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ACE > Chapter 7 Functional Assessments > Flashcards

Chapter 7 Functional Assessments Flashcards

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1
Q

what does ADL stand for and why is it important to a fitness instructor?

A

ACTIVITIES OF DAILY LIVING and it involves the functionality of daily activities that involves movement efficiency, or the ability of an individual to generate appropriate levels of force and movement at desired joints, while controlling or stabilizing the entire kinetic chain against REACTIVE FORCES and GRAVITY-BASED FORCES.

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2
Q

what does the static posture represent?

A

the alignment of the body’s segment. how a person holds themselves “ISOMETRICALLY” or “STATICALLY”.

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3
Q

what is good posture?

A

the state of musculoskeletal alignment and balance that allows muscles, joints, and nerves to function efficiently

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4
Q

what are some of the facilitated/hypertonic (shortened) muscle imbalances that are associated with Kyphosis-Lordosis posture?

A

(1) hip flexors (2) lumbar extensors (3) anterior chest/shoulders (4) latissimus dorsi (5) neck extensors

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5
Q

what are some of the inhibited (lengthened) muscle imbalances that are associated with Kyphosis-Lordosis Posture?

A

(1) hip extensors (2) external obliques (3) upper-back extensors (4) scapular stabilizers (5) neck flexors

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6
Q

what are some of the facilitated/hypertonic (shortened) muscle imbalances that are associated with flat-back posture?

A

(1) rectus abdominis (2) upper-back extensors (3) neck extensors (4) ankle plantar flexors

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7
Q

what are some of the inhibited (lengthened) muscle imbalances that are associated with flat-back posture?

A

(1) iliacus/psoas major (2) internal oblique (3) lumbar extensors (4) neck flexors

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8
Q

what are some of the facilitated/hypertonic (shortened) muscle imbalances that are associated with sway-back posture?

A

(1) hamstrings (2) upper fibers of posterior obliques (3) lumbar extensors (4) neck extensors

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9
Q

what are some of the inhibited (lengthened) muscle imbalances that are associated with sway-back posture?

A

(1) iliacus/psoas major (2) rectus femoris (3) external oblique (4) upper-back extensors (5) neck flexors

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10
Q

what is the postural deviation lordosis?

A

increased anterior lumbar curve from neutral

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11
Q

what is the postural deviation kyphosis ?

A

increased posterior thoracic curve from neutral

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12
Q

what is the postural deviation flat back?

A

decreased anterior lumbar curve

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13
Q

what is the postural deviation sway back?

A

decreased anterior lumbar curve and increased posterior thoracic curve from neutral (combo of flat back and kyphosis)

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14
Q

what is neuromuscular efficiency

A

a static postural assessment that is considered very useful and serves as a starting point from which a personal trainer can identify the muscle imbalances and potential movement compensations associated with poor posture

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15
Q

what does muscle imbalance often contribute to

A

dysfunctional movement

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16
Q

what are some correctible muscle imbalances

A

(1) repetitive movements; muscular pattern overload (2) awkward positions and movements; habitually poor posture (3) side dominance (4) lack of joint stability (lack of joint mobility (5) imbalanced strength-training programs

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17
Q

what are some non-correctible muscle imbalances

A

(1) congenial conditions; ie scoliosis (2) some pathologies ; ie rheumatoid arthritis (3) structural deviations; ie tibial or femoral torsion, or femoral anteversion (4) certain types of trauma

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18
Q

in what order does the movement efficiency pattern flow?

A

muscle balance > normal length-tension relationships and normal force-coupling relationships > proper joint mechanics (arthrokinematics) > efficient force acceptance and generation > promotes joints stability and mobility > movement efficiency

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19
Q

what should the initial focus of trainers be before they attempt to strengthen it?

A

straighten it

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20
Q

what is the correct formation of both feet

A

both feet should face forward in parallel or with slight external rotation (toes pointing outward from the midline)

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21
Q

what does it mean when the feet are pronated

A

arch flattening

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22
Q

what does it mean when the feet are supinated

A

high arches

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23
Q

what effect does pronated feet have on the feet, tibia, and femur?

A

foot movement is everted, internal rotation of the tibial (knee) movement, and internal rotation of the femoral movement

subtalar joint pronation forces rotation at the knees and places additional stresses on some knee ligaments. might actually lift the outside of the heel slightly off the ground.

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24
Q

what effect does supinated feet have on the feet, tibia, and femur?

A

foot movement is inverted, external rotation of the tibial (knee) movement, and external rotation of the femoral movement

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25
Q

what does gait mean

A

the manner of walking

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26
Q

what are 5 common deviations from an isometric posture?

A

(1) ankle pronation/supination and the effect on tibial and femoral rotation (2) hip adduction (3) pelvic tilting (anterior or posterior) (4) shoulder position and the thoracic spine (5) head position

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27
Q

what is the second posture deviation: hip adduction

A

in standing and in gait, it is a lateral tilt of the pelvis that elevates one hip higher than the other (also called “hip hiking”).

may be evident in individuals who have a limb-length discrepancy

28
Q

from a posterior view, what does a hip adduction look like on the right hip

A

elevated (vs. left side), hips usually shifted right

29
Q

from a posterior view, what does a hip adduction look like on the left hip

A

elevated (vs. right), hips usually shifted left

30
Q

what is the third posture deviation: pelvic tilting?

A

frequently occurs in individuals with tight hip flexors, which is generally associated with sedentary lifestyles where individuals spend countless hours in seated positions

31
Q

what happens when there is an anterior pelvic tilt

A

standing: shortened hip flexor pulls the pelvis into an anterior tilt (the superior anterior portion of the pelvis rotates downward and forward, spilling the water out of the front of the bucket)

32
Q

what happens when there is a posterior pelvic tilt

A

rotates the superior, posterior portion of the pelvis backward and downward, spilling water out of the back of the bucket.

33
Q

what does tight or over dominant hip flexors generally coupled with

A

tight erector spine muscle, producing an anterior pelvic tilt

34
Q

what are tight or over dominant rectus abdomens muscles generally coupled with

A

tight hamstrings, producing a posterior tilt

35
Q

what is a lower-cross syndrome

A

coupling relationship between tight hip flexors and erector spinae

36
Q

What are the 5 primary movements that people perform during many daily activities?

A

Bending/raising and lifting/lowering
Single leg movements
Pushing movements and resultant movement
Pulling movements and resultant movement
Rotational movements

37
Q

What are the 4 common movement screens?

A

(1) Bend and lift screen
(2) Hurdle step screen
(3) Shoulder push and stabilization screen
(4) Thoracic spine mobility screen

38
Q

What are the 5 common protocols for the flexibility and muscle-length tests?

A

(1) Thomas test for hip flexion/quadriceps length
(2) Passive Straight-leg (PSL) raise
(3) Shoulder flexion and extension
(4) Internal and external rotation of the humerus at the shoulder
(5) Apley’s scratch test for shoulder mobility

39
Q

What are the 3 common protocols for balance and for function tests?

A

(1) Sharpened Rhomberg test
(2) Stork-stand balance test
(3) McGill’s torso muscular endurance test battery

40
Q

What other joint works with the glenohumeral joint that offers greater stability and mobility when it comes to shoulder movements?

A

The scapulothoracic joint; it contibules approx. 60 degrees of movement in raising the arms overhead, with the glenohumeral joint contributing the remaining 120 degrees.

41
Q

What does the scapulae usually lie flat against?

A

The rib cage; the orientation depends on the size and shape of the person and the rib cage

42
Q

What are the 6 scapular movements?

A

(1) elevation (2) depression (3) adduction (retraction) (4) abduction (protraction) (5) upward rotation (6) downward rotation (return to anatomical position)

43
Q

How can a personal trainer identify scapular winging and scapular protraction?

A

Looking at the client from posterior view, Noticable protrusion of the vertebral (medial) border outwards is termed “scapular protraction”, while protrusion of the inferior angel and vertebral (medial) border outward is termed “winged scapulae)

if the vertebral (medial) and/or inferior angle of the scapulae protrude outward, this indicates an inability of the scapular stabilizers (primarily the rhomboids and serrates anterior) to hold the scapulae in place.

44
Q

What is another way scapular protraction can be identified (from the anterior view) ?

A

If the palms face backward instead of the sides; there is often a natural amount of “shrugging” inward with scapular protraction

45
Q

What muscles are suspected to be tight if you observe that a client’s shoulders are not level from a frontal view?

A

Upper trapezius, levator scapula, and rhomboids

46
Q

What muscles are suspected to be tight if you observe that a client’s shoulders are asymmetrical to midline from a frontal view?

A

Lateral trunk flexors (flexed side)

47
Q

What muscles are suspected to be tight if you observe that a client’s shoulder are protracted from a sagittal view?

A

Serrates anterior, anterior scapula-humeral muscles, and upper trapezius

48
Q

What muscles are suspected to be tight if you observe that a client’s shoulders are medially rotated humerus from a frontal view?

A

Pectorals major and latissimus doors (shoulder adductors), subscapularis

49
Q

What muscles are suspected to be tight if you observe that a client’s shoulders show kyphosis and a depressed chest from a sagittal view?

A

Shoulder adductors, pectoralis minor, rectus abdominis, internal oblique

50
Q

What shows good posture for head positions?

A

The earlobe should align approx over the acrominon process.

51
Q

What is a common deviation for the head position?

A

A forward-headed position. Doesn’t tilt downward but simply shifts forward so that the earlobe appears significantly forward of the acromioclavicular (AC) joint. You can observe this in the sagittal view, aligning the plumb line with the AC joint.

52
Q

What does a forward headed position represent?

A

Tightness in the cervial extensors and lengthening of the cervical flexors.

53
Q

What is an alternative to figuring out if a client has good head posture?

A

Alignment of the cheek bone and the collarbone from the sagittal plane

54
Q

from the bend and lift screening, what observations would you make from the frontal view

A

(1st rep) observe the stability of the foot

(2nd rep) observe the alignment of the knees over the second toe

(3rd rep) observe the overall symmetry of the entire body over the base of support

55
Q

from the bend and lift screening, what observations would you make from the sagittal view

A

(1st rep) observe whether the heel remains in contact with the floor throughout the movement

(2nd rep) determine whether the client exhibits “glute” or “quad” dominance (ie. does she initiate the downward phase by driving the knees forward or pushing the hips backward?

(3rd rep) observe whether the client achieves a parallel position between the tibia and torso in the lowered position (aka “figure 4 position”) while also seeing if they control the descent to avoid resting the hamstrings against the calves.

(4th rep) observe the degree of lordosis in the lumbar/thoracic spine during the lowering movement and while the client is in the lowered position and watch for excessive thoracic extension in the lowered position

(5th rep) observe any changes in head position during the lowering phase

56
Q

From an anterior view, if the feet are showing lack of stability and the ankles collapse inward/feet turn outward during a bend and lift screen, what are the key suspected compensations: overactive (tight) and which ones are underachieve (lengthened)

A

(tight) soles, lateral gastrocnemius, peroneals

(lengthened) medial gastrocnemius, gracilis, sartorius, tibialis group

57
Q

from an anterior view, if the knees are moving inward during a bend and lift screen, what are the key suspected compensations: overactive (tight) and which ones are underachieve (lengthened)

A

(tight) hip adductors, tensor fascia latae

(lengthened) gluteus medium and Maximus

58
Q

from an anterior view, if the torso lateral is shifting to a side during a bend and lift screen, what are the key suspected compensations: overactive (tight)

A

(tight) side dominance and muscle imbalance due to potential lack of stability in the lower extremity during joint loading

59
Q

from a sagittal view, if the feet are unable to keep the heels in contact with the floor during a bend and lift screen, what are the key suspected compensations: overactive (tight) and which ones are underachieve (lengthened)

A

(tight) plantar flexors

(lengthened) none

60
Q

from a sagittal view, if the hip and knee are the initiation of the movement during a bend and lift screen, what are the key suspected compensations: overactive (tight)

A

movement initiated at the knees may indicate quadriceps and hip flexor dominance, as well as insufficient activation of the gluteus group.

61
Q

from a sagittal view, if the tibia and torso relationship contact behind the knee and are unable to be parallel where the hamstrings touch the back of the calves during a bend and lift screen, what are the key suspected compensations: overactive (tight)

A

poor mechanics, lack of dorsiflexion due to tight plantar flexors (which normally allow the tibia to move forward)

muscle weakness and poor mechanics, result in an inability to stabilize and control the lowering phase

62
Q

from a sagittal view, if the lumbar and thoracic spine excessively arches or the back rounds forward during a bend and lift screen, what are the key suspected compensations: overactive (tight) and which ones are underachieve (lengthened)

A

(tight) (excessive arches) hip flexors, back extensors, latissimus doors

(rounds forward) latissimus doors, teres major, pectoralis major and minor

(lengthened) (excessive arches) core, rectus abdominis, gluteal group, hamstrings

(rounds forward) upper back extensors

63
Q

from a sagittal view, if the head is downward or upward during a bend and lift screen, what are the key suspected compensations: overactive (tight)

A

(down) increased hip and trunk flexion

(up) compression and tightness in the cervical extensor region

64
Q

during a squat, what does it mean to have lumbar dominance

A

implies a lack of core abdominal and gluteal muscle strength to counteract the force of the hip flexors and erector spine as they pull the pelvis forward during a squat mvmt.

65
Q

during a squat, what does it mean to have quadriceps dominance

A

implies reliance on loading the quads group during a squat mvmt. the first 10-15 degrees of the downward phase are initiated by driving the tibia forward, creating shearing forces across the knee as the femur slides over the tibia. in this lowered position, the gluteus Maximus does not eccentrically load and cannot generate much force during the upward phase. transfers more pressure to the knees, placing greater loads on the anterior cruciate ligament (ACL)

66
Q

during a squat, what does it mean to have glute dominance

A

implies reliance on eccentrically loading the gluteus Maximus during a squat. the first 10-15 degrees of the downward phase are initiated by pushing the hips backward, creating a hip-hinge. maximizes the eccentric loading on the gluteus Maximus to generate significant force during the upward, concentric phase. it is the preferred method of squatting cuz it spares the lumbar spine and relieves undue stress on the knees. also helps activate the hamstrings which pull on the posterior surface of the tibia and help unload the ACL to protect it from potential injury.

67
Q

what is the objective of the hurdle step screen

A

to examine simultaneous mobility of one limb and stability of the contralateral limb while maintaining both hip and torso stabilization during a balance challenge of staying on one left

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