ms 10 Flashcards
UL tx process
Activity -> strengthen -> dexterity
- Work eccentrically, isometrically and then concentrically
- Mid range is easiest
- Closed then open chain
- Increase reps, load, freq, change timing, speed
Outcome measures
- running and gait
- Hi MAT
- Community Mobility Assessment
- Illionis agility test
Pre thighs off
Weight shift
Trunk inclination - trunk ext turn on (keep you upright)
Hip flexion (concentrically - iliopsoas)/anterior pelvic tilt
- 80-120 degrees
Hip extensors (gluts) (eccentrically)
Forward knee translation/flexion
90/100 – 120 degrees
Hamstrings
Tib ant concentric (DF neutral/+5 to 10
degrees)
, soleus eccentric, quad eccentric, hamstrings concentric to counteract
Post thighs off
Hip ext - glut concentric (120˚ - neutral)
Knee ext - 120˚ > just of full ext
Ankle PF - 10˚ DF > neutral
Common deficits
• Reduced weight loading to weaker side
• Feet uneven alignment
• Reduced forward knee translation
• Quick extension of knee post thighs off
• Reduced hip extension in final standing
alignment
• Hip retraction and knee hyperextension on
weaker side.
reasoning for s2s deficits
• Hip flexion (ant pelvic tilt) 80-120
degrees
Weak concentric hip flexors / ecc hip extensors / overactive hip extensors
• Knee flexion 90/100 – 120 degrees
- Weak concentric hamstrings / ecc quads / overactive quads.
• Ankle dorsiflexion neutral/+5-10 degrees
• Weak concentric DF / ecc PF / overactive - tight PF (soleus)
Knee hyperextension
Weak concentric knee extensors / flexors eccentrically /overactive knee extensors –
overactive / short tricep surae
Rolling:
KC
-Head rotation
- Shoulder flexion –> horizontal adduction
Anterior delt concentric contraction to about 45 degrees (for flexion) then pecs concentric
Scapular protraction (for add)
- Hip and knee flexion + rot.
50 degrees concentric contraction hip muscles
- Hip adduction/IR –> hip extension
Hip ext. is closed chain (glut max concentrically, hamstring co-contraction)
- need hamstring co-contraction against quads that are pushing through foot to keep foot placed (Ecc) otherwise feet will move
Sidelye to sitting over edge of bed:
Essential components from side-lye to sitting on edge of bed
Lift head - lat flex
Trunk lat flx
The under arm: shoulder abd (horiz) - post delt/post muscles
Hip/knee flx –> knee needs to be just over edge of bed. Then knee ext (if legs drop down then pelzis will follow)
Deload under arm by pushing with other arm
Top arm loading response. Bit of elbow flx and scap control which allows you to shift bottom arm to have hand on bed and extend elbow. Make sure trunk is far enough back that elbow isn’t on edge of bed
When pushing off the top arm and before shifting bottom arm, they need to weight shift forward a bit
standing
even weight - ears over shoulders over hips over ankles - back exts. - BOS - feet shoulder width, or narrow/stymettry - slightly flexed kness neutral pelvic rtn slight ant. pelvic tilt shoulder retr/prot
stance phase
Hip extension throughout
Hip extension + DF brings the trunk forward over the stance foot (E/Mstance)
Ankle DF (e and mid) then fast PF (end and terminal)
Rapid PF at end stance propels body forward (80% propulsion)
Knee flexion (2-10/20 degrees) at HS (early), extension through mid stnace and flexion (end stance) before toe off at last stage of stance)
Lateral horizontal shift of pelvis and trunk - 5cm
Lateral trunk placement is accompanied by stance hip adduction and eversion of stance foot
swing
Knee flexion with hip extended
Commences in late stance and continues into ¼ swing
Hip flexion in first ½ swing then sustained
Knee extension → just prior to HS - the knee flexes in preparation for next stance (terminal swing)
Ankle DF commences just after toe-off and maintained through swing
Forward rotation of pelvis 8 degrees (reduces the angles of hip F/E longer step length no loss of COG
Slight lateral pelvic tilt downwards - mid swing - 5 degrees reduced height of COG curve
