impairments Flashcards
in a patient with poor proprioception we would expect to see:
ankle plantarflexion and knee hyperextension with a wide base of support and excessive variability
in a patient with vestibular issues we would expect to see:
wide base of support and limited time in single limb stance, poor reactive balance, limiting head motion, limited time in single leg stance
if a patient aligns the ground reaction forces so they can fall on passive structures then you would expect and issue with:
muscle strength
if a patient has insufficient or excessive amplitude of muscle activity through the entire ROM then:
you suspect an issue with muscle activation
if a patient has insufficient amplitude of motion during swing limb advancement or difficulty stabilizing a joint during stance phase then:
you suspect an issue with timing of muscle activity
if patients gait pattern appears to be stiff or arrhythmic then:
you suspect an issue with sequencing of the muscle activity
if a gait deviation is present in all phase of motion then you should consider the __________ of the muscle
flexibility
if a gait deviation is found in most phases along with excessive stiffness, jerky motion, or a wobble, take a look at
hypertonicity
if the individual aligns the ground reaction forces such that they rely on passive structures you should take a gander at:
hypotonicity
shortened gastroc-soleus lacking ~15 degrees DF
knee hyperextension at WA and Mst, foot flat contact, excessive plantarflexion at LR, MSt, and TSt. Compensatory strategy to clear swing limb
shortened gastroc-soleus lacking ~30 degrees DF
heel off in all phases, forefoot contact, compensatory strategy to clear swing limb
shortened hamstring with popliteal angle of at least 45 degrees
excessive hip and knee flexion during all stance phases except for PSw, TSw will be an issue due to missing extension
shortened iliopsoas with thomas test of at least 10 degrees
excessive hip flexion, knee flexion and dorsiflexion in all phases of gait, TSt will be difficult due to lack of hip extension
hypertonicity of gastroc-soleus
excessive plantarflexion in all phases, compensatory strategy to clear swing limb, KNEE WOBBLE (this is what separates it from shortened gastroc-soleus)
hypertonicity of hamstrings
excessive knee flexion during stance phases and at TSw, excessive hip flexion and ankle dorsiflexion during stance phases
hypertonicity of quadriceps
limited knee flexion at LR, PSw, and ISw, may also have knee wobble at LR and PSw
hypertonicity of iliopsoas
will have difficult at TSt, as limb is unloaded for SLA you may observe a jerky motion
weak tibialis anterior
will struggle most with SLA, will have forefoot contact or foot slap, compensatory strategy is used to clear the swing limb
weak gastroc-soleus
difficulty stabilizing the limb in single limb stance, excessive dorsiflexion, knee flexion, and hip flexion during MSt and TSt, reduced push off during PSw
weak quads
greatest difficulty with LR, will change GRF with knee hyperextension and forward trunk lean
weak hamstrings
may see past retract as hamstrings cannot decelerate tibia
weak iliopsoas and rectus femoris
hip will externally rotate to allow adductor longus to function as a hip flexor, compensatory strategy to clear swing limb
weak iliopsoas, rectus femoris, and adductor longus
the andreas walk, enough said
weak glut max
can head bob, if you have bilateral weakness will use compensated strategy of leaning back
weak glut med
with small impairment there will be a contralateral pelvic drop, large impairment will involve a lateral trunk lean
