Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Movement Analysis > Movement Analysis Test 1 > Flashcards

Movement Analysis Test 1 Flashcards

1
Q

Ipsilateral pelvic drop

Task, cause, significance

A

All

Compensatory for shortened reference limb (WA, SLS)
Weak hip abductors on opposite limb (SLA)
Intentional to lower the limb for IC (SLA)
Adductor spasticity (SLA)

May result in back pain (WA, SLS)
May decrease opposite stance limb stability (SLA)
Increase relative length of reference limb (SLA)
May increase energy cost (SLA)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What is gait?

A

The manner in which a person walks

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Kinematic variables of gait

A

joint ROM

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

During which phase is greatest ankle DF required?

A

Terminal stance

2nd is Mid-Stance at 5*

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

How does running differ from walking?

A

Running requires greater:
Balance (no double limb support period; “float periods”)
Strength
ROM

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

A significant amount of hip ___ is required for mid-swing

A

Flexion 25*

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Which phases of the gait cycle are involved in weight acceptance?

A
  1. Initial contact

2. Loading response

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

How does pronation of the subtalar joint affect the rest of the foot?

A

Unlocks the midtarsal joint for shock absorption during forefoot floor contact

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

The posterior tibialis ___ during initial contact

A

Not typically active

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

The ____ are minimally active in Terminal stance

A

Pretibial

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Excess PF in WA

Most likely cause

A

PF contracture

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Contracture intervention

Not short-term effective per research

A

Stretching on QOL, pain, joint mobility

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Terminal stance

Critical events

A

Controlled ankle DF with heel rise; trailing limb

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Secondary deviations

A

Gait deviation occurring as a secondary consequence of a more distant or obscure impairment

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Phase of gait with heel rocker

A

Positioned in Initial contact;

Heel rocker action during Loading Response

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

During pre-swing what is happening at the MTP joints?

A

ROM- move into 60* extension

Torque- extension torque rapidly decreases

Muscle action- calf muscle activity ceases

Functional significance- forefoot on floor assists balance

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Can no heel off affect swing period of gait?

A

Results in limited knee flexion which can limit limb clearance (drag toes)
Especially in ISw

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Loading response is completed with __* of ankle __

A

5* PF

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

How does excess eversion affect SLA?

A

May be caused by selective weakness of anterior tibialis or hypertonicity of peroneal muscles

Interferes with foot position for IC

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Initial swing

Ankle

A

5* PF

Pretibials

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Terminal stance

Hip

A

20* apparent hyperextension

No muscle activity

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Mid Swing

Critical events

A

Further hip flexion to 25*

Ankle DF to 0*

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

During mid-stance what is happening at the pelvis?

A

Rotated backward in horizontal plane to neutral

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Weight acceptance

A

1st task of stance

  1. Initial contact
  2. Loading response

Most challenging
Forward progression, limb stability, and shock absorption

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

Contralateral vaulting SLA

Significance

A

Increases demand on calf muscles

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

How can impaired motor control contribute to pathological gait?

A

Peripheral origin:
Weakness

Central origin:
Weakness 
Hypertonicity
Lack of selective control 
Apraxia 
Ataxia 
Rigidity
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

The Ipsilateral erector spinae are active during

A

Pre-swing as the contralateral limb is loaded

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

How can different types of contracture affect ROM and gait?

A
  1. Elastic
    Inactivity or increased stiffness of bully tissues. Yield to forceful stretch.
  2. Rigid
    May arise from muscle shortness. May be enhanced by scarring. Resistant to considerable force
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

Mid-Stance

Hip

A

0*

Abductors

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

Thigh continues to advance as knee begins to extend. Foot clearance maintained

A

Mid Swing

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

Orthotic fitting/follow up

A

conservative:
Days 1-2: 15-30 min NWB if necessary
Days 3-7: WB 15-30 intervals
Days 8+: extend WB as tolerated

Check skin frequently- esp DM patients

Accommodation period- gradually increase wear tins and activity; determine skin tolerance
Enhanced w/ gait training.
Anticipate need for adjustments- no device permanent

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

Phases of swing limb advancement

A
  1. Pre-swing
  2. Initial swing
  3. Mid-swing
  4. Terminal swing
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

___* of knee ___ required for normal single limb support

A

5* knee flexion

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

How pain contributes to pathological gait

A

Slowed walking speed
Shortened stance phase on the painful limb
Tendency to stiffen the limb to avoid joint excursion
Absence of forceful foot contact or push-off

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

Most likely cause of forefoot or foot-flat contact in WA?

A
  1. 2ndary to excess knee flex in TSw
  2. Compensation for weak quads to avoid LR
  3. 2ndary to excess PF in TSw
  4. Heel pain
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
36
Q

Articulated AFO with ankle stops - DF weakness

A

PF stop
Induces immediate knee flexion moment
Eliminates foot slap from weak DF
Prevents foot drop and steppage gait (equinus) in swing phase

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
37
Q

3 primary functional tasks of gait

A

Weight acceptance
Single limb support
Swing limb advancement

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
38
Q

Neutral position of pelvis in sagittal plane

A

10* anterior tilt

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
39
Q

When do rigid contracture causing excess PF manifest in gait?

A

Consistently through all phases of gait cycle

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
40
Q

Initiation of heel rocker is critical event in ___ phase

A

Initial contact

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
41
Q

Initial swing

Knee

A

60* flexion

Flexors

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
42
Q

Foot slap in WA

Most likely cause?

A

Weak pretibials

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
43
Q

During initial swing what is happening at the hip joint?

A

ROM- moves to position of 15* flexion

Torque- hip extension torque initial which approaches 0 by end of phase

Muscle action- iliacus, gracilis, sartorius, and ADD longus active

Functional significance- limb advancement continues

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
44
Q

Subtalar joint is positioned ___ in initial swing

A

Near neutral

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
45
Q

Cadence is…

A

Number of steps per unit of time

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
46
Q

The glut max is active during ___ to decelerate the effects of impact, but not to the extents it is during ___.

A

Initial contact

Loading response

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
47
Q

Single limb support is the period where…

Includes ____ phase(s).

A

Body progresses over a single stable limb.
Weight is transferred onto the metatarsal heads and the heel comes off the ground.
Mid-stance
Terminal stance

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
48
Q

Subtalar joint inverts and positioned near 2* of eversion in ___.

A

Terminal stance

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
49
Q

Mid Swing

Ankle

A

0*

Pretibials

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
50
Q

The vertical ground reaction force vector begins at___

A

Center of pressure

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
51
Q

Initiation of gait:

Center of pressure shifts…

A

Posteriorly and briefly toward swing foot
Then towards stance foot heel,
Stance foot forefoot,
And ultimately medial forefoot of stance foot.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
52
Q

The glut max is active during ___ to decelerate hip flexion, but not to the extent it is during ___

A

Terminal swing

Loading response

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
53
Q

Reactionary torques in gait

A

Muscle

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
54
Q

How does treadmill walking differ from walking across ground?

A

Higher cadence and shorter stance times with treadmill (at comparable speeds)

Push-off forces and maximal ground reaction forces generally lower with treadmill

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
55
Q

Swing limb advancement

A

3rd task

  1. Pre-swing
  2. Initial swing
  3. Mid-swing
  4. Terminal swing

Foot clearance and limb advancement

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
56
Q

During terminal stance what is happening at the knee joint?

A

ROM- unchanged from mid-stance in 5* flexion

Torque- extension torque peaks and then diminishes

Muscle action- calf muscles continue to stabilize knee by restraining tibia; biceps femoris may be active

Functional significance- joint stability maintained m; biceps femoris may act to prevent hyperextension

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
57
Q

How is step width found?

A

Linear distance between midpoint of heel of one foot and same point on other foot in completing a step.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
58
Q

What is terminal swing?

Critical events?

A

Knee extends as the limb prepares for contact with the ground

Deceleration and inhibition of hip flexion
Deceleration at knee
Adequate knee extension
Adequate ankle DF

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
59
Q

Body progresses past forefoot

A

Terminal stance

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
60
Q

Initial contact

Hip

A

20* flexion

Extensors

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
61
Q

The pretibial muscle eccentrically control DF during

A

Loading response

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
62
Q

What is a stride?

A

Heel strike to next ipsilateral heel strike

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
63
Q

The thigh begins to advance; knee continues to flex and the foot clears the ground

A

Initial swing

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
64
Q

Periods of gait

A

Stance

Swing

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
65
Q

What is heel off deviation?

A

Deviation
Excess PF and only forefoot contact maintained

Loading response->
Late Mid-Stance

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
66
Q

Contralateral vaulting SLA

Most likely cause

A

Compensatory for limited flex of swing limb

Compensatory for longer swing limb

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
67
Q

During mid-stance, what is happening at the ankle joint?

A

ROM - moves into 5* DF

Torque- markedly increasing DF torque

Muscle action- soleus and gastroc contract eccentrically to control forward progression of tibia

Functional significance- calf muscles stabilize knee; ankle rocker action created; body progresses forward

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
68
Q

Foot orthoses May help..

A 
Plantar fasciitis 
Ankle sprain 
Stress fracture 
Metatarsalgia 
Tendonitis 
1st MP joint sprain 
Pea planus/cavus 
Hallux valgus 
Morton’s neuroma 
Tarsal tunnel 
Rear foot valgus/varus 
Forefoot ADD/ABD
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
69
Q

Major deviations of hip

A 
Hike 
Ipsilateral drop
Contralateral drop
Lack of forward rotation 
Lack of backward rotation 
Excess backward rotation
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
70
Q

Anterior pelvic tilt

Task, cause, significance

A

All

Weak abdominals
Hip flexion contracture
2ndary to forward trunk lean

May increase energy cost
May increase lordotic curve which may result in LBP

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
71
Q

During terminal swing what is happening at the pelvis?

A

Rotates forward 5* in horizontal plane

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
72
Q

During LR (loading response), what is happening at the hip joint?

A

ROM- remains at 20* flexion

Torque- rapid, high intensity flexion torque; ADD torque begins

Muscle action- hip extensors and ABD active

Functional significance- hip joint, pelvis, and trunk stabilized in sagittal and frontal planes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
73
Q

Past retract

A

A visible forward and then backward movement of thigh during TSw

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
74
Q

Pre Swing

Hip

A

10* apparent hyperextension

Adductors

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
75
Q

Toe-out: normal men

A

7*

Decreases as speed of walking increases

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
76
Q

Stair descent…

A
  1. Weight acceptance
  2. Controlled lowering
  3. Forward continuance
  4. Leg pull-through
  5. Foot placement
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
77
Q

Weakness of ___ causes difficulty during mid-swing

A

Pretibial muscles

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
78
Q

Pre Swing

Critical events

A

Passive knee flexion to 40*

Ankle PF

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
79
Q

Excess eversion-WA

Significance

A

Rotary strain in mid foot and knee

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
80
Q

The initiation of the forefoot rocker is a critical event in…

A

Terminal stance

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
81
Q

During terminal stance what is happening at the ankle joint?

A

ROM- moves into 10* DF

Torque- DF torque peaks

Muscle action- calf muscle activity peaks

Functional significance- maximal forward progression of the tibia; heel allowed to rise

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
82
Q

Mid Stance

Critical event

A

Controlled tibial advancement

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
83
Q

During terminal swing what is happening at the knee joint?

A

ROM- extends to neutral, but then may move into 5* flexion

Torque- extension torque

Muscle action- quads active concentrically; hamstrings peak in activity

Functional significance- step length optimized by leg reaching out

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
84
Q

What is initial swing?

Critical events?

A

Thigh begins to advance as foot comes up off floor

Adequate knee flexion
Adequate hip flexion

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
85
Q

Consequence of excess PF in swing?

A

Foot clearance (drag)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
86
Q

During which phase of gait are quadriceps most active?

A

Loading response

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
87
Q

Terminal swing

Hip

A

20* flexion

Hamstrings

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
88
Q

Loading response

Hip

A

20* flexion

Extensors and Abductors

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
89
Q

During mid-stance what is happening at the knee?

A

ROM- extends to 5* flexed

Torque- extension torque

Muscle action- quads stabilize knee until knee extension torque begins; calf muscles restrain tibia

Functional significance- knee stability maintained by knee extension torque and calf muscle activity

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
90
Q

What is the functional limb varus angle?

A

Angle between bisection of lower leg and ground.

Increases during running

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
91
Q

Alternating flexion and extension of knee occurring during a single phase

A

Wobbles

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
92
Q

Drag in SLA

Significance

A

May result in loss of balance
Interferes with limb advancement
May cause injury to toes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
93
Q

Excess PF in WA

Significance

A

Poor position for heel rocker

Decreases shock absorption by limiting knee flex

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
94
Q

The glut max peaks in activity when acting isometrically to sustain hip flexion during

A

Loading response

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
95
Q

Less than normal knee flexion for a specific phase of gait

A

Limited flexion

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
96
Q

Mid Swing

Knee

A

25* flexion

Flexors

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
97
Q

How does excess PF affect Initial contact?

A

Pretibial muscle weakness or limitations in ankle DF ROM

  1. Foot flat contact
  2. Forefoot contact
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
98
Q

What is contralateral vaulting?

A

Rising on forefoot of contralateral stance limb during SLA of reference limb

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
99
Q

How does excess eversion affect WA?

A

May lead to rotatory strain of midfoot and knee

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
100
Q

During mid-swing what is happening at the hip joint?

A

ROM- moves to 25* flexion

Torque- gradually increasing hip flexion torque

Muscle action- hamstrings become active late in phase

Functional significance- thigh advancement slows; momentum of swing limb helps carry body past stance limb

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
101
Q

Running commences at…

A

Cadence of 180 steps per minute

Double support disappears

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
102
Q

During pre-swing what is happening at the pelvis?

A

Remains in 5* of backward rotation in horizontal plane

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
103
Q

Step duration

A

Amount of time spent during a single step.
Usually expressed as seconds per step.
Weakness/pain in extremity = step duration decreased on affected side; increased on in-affected side

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
104
Q

Excess PF in SLS

Significance

A

Decreases forward progression of the tibia over the ankle and forefoot

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
105
Q

Phase of gait most likely to be affected by pretibial weakness

A

Loading response

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
106
Q

Significance of foot slap in WA

A
  1. Decreases forward momentum of tibia

2. Decreases shock absorption by limiting knee flex

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
107
Q

Loading response

Knee

A

15* flexion

Quadriceps

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
108
Q

Pre Swing

Ankle

A

15* PF

No muscle activity

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
109
Q

What is included in a single gait cycle?

A

One stride

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
110
Q

During terminal stance what is happening at the hip joint?

A

ROM- thigh moves to trailing position of 20* extension

Torque- hip extension torque; ADD torque rapidly diminishes

Muscle action- posterior fibers of TFL cease; anterior fibers of TFL may become active

Functional significance- body allowed to advance past foot to maximize step length while limb remains stable

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
111
Q

Initial contact

Knee

A

5* flexion

Quadriceps

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
112
Q

Solid ankle AFO

A

DF and PF deficits

Coronal instability of ankle

Places moments on the knee that require fair-good quad strength for control

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
113
Q

What is terminal stance (TSt)?

Critical events?

A

Body moves ahead of limb and weight is transferred to forefoot

Initiation of forefoot rocker
Controlled ankle DF with heel rise
Trailing limb posture
Free forward fall

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
114
Q

How does excess eversion affect SLS?

A

Interfere with function of midfoot and forefoot as a rigid lever - which is essential for function of forefoot rocker

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
115
Q

What happens during termination of gait?

A

Push-off reduced in stance limb.

Swing limb provides braking forces at initial contact.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
116
Q

No heel off- SLA

Significance

A

Decreases step length of opposite limb

Results in limited knee flex in SLA

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
117
Q

During terminal stance what is happening at the pelvis?

A

Anterior tilt and 5* backward rotation in horizontal plane

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
118
Q

The forefoot remains on the floor. The knee rapidly flexed while weight is shifted to other limb.

A

Pre-Swing

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
119
Q

Clawed toes vs Hammered toes

A

Clawed- flexion of proximal and distal pharyngeal joints

Hammered- flexion: proximal, extension: distal

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
120
Q

Terminal stance

Ankle

A

10* DF

Calf

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
121
Q

Loading response

Critical events

A

Hip stability
Controlled knee flexion
Ankle PF

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
122
Q

In mid-swing the glut max is

A

Minimally active

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
123
Q

Swing limb advancement

Accomplishments

A

Foot clearance

Limb advancement

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
124
Q

During mid-swing what is happening at the knee joint?

A

ROM- rapidly extends to 25* flexion

Torque- transition to knee extension torque late in phase

Muscle action- short head of biceps femoris may control rate of extension

Functional significance- extension necessary for step length begins in this phase

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
125
Q

What is a step?

A

Heel strike to next contralateral heel strike

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
126
Q

How does excess inversion affect gait?

A

Reduced shock absorption in WA

Decreased limb stability in SLS

Reduced clearance of foot in SLA

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
127
Q

What creates the torque demands at the joints during gaits

A

External torque
Gravitational torque
Intersegmental torque
Muscle torque

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
128
Q

During initial contact (IC) , what is happening at the pelvis?

A

5* forward rotation in horizontal plane

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
129
Q

Phases of gait cycle involved in single limb support?

A
  1. Mid-stance

4. Terminal stance

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
130
Q

Terminal swing

Ankle

A

0*

Pretibials

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
131
Q

Symmetrical gait pattern indication

A

Right and left step length comparison

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
132
Q

Phase of gait most likely affected by weak gluteus Maximus

A

Loading response

133
Q

Excess inversion

Most likely cause

A

Tibialis anterior, tibialis posterior or soleus overactivity
Varus contracture
PF contracture
Weak peroneals
Lack of selective motor control of pretibials
Variations in skeletal alignment resulting in high arch
Internal tibial torsion

134
Q

Backward lean of trunk

Task, cause and significance

A

All

Cause:
Intentional to decrease the demand on hip extensors (WA and SLS)
Intentional to advance the limb (SLA)

Significance:
May increase energy cost
Decreases forward movement

135
Q

Initial contact

Critical event

A

Heel first contact

136
Q

FO (foot orthoses)

A

Can have effect below talo-crural joint
Hindfoot/subtalar and midfoot anomalies
Prefabricated or custom

137
Q

Major and minor hip deviations

A

Major:
Limited FLEX
Past retract
Excess FLEX

Minor:
ADD
ABD
IR
ER
138
Q

Much of the inversion if the subtalar joint occurs through ____ while activity decreases during ___

A

Terminal stance

Pre-swing as unloading of the limb occurs

139
Q

During mid-swing what is happening at the pelvis?

A

Rotates forward in horizontal plane to neutral

140
Q

Excess contralateral flexion (knee)

A

Knee flexion greater than normal during LR, MSt, or TSt of opposite limb;
occurs during SLA of reference limb (PSw -> TSw)

141
Q

During mid-stance what is happening at the subtalar joint?

A

ROM- eversion position remains relatively unchanged from end of LR (loading response)

Torque- eversion torque diminishes

Muscle action- posterior tibialis, soleus, and peroneals all eccentrically active

Functional significance- control of eversion

142
Q

No heel off- SLS

Significance

A

Interferes with progression over forefoot

143
Q

Normal mid-stance requires ___* ankle ___

A

5* DF

144
Q

Subtalar joint is positioned ___ in pre-swing

A

Near neutral

145
Q

Drag in SLA

Most likely cause

A

2ndary to limited hip flex, knee flex or excess PF

Impaired proprioception

146
Q

No heel off -SLS

Most likely cause

A

Weak calf

147
Q

What is foot slap?

A

Uncontrolled PF after heel contact

Only occurs if pretibial muscles are strong enough to provide heel first contact in IC

148
Q

AFO (ankle/foot orthoses)

A 
Crosses talo-crural joint and can effect...
PF/DF
Coronal stability of subtalar joint 
Midfoot positioning: 
Transverse arch
Longitudinal arch
Forefoot ADD/ABD
149
Q

Rupture of Posterior Tibialis tendon- which phase most likely to deviate from normal?

A

Mid Stance

150
Q

Speed is…

A

Rate of linear forward motion of the body

151
Q

____ is highly active during single limb support to provide for stability of pelvis in __ plane

A

Glut med

Frontal

152
Q

Trunk rotates back

Task, cause and significance

A

All

Inability to dissociate trunk movements from pelvic or limb movements
Use of UE aids
2ndary to excess PF (TSt)

May increase energy cost
May decrease stability
Decreases forward progression

153
Q

If one leg is beginning initial swing, what is the other leg beginning?

A

Mid-stance

154
Q

Excess eversion- WA

Most likely cause

A

Weak tibialis posterior

155
Q

Ground reaction AFO

A

Mild/Mod quad weakness

Provides knee extension moment against tibial cuff during Midstance

Must have DF stop to prevent tibial progression

156
Q

Indications for custom FO intervention

A

Foot/ankle alignment
Moderate: supination, pronation
Sub-Talar deviations
Forefoot ADD/ABD

157
Q

Knee wobbles

Most likely cause

A

Impaired proprioception
Quadriceps hypertonicity
PF hypertonicity

158
Q

What happens through the trunk during the gait cycle?

A

Trunk rotation occurs opposite to direction of rotation of pelvis

Arm swing follows pattern- opposite upper and lower extremities swing forward concurrently during gait

159
Q

Phases of gait cycle

A
  1. Initial contact
  2. Loading response
  3. Mid-stance
  4. Terminal stance
  5. Pre-swing
  6. Initial swing
  7. Mid-swing
  8. Terminal swing
160
Q

Initiation of gait starts with….

A

Bilateral inhibition of plantar flexors and activation of dorsiflexors.

161
Q

Stance defined

A

62% of gait cycle

When reference limb is in contact with the ground

162
Q

Heel off- SLS

Significance

A

Increases pressure on MT heads

163
Q

Excess inversion

Significance

A

Poor position for WA
Rigid foot resulting in decreased shock absorption
Decreased stability in SLS
Decreased foot clearance in SLA

164
Q

Toe-out defined

A

Angle between:
Center of heel along line of progression
Line of the 2nd toe

165
Q

What is mid-stance?

Critical events?

A

Body progresses over a single, stable limb.

Ankle rocker
Restrained ankle DF
Restrained knee extension
Frontal plane hip stabilization

166
Q

During mid-swing what is happening at the ankle joint?

A

ROM- DF to neutral

Torque- very low level of PF torque

Muscle action- pretibial muscles contract concentrically

Functional significance- foot clears ground by 1cm

167
Q

The ___ are active during mid-swing to maintain ___

A

Pretibial

Maintain ankle DF aiding in foot clearance

168
Q

Contralateral pelvic drop- SLA

Cause and significance

A

Compensatory for shortened opposite limb

May result in back pain

169
Q

During initial swing what is happening at the pelvis?

A

Remains in 5* of backward rotation in horizontal plane

170
Q

Excess inversion is more often in individuals with ___ disorders than ___disorders

A

NM disorders > MSK disorders

171
Q

How does the center of pressure change through the gait cycle?

A

Stance phase- posterolateral heel
Moves linear…and then medially across…
Late stance - 1st/2nd toes

172
Q

How does inadequate extension of toes affect gait pattern

A

SLS- esp TSt

SLA- esp Pre-swing

Promotes loss of heel rise

173
Q

During initial swing what is happening at the knee joint?

A

ROM- further rapid flexion to 60*

Torque- knee flexion torque

Muscle action- peak activity of biceps femoris short head, sartorius and gracilis

Functional significance- foot clears floor as thigh begins to advance

174
Q

During initial swing what is happening at the ankle joint?

A

ROM- moves into 5* PF

Torque- very low level PF torque

Muscle action- pretibial muscles contract concentrically to initiate DF

Functional significance- DF needed to clear foot in next phase begins

175
Q

Terminal swing

Critical events

A

Knee extension to neutral (possibly 5* flexion)

176
Q

What is initial contact?

Critical events?

A

Moment when foot contacts ground.

Heel first contact
Initiation of heel rocker
Impact deceleration

177
Q

Terminal stance

Knee

A

5* flexion

No muscle activity

178
Q

Initial swing is completed with ankle in __* of ___

A

5* PF

179
Q

Impairments of central origin

A 
Weakness 
Hypertonicity 
Lack of selective control 
Apraxia 
Ataxia 
Rigidity
180
Q

Excess DF in SLS

Significance

A

Increases demand on hip and knee extensors

Interferes with heel rise and decreases step length of opposite limb (TSt)

181
Q

Contracture intervention - effective per research - post TBI

A

Botulin toxin injections

Improvement in DF ankle ROM (26*)
No change in strength

182
Q

Excess DF SLS

Most likely cause

A
  1. Weak calf
  2. 2ndary to excess hip and knee flex
  3. Intentional to lower opposite limb for contact (TSt)
  4. Excess midfoot DF 2ndary to limited ankle mobility
183
Q

Trunk rotates forward

Task, cause, significance

A

All

Inability to disassociate trunk movements from pelvic or limb movements
Excessive use of UE aids
Intentional to advance limb

May increase energy cost
May decrease stability

184
Q

Stair gait- Stance period

A

64%

  1. Weight acceptance
  2. Pull up
  3. Forward continuance
185
Q

What is loading response (LR) ?

Critical events?

A

Weight rapidly transferred onto outstretched limb.

Progression of heel rocker
Restrained ankle plantar flexion
Restrained knee flexion
Sustained hip flexion

186
Q

Single limb support

A

2nd task

  1. Mid-stance
  2. Terminal stance

Stability and forward progression

187
Q

Articulated AFO with ankle stops - PF weakness

A

DF stop
Allowed controlled tibial progression
Prevents drop off in terminal stance from lace of PF strength

188
Q

Mid-Stance

Ankle

A

5* DF

Calf

189
Q

During initial contact (IC) , what is happening at the hip joint?

A

ROM- flexed 20*

Torque- rapid, high intensity flexion torque begins

Muscle action- all hip extensors active; semimembranosis and biceps femoris long head activity wanes

Functional significance- hip in position of forward reach

190
Q

During pre-swing what is happening at the subtalar joint?

A

ROM - achieves neutral position

Torque- inversion torque diminishes to 0

Muscle action- anterior tibialis begins to contract

Functional significance- preparation for foot clearing the ground during swing

191
Q

Excess PF SLS

Most likely cause

A
  1. PF hypertonicity
  2. Weak quads
  3. Impaired proprioception
  4. Ankle pain
192
Q

Completion of heel rocker is critical event in ___ phase

A

Loading response

193
Q

The glut med is primarily active during ____, which are component(s) of ___.

A

Loading response
Mid Stance

Weight acceptance
Single limb support

194
Q

___ is required of subtalar joint for normal swing limb advancement.
____ May interfere with ___

A

Positioning in neutral

Excessive positioning in inversion may interfere with foot clearance

195
Q

What does ankle rocker action provide?

A

Ankle becomes fulcrum for continued progression of limb over stationary foot

196
Q

Motions at the ___ (joints) in the ___ plane are the most important in contributing to critical events and thus are focus of observational gait analysis

A

Ankle, knee and hip

Sagittal plane

197
Q

Speed up to 120 steps per minute brought about by …

A

Cadence and stride length.

Above 120 steps per minute- only cadence increase; length levels off

198
Q

Knee wobbles

Significance

A

Decreased forward momentum

Decreased limb stability and balance

199
Q

Pelvis lacks backward rotation

Task, cause, significance

A

SLS
SLA

Impaired motor control of trunk and pelvic muscles
Back pain
2ndary to excess hip flexion

Decreases step length of the opposite limb (TSt)

200
Q

Excess eversion - SLS

Most likely cause

A 
Weak tibialis posterior, soleus 
PF contracture 
Valgus deformity 
Referred from knee or hip joint 
Variations in skeletal alignment resulting in low arch
201
Q

Heel off - WA

Most likely cause

A

2ndary to excess PF

202
Q

Hyperextension/Extension Thrust (knee)

Functional task

A

WA
SLS
SLA

203
Q

What if heel does contact ground with excess PF?

A

Reduced forward progression of tibia over stationary foot

204
Q

Normal range and mean of step width

A

3.5” mean

1-5” range

205
Q

Swing defined

A

38% gait cycle

When reference limb is off the ground

206
Q

Deviations to consider:

Excess PF

A 
Foot flat contact 
Forefoot contact
Heel off 
Drag 
Foot slap
207
Q

Point of observational gait analysis

A

Understand abilities and impairments
Assist diagnosis
Inform intervention
Evaluate effectiveness

208
Q

Terminal swing

Knee

A

5* flexion

Quadriceps

209
Q

Phase of gait with ankle rocker

A

Mid-Stance

210
Q

Impairments can be of __ or ___ origin

A

Peripheral or central origin

211
Q

What creates external torque in gait

A

Vertical ground reaction force vector

212
Q

Achievement of adequate ankle PF is a critical event in ___ which is included in the functional task of ___

A

Pre-swing

Swing limb advancement

213
Q

During LR (loading response), what is happening at the subtalar joint?

A

ROM- calcaneus everts 5*; subtalar joint pronates

Torque- reversion torque

Muscle action- both anterior and posterior tibialis muscles contract eccentrically

Functional significance- assists shock absorption; induces IR of tibia which reduces rotatory stress on ankle

214
Q

When do elastic contracture causing excess PF manifest in gait?

A

Potentially all phases

May not be present in stance: 
LR, 
MSt, 
TSt 
and/or PSw
215
Q

The posterior tibialis ___ during mid-swing

A

Not typically active

216
Q

During LR (loading response), what is happening at the ankle joint?

A

ROM- 5* rapid PF

Torque- PF torque forces foot to floor then diminishes

Muscle action- pretibials contract eccentrically; soleus and gastroc act to control tibial advancement

Functional significance- heel rocker action created; momentum carried forward; knee flexion initiated

217
Q

During terminal swing what is happening at the ankle joint?

A

ROM- remains in neutral

Torque- PF torque diminishes to 0

Muscle action - pretibial muscles contract isometrically

Functional significance- neutral position assures heel contact for initial contact

218
Q

Initial contact

Ankle

A

0*

Pretibials

219
Q

Prefabricated FO

A

Usually accommodative-
Provide cushion, shock absorption, arch support

Negligible adjustment possible

220
Q

Custom molded FO

A

Corrective or accommodative

Joint realignment
Provide corrective support: longitudinal arch, transverse arch, metatarsal relief

May be more adjustable

221
Q

The ____ are minimally active in Mid-stance

A

Pretibial

222
Q

During LR (loading response), what is happening at the knee joint?

A

ROM- moves to 15* flexion

Torque- rapid, moderate intensity flexion torque

Muscle action- eccentric quad activity; diminishing hamstring activity

Functional significance- shock absorbed; limb stability maintained

223
Q

Swing limb advancement is when….

Involves ___ phase(s)

A

Time when limb is unloaded and foot comes off ground.
Limb is moved from behind body to in front, reaching out to take next step.

Pre-swing
Initial swing
Mid-swing
Terminal swing

224
Q

Stair gait- Swing phase

A

36%

  1. Foot clearance
  2. Foot placement
225
Q

Common pathologies where AFO (ankle-foot orthoses) may be indicated

A 
Muscular imbalances: acquired deformity; altered gait 
CVA
CP
Brain injury 
Guillain-barre 
Ataxia 
Parkinson’s 
MS
MD
226
Q

Impairments of peripheral origin

A

Weakness

227
Q

During which phase is limitation in hamstring flexibility most likely to affect?

A

Terminal swing

228
Q

Calf muscle activity peaks during

A

Terminal stance

229
Q

Loading response

Ankle

A

5* PF

Pretibials

230
Q

1 stride for a normal adult lasts approximately…

A

1 second

231
Q

During pre-swing what is happening at the ankle joint?

A

ROM- moves into 15* of PF

Torque- DF torque rapidly decreases

Muscle action- calf muscle activity ceases; pretibial muscle activity initiated

Functional significance- forefoot on floor assists balance; PF assists knee flexion and limb advancement

232
Q

The glut max ___ to aid in decelerating forward advancement of thigh, during swing limb advancement

A

Becomes active at end of terminal swing

233
Q

How might impaired sensation contribute to pathologic gait?

A

Inconsistent gait pattern
Prevents prompt substitution
Includes perceptual deficits

234
Q

PTB (patella tendon bearing orthosis)

A

Axial load bearing pain

Calcaneal Fx
Talocrural degeneration
Arthritis
Intermediate use to allow ambulation

235
Q

Typical cadence for adult

A

Men: 120 steps per minute
Women: 116 steps per minute

236
Q

The calf muscles begin to become active at __

A

End of loading response

237
Q

Leg reaches out to achieve step length

A

Terminal swing

238
Q

Excess PF in SLA

Significance

A

Interferes with foot clearance

Interferes with foot position for IC

239
Q

Antalgic gait

A

Slowed walking speed
Shortened stance phase
Reduced joint excursion
Reduced limb loading and push off

(Pain gait)

240
Q

What is “no heel off”

A

Absence of heel rise during TSt or PSw

241
Q

Compressive forces of ankle

A

1/2 BW during standing
5x BW during walking
13x BW during running

242
Q

Excess DF WA

Most likely cause

A

2ndary to excess hip or knee flex

243
Q

During terminal swing what is happening at the subtalar joint?

A

ROM- maintains neutral position

Torque- none to very slight inversion torque

Muscle action- anterior tibialis stabilizes medially

Functional significance- foot positioned for heel contact

244
Q

How are limited flexion, hyperextension and extension thrust related?

A

A

245
Q

Hip angle is measured as

A

Thigh relative to vertical

246
Q

Heel off -WA

Significance

A

Decreases BOS due to smaller WB surface

247
Q

Subtalar eversion peaks at __ degrees in ____ during normal gait

A

5*

Loading response and Mid-Stance

248
Q

Articulated AFO with adjustable joints

A

Variable ROM

Can be adjusted as patient progresses in strength and/or range

Request if you anticipate your patient having a significant return

249
Q

Swing limb advancement

Percentage of gait cycle

A

50-100%

250
Q

Pre-swing concludes with ankle in ___* of __.

A

15* PF

251
Q

Phase of gait with forefoot rocker

A

Terminal stance

252
Q

Gait problem- toes up

Task, cause, significance

A

SLA

Cause:
Compensation weak tibialis anterior or insufficient DF
Toe extensor hypertonicity

Significance:
Foot clearance
May cause skin irritation or callouses on dorsum of toes from rubbing against shoes

253
Q

Stair ascent…

A
  1. Weight acceptance
  2. Pull-up
  3. Forward continuance
  4. Foot clearance
  5. Foot placement
254
Q

Orthotic treatment patterns - goals

A 
Restore function 
Prevent further injury and progression 
Protection of involved joints
Kinesthetic reminder of previous injury 
Return to prior activity levels; work, exercise, leisure
255
Q

Lowest vertical ground reaction forces - phases of gait

A

Mid-stance

256
Q

What does heel rocker action provide?

A

Facilitates forward progression of entire stance limb

257
Q

Calf muscles are active to decelerate forward advancement in ___, their activity peaks during __

A

Mid-stance

Terminal stance

258
Q

Contralateral pelvic drop- WA/SLS

Cause and significance

A

Weak hip abductors on reference limb
Intentional to lower opposite limb for IC
Adductor spasticity

May decrease stance limb stability
Increase relative length of opposite limb
May increase energy cost

259
Q

Rectus abdominus activity usually occurs during

A

Ipsilateral and contralateral Mid and Terminal Swing

260
Q

The ____ are minimally active in Pre-swing

A

Pretibial

261
Q

Primary deviation

A

Gait deviation occurring as a direct result of a readily associated impairment

262
Q

The __ is active during ___ to control subtalar joint eversion

A

Posterior tibialis

Mid-stance

263
Q

Excess eversion

Significance

A

Rotary strain on mid foot and knee
Interferes with rigid lever for forefoot rocker
Can be used to gain DF range when ankle mobility limited

264
Q

2ndary benefits of AFO use

A

Mild knee alignment and function

Most successful w/ sagittal plane involvement
Mild genu recurvatum
Weaknesses in knee control

265
Q

Pelvis excess forward rotation

Task, cause, significance

A

All

Intentional to advance limb
Excess backward rotation of opposite limb

Increases step length (TSw)

266
Q

Lateral lean of trunk

Task, cause, significance

A

All

Weak hip abductors 
Intentional to avoid hip pain 
Compensatory for short stance limb
Intentional to clear swing limb 
Use of UE aids

May increase energy cost
Decreases forward momentum

267
Q

Single limb support

Percentage of gait cycle

A

12-50%

268
Q

Heel off -SLS

Most likely cause

A

Heel pain

2ndary to excess knee flex

269
Q

During terminal stance what is happening at the MTP joints?

A

ROM- move into 30* extension

Torque- extension torque created

Muscle action- calf muscle activity peaks; posterior tibialis and soleus contract concentrically

Functional significance- forefoot rocker action created; contributes to contralateral step length

270
Q

Mechanisms that contribute to pathological gait

A

Impaired motor control
Abnormal ROM
Impaired sensation
Pain

271
Q

During LR (loading response), what is happening at the pelvis?

A

Remains in 5* of forward rotation in horizontal plane

272
Q

Indications for orthosis rx

A 
Demonstrated need for:
Support and alignment 
Prevention or correction of deformity 
Substitution or enhancement of function 
Decrease pain
273
Q

A stride involves ___.

A

2 steps: a right and left step

274
Q

During terminal swing what is happening at the hip joint?

A

ROM- falls slightly to position of 20* flexion

Torque- hip flexion torque diminishes at the end of phase

Muscle action- hamstrings, ADD magnus, glute max, glute med, and TFL active

Functional significance- limb positioned for heel first initial contact

275
Q

Excess eversion- SLA

Most likely cause

A

Weak tibialis anterior

Peroneal hypertonicity

276
Q

Mid-Stance

Knee

A

5* flexion

Quadriceps initially; then no muscle activity

277
Q

Excess DF in WA

Significance

A

Increase demand on hip and knee extensors

Decreases limb stability

278
Q

If only leg is in pre-swing what is opposite leg doing?

A

Initial contact

Loading response

279
Q

Initial swing

Critical events

A

Hip flexion to 15*

Flexors

280
Q

Custom molded orthotics

A

Chronic and progressive prognosis
Long term use
Maximal control
Control needed at multiple joints

281
Q

Posterior pelvic tilt

Task, cause, significance

A

All

Tight hamstrings
Intentional to decrease demand on hip extensors (WA) 
Intentional to advance limb (SLA)
LBP
Limited lumbar extension

May increase energy cost
May result in excess knee flexion in SLS

282
Q

During initial contact (IC) , what is happening at the knee joint?

A

ROM- neutral to 5* flexed

Torque- brief extension torque

Muscle action- quads prep for next phase; hamstrings counter extension torque

Functional significance- extension torque stabilizes knee

283
Q

Mid Swing

Hip

A

25* flexion

Flexors initially, then hamstrings

284
Q

During initial swing what is happening at the MTP joints?

A

ROM- flexion to neutral position and maintained there throughout swing

Torque- flexion torque which quickly decreased

Muscle action- EHL and EDL peak in activity

Functional significance- toes stabilized allowing EHL and EDL to facilitate DF at ankle

285
Q

Body progresses over the foot in a controlled manner. The contralateral swing limb provides the momentum.

A

Mid Stance

286
Q

Pelvis lacks forward rotation

Task, cause, significance

A

WA
SLA

Retracted pelvis
Compensatory to decrease demand on quads and hip extensors at LR
Lack of backward rotation on opposite limb
Back pain

Decreases step length

287
Q

Gait problem- inadequate extension of toes

Task, cause, significance

A

SLS and SLA

Cause:
Ltd toe extension ROM- incl hallux valgus or hallux rigidus 
Toe flexor hypertonicity 
Forefoot pain 
2ndary to no heel off

Interferes with forward progression
Decreases step length of opposite limb

288
Q

Single limb support

Accomplishments

A

Stability

Forward progression

289
Q

What does the forefoot rocker action provide?

A

Metatarsal heads serve to facilitate continued forward progression of tibia

290
Q

Deviations to consider:

Excess DF

A

No heel off

291
Q

Kinetic variables of gait?

A

Torque demands

Muscle actions

292
Q

Knee wobbles

Phase/function

A

WA -> LR

SLS -> MSt TSt

293
Q

During mid-stance what is happening at the subtalar joint?

A

ROM- progressive reduction of eversion to approximately 2* eversion

Torque- inversion torque created as heel rises

Muscle action- posterior tibialis and soleus contract concentrically; peroneals isometrically active

Functional significance- reduction in eversion increases stability of midtarsal joint

294
Q

During initial swing what is happening at the subtalar joint?

A

ROM- maintains neutral position

Torque- none to very slight inversion torque

Muscle action- anterior tibialis stabilizes medially

Functional significance- foot positioned to clear the ground

295
Q

During mid-stance what is happening at the hip joint?

A

ROM- extension to neutral

Torque- change from flexion to extension torque; ADD torque continues

Muscle action- no hip muscle activity in sagittal plane; hip ABD active

Functional significance- stable hip joint position achieved in sagittal plane; pelvis stabilized in frontal plane

296
Q

During initial contact (IC) , what is happening at the ankle joint?

A

ROM- neutral

Torque- PF

Muscle action- isometric contraction of pretibial muscles

Functional significance- foot correctly positioned for heel rocker action in LR (loading response)

297
Q

The ankle rocker is a critical event of this phase

A

Mid-stance

298
Q

Shock is absorbed as forward momentum is preserved.

A foot-flat position is achieved

A

Loading response

299
Q

Excess eversion AKA

A

Excessive pronation

300
Q

During mid-swing what is happening at the subtalar joint?

A

ROM- maintains neutral position

Torque- none to very slight inversion torque

Muscle action- anterior tibialis stabilizes medially

Functional significance- foot positioned to clear the ground

301
Q

Highest vertical ground reaction forces - phases of gait

A

Late loading response

Towards end of terminal stance

302
Q

Prefabricated orthotics

A

Short term need
Temporary use
Simple function
Diagnostic

303
Q

Gait problem- clawed/hammered toes

Task, cause, significance

A

SLS

Toe flexor/extensor hypertonicity
Imbalance of long toe extensors and intrinsic foot muscles
Compensatory for weak PF

Interferes with forward progression
Decreases step length of opposite limb

304
Q

Free motion ankle joint (AFO)

A

Coronal control only
Ligamentous Instability
Strength deficits

Requires normal DF/PF strength

305
Q

During pre-swing what is happening at the hip joint?

A

ROM- thigh flexes forward by falling to position of 10* of extension

Torque- hip extension torque diminishes

Muscle action- ADD longus contracts concentrically; rectus femoris may be active

Functional significance- limb advancement begins; hip flexion motion contributes to knee flexion

306
Q

Weight acceptance

Accomplishments

A

Forward progression
Stability
Shock absorption

307
Q

During pre-swing what is happening at the knee joint?

A

ROM- rapidly flexes to 40*

Torque- flexion torque demand

Muscle action- minimal knee flexor activity from gracilis; rectus femoris may be active

Functional significance- contributes to knee flexion; rectus femoris may restrain speed of knee flexion

308
Q

Difficulty during Swing limb advancement

Limitation of ___ ROM

A

Ankle PF ROM

309
Q

During which phase is hypermobility of knee into extension most likely to affect?

A

Terminal stance

310
Q

Significance of forefoot or flat-foot contact in WA?

A
  1. Poor position for heel rocker
  2. Decreases forward momentum of the tibia
  3. Decreases shock absorption by limiting knee flex (forefoot contact)
311
Q

Which phase(s) of gait has greatest subtalar joint eversion?

A

Subtalar eversion peaks at 5* in Loading Response and Mid Stance

312
Q

What to look for in patient evaluation (AFO)

A

Functional MMT:
Functional strength, muscle tone imbalances, tone triggers

Functional ROM:
Midtarsal, subtalar, talocrural, knee and hip joints

313
Q

Forceful motion of knee towards extension

A

Extension thrust

314
Q

Limited knee flexion

Major deviation in phase/function

A

WA -> LR

SLA -> PSw and ISw

315
Q

Weight acceptance

Percent of gait cycle

A

0-12%

316
Q

Pre Swing

Knee

A

40* flexion

No muscle activity

317
Q

Forward trunk lean

Task, cause, significance

A

WA
SLS

2ndary to excess hip flex
Intentional to reduce quad demand
Intentional to substitute visual input for impaired proprioception
Use of UE aids
Ltd trunk EXT ROM
Intentional to progress over excessively PF ankle
Abdominal pain

Increases energy cost and demand on hip and trunk extensors
May improve stability and/or forward progression

318
Q

No heel off-SLA

Most likely cause

A

Ankle or metatarsal head pain
2ndary to inadequate ext of toes
2ndary to excess DF

319
Q

Weight acceptance includes ___ phase(s).

This is the period when…

A

Initial contact
Loading response

Weight rapidly loaded onto outstretched limb.
Impact of the floor-reaction force is absorbed and the body continues in a forward path while stability is maintained.
Both feet are in contact with the ground.

320
Q

When is custom AFO needed

A

Chronic conditions
Progressive deficits
Moderate weakness and instability
Maximal control of joint needed

321
Q

Pelvis- hike

Task, cause, significance

A

SLA

Intentional to clear swing limb

May increase energy cost

322
Q

What is pre-swing?

Critical events?

A

Rapid unloading of limb occurs as weight is transferred to contralateral limb

Adequate knee flexion
Adequate ankle PF

323
Q

Hip motion from neutral to 20* extension are required for ___ (functional)

A

Single limb support

324
Q

What is mid-swing?

Critical events?

A

Thigh continues to advance as knee begins to extend

Adequate hip flexion
Adequate ankle DF

325
Q

When does pretibial weakness cause excess PF manifest in gait?

A

Only in swing phase of gait leading into initial contact

IC
ISw
MSw
TSw

326
Q

Excess PF in SLA

Most likely cause

A
  1. Weak pretibials
  2. PF contracture
  3. PF hypertonicity
  4. Lack of selective DF control (TSw)
327
Q

S1 radiculopathy- phase of gait most likely to have deviations

A

Terminal stance

328
Q

Pelvis excess backward rotation

Task, cause, significance

A

SLS
SLA

Inability to disassociate pelvis from limb movement
2ndary to excess PF
Compensatory for excess hip flexion (SLS)
Weak calf with no heel-off

May decrease forward progression (WA, SLA)
May decrease limb advancement (SLA)
Intentional to increase forward progression (SLS)

Movement Analysis (2 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions