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PHTH 534: Gait and Movement > Final Exam Prep > Flashcards

Final Exam Prep Flashcards

1
Q

What is the purpose of orthotics?

A

-Control abnormal compensatory movements by the foot
-Create a biomechanical balanced kinetic chain by controlling/reducing pathologic motion in the foot and leg by maintaining the foot in or close to subtalar neutral position

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2
Q

What movement can knee valgus create at the foot?

A

Over pronation

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3
Q

What movement can knee varus create at the foot?

A

Over supination

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4
Q

What combined movements create pronation?

A

-Eversion
-Abduction
-Dorsiflexion
-Internally rotated subtalar joint

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5
Q

What combined movements create supination?

A

-Inversion
-Adduction
-Plantar flexion
-Externally rotated subtalar joint

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6
Q

What joints make up the hindfoot?

A

-Talocrural joint
-Subtalar joint

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7
Q

What joints make up the midfoot?

A

-Tarsometatarsal joint
-Calcaneocuboid joint
-Talonavicular joint

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8
Q

What joints make up the forefoot?

A

First MTP joint

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9
Q

What can over pronation in closed chain cause?

A

-Problems up the kinetic chain
-Anterior pelvic tilt
-Internal rotation of femur
-Valgus knee
-Internal rotation of tibia and fibula
-Medial rotation of talus
-Adduction and plantar flexion of talus
-Calcaneal eversion

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10
Q

What can over supination in closed chain cause?

A

-Posterior pelvic tilt
-External rotation of femur
-Knee varus
-External rotation of tibia and fibula
-Adduction and dorsiflexion of talus
-Calcaneal inversion

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11
Q

What disease in children causes knee varus?

A

Rickett’s or kidney disease

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12
Q

What is knee adduction moment (KAM)? What does it cause?

A

-Knee adduction moment occurs during gait, the leg produces an adduction moment that places the knee into varus
-Causes compressive forces across the medial compartment of the knee

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13
Q

What percentage of weight bearing forces pass through the medial compartment of the knee during gait?

A

60-70%

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14
Q

What causes KAM?

A

Ground reaction forces

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15
Q

What phases of stance phase does KAM peak in?

A

-Loading response
-Late stance

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16
Q

What happens to KAM during abnormal knee varus?

A

-It increases
-Causes increased forces on the medial knee

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17
Q

What types of foot orthoses are there?

A

-Heel cup cushion
-Heel lift
-Wedge

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18
Q

What are orthotics?

A

-Lower extremity supportive apparel that provides soft tissue protection, bone/joint stability and control of body segment motion
-They play a role in nonoperative foot and ankle pathology

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19
Q

What is the overall static and dynamic functions of orthotics?

A

-Static: rigid device, supports body segment in fixed position
-Dynamic: mobile device, permits body segment motion

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20
Q

What are the principles of orthotics?

A

-Patient-related (easy to don and doff)
-Soft tissue: not break down skin
-At risk diagnoses (diabetics, neuropathy)
-Tolerant to compression and shear forces
-Functional level of patient

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21
Q

What are some other uses for foot othoses?

A

-Helpful in treating painful foot and lower extremity pathologies
-Plantar fasciitis
-Tibialis posterior tendon dysfunction
-Rheumatoid arthritis
-Juvenile idiopathic arthritis
-Patellofemoral syndrome
-Hemophilia A

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22
Q

What is a UCBL? Where was it developed? What conditions is it used for?

A

-An orthotic for significant issues such as arthritis and hypotonia
-Holds the calcaneus in a neutral position
-Used for significant pronation
-University of California Berkeley Lab

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23
Q

How do the trim lines effect the orthotic?

A

The higher trim lines are, the more control there is of the calcaneus

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24
Q

What team members are involved in lower limb gait orthoses? What are their roles?

A

-MD: medications for spasticity, considerations for e-stim, long term prognosis
-Orthotist: offers orthotic possibilities
-PT: gait mechanics, determines greatest need/problems, stability vs mobility, joint integrity
-Family members: support

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25
Q

What are the steps to assess the need of an ankle orthotic?

A

-Assess gait deviation
-Assess if it can provide protection from injury

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26
Q

What is a standard AFO? What is it typically used for?

A

-Standard ankle-foot orthotic
-Used for drop foot

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27
Q

What conditions are AFO’s widely prescribed for?

A

-Weakness
-Stroke
-Cerebral palsy
-Head injury
-Peripheral neuropathy
-Alignment
-Spinal cord injury
-Progressive disease

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28
Q

What principles does every orthotic use?

A

Force principles are used to accomplish the goals of its design

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29
Q

When is an orthosis most comfortable?

A

-Pressure is distributed equally (force/area)
-When direction of primary force and direction of counterforces are controlled

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30
Q

What AFO’s are available off the shelf? What are the disadvantages of off the shelf AFO’s?

A

-Standard AFO
-Leaf spring AFO
-They are not personalized/fitted for each specific person

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31
Q

What is a leaf spring AFO? What is it used for?

A

-Mass produced orthotic
-Dynamic thermoplastic AFO
-Supports the weight of the foot during swing phase as a means of enhancing swing limb clearance
-Assists with controlled lowering of the foot during loading response in stance as part of the heel rocker

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32
Q

What is a step smart AFO?

A

Has a posterior shell

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32
Q

What are common causes of foot drop?

A

-Peripheral neuropathy (common fibular nerve)
-Fracture of knee or fibular head
-Knee dislocation
-Crossing your leg
-Weight loss (can now cross legs which puts pressure on common fibular nerve)
-Bed rest
-MS
-Stroke or CVA
-Myositis

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33
Q

What is a dorsiflexion assist brace?

A

-Lightweight
-Carbon fiber
-Stiff with energy storage in shell
-Enhances plantar flexion power

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34
Q

What is a solid AFO?

A

-More solid structure
-Resists plantar flexion during swing phase
-Fulcrum applied at anterior ankle
-Counterforce upward under the metatarsal heads and a proximal counterforce at the posterior proximal surface of AFO
-Has larger trim lines that allows for more tibial control
-Supports calcaneus
-Wider control of the footplate to control inversion or eversion

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35
Q

How does a solid AFO hold the foot?

A

-0 degrees of dorsiflexion
-Subtalar and calcaneal neutral
-Balanced forefoot

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36
Q

What are the disadvantages of a solid AFO?

A

-Biomechanically interferes with transitions through all three ankle rockers
-Loses toe off
-Prevents controlled lowering of the foot during LR
-Prevents forward progression of tibia during stance phase

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37
Q

When should solid AFO’s be used? Why?

A

They should only be used if someone has a very poor prognosis and will not get better, because it prevents a lot of movement that is needed for proper gait

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38
Q

What is the time frame that stroke patients should be out of bed? Why?

A

Getting stroke patients out of bed within 24-48 hours significantly improves their outcomes

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39
Q

What is the difference between orthopedic and neurologic gait?

A

Orthopedic
-Muscular strains
-Ligament sprains and tears
-Pain
-Tendon pathology
-Soft tissue injury
-Joint pathology

Neurologic
-Peripheral nerve pathology or injury
-Guillan Barre
-CNS: synergies, ataxia, spasticity

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40
Q

What are gait impairments in neurologic disorders?

A

-Abnormal tone
-Loss of selective motor control (synergy, ataxia)
-Sensory loss: proprioception and tactile
-Abnormal alignment
-Poor balance or postural control
-Contractures (gastroc, soleus)
-Decreased gait speed
-Impaired cognition
-Timing of muscular activation/co-activation
-Lack of visual awareness/ability to scan

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41
Q

Where should the therapist stand when guarding a patient with a neurological disorder? Why?

A

On the patients involved side, because that is the side they will fall to

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42
Q

When should gait training be initiated with a patient with a neurological disorder?

A

-Ability to stand and partial weight bear on involved limb
-Ability to understand and follow directions
-Has head and trunk control
-Has protective responses
-If they are unable to bear weight/properly load involved limb, they can start with parallel bars
-Can use a cane

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43
Q

What is a problem that patients with CVA typically have during initial contact?

A

Loss of heel contact

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44
Q

What is a problem that patients with CVA typically have during loading response?

A

Knee wobbles

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45
Q

What is a problem that patients with CVA typically have during midstance?

A

Knee hyperextension

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46
Q

What is a problem that patients with CVA typically have during terminal stance?

A

Loss of hip extension

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47
Q

What is a problem that patients with CVA typically have during toe off/push off?

A

-No heel off
-No knee flexion

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48
Q

What is a problem that patients with CVA typically have during initial and mid swing?

A

Lack of knee flexion

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49
Q

What is a problem that patients with CVA typically have during terminal swing?

A

-Loss of hip flexion
-Loss of knee extension
-Loss of dorsiflexion

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50
Q

What do problems with gait in patients with CVA typically result in?

A

-Reduced step and stride length
-Increased cadence
-Changes in step width

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51
Q

What should be included when writing notes for gait?

A

-Level of assistance for sit to stand and gait
-Assistive device used
-Description of gait after observational analysis
-Problem statement for the three major areas of gait: weight acceptance (WA), single leg stance (SLS), single leg advancement (SLA)
-Most likely cause of gait deviation i.e. lack of selective motor control

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52
Q

What are the most important determinants of gait in persons with CVA?

A

-Single leg stance on affected side: duration of stance on affected limb increases contralateral step length
-Single limb advancement: knee flexion during mid swing allows for foot clearance and prevents swing limb deviations
-Plantar flexion range of motion: good push/toe off
-Standing balance

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53
Q

What are gait characteristics in people with Parkinson’s disease?

A

-Reduced step length
-Amplitude of arm swing: earliest gait deviation
-Interlimb asymmetries
-Increased duration in double time
-Reduced gait width
-Shuffling steps/festinating gait
-Freezing of gait

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54
Q

What patient population should PT’s NOT perform a gait analysis with? Why?

A

-People with Huntington’s disease
-Because they do not have a consistent gait pattern

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55
Q

What is pediatric gait terminology?

A

-Scissoring gait
-Crouch walking
-Hyperextension/low tone
-Toe walking (no CNS injury)
-Equinus gait

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56
Q

What is equinus gait?

A

-Unable to effectively bear weight
-Does not possess balance or postural control
-Toe walking due to weakness or abnormal tone
-Forefoot contact throughout gait pattern
-Hip internal rotation
-Tibial torsion

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57
Q

What is the Taub and Berman study?

A

-Constraint induced or forced use
-Forced use of a sensory deprived animal by constraining the other limb
-Conclusion: rehab should include engaging the affected limb in activities

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58
Q

What is the Forssberg study?

A

-Muscles of cats with transected spinal cords have the same activity as normal cats
-The cats were still recruiting motor units
-Conclusion: lower limb activity can be activated under certain situations

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59
Q

What is the Sherrington neural control of walking study?

A

-Severed the spinal cord of cats
-Hind limbs continued alternating movements
-Conclusion: we do not need influence of higher brain centers to walk
-Sensory information was eliminated in monkeys
-Conclusion: removing the sensory input in both side resulted in the same alternating pattern

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60
Q

What motor tasks does the emergence of walking involve?

A

-Strength sufficient for the support of body weight: ground reaction forces, stability before mobility
-Stable enough to compensate for balance shifts: maturation of the balance system
-Adaptations to uneven surfaces

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61
Q

What is involved in prenatal to postnatal stepping?

A

-Infants kick or step in utero
-At birth, elicit stepping pattern
-Disappears at 2 months: reappears at the start of walking, continues kicking in supine
-Same pattern in standing

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62
Q

What is the progression from stability to mobility in the emergence of walking?

A

-Standing with assistance
-Mobility with two hands holding onto something
-Standing alone
-Independent mobility

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63
Q

What is the average time frame for the emergence of walking in infants? When is walking considered delayed?

A

-Infants begin to walk without assistance from 9-15 months
-Motor delay in gait is at 18 months

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64
Q

How does myelination occur in infants? What age does the myelin reach the lower limbs? How does this effect gait emergence?

A

-Myelination occurs from caudal to distal (head to legs)
-At 9 months it reaches the lower limbs
-This plays a critical factor in gait emergence

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65
Q

What gait factors/components are developed in the first year?

A

-Locomotion pattern (CPG): innate
-Postural control in standing (at tabletop)
-Motivation and navigation toward a distant object
-Standing on one leg: stance phase stability
-High guard posture

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66
Q

What are components necessary for gait emergence?

A

-Motor production: stabilization, force or power
-Central pattern generation
-Dissociation of limbs
-Balance or postural control
-Intact sensory system: vision, vestibular, somatosensory (tactile and proprioception)

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67
Q

What are the sensory contributions to emergence of gait?

A

-Vision
-Visual optic flow
-Stabilizing head: vision vertical
-Vestibular system
-Postural control
-Somatosensory/proprioception

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68
Q

Why is vision an important sensory contribution for walking?

A

-Balance and steering
-Avoiding obstacles

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69
Q

Why is somatosensory/proprioception an important sensory contribution for walking?

A

-Provides feedback of body awareness
-Tactile feedback from ground

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70
Q

What do the first steps look like for infants learning to walk?

A

-High step pattern
-Wide base of support
-No push off
-Knees flexed at stance
-UE: no arm swing and high guard (arms out)
-Short steps
-Synchronized pattern in legs
-Waddling pattern

71
Q

What is synchronization in gait?

A

Joints moving simultaneously

72
Q

What is dissociation in gait?

A

Joints moving individually

73
Q

How does an immature pattern of primary stepping in infants develop over time?

A

-Gradual emergence of normal gait
-The joints demonstrate increasing complexity and go from synchronization to dissociation
-Controlled falls: infants lean forward when walking

74
Q

What is a posture typically seen in infants who are learning how to walk?

A

Forward center of mass (leaning forward)

75
Q

How long does it typically take after initial emergence of walking for infants to develop dissociation of their joints?

A

4.5 months after first steps

76
Q

How do infants usually fall when walking?

A

-Forward with hands extended
-Backwards on bottom

77
Q

What age are children typically able to control single leg stance?

A

At one year they have about 32% control of single leg stance

78
Q

What age are children able to change directions?

A

15-18 months

79
Q

When does a heel strike typically develop?

A

2 years

80
Q

What happens with gait between the ages of 3-7?

A

Gait matures with small improvements until around age 7

81
Q

When does the center of mass stabilize and kids develop an adult gait pattern?

A

Between 7-10 years old

82
Q

What are other skills associated with walking?

A

-Avoiding obstacles
-Protective responses
-Distance
-Navigation
-Cognitive processing and dual task emergence

83
Q

What does stretching of the hip flexors during trailing limb and loading the limbs provide?

A

-More sensory contributions
-Trailing limb activates flexors for forward limb advancement
-Step length, appropriate frequency
-Loading the limbs activates pressure sensors

84
Q

What happens to muscle mass after the age of 60?

A

-Significant muscle loss occurs after the age of 60
-Fast fatigable fibers are lost first
-May lead to sarcopenia in the elderly

85
Q

What occurs during atrophy from simple disuse?

A

-Protein breakdown stays the same
-Protein synthesis goes down
-Reduced mechanical load leads to decrease in muscle mass/size of muscle fibers
-Reduced mechanical load anabolic resistance

86
Q

What occurs during atrophy due to sarcopenia?

A

-Aging induced anabolic resistance
-Low grade, chronic inflammation
-Longer term inactivity
-Protein breakdown goes up
-Protein synthesis goes down

87
Q

What can be done to minimize the loss of muscle mass in the elderly?

A

-Staying active
-Lifting weights

88
Q

What can sarcopenia do?

A

It can lead to loss of mobility

89
Q

What does muscle turn into when it atrophies/is not used anymore?

A

It turns to fat

90
Q

What happens to the spine as we age? What can be done to minimize/prevent this?

A

-Loss of vertebral body height
-Increased risk of fracture
-Can be reversed or reduced with exercise

91
Q

What happens to tactile and cutaneous receptors as we age?

A

-We lose tactile and cutaneous receptors
-Can be caused by diseases such as type II diabetes, peripheral nerve damage, or stroke
-Age
-Loss of fine touch sensation
-Loss of heart and cold sensation
-Loss of pain perception

92
Q

What can be the cause of losses in the visual system?

A

-Loss of visual acuity
-Loss of ability to see far distances
-Can be caused by type II diabetes, retinal damage, macular degeneration, glaucoma

93
Q

What happens in vestibular disuse in the elderly?

A

-Vestibular is a use it or lose it system
-Elderly show a loss of quick acceleration in movement
-Loss of cervical rotation
-Forward head posture
-Forward trunk posture
-Lose protective responses

94
Q

What happens when elderly have dulled protective responses?

A

-Reduced ankle and hip strategies
-Reduced speed of protective arm extension (parachute response)
-20-30% lead to head injuries

95
Q

What is decreased gait speed associated with? What happens to gait speed as we age?

A

-A higher fall risk
-Dementia/cognitive decline
-Gait speed decreases significantly as we age

96
Q

What can help reduce the amount of cognitive decline?

A

Aerobic exercise

97
Q

What is principle 5 of the APTA geriatric guide to practice?

A

Prioritize physical activity to promote health, well-being, chronic disease management, and enhance mobility

98
Q

What are kinetics?

A

Internal and external forces

99
Q

What are kinematic measurements of gait?

A

-Gait phases
-Range of motion
-Muscle activity

100
Q

What are the spatial temporal factors of gait?

A

-Velocity
-Step length

101
Q

What are 2 dimensional gait analysis techniques?

A

-Surface mat embedded with sensors
-Markers for 2D gait analysis

102
Q

What are graphs in gait analyses used for? Which measures are kinetics and which are kinematics?

A

-Joint ROM (kinematics)
-Ground reaction forces (kinetics)
-Power and moments (kinetics)
-Each provide a different attribute of gait

103
Q

What measurements does the Zeno mat and Protokinetics software provide?

A

-GAME lab 2D analysis
-Provides spatial-temporal output kinematics
-Visual video of footprints

104
Q

How is a 3D gait analysis done?

A

-Taking 3D body kinematics
-Position, velocity, and acceleration
-Ground reaction forces, joint moments, power (kinetics)
-Uses force plates, EMG sensors, and cameras

105
Q

Are ground reaction forces kinetics or kinematics? Is it an internal or external force?

A

-Kinetics
-External force

106
Q

What are joint moments? Are they internal or external?

A

-Amount of force needed to cause rotation around a joint
-Internal and external moments

107
Q

Is power a measure of kinetics or kinematics? How is it measured?

A

-Kinetics
-Power= force/time
-Concentric and eccentric power
-Used in 3D gait analysis

108
Q

What are the joint moments during gait? When do internal moments occur? When do external moments occur?

A

-During walking, the body accepts greater moments/forces during stance phase
-Internal moments: created by the contraction of the muscle, joint ligaments, and fascia
-External moments: created by the landing surface (ground reaction forces)

109
Q

What are the purpose of the internal joint moments?

A

To counteract the forces from the ground

110
Q

Why does each joint create a moment?

A

-Stabilize/control stance phase
-Produce movement

111
Q

How are internal moments measured through the gait cycle? What do negative and positive values mean?

A

-Measured in percentage of Newtons/body weight
-Negative values mean flexor moments
-Positive values mean extension moments

112
Q

What do extensor moments do?

A

Provide support for the body on the surface

113
Q

What do flexor moments do?

A

Provide force to pull away from the surface

114
Q

When are the ground reaction forces the highest during stance?

A

-During foot flat contact after heel strike
-Second highest during heel-off right before toe off

115
Q

How is power defined in gait kinetics?

A

-Power is energy/time
-Greater power is created when it is performed in a shorter time frame
-Power is created concentrically
-Power is absorbed eccentrically
-Measured in Watts or Joules/second
-Structures can create or absorb power

116
Q

How is power analyzed in gait?

A

By analyzing joint power or total joint power at specific points in the gait cycle

117
Q

What are the clinical implication of power in normal gait?

A

-Plantar flexors provide important propulsive energy during push off
-Hip flexors provide propulsive force during pull off
-Knee power is relatively low, and often negative indicating eccentric activity in extensors or flexors

118
Q

What is postural control?

A

Controlling the body’s position in space for the dual purposes of stability and orientation

119
Q

What is postural orientation?

A

Ability to maintain an appropriate relationship between the body and environment for a task

120
Q

What is postural alignment?

A

Biomechanical alignment (body’s alignment)

121
Q

What is the center of mass (COM)? Where is it located?

A

-Point that is the center of the body mass
-Anterior to S2

122
Q

What is the base of support (BOS)?

A

Area of the body that is in contact with the support surface

123
Q

What is the center of gravity (COG)?

A

Vertical projection of the COM

124
Q

What is ideal postural alignment in relation to the COM and BOS? What is a stable posture?

A

-Controlling the COM relative to the BOS
-Stable posture is the COM falling within the BOS
-Requires minimal muscular effort

125
Q

What changes according to the COM?

A

Muscular activity of dorsiflexors and plantar flexors

126
Q

What are the key points about the COM?

A

-The COM is not a physical entity but a virtual point in space that depends on the position of all body segments
-If the nervous system controls the COM, it must be able to estimate the position of the COM using information from the various sensory receptors
-The key variable controlled by the CNS during postural control is control of the COM

127
Q

What are the frontal plane surface landmarks for postural alignment?

A

-Midline through the body
-Tops of shoulder
-Iliac crests
-Midline of patella
-Superior and inferior angles of scapula
-PSIS
-Popliteal fossa
-Ear height
-Acromion height
-Humeral folds
-Arm “windows”
-Genu varum/valgum
-Calcaneus with midfoot

128
Q

What should the alignment be between the subtalar joint and knee?

A

There should be a neutral, straight line between the knee and the subtalar joint with no pronation, supination, internal, or external rotation

129
Q

What is the Adam’s test?

A

-Scoliosis screening
-Patient bends forward so therapist can check for rib hump and curving of the spine

130
Q

What are sagittal view landmarks for postural alignment?

A

-Ear lobe (tragus)
-Acromion
-Greater trochanter
-Axis of the knee
-Ankle joint/lateral malleolus

131
Q

What muscles are active in static standing?

A

-Gastroc/soleus
-Erector spinae
-Abdominals
-Paraspinals in cervical spine

132
Q

What are the 1st responders to loss of balance?

A

-Gastroc
-Tibialis anterior

133
Q

What does forward head posture cause?

A

-Changes the scapula musculature
-Impaired rhomboid and middle trap
-Anterior thoracic musculature becomes shortened
-Increases thoracic kyphosis

134
Q

How do forces on the neck increase with different angles of the head?

A

-0 degrees: 10-12lb
-15 degrees: 27lb
-30 degrees: 40lb
-45 degrees: 49lb
-60 degrees: 60 lb

135
Q

What muscles are tight and which are weak in upper crossed syndrome?

A

-Upper traps, levator scap, and pecs are tight
-Deep neck flexors, lower traps, and serratus anterior are weak

136
Q

What is considered to be an increased pelvic tilt?

A

13-14 degrees or more

137
Q

What muscles are tight and which are weak with an anterior pelvic tilt?

A

-Iliopsoas, rectus femoris, and erector spinae are tight
-Glute max and abdominals are weak

138
Q

What muscles are tight and which are weak with an posterior pelvic tilt?

A

-Hamstrings, glutes, and rectus abdominis are tight
-Iliopsoas, rectus femoris, erector spinae are weak

139
Q

What are the effects of an anterior pelvic tilt?

A

Lordotic back

140
Q

What are the effects of a posterior pelvic tilt?

A

Flat lumbar spine

141
Q

What are the effects of a forward shifted pelvis?

A

-Sway back
-Upper trunk shifts backward
-Hips hyperextend
-Knees hyperextend

142
Q

What happens when someone moves out of line with gravity?

A

Creates more muscular work

143
Q

What are major factors in dynamic postural control?

A

-Biomechanical alignment
-Muscle groups work together to maintain position
-Organization of firing pattern bases upon task
-Task that the individual is performing adapts to COM, BOS, and COG
-Sensory systems play a large role in dynamic posture

144
Q

What does dynamic postural control during walking require?

A

-COM changes as there are ground reaction forces and movement
-COM has linear movement
-BOS and COG over gravity line

145
Q

What do unique dynamic situations require?

A

-Hundreds of hours of practice
-Base of support outside the center of mass
-Creates a situation with greater risk for falls or loss of balance
-Repetition
-Specificity
-Transference

146
Q

What is the purpose of postural strategies?

A

-Adapt to a situation
-Postural strategies are “set” neuromuscular patterns
-Provide a fast and unconscious motor pattern to provide adaptation to changes in COM
-Humans have several unique strategies in quiet standing to a perturbation or force that moves their COM

147
Q

How do postural strategies respond?

A

-Respond via sensory input
-Activate a sensory response
-Muscular system responds with a set of muscular responses

148
Q

What are common postural strategies in adults?

A

-Ankle strategy
-Stepping response
-Hip strategy

149
Q

When do children acquire adult postural strategies?

A

Usually children get postural strategies at age 7

150
Q

What is pectus excavatum?

A

-Most common chest wall deformity
-1 out of 400 male births
-Males > female incidence
-Connective tissue begins to overgrow in the area of the sternum and ribs
-May lead to serious respiratory and cardiac issues

151
Q

What is Gibbus deformity? What is it caused by?

A

-Extreme thoracic kyphosis
-Spinal osteomyelitis
-Spinal tuberculosis
-Vertebral collapse

152
Q

What is a Dowager’s hump? What is it caused by?

A

-Over 50 degrees of thoracic kyphosis causing a hump
-Postural changes
-Age
-Computer use
-Steroid use
-Osteroporosis
-Fat build up
-Combines with forward shoulders

153
Q

What is Scheurmann’s disease?

A

-Juvenile kyphosis
-Occurs mostly in adolescent males
-Begins at 10-15 years of age
-Lasts about 3 years
-Pain
-Stiffness
-Fatigue
-Hamstring tightness

154
Q

What is the difference between postural kyphosis and Scheurmann’s disease?

A

-Ask the pt to bend forward
-If the curve in the back is steady/an even curve it is postural
-If the curve is uneven/very steep curve at one point then it is Scheurmann’s disease

155
Q

What is a test that can be done for femoral anteversion?

A

-Craig’s test
-Pt is prone with knee bent to 90 degrees
-Pt brings lower leg towards table into internal rotation until it stops
-Normal is between 8-15 degrees with the vertical
-More than 50 degrees of internal rotation indicates increased femoral anteversion

156
Q

What is static postural control?

A

-Static base of support
-Static individual

157
Q

What is dynamic postural control?

A

-Individual moving on static BOS (swaying)
-BOS is moving while individual is static (walking)

158
Q

What is static steady state?

A

-Sitting
-Standing

159
Q

What is dynamic steady state?

A

Steady position while wallking

160
Q

What is proactive state?

A

-Anticipatory balance
-Preparation for predicted change in balance
-Used during walking & steering as well

161
Q

What is reactive balance state?

A

-Responding to a push or trip
-Unexpected perturbation

162
Q

What are the four types of postural activity? Are they independent of each other?

A

-Static steady state
-Dynamic steady state
-Proactive/anticipatory
-Reactive
-These four activities are independent and separate tasks

163
Q

Which of the four types of postural activities are purely sensory? Which is sensory driven?

A

-Reactive is purely sensory
-Static steady state is sensory driven

164
Q

Which of the four types of postural activities are learned?

A

-Dynamic steady balance
-Proactive/anticipatory

165
Q

Do the four types of postural activity have transference from one task to another?

A

No, they are separate tasks and have to be trained differently

166
Q

What are the elements of postural control?

A

-Biomechanical alignment
-Sensory feedback
-Muscular activation

167
Q

How do humans initially learn to obtain posture?

A

With the visual system

168
Q

Why is the visual system important for postural control?

A

It is an important source of information for steady state postural control

169
Q

How is the vestibular system involved in postural control?

A

The vestibular system provides the CNS with information about the position and movement of the head with respect to gravity and inertial forces, providing a reference for postural control

170
Q

What receptors are found in the soles of the feet and the palms of the hands? How do they help us with postural control?

A

-Merkels cells: epidermis light touch
-Pacinian corpuscles: pressure, vibration
-Meissner’s corpuscles: fine detail touch
-Ruffini endings: stretch and movement
-Proprioception and kinesthesia
-Sense awareness of joints
-Sense joint movement
-Sense joint force and weight heaviness

171
Q

What type of information does the muscle spindle provide?

A

-Awareness of movement
-Speed of contraction and length of muscle

172
Q

What type of information does the golgi tendon organ provide?

A

Force of heaviness in objects or creation of force

173
Q

What type of information do joint capsule receptors provide?

A

Information regarding joint movement

174
Q

What do the sensory systems integrate together to do? What systems are involved?

A

-The sensory systems integrate together to provide feedback to keep upright and in alignment
-Vision
-Cervical proprioception
-Vestibular system
-The CNS takes information from sensorimotor cortex and cervical spine

175
Q

What happens after the CNS receives the sensory information regarding postural control?

A

-An automatic motor response is activated based upon the direction of change, force, and postural position
-Creates a muscular response that is organized, on time, spatially organized, and has the correct force

PHTH 534: Gait and Movement (2 decks)

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