Lecture Exam 2 Flashcards
conscientious, explicit, and judicious use of current best evidence when making decisions about the care of patients
EBP
the following 3 areas are commonly used to develop what?
relevant published evidence
clinical expertise
patient’s circumstances & values
EBP
name the 6 most common levels of evidence (from most to least effective) used in PT research studies?
- Meta Analysis
- Randomized Control Trial (RCT)
- Cohort Study
- Case Control Study
- Cross Sectional Study
- Case Reports
which level of evidence is being described?
- systemic review
- uses a statistical technique to get an estimate of the amount of effect
- combines the results of several RCT to determine the overall effectiveness of a treatment
Meta Analysis
which level of evidence is being described?
- used to assess the relative effect of specific interventions compared to a controlled condition
- subjects are randomized into groups (control & experimental group)
- groups are identical except for the treatment being provided
- double blind random application
Randomized Control Trial (RCT)
which level of evidence is being described?
- longitudinal study where subjects are followed overtime
- can be performed by looking at historical records
- takes a very long time to conduct
- not very controlled; many variables could be present that can influence the outcomes
Cohort Study
which level of evidence is being described?
- 2 groups of subjects
- one group has the condition/disease
- one group does not have the condition/disease
- provides better information about the effects of an intervention than a case report
Case Control Study
which level of evidence is being described?
- observations/data made at one point in time
- all subjects are tested around the same time
- looks at relationships between diseases/conditions & a factor/interest that happens at a certain time
- limited studies because they can’t show casual relationships
Cross Sectional Study
which level of evidence is being described?
- provide information about what was done to a particular patient & what happened to them
- no clear indications of what caused observed changes
- considered the least strong evidence for the effectiveness of an intervention for a particular problem
Case reports
what term is being described?
neither the subjects or clinician should know if an active or placebo treatment is being used to most accurately determine the effects of an intervention
Double Blind Random Application
what term is being described?
selections depends on:
- what’s being studied
- type of desired outcome
- subject availability
subjects
what term is being described?
needed to be able to differentiate:
effects of chance
normal progression
nonspecific effects from specific effects of the intervention being evaluated
double blind RCT is gold standard for research design
controls
what term is being described?
interventions without known or expected biological effects
placebo
what term is being described?
- reproducibility of data
- gives the same result when applied in the same situation
reliability
what term is being described?
consistent agreement of measurements taken by different examiners
interrater reliability
what term is being described?
consistent repeated measurement made by the same person over time
intrarater reliability
what term is being described?
how often the instrument measures what it’s intended to measure
validity
what term is being described?
integrity of the study design
internal validity
what term is being described?
how the results can be applied to non-study patients or populations
external validity
what term is being described?
- should be clinically relevant & relate directly to goal(s) of treatment
outcome measures
what term is being described?
- probability of any difference being purely a result of chance
- smaller the value, the less likely the null hypothesis is true & more likely that the intervention had an effect
p value
findings with a p value of less than 0.05 are considered what?
statistically significant
which component of the gait cycle is being described?
stance foot touches the ground
heel strike/
initial contact
which component of the gait cycle is being described?
- period of initial double limb support
- knee flexes to help conserve energy & absorb shock
- BEGINS: when entire foot makes contact with the ground
- ENDS: when opposite foot leaves ground
foot flat/
loading response
which component of the gait cycle is being described?
- single leg support begins
- body is passing over WB limb
- pelvis in neutral position & arms parallel with body
- COG at highest point
- BEGINS: when opposite foot leaves ground
- ENDS: when body is directly over WB limb
midstance
which component of the gait cycle is being described?
- body moves ahead of WB limb
- single leg support ends
- BEGINS: as heel of WB limb rises
- ENDS: initial contact of opposite limb
heel-off/
terminal stance
which component of the gait cycle is being described?
- leg advancement ends
- double leg support begins & ends
toe-off/
pre-swing
which component of the gait cycle is being described?
- swing phase begins
- single leg support begins on contralateral side
- ipsilateral arms swings backwards
- BEGINS: when toe leaves the ground
- ENDS: when the swing limb is opposite to the WB limb & the knee is in maximum flexion
initial swing/
acceleration
which component of the gait cycle is being described?
- leg shortens to clear ground
- single leg support on contralateral side continues
- pelvis is neutral & arms are parallel with body & moving in opposite directions
- BEGINS: when the swing limb is opposite the WB limb
- ENDS: when the swing limb has moved in front of the body & the tibia is in a vertical position
midswing
which component of the gait cycle is being described?
- leg advancement ends
- single leg support ends
- ipsilateral arm back & contralateral arm forward
- BEGINS: when the tibia is in a vertical position
- ENDS: just before initial contact
terminal swing/
deceleration
which phase of gait makes up 60% of the cycle?
stance phase
which phase of gait makes up 40% of the cycle?
swing phase
0-30 degrees is the necessary ROM requirement for which LE movement involved in a typical gait pattern?
hip flexion
0-10 degrees is the necessary ROM requirement for which LE movement(s) involved in a typical gait pattern?
hip extension
dorsiflexion
0-60 degrees is the necessary ROM requirement for which LE movement involved in a typical gait pattern?
knee flexion
0 degrees is the necessary ROM requirement for which LE movement involved in a typical gait pattern?
knee extension
0-20 degrees is the necessary ROM requirement for which LE movement involved in a typical gait pattern?
plantar flexion
what are the 3 functions of the foot & ankle during gait?
shock absorption
terrain comforting
propulsion
what term is being described?
the number of steps per unit of time (steps/min)
cadence
what is the average cadence of
male:
female:
total average:
male: 111 steps/min
female: 117 steps/min
total average: 90-120 steps/min
what term is being described?
distance between point of initial contact of one extremity & the next point of initial contact of the same extremity
stride length
what term is being described?
distance between point of initial contact of one extremity & the point of contact of the opposite extremity
step length
1 step length is equal to how many stride lengths?
1/2 a stride length
what term is being described?
fundamental unit of walking
gait cycle
what term is being described?
takes place during loading response & preswing
double limb support
what term is being described?
occurs as the body weight shifts completely onto the stance leg so the opposite leg can swing forward (midstance & terminal stance)
single limb support
during the gait cycle, which muscle’s role is being described?
initial swing
iliopsoas
during the gait cycle, which muscle’s role is being described?
- initial contact (E)
- initial swing (c)
- midswing (c)
- terminal swing (c)
ankle DFs
during the gait cycle, which muscle’s role is being described?
- initial contact (c)
- loading response (E)
quadriceps femoris
during the gait cycle, which muscle’s role is being described?
- initial contact (c)
- loading response (c)
- midstance (c)
gluteus maximus & medius
during the gait cycle, which muscle’s role is being described?
- loading response (c)
- midstance (E)
- terminal stance (c)
- preswing (c)
ankle PFs
during the gait cycle, which muscle’s role is being described?
- terminal swing (E)
hamstrings
what gait deviation is being described?
- body weight is shifted to involved side during stance phase, hip abductors can’t support the pelvis, and the pelvis drops/tilts toward the swing limb
- excessive lateral trunk flexion
- weight shifting over stance leg
- glute med weakness
trendelenberg
what gait deviation is being described?
- limb is swung in a circular motion to advance
- weak hip flexors
- decreased knee flexion
- inability to dorsiflex
- leg length difference
circumduction
what gait deviation is being described?
- DF not strong enough to hold against gravity
- causes foot to drop into PF in swing
foot drop
what gait deviation is being described?
- DF unable to eccentrically & slowly lower foot down into PF at initial contact
foot slap
what gait deviation is being described?
toe drag
what gait deviation is being described?
- toes strike first at initial contact
equinnus gait
what gait deviation is being described?
- to advance, the swing leg compensates through a combination of pelvis elevation & PF of stance leg
- rise on toes of uninvolved extremity
- decreased hip flexion, knee flexion, or DF of involved extremity
vaulting
what gait deviation is being described?
shorter stance time because of pain in stance limb
antalgic
what gait deviation is being described?
- legs cross midline upon advancement (swing)
- narrow base
trunk may lean over stance leg
scissoring
what gait deviation is being described?
- knee raised higher than normal during swing
- toes land first
steppage
what gait deviation is being described?
- ipsilateral pelvis elevation in swing phase
- decreased knee flexion or DF
hip hiking
what gait deviation is being described?
- B LE involvement
- excessive hip & knee flexion
- excessive hip adduction, MR & PF
crouch knee
what gait deviation is being described?
stiff knee
what gait deviation is being described?
has 3 types of length discrepancy: minimal, moderate (3-5 inches), and severe
unequal leg length
what gait deviation is being described?
(closed chain) glute max & gastroc/soleus pull knee into extension at heel strike
quad weakness
