Knee Pathological Joint Deviations Flashcards

1
Q

what are the direct / indirect causes of Limited Knee Flexion?

A
  • Hypertonic quads (WA)
  • decreased proprioception (WA)
  • Forefoot or foot-flat contact w/ increased PF (WA)
  • Purposeful to increase limb stability (WA)
  • Weak quads (WA) – how to compensate?
  • Knee pain (effusion) (WA, SLA)
  • Extensor spasticity (ankle PF) (SLA)
  • PF contracture (SLA)
  • Knee Extension contracture (SLA)
  • increased hip flexion or no heel-off in TSt (SLA)
  • Impaired motor control knee flexors (SLA)
  • Limited thigh advancement 2° increased hamstrings activity(SLA)
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2
Q

what are the effects of Limited Knee Flexion?

A
  • increased passive dorsiflexion
  • increased energy cost
  • interferes with foot clearance –> toe drag
  • seen in pass-retract
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3
Q

what are substitutions for Weak Quads?

A
  • pass retract motion will extend knee at terminal swing
  • hip extension / early PF limit tibial advancement and quad strain in LR
  • hyperextension of knee thru stance via anterior BW vector
  • extensor thrust
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4
Q

what are the effects of Knee Extensor Thrust?

A
  • Decreases forward progression of tibia (WA, SLS)
  • Decreased normal shock absorbing flexion (WA)
  • Potential injury to posterior knee capsule (WA, SLS)
  • Provides stability (WA, SLS)
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5
Q

what are the direct / indirect causes of Excessive Knee Flexion?

A
  • Knee flexion contracture or hypertonicity (of which muscles?)
  • Weak quads (ecc control)
  • Knee pain
  • Mass flexion - synergy
  • increased PF ROM – Stance
  • increased dorsiflexion ROM - Stance
  • Inability to extend knee while maintaining flexed hip - Swing
  • Purposeful to lower opposite limb (TSt) for forefoot or foot-flat IC - Stance
  • PPT w/ hip flexion contracture - Swing
  • increased contralateral stance stability
  • increased hip flexion ROM - Swing
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6
Q

what are the effects of Excessive Knee Flexion?

A
  • increases demand on the plantarflexors, quadriceps, and hip extensors
  • decreased body advancement @ thigh
  • decreases limb stability
  • increased dorsiflexion
  • decreased step length
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7
Q

what are the effects of Excessive Knee Flexion in SWING?

A
  • decreased step length of reference limb
  • interferes with heel first IC
  • allows clearance of PF’d foot
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8
Q

what are the causes / effects of Varus/Valgus Angulation?

A

Causes:
- Joint or ligamentous instability, congenital, developmental or traumatic bony deformity
- Dysfunctional subtalar joint

Effects:
- decreases limb stability
- May require proximal or distal compensation
- May result in knee pain
- May increase or decrease BOS

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9
Q

what are the causes / effects of Wobble Knee?

A

Small alternations of knee flexion/extension

Causes:
- decreased proprioception
- increased quads or PF activity – spastic clonus

Effects:
- decreases forward momentum
- decreases limb stability & balance

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