FUNCTIONAL MOBILITY

Question 1

Biomechanical components required to roll

Answer 1

• Move head relative tot thorax (cervical flexion and rotation toward side)
• Reach upper arm across stable thorax (includes upper limb reach pattern)
• Pelvic rotation toward side
• Move upper leg relative to pelvis

Question 2

Components required to lie to for

Answer 2

• Move head relative to thorax
• Reach upper arm across stable thorax (includes upper limb reach pattern)
• Move one leg relative to pelvis and other leg

Question 3

Components required for sit to stand

Answer 3

• Initial foot placement back, feet in line with hips
• Forward movement of erect trunk (hip flexion)
• Forward knee translation
• Head upright but not over-extending
• hip and knee extension
• Complete extension of knee and hip
• Ability to symmetrically weight bear

Question 4

What do you want to look at in movement analysis

Answer 4

• What is moving
• what is working concentrically
• What is acting eccentrically
• Angles of biomechanical movements
• Strategies client utilizes to move

Question 5

Critical components of sit to stand ** EXAM QUESTION**

Answer 5

• Initial foot placement (10cm back of vertical, ~15 degrees of DF from neutral)
• Flexion of the extended trunk at the hips to move body mass forward with DF at ankles
• Knee and hip extension with coordinated ankle plantarflexors working together in extension phase
• Generation of sufficient speed - horizontal and vertical momentum to propel body forward and upward over feet
• Generation of sustaining of lower limb joint forces to support and raise the body mass into standing
• Postural stability at thighs-off, controlling the COM in relation to foot support

Question 6

Common deviations in Sit to stand after a neurological injury - this card is effed

Answer 6

• Inability to stand up independently: lower limb weakness, lack of coordination
• In sitting: absent/insufficient foot placement backwards - (weakness of hamstrings and ankle DF) or decreased extensibility of soleus
• Decreased projection of body mass forward (flex hips and DF ankles)
• Fear of falling forward/backward
• Decreased stability at lift off when momentum switches from horizontal to vertical displacement
• Switching from hip flexion to extension and vice versa
• Spine flexes instead of hips flexing
• moving very slowly
• Decreased control ins itting (weakness in eccentric control)
• Biasing strong leg
• use of hands for balance
• Arms swing forward to assist with horizontal and vertical propulsion
• increase BOS between feet

Question 7

Outcome scales for functional mobility

Answer 7

• Timed STS test (10 times)
• COVS
• TUG
• FIM
• Chedoke

Question 8

When do we aim for recovery?

Answer 8

• Early in rehab
  
  • Demonstrating recovery/regaining normal movement
  • Numerous positive prognostic indicators
  • Client motivated/able to follow commands
    Helps initiate

Question 9

When do we aim for compensatory strategies

Answer 9

• Have given recovery/normal movement training a good try
• No significant change in functional mobility
  
  • An adaptive device/method give client more functional independence
  • Numerous negative prognostic indicators - prognosis does not indicate potential for improvement
  • Need client to be functional only means of independence for an individual
  • Training caregivers to care for client
    Prevention of injury for client or caregivers

Question 10

When is compensation not appropriate

Answer 10

• Leads to learned non-use
• Impeded potential for recovery
• Leads to pain
  Impacts functional performance of the task in various environments
• Impacts the functional performance of other tasks in various environments
• Impacts future performance