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MSPT I > GAIT--Knee > Flashcards

GAIT--Knee Flashcards

1
Q

Put in knee motion in sagittal plane chart from Notability!!!!

A

see chart

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2
Q

Knee motion sag. plane

IC

A
  • motion== neutral
  • quantity==neutral
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3
Q

Knee motion sag plane

LR

A
  • motion== flexing
  • quanitity== 0-20deg
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4
Q

Knee motion sag. plane

MSt

A
  • motion== EXT
  • quantity== 20-0deg
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5
Q

Knee motion sag plane

TSt

A
  • Motion== Holding
  • Quantity== Neutral
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6
Q

Knee motion Sag plane

PSw

A
  • Motion== flexing
  • quant== 0-40deg
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7
Q

Knee motion sag plane

ISw

A
  • Motion== Flexing
  • quant== 40-60/70deg
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8
Q

Knee motion sag plane

MSw

A
  • motion== EXT
  • quant== 60/70– 30deg
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9
Q

knee motion sag plane

TSw

A
  • Motion== EXT to FULL EXT
  • quant== 30–0deg (neutral)
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10
Q

Knee Flex Contracture

Step length==

A

DECd ipsilateral step length

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11
Q

Knee flex contracture

Cadence

A
  • No change UNLESS pt makes effort to maintain velocity
    • ​this req’s quicker steps to make up for step length
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12
Q

knee flex contracture

Velocity

A
  • DECd due to less distance covered w/ ea step/stride ​
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13
Q

Knee flex contracture

Stride Length

A
  • Shortened stride UNLESS Contralat. limb compensates w/ longer step
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14
Q

GRF @ IC

*NOTE: knee ext in TSw created by momentum of limb

A
  • IC—> GRF
    • ANT to knee ==== EXT moment
    • ​Quads act minimally to stabilize knee & control momentum
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15
Q

GRF @ LR

A
  • GRF shifts from ANT @ IC to POST @ LR as HAT continues forward over flexed foot
    • ​=== External knee FLEX moment
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16
Q

Quads activity in LR

A
  • External knee flex moment OPPOSED by Quad activity as an Internal knee EXT moment
    • ​ESP Vasti muscles!!!
      • ​Mostly VL
    • NOTE: rec fem only in SWING
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17
Q

Hamstrings in LR

A

NONE

  • undesired
  • could cause excess FLEX or Jt compression
    • ​HS and Quads @ same time===co-contraction==jt. loading
      • ​== lig injury, meniscus injury, OA
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18
Q

GRF during Stance

LR

Gastroc

A
  • despite being 2jt mm====> gastroc rel. silent @ LR
    • ​Soleus helps to control tibia advancing forward
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19
Q

PF Spasticity

LR–> MSt

A
  • patho. gait pattern often seen in pts post-CVA
    • spastic PFs===knee hyperext
      • ​== Extensor Thrust
    • As limb loads—> excess PF spasticity drives tibia POST
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20
Q

Knee Discomfort in MSt

3 Factors:

A
    1. Contralat limb is in swing, therefore 100% of WB occurs on involved limb
      * ​HAT creates rel. ADD moment
    1. Transverse plane rotation b/w tibia and femoral condyles
    1. MAY see Varus Thrust as degenerated medial compartment approximates
      * == Lat. tension (stretching)
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21
Q

Knee ROM during gait

MOST during where

A

SWING

*indiv. tries to shorten limb for clearance

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22
Q

HIP compensation for knee and Clearing limb

A
  • IF knee is unable to flex=== becomes functionally longer
  • now Limb Clearance is an issue=== compensatory strategies BEFORE swing OR @ ISw
  • @ Hip/Trunk you will observe:
    • ​CONTRALAT. trunk lean
    • IPSILAT hip hike
    • Circumduction
    • others or combo of above
23
Q

30deg Knee Flex contracture

Step Length

A

DECd

24
Q

30deg Knee flex contracture

IC

A
  • IC likely on forefoot as pt PFs to functionally lengthen
    • ​TRUE heel strike is UNLIKELY
      • ​due to lack of Knee EXT advancing tibia and foot past knee
25
Q

30deg Knee flex contracture

Persistent knee flex creates_______

A
  • persistent knee flex creates persistent external knee FLEX moment
    • ​INCd distance from knee jt axis to GRF vector POST to knee
    • Quad activation must INC to prevent collapse into FLEX
26
Q

30deg Knee flex contracture

If uncompensated for elsewhere=====

A
  • Trunk will likely lean TOWARDS shorter limb (contracture side) in order to put foot on ground
27
Q

MAX amt Knee flexion in STANCE

A

20deg

28
Q

MAX amt Knee Flex in SWING

A

60-70 deg

29
Q

Talocrural motion during Gait sag plane

IC

A
  • motion== Hold
  • quant== neutral
30
Q

Talocrural motion sag plane

LR

A
  • motion== PF
  • quant== 10deg
31
Q

Talocrural motion sag plane

MSt

A
  • motion== DF
  • quant== 5-15deg
32
Q

Talocrural motion sag plane

TSt

A
  • Motion== into MORE DF
  • quant== 10-15 (MAX DF)
33
Q

Talocrural motion sag plane

PSw

A
  • Motion== PF
  • quant== ~20deg
34
Q

Talocrural motion sag plane

ISw

A
  • Motion== DF back toward neutral
  • quant== FROM 20deg PF TO 5deg PF
35
Q

Talocrural motion sag plane

MSw

A
  • Motion== DF back to neutral
  • quant== 5deg–0deg (neutral)
36
Q

Talocrural motion sag plane

TSw

A
  • motion== HOLD
  • quant== Neutral
37
Q

Ankle upon IC

A

NEUTRAL

  • quickly moves into PF during IC
  • foot slightly inverted (SUPINATED) for Stability @ IC
    • ​remember supinated foot==RIGID foot
      • ​this is when we NEED rigid foot!!!
38
Q

@ IC

ankle joint axis

A
  • loc’d obliquely thru malleoli @ IC
    • vector from GRF passes POST to the axis
39
Q

IC–LR

ankle mm activity

A
  • Tib Post (most active)
    • ​Ecc. controls Eversion (pronation)
      • ​remember we need the rigid (supinated) foot****
  • Tib Ant
    • ​Ecc. controls PF
40
Q

MSt

ankle mm activity

A
  • Gastroc
    • Ecc. controls DF
41
Q

Ankle mm activity

TSt

A
  • Fibularis/Peroneus Longus
    • Ecc. Counter inversion (supination)
42
Q

Ankle @ IC–> LR

A
  • Subtalar moving from supinated or neutral to more pronated pos. @ end of LR
    • ​accomodating TO floor
      • ​need to SLOW this down
        • ====Tib Post
43
Q

Ankle @ LR

A
  • Vector from GRF passes thru heel—> moving ANT from LR–> MSt
    • ​== DF moment
44
Q

Ankle @ MSt===

A

PFs

  • Contract Ecc. to SLOW the forward progress of tibia as it moves over a fixed foot
45
Q

TSt begins w/______

A

Heel Rise*****

46
Q

Ankle @ TSt

A
  • Begins w/ heel rise****
  • Ankle pos’d in 15deg DF moving TOWARDS PF in prep for PSw
  • PFs contract CONC. w/ 1st MTPJ on floor to INVERT calcaneus (supinate) & lift heel off the floor
47
Q

PSw will be MOST affected by_____

A

Hallux Rigidus

*we need 55deg of 1st MTPJ EXT here

48
Q

Ankle

what muscle MOST active during SWING?

A

Tib Ant

49
Q

Tib Ant MOST active during SWING

A
  • Conc. to DF foot and clear floor
  • EHL and EDL also act Conc. to ASSIST w/ DF, BUT in normal gait====> Tib Ant MOST active
50
Q

Ankle in PSw

A
  • ankle PF to 20deg
  • THIS IS MOST NEEDED PF PHASE!!!
51
Q

MOST needed PF phase

A

PSw

52
Q

Paralyzed OR Severe Weakness of DF’s

A
  • Footslap @ IC +
  • Toe Drag @ MSw w/out compensation
53
Q

Severe weakness of IPSILAT DF’s

A
  • MOST LIKELY cause excessive flexion in hip and knee in order to clear PF’d foot and avoid tripping
  • MOSTLY in MSw
54
Q
A

MSPT I (10 decks)

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