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Motor Control > Exam 2 > Flashcards

Exam 2 Flashcards

1
Q

What are the six determinants of gait?

A
  • pelvic rotation
  • pelvic tilt
  • knee flexion
  • foot mechanisms
  • knee mechanisms
  • lateral displacement of pelvis
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2
Q

Six determinants of gait

A

developed by Saunders et al. in 1953; based on three principles: the body attempts to minimize energy expenditure, the body’s COG is just anterior to S2, and the vertical and horizontal displacement of COG moves in a perfect figure 8 pattern

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3
Q

Vertical displacement

A

lowest is at double limb support (50% gait cycle); highest single limb support (25% and 75% gait cycle)

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4
Q

Horizontal displacement

A

lowest is at double limb support (50% gait cycle); highest single limb support (25% and 75% gait cycle)

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5
Q

Which of the six determinants of gait are responsible for depressing the peaks and raising the valleys?

A

pelvic rotation, pelvic tilt, and knee flexion

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6
Q

Which of the six determinants of gait are responsible for smooth transition movements?

A

knee mechanisms, foot mechanisms, and lateral displacement of pelvis

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7
Q

What is the effect of pelvic rotation?

A

pelvis rotates to the right and left about 5˚; effect of pelvic rotation is to somewhat flatten arc of center of gravity, arc less severe, energy cost is reduced

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8
Q

What is the effect of pelvic tilt?

A

pelvis alternately drops 5˚ on the side opposite of the weight bearing limb; relative adduction stance limb and abduction swing limb; effect of pelvic tilt is to somewhat flatten arc of COG, arcs less severe, energy cost reduced

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9
Q

What is the effect of knee flexion?

A

knee flexes during weight acceptance and terminal stance (20˚); effect of knee flexion is to further flatten the arc of COG, arc less severe, energy cost reduced

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10
Q

What are potential causes of gait deviations?

A
  • pain
  • contracture
  • mm weakness
  • decreased proprioception
  • impaired motor control
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11
Q

Excessive ankle plantarflexion at initial contact

A
  • weak ant. tib.
  • PF contracture
  • combo of excessive ankle PF and knee flexion (spasticity in both PF and HS)
  • heel pain
  • short leg
  • voluntary excessive ankle PF to compensate for weak quadriceps
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12
Q

Where should DF occur in a “normal” gait pattern?

A

midstance and terminal stance

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13
Q

Excessive DF is primarily an issue during:

A

stance phase

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14
Q

Excessive DF at loading response

A

increase heel rocker (land more posteriorly on heel) and increased knee flexion in order to achieve foot flat

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15
Q

Excessive DF at midstance

A

increased knee flexion and activation of the quads, unstable tibia

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16
Q

Inadequate knee flexion occurs during:

A

loading response, terminal swing, and initial swing

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17
Q

Inadequate hip flexion

A

stance - interferes with normal knee flexion and ankle PF

swing - reduces limb advancement

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18
Q

What are substitutive actions for inadequate hip flexion?

A
  • anterior pelvic tilt
  • circumduction
  • excessive knee flexion
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19
Q

Pseudo adduction

A

hip flexion combined with internal rotation gives the appearance of excessive hip adduction

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20
Q

Causes of excessive hip adduction

A
  • abductor weakness
  • adductor contracture/spasticity
  • adductor substitute for hip flexor weakness
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21
Q

Causes of excessive internal rotation

A
  • glut max/med activity

- bony deformity

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22
Q

Causes of excessive external rotation

A
  • glut max/med activity

- bony deformity

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23
Q

Causes of increased anterior pelvic tilt

A
  • hip extensor weakness

- hip flexor tightness/spasticity

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24
Q

Causes of increased posterior pelvic tilt

A

trunk/pelvis used to advance the leg

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25
Q

Causes of excessive forward rotation

A

trunk/pelvis used to advance the leg

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26
Q

Causes of backward lean

A
  • hip extensor weakness

- inadequate hip flexion

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27
Q

Causes of forward trunk lean

A
  • quadriceps weakness
  • hip extensor weakness
  • hip flexion contracture
  • ankle plantarflexion contracture
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28
Q

Causes of lateral trunk lean

A
  • weak hip abductors
  • contracture
  • short limb
  • scoliosis
  • impaired body image
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29
Q

Causes of contralateral pelvic drop

A
  • weak hip abductor

- hip adductor contracture

30
Q

Causes of excessive trunk rotation

A
  • synergy with pelvis
  • walking aide synergy
  • arm swing synergy
31
Q

Why do people run?

A
  • function
  • recreation
  • developmental milestone
32
Q

What is the main difference between walking and running?

A

walking involves period of double limb support, while running involves a float phase

33
Q

What are other differences between walking and running?

A
  • joint patterns are similar
  • excursions are greater (2x)
  • stance phase occurs over a shorter period of time
  • velocities are greater
  • forces are greater (2x)
34
Q

What is the relationship between kinetic and potential energy during walking?

A

kinetic and potential energy are out of phase during walking; the center of mass falls and rises twice during stance

35
Q

What is the relationship between kinetic and potential energy during running?

A

kinetic and potential energy are in phase; center of mass falls to a low point in midstance then back to high point during double float

36
Q

Efficient running is achieved through what two mechanisms?

A
  1. elastic structures

2. two joint muscles

37
Q

At which speed does running become more economical?

A

2.0 m/s (4.5 mph)

38
Q

What is the limit of possible normal walking speeds

A

3.5 m/s (7.8 mph)

39
Q

What occurs at the medial longitudinal arch during running?

A

slightly raised during IC, then collapses during LR, and raises again during propulsion

40
Q

Vertical Loading Rate

A

can be an average or instantaneous

41
Q

What is the rearfoot angle at FS/IC for FFS/MFS?

A

FFS have greater PF, INV, and ABD

42
Q

What is the rearfoot angle at propulsion for FFS/MFS?

A

FFS have greater INV and ABD

43
Q

What is the knee angle at FS/IC for FFS/MFS?

A

FFS have greater ADD

44
Q

What are the advantages of gait analysis?

A
  • no unique equipment required
  • not invasive
  • inexpensive
  • not time consuming
45
Q

What are the disadvantages of gait analysis?

A
  • required expertise
  • subjective
  • subtle changes difficult to detect
  • no kinetic measurements
46
Q

What are the main gender differences during running?

A

females land in about 4˚ greater hip adduction and 4˚ greater hip internal rotation

47
Q

What are the most common running injuries?

A
  • patellofemoral pain
  • iliotibial pain syndrome
  • tibial stress fracture
  • plantar fasciitis
  • patellar tendonitis
  • achilles tendonitis
48
Q

Iliotibial pain syndrome

A

Distal factors: coupling of rearfoot eversion and tibial IR causes increased strain on ITB

Proximal factors: weak hip abductors and increased hip adduction in runners with ITB

49
Q

What are the three layers of the ITB?

A
  • superficial: lateral aspect of patella
  • middle: attaches to Gerdy’s tubercle
  • deep: lateral aspect of femoral condyle
50
Q

Retrospective studies indicate the TSF is associated with:

A
  • inc. vertical GRF impact peak
  • inc. vertical GRF load rate
  • inc. tibial acceleration
  • inc. adduction free moment peak
51
Q

Retrospective studies indicate the TSF is associated with:

A
  • inc. vertical GRF impact peak
  • inc. vertical GRF load rate
  • inc. tibial acceleration
  • inc. adduction free moment peak
52
Q

Proprioceptive neuromuscular facilitation

A

developed by Dr. Herman Kabat; Maggie Knott, PT; and Dorothy Voss, PT

Based on the dynamic systems theory

53
Q

What is the first PNF principle developed by Voss?

A

humans have potentials not fully developed; abilities should be channeled toward the reduction of inabilities

54
Q

What is the fourth PNF principle developed by Voss?

A

rhythmic/reversing movement re-establish muscular interaction; goal directed activity is composed of these movements

55
Q

D2 Position

A

arm begins in flexion, abduction, and ER; then ends in extension, adduction, and IR

Squeeze, turn, pull down and across; open, turn, push up and out

56
Q

What is the fifth PNF principle developed by Voss?

A

total patterns and diagonal movement; development of motor behavior proceeds in a sequence of total body patterns; diagonal and rotational movement are the keys to strength

57
Q

What are the sixth and seventh principles developed by Voss?

A

development is orderly; flexor and extensor dominance are cyclic, alternating between positions helps develop balance

58
Q

What are the sixth and seventh PNF principles developed by Voss?

A

development is orderly; flexor and extensor dominance are cyclic, alternating between positions helps develop balance

59
Q

What is the seventh PNF principle developed by Voss?

A

variety of patterns; use of several total patterns and extremity patterns optimizes the rate of mastery of an activity

60
Q

What is the eighth PNF principle developed by Voss?

A

correction of imbalances; balanced interaction of antagonists, imbalances lead to decreased efficiency of movement and to injury; normal movements and posture depend on balance of antagonists; imbalances are addressed by many approaches including PNF

61
Q

What are the ninth and tenth PNF principles developed by Voss?

A

improved motor ability is dependent upon motor learning; increased repetitions improves retention in motor learning; increased variability improves motor learning

62
Q

What is the eleventh PNF principle developed by Voss?

A

goal directed activities; goal direction hastens learning of a total pattern of movement

63
Q

What are the four stages of motor control?

A

1) mobility
2) stability
3) controlled mobility
4) skill

64
Q

What is motor control like in older adults?

A
  • lose most coordinated movements first
  • decreased extensor dominance in stance
  • less eccentric control
  • decreased rotation; last to develop, first to go
65
Q

What PNF techniques are used for mobility?

A
  • rhythmic initiation
  • slow reversal
  • agonist reversal
  • contract relax
  • hold relax
66
Q

What PNF techniques are used for stability?

A
  • slow reversal - hold

- rhythmic stabilization

67
Q

What PNF techniques are used for controlled mobility?

A

techniques applied with distal component stable and movement proximal

includes RI, SR, SR-H, and AR

68
Q

What PNF techniques are used for skill?

A

resisted progression

69
Q

Reciprocal inhibition

A

muscle spindle; stretch or stimulation of the agonist elicits activation of the agonist and inhibition of the antagonist so the mm works in cooperation

slow reversal, agonist reversal, hold-relax-contract

70
Q

Autogenic inhibition

A

GTO; a tight muscle is activated strongly in an isometric fashion to facilitate a reflexive relaxation and allow stretch

hold-relax-contract, contract-relax-contract

Motor Control (3 decks)

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