Lecture 9 Flashcards
What is the difference between a structural and a functional abnormality?
- Structural deformity is always present => anatomical cause
- Functional deformity is only during a respective function => functional cause (weakness, coordination, neuromuscular control, tone…)
What is the result of the restriction against movement is “non-neural”?
It is muscle (tissue) stiffness that results in slow movement
What is the result if the restriction against movement is “neural”?
Either:
- It is spasticity, which results in fast movement (TARDIEU)
Or:
- it is unconsious background activity (high tone), whcih results in slow movement (ASHWORTH)
Repitition: What are the conditions for normal walking, with the correct otder priority?
- Stability in stance
- Free step clearance
- Pre-ositioning of the foot during swing
- Adapted step length
- Energy conservation
For stability in stance, what is the required joint position (maximal)?
- Hip less than 10 degrees of flexion
- Knee at 0 degrees
- Ankle neutral
For dynamics in in swing, what is the required joint position (maximal)?
- Ankle at neutral (if plantar flexion is not possible)
- Knee at 50 degrees
- Hip at 40 degrees of flexion
Whic muscles are considered in “dynamics in swing “?
- Plantar flexors (push off at pre-swing)
- Rectus (hip flexion + knee extension pre-swing to mid-swing)
- Hip flexors (acceleration of leg)
Which anatomical feature is a good indicator for abnormalities?
The kneecap
e.g. if the knee cap is straight but the foot is turned, then the issue is must likely below the knee
How can functional outcomes from a clinical study (e.g. ACL repair methods) be determined?
Performance outcomes (quantitaive: how much is the performance?)
Biomechanical outcomes (qualitative: how is this performance achieved?)
What are some challanges of biomechanics in clinical settings?
- It is time-consuming
- Limited or challanging reimbursement
