Functional Mobility

Question 1

Functional mobility

Answer 1

• important to OTs because of ADLs
• ambulation

Question 2

Stability

Answer 2

• the ability to maintain control of the position or movement of your body
• depends on vision, vestibular system, proprioception, and tactile sensation
• base of support (BoS)
• center of gravity (CoG)

Question 3

Base of support (BoS)

Answer 3

• parts of the body or mobility devices that come into contact with the ground and the distance between those points
• the more points of contact and the larger the distance between them = the better the base of support and stability (to help make it easier to do functional mobility)

Question 4

Center of gravity (CoG)

Answer 4

• focal point at which gravity acts
• where the weight of an object is evenly distributed
• lowering towards the ground increases center of gravity and stability (athletic stance)
• anatomical position = center of gravity is at the 2nd sacral level
• center of gravity changes with carrying of objects and movement of the body

Question 5

Key takeaways of stability

Answer 5

• as your base of support widens, stability increases
• as your center of gravity lowers towards the ground, stability increases

Question 6

Positioning and postural alignment

Answer 6

• OTs assess positioning of individuals who spend a lot of time in bed or in a seated position (like in ICU, hospital, and wheelchairs)
• posture

Question 7

Bony processes that can lead to skin breakdown if sitting for prolonged time or laying on the bed

Answer 7

• occiput
• scapula
• olecranon
• sacrum
• calcaneus
• ear
• acromion
• lateral epicondyle
• greater trochanter
• epicondyles (of the knee)
• malleoli
• medial epicondyle
• rib cage
• iliac crest
• patella
• toes
• thoracic spinous processes
• ischial tuberosity
• back of knees
• foot

Question 8

Posture

Answer 8

• relative position of body segments in response to demands of activity
• depends on sensory input and motor output
• voluntary and involuntary
• lighting, workspace, and environment

Question 9

Ergonomics

Answer 9

• fitting the workplace to the worker
• lumbar spine supported against back of chair
• hips, knees, and elbows at 90 degrees
• wrist neutral
• monitor 18-24 inches away from face at eye level
• head and neck in neutral

Question 10

Functional mobility

Answer 10

• OTPF
• bed mobility
• wheelchair mobility
• gait
• stance phase
• swing phase

Question 11

OTPF

Answer 11

• moving from one position/place to another such as in bed mobility, without mobility, and transfers
• includes functional ambulation and transfer of objects

Question 12

Bed mobility

Answer 12

• pain, generalized weakness, paralysis can all impact ability to move in bed (ex: with their core)
• lack of bed mobility can contribute to skin breakdown
• OT provides education on position changes
• use of logrolling, bridging, and sometimes a trapeze bar (SCI)
• speciality bed, hospital beds

Question 13

Gait

Answer 13

• typical gait features a reciprocal pattern of lower extremity movement
• alternating stance and swing phases
• includes concentric, eccentric, and isometric contraction
• step
• step width
• cadence

Question 14

Step

Answer 14

• distance that one foot advances to the other foot
• measured as the right heel strike to the left heel strike

Question 15

Step width

Answer 15

• width (distance) between heels
• determines base of support

Question 16

Cadence

Answer 16

• number of steps per minute

Question 17

Sequence of stance phase

Answer 17

• heel strike
• foot flat
• mid stance
• heel off
• toe off

Question 18

Sequence of swing phase

Answer 18

• acceleration
• mid swing
• deceleration

Question 19

Abnormal gait patterns

Answer 19

• Trendelenburg gait
• circumduction gait
• foot drop
• hemiplegic gait
• Parkinsonian gait
• scissor gait
• ataxic gait

Question 20

Trendelenburg gait

Answer 20

• weakness in gluteus medius (abductor of hip)
• causes lateral lean to the affected side to compensate for the weakness

Question 21

Circumduction gait

Answer 21

• muscle weakness in legs causes trunk and pelvis to compensate by laterally swinging leg out to the side of the body to propel it forward
• occurs with hemiplegia, osteoarthritis of the knee, and general muscle weakness

Question 22

Foot drop

Answer 22

• weakness or paralysis of ankle dorsiflexors impair heel strike
• toes come into contact with the ground before the heel
• common after a stroke or traumatic brain injury (TBI)

Question 23

Hemiplegic gait

Answer 23

• paralysis of one side of the body resulting from stroke, CVA (cerebrovascular accident), or cerebral palsy
• can include circumduction of the leg and foot drop
• hip is adducted and knee locked in extension
• arm is flexed at the elbow and wrist and is held against the body = limits balance

Question 24

Parkinsonian gait

Answer 24

• affected by impaired perception and modulation of motor movements
• shuffling feet with small forward movements and limited elevation of the legs
• weight is placed on the balls of the heels with flexion of trunk

Question 25

Scissor gait

Answer 25

- narrowing or crossing over the legs during ambulation - associated with cerebral palsy and other neurological diagnoses

Question 26

Ataxic gait

Answer 26

- unique gait where strength and range of motion are not compromised BUT the coordination is - usually caused by neurological impairment of the cerebellum