
Functional Assessments, Posture, Movement, Core, Balance and Flexibility
What are activities of daily living?
Activities normally performed for hygiene, bathing, household chores, walking, shopping, and similar activities.
What are reactive forces?
Forces that oppose an initial active force.
Example: ground reaction forces occur at the foot when it comes in contact with the ground during running
What are gravity based forces?
Forces that act on an object (such as the body) related to the gravitational pull of the earth.
Define posture:
The arrangement of the body and its limbs
What are type I muscle fibers?
Also known as slow twitch muscle fibers
A muscle fiber type designed to use of aerobic glycolysis and fatty acid oxidation, recruited for low-intensity, longer duration activities such as walking and swimming
Muscle Imbalances Associated with Kyphosis-Lordosis Posture - Facilitated/Hypersonic (Shortened) Muscles
Hip Flexors (Lordosis) Lumbar Extensors (Lordosis) Anterior chest/shoulders (Kyphosis) Latissimus dorsi (Lordosis) Neck extensors (Kyphosis)
Muscle Imbalances Associated with Kyphosis-Lordosis Posture - Inhibited (Lengthened) Muscles
Hip Extensors (Lordosis) External Obliques (Lordosis) Upper-back extensors (Kyphosis) Scapula stabilizers (Lordosis) Neck Flexors (Kyphosis)
Muscle Imbalances Associated with Flat-back Posture Facilitated/Hypertonic (Shortened)
Rectus Abdominus
Upper-back Extensors
Neck Extensors
Ankle plantar flexors
Muscle Imbalances Associated with Flat-back Posture Inhibited (Lengthened)
Iliacus/psoas major
Internal oblique
Lumbar Extensors
Neck flexors
Muscle Imbalances Associated with Sway-back Posture Facilitated/Hypertonic (Shortened)
Hamstrings
Upper fiber of posterior obliques
Lumbar Extensors
Neck Extensors
Muscle Imbalances Associated with Sway-back Posture Inhibited (Shortened)
Iliacus/psoas major Rectus Femoris External Oblique Upper-back extensors Neck flexors
What is neuromuscular efficiency?
The ability of the neuromuscular system to allow muscles to produce movement and muscles that provide stability to work together synergistically as an integrated functional unit
What is hypertonicity?
Aka Hypertonic - having extreme muscular tension
Correctable factors for muscle Imbalances and posture deviations
Repetitive movements (muscular pattern overload)
Awkward positions and movements (habitually poor posture)
Side dominance
Lack of joint stability
Lack of joint mobility
Imbalanced strength-training programs
Non- correctible factors for muscule imbalance and postural deviations
Congenitial conditions (eg scoliosis)
Some pathologies (eg rheumatoid arthritis)
Structural deviations (eg tibial or femoral torsion or femoral anteversion)
Certain types of trauma (eg surgery, injury, amputation)
Define stability:
A characteristic of the body’s joints or posture that represents resistance to change of position
Define Mobility:
The degree to which an articulation is allowed to move before being restricted by surrounding tissues
What is the frontal plane?
A longitudinal section that runs at a right angle to the saggital plane, dividing the body into the anterior (front) and posterior (back) portions.
AKA the Coronal Plane
What is the saggital plane?
The loginitudal plane that divides the body into right and left portions.
Define “line of gravity” (LOG)
A theoretical vertical line passing through the center of gravity, dissecting the body into two hemispheres.
Define “scope of practice”
The range and limit of responsibilities normally associated with a specific job or profession
Key components in posture and movement assessments
Client History
- health history
- lifestyle information
Visual and manual observation
Define”external rotation”
Outward turning about the vertical axis of a bone
What is pronation?
Forearm: Internal rotation of the forearm causing the radius to to cross diagonally over the ulna and the palm.of the hand to face posteriorly
Foot: Flattening of the arch of the foot, by where the tibia and fewer are internally rotated
What is supination?
Forearm: external rotation of the forearm (radioulnar joint) that causes the palm to face anteriorly
Foot: high arches or heightening of the arches, by which can cause external rotation of the tibia and femur
What is platar flexion?
Distill movement of the plantar surface of the foot; opposite of dorsiflexion
Extending the foot downward
Define “gait”
The manner or style of walking
Name the 5 Posture Deviations
1) Ankle Pronation/Supination
2) Hip Adduction
3) Pelvic Tilting (Anterior or Posterior)
4) Shoulder Position and the Thoracic Spine
5) Head Position
In what direction is adduction?
Movement toward the midline of the body…
You’re “adding” to the body
When a hip is ADDucted in which direction are the hips tilted?
ADDucted hip is elevated and usually shifted in the direction of the elevated hip
Shortened hip flexors causes the pelvis to tilt in what direction?
Anterior or towards the front
The superior, anterior portion of the pelvis rotates downward and forward
What does ASIS stand for?
Anterior Superior Iliac Spine
What is “Lower Cross Syndrome”?
Tight hip flexors + tight erector spinae causing the ASIS to tilt forward.
What is “scapula protraction”?
Noticeable protrusion of the vertebral (medial) border outward
What are “winged scapulae”?
Protrusion of the inferior angle and vertebral (medial) border of the scapulae outward
Forward head position indicates which muscles are tightened and which are lengthened
Tight: cervical extensors
Lengthened: cervical flexors
What are the five primary movements?
1) Bending/raising & lifting lowering (squatting)
2) Single-leg movements (e.g. stepping)
3) Pushing movements (vertical/horizontal planes)
4) Pulling movements (vertical/horizontal planes)
5) Rotational movements
*ADL are essentially the integration of one or more of these primary movements
What is the objective of the BEND AND LIFT SCREEN?
To examine symmetrical lower-extremity mobility & stability, and upper-extremity stability during a bend-and-lif movement
During the bend and lift screen ANTERIORLY observing the FEET with a compensation of LACK OF FOOT STABILITY; ANKLES COLLAPSE INWARD/FEET TURN OUTWARD what are the key suspected overactive(tight) and underactive (legthened) compensations?
Overactive:
Soleus
Lateral gastronemius
Peroneals
Underactive: Medial gastronemius Gracilis Satorius Tibialis group
During the bend and lift screen ANTERIORLY observing the KNEES with a compensation of the KNEES MOVING INWARD are the key suspected overactive(tight) and underactive (legthened) compensations?
Overactive:
Hip Adductors
Tensor fascia latae
Underactive:
Gluteus medius & maximus
During the bend and lift screen ANTERIORLY observing the TORSO with a compensation of a LATERAL SHIFT TO A SIDE what are the key suspected compensations?
Key Suspected Compensations:
Side dominance and muscle imbalance due to potential lack of stability in the lower extremity during joint loading
During the bend and lift screen SAGITTALLY observing the FEET with a compensation of CLIENT BEING UNABLE TO KEEP HEELS IN CONTACT WITH THE FLOOR what are the key suspected overactive(tight) and underactive (legthened) compensations?
Overactive:
Plantar flexors
Underactive:
None
During the bend and lift screen SAGITTALLY observing the HIP AND KNEE with a compensation on the INITIATION OF MOVEMENT OF THE KNEES what are the key suspected compensations?
Key Suspected Compensations:
Movement initiated at the knees may indicate quadriceps and hip flexor dominance, as well as insufficient activation of the gluteus group
During the bend and lift screen SAGITTALLY observing the TIBAL AND TORSO relationship with a compensation of BEING UNABLE TO ACHIEVE PARALLEL BETWEEN THE TIBIA AND TORSO what are the key suspected compensations?
Key Suspected Compensations:
Poor mechanics, lack of dorsiflexion due to the tight plantar flexors (which normally allow the tibia to move forward)
During the bend and lift screen SAGITTALLY observing the CONTACT BEHIND THE KNEE relationship with a compensation of the HAMSTRINGS CONTACTING THE BACK OF CALVES what are the key suspected compensations?
Key Suspected Compensations:
Muscle weakness and poor mechanics, resulting in an inability to stabilize and control the lowering phase.
During the bend and lift screen SAGITTALLY observing the LUMBAR AND THORACIC spine with a compensation of an EXCESSIVELY ARCHED BACK what are the key suspected overactive(tight) and underactive (legthened) compensations?
Overactive (Tight): Hip Flexors, back extensors, latissimus dorsi
Underactive (Lengthened): Core, rectus abdominus, gluten group, hamstrings
During the bend and lift screen SAGITTALLY observing the lumbar and thoracic spine with a compensation of back that rounds forward what are the key suspected overactive(tight) and underactive (legthened) compensations?
Overactive (Tight): Latissimus dorsi, teres major, pectoralis major and minor
Underactive (Legthened): Upper back extensors
During the bend and lift screen SAGITTALLY observing the HEAD with a compensation of LOOKING DOWNWARD what are the key suspected overactive(tight) and underactive (legthened) compensations?
Key Suspected Compensations: Increased hip and trunk flexion
During the bend and lift screen SAGITTALLY observing the HEAD with a compensation of LOOKING UPWARD what are the key suspected overactive(tight) and underactive (legthened) compensations?
Key suspected Compensations:
Compression and tightness in the cervical extensor region
What is the objective of the HURDLE STEP SCREEN?
Toa examine simultaneous mobility if one limb and stability of the contralateral limb while maintaining both hip and torso stabilization during a balance challenge of standing on one leg
Define contralateral…
The opposite side of the body; the other limb
During the hurdle step screen ANTERIORLY observing the FEET with a compensation of lack of FOOT STABILITY; ANKLES COLLAPSE INWARD/FEET TURN OUTWARD what are the key suspected overactive(tight) and underactive (legthened) compensations?
Overactive (Tight): Soleus, lateral gastronemius, peroneals
Underactive (Legthened): Medial gastronemius, gracilis, satorius, tibialis group, gluteus medius and maximus - inability to control internal rotation
During the hurdle step screen ANTERIORLY observing the KNEES with a compensation of the KNEES MOVING INWARD, what are the key suspected overactive(tight) and underactive (legthened) compensations?
Overactive (Tight): Hip abductors, tensor fascia latae
Underactive (Legthened): Gluteus medius & maximus
During the hurdle step screen ANTERIORLY observing the HIPS with a compensation of Hip adduction* >2 inches stability; what are the key suspected overactive(tight) and underactive (legthened) compensations?
*Hip adduction involves weight transference over the stance leg while preserving hip, knee and foot alignment. This weight transference requires a 1 - to - 2 inch lateral shift over the stance-leg, with a small hike in the stance-hip of 4 to 5 degrees or less.
Overactive (Tight): Hip abductors, tensor fascia latae
Underactive (Legthened): Gluteus medius and maximus
During the hurdle step screen ANTERIORLY observing the HIPS with a compensation of STANCE-LEG HIP INWARD ROTATION, what are the key suspected overactive(tight) and underactive (legthened) compensations?
Overactive (Tight): Stance-leg or raised-leg internal rotators
Underactive (Legthened): Stance-leg or raised-leg external rotators
During the hurdle step screen ANTERIORLY observing the TORSO with a compensation of LATERAL TILT, FORWARD LEAN, ROTATION what are the key suspected compensations?
Lack of core stability
During the hurdle step screen ANTERIORLY observing the RAISED-LEG with a compensation LACK OF ANKLE DORSIFLEXION what are the key suspected overactive(tight) and underactive (legthened) compensations?
Overactive (Tight): Ankle Plantar Flexors
Underactive (Legthened): Ankle dorsiflexors
During the hurdle step screen anteriorly observing the RAISED-LEG with a compensation of a LIMB DEVIATES FROM SAGGITAL PLANE what are the key suspected overactive(tight) and underactive (legthened) compensations?
Overactive (Tight): Raised-leg hip extensors
Underactive (Legthened): Raised-leg hip flexors
During the hurdle step screen ANTERIORLY observing the RAISED-LEG with a compensation of a HIKING THE RAISED HIP what are the key suspected overactive(tight) and underactive (legthened) compensations?
Overactive (Tight): Stance-leg hip flexors - limiting posterior hip rotation during raise
During the hurdle step screen SAGITTALLY observing the PELVIS AND LOW BACK with a compensation of ANTERIOR TILT WITH FORWARD TORSO LEAN what are the key suspected overactive(tight) and underactive (legthened) compensations?
Overactive (Tight): Stance-leg hip flexors
Underactive (Legthened): Rectus abdominus and hip extensors
During the hurdle step screen SAGITTALLY observing PELVIS AND LOW BACK with a compensation of POSTERIOR TILT WITH HUNCHED-OVER TORSO what are the key suspected overactive(tight) and underactive (legthened) compensations?
Overactive (Tight): Rectus Abdominus and hip extensors
Underactive (Legthened): Stance-leg hip flexors
What is the objective of the Shoulder Push Stabilization Screen?
To examine stabilization of the scapulothoracic joint and core control during closed-kinetic-chain pushing movements
During the Shoulder Push Stabilization Screen SAGITTALLY observing SCAPULOTHORACIC with a compensation of EXHIBITING “WINGING” DURING THE PUSH-UP MOVEMENT what are the key suspected compensations?
Inability of the parascapular muscles (i.e., serratus anterior, trapezius, levator scapula, rhomboids) to stabilize the scapulae against the rib cage. Can also be due to a flat thoracic spine.
During the Shoulder Push Stabilization Screen SAGITTALLY observing TRUNK with a compensation of HYPEREXTENSION OF “COLLAPSING” OF THE LOW BACK what are the key suspected compensations?
Lack of core, abdominal, and low-back strength, resulting in instability
What is the objective of the THORACIC SPINE MOBILITY SCREEN?
To examine bilateral mobility of the thoracic spine. Lumbar spine rotation is considered insignificant, as it only offers approx 15 degress of rotation.
During the Thoracic Spine Mobility Screen TRANSVERSELY observing TRUNK with a compensation of BILATERAL DISCREPANCY (ASSUMING NO EXISTING CONGENITAL ISSUES IN THE SPINE) what are the key suspected compensations?
Side-dominance
Differences in paraspinal development
Torso rotation, perhaps associated with some hip rotation
Note: Lack of thoracic mobility will negatively impact glenohumeral mobility
During the Thoracic Spine Mobility Screen TRANSVERSELY observing the TRUNK and you see a TRUNK rotation of 45 degrees in each direction what is the key suspected compensations if any?
No compensation if trunk rotation achieves 45 degrees in each direction.
Define flexibility:
the ability to move joints through their normal full ranges of motion
What are the DORSIFLEXION AND PLANTAR FLEXION ranges for the ankle when the knee is bent 90 degrees?
DORSIFLEXION = 20 Degrees
PLANTAR FLEXION = 45 - 50 Degrees
What is the range of motion of the KNEE?
FLEXION: 125 - 145 Degrees
HYPEREXTENSION: 0 - 10 Degrees
What are the ranges of motion for the HIP?
FLEXION: 100 - 120 Degrees
EXTENSION: 10 - 30 Degrees
ABDUCTION: 40 - 45 Degrees
ADDUCTION: 20 - 30 Degrees
INTERNAL/MEDIAL ROTATION: 35 - 45 Degrees
EXTERNAL/LATERAL ROTATION: 45 - 60 Degrees
What are the average ranges of motion for the SHOULDER/SCAPULAE?
FLEXION: 150 - 180 Degrees
(hyper)EXTENSION: 50 - 60 Degrees
ABDUCTION: 180 Degrees
INTERNAL/MEDIAL ROTATION: 70 - 80 Degrees
EXTERNAL/LATERAL ROTATION: 90 Degrees
SHOULDER HORIZONTAL ADDUCTION: 90 Degrees
SHOULDER HORIZONTAL ABDUCTION: 30 - 40 Degrees*
*zero point (0 degrees) is with the arms position in frontal-plane abduction at shoulder height.
What are the ranges of motion for the ELBOW?
FLEXION: 145 Degrees
EXTENSION: 0 Degrees
What are the ranges of motion for the RADIO-ULNAR joint?
PRONATION: 90 Degrees
SUPINATION: 90 Degrees
What are the ranges of motion for the WRIST?
FLEXION: 80 Degrees
EXTENSION: 70 Degrees
RADIAL DEVIATION: 20 Degrees
ULNAR DEVIATION: 45 Degrees
What are the ranges of motion for the CERVICAL SPINE?
FLEXION: 45 - 50 Degrees
EXTENSION: 45 - 75 Degrees
LATERAL FLEXION: 45 Degrees
ROTATION: 65- 75 Degrees
What are the ranges of motion for the THORACO-LUMBAR SPINE?
LUMBAR FLEXION: 40 - 45 Degrees
THORACIC FLEXION: 30 - 40 Degrees
LUMBAR EXTENSION: 30 - 40 Degrees
THORACIC EXTENSION: 20 - 30 Degrees
LUMBAR ROTATION: 10 - 15 Degrees
THORACIC ROTATION: 35 Degrees
LUMBAR LATERAL FLEXION: 20 Degrees
THORACIC LATERAL FLEXION: 20 - 25 Degrees
What are the ranges of motion for the SUBTALAR joint?
INVERSION: 30 - 35 Degrees
EVERSION: 15 - 20 Degrees
