Pathological Trunk & Pelvis Deviations Flashcards
what are possible causes and effects of a trunk backward lean during stance in IC/LR?
Causes:
- purposeful to decrease demand on hip extensors
- countering rigid hip flexion contracture
Effects:
- decreases forward momentum
- may increase energy cost
what are possible causes and effects of a trunk backward lean during swing?
Causes:
- purposeful to advance limb
Effects:
- may increase energy cost
what are possible causes and effects of a trunk forward lean?
Causes:
- 2° increased hip flexion in IC/LR or stance
- purposeful to decrease demand on quads
- purposeful to advance over rigid PF’d ankle
- purposeful to substitute visual input for impaired proprioception
- use of AD
- decreased available trunk extension ROM
- abdominal pain
Effects:
- increased energy cost and demands on hip/trunk extensors – increased lumbar lordosis
- may improve stability and/or forward progression
what are possible causes and effects of a trunk lateral lean?
Causes:
- Ipsi lean 2° weak hip aBductors - decreased MS demand
- Ipsi lean 2° ADductor contraction & contralateral pelvic tilt
- Ipsi lean 2° ABductor or ITB tightness
- Contra lean 2° impaired body image “pusher”
- Ipsi lean with contra hip hike clear swing limb
- Postural response for reference short stance limb
- Purposeful to avoid hip pain
- Use of (A) devices
Effects:
- increases energy cost
- decreases forward momentum
what are possible causes and effects for pelvic hiking in swing?
Causes:
- Weak hip or knee flexors
- Weak dorsiflexors
- Leg length discrepancy
- Inability to flex knee (brace, cast)
- Overactive Quadratus Lumborum
Effects:
- Reference side elevates in voluntary coordination with swing limb
- Purposeful to assist foot clearance
- May decrease energy costs
- May be seen with circumduction
what are possible causes and effects for posterior pelvic tilts?
Causes:
- Tight hamstrings
- Purposeful to decrease demand on hip extensors in IC/LR
- Purposeful for swing (SLA)
- LBP
- decreased lumbar extension
- Weak hip flexors
Effects:
- With thigh vertical, hip hyperextends on stance limb
- Advances limb in absence of effective hip flexors
- May increase energy cost
what are possible causes and effects for anterior pelvic tilts?
Causes:
- weak abdominals
- hip flexion
- 2° forward trunk lean
Effects:
- may increase energy cost
- may increase lordotic curve which may result in LBP
- compensations as seen in with increased hip flexion
what are possible causes and effects for decreased anterior pelvic rotation?
Possible Causes:
- 2° Retracted pelvis
- Comp to decreased demand on quads & hip extensors at LR
- 2° decreased backward rotation of opposite limb
- 2° Back pain
Effect:
- decreases ipsilateral step length
what are possible causes and effects for decreased posterior pelvic rotation?
Possible Causes:
- 2° decreased motor control trunk & pelvic muscles
- 2° Back pain
- 2° excess hip flexion
Effect:
- decreased Contralateral step length (TSt)
what are possible causes and effects for increased anterior pelvic rotation?
Possible Causes:
- 2° Purposeful to advance limb
- 2° Excess backward rotation opposite limb
Effect:
- Increases ipsilateral step length (TSw)
what are possible causes and effects for increased posterior pelvic rotation?
Possible Causes:
- 2° inability to dissociate pelvis from limb movement
- 2° excess plantarflexion
- 2° compensation for increased hip flexion in stance
- 2° weak plantarflexors with no heel-off
Effects:
- decreased forward progression & limb advancement in swing
- Used on purpose to increased forward progression in stance
what are possible causes and effects for ipsilateral pelvic drop?
**iliac crest is lower on reference limb
Causes:
- Contralateral abductor weakness
- May be present w/ scoliosis
- Compensation for shortened reference limb (LLD)
- Purposeful to lower limb for IC
Effects:
- Increased lateral shift of COM
- May increased energy cost
- May result in back pain
what are possible causes and effects for contralateral pelvic drop?
**iliac crest is higher on reference limb
Causes:
Weak hip abductors of reference limb (B & C) w/ & w/o compensation
- Ipsilateral adductor spasticity (D)
- Contralateral abductor spasticity (D)
- Purposeful to lower opposite limb for IC
Effects:
- increased relative length of reference limb
- May decrease opposite limb stability
- May increase energy cost
- May result in back pain
what are the causes of Trendelenburg?
weakness of ipsilateral hip abductors
contralateral hip drop
what are compensatory techniques for Trendelenburg?
- using a cane
- cane on opposite side decreases joint reaction forces in painful reference hip by 36% and reduces demands/reduced compression force on hip joint
- carrying a load
- holding a load on ipsilateral side decreases joint reaction forces in painful reference hip
