Knee Pathological Joint Deviations Flashcards
what are the direct / indirect causes of Limited Knee Flexion?
- 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)
what are the effects of Limited Knee Flexion?
- increased passive dorsiflexion
- increased energy cost
- interferes with foot clearance –> toe drag
- seen in pass-retract
what are substitutions for Weak Quads?
- 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
what are the effects of Knee Extensor Thrust?
- 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)
what are the direct / indirect causes of Excessive Knee Flexion?
- 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
what are the effects of Excessive Knee Flexion?
- increases demand on the plantarflexors, quadriceps, and hip extensors
- decreased body advancement @ thigh
- decreases limb stability
- increased dorsiflexion
- decreased step length
what are the effects of Excessive Knee Flexion in SWING?
- decreased step length of reference limb
- interferes with heel first IC
- allows clearance of PF’d foot
what are the causes / effects of Varus/Valgus Angulation?
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
what are the causes / effects of Wobble Knee?
Small alternations of knee flexion/extension
Causes:
- decreased proprioception
- increased quads or PF activity – spastic clonus
Effects:
- decreases forward momentum
- decreases limb stability & balance