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Kinesiology > Posture and Gait > Flashcards

Posture and Gait Flashcards

1
Q

Define Base of Support

A

area bounded posteriorly by the tips of the heels and anteriorly by a line joining the tips of the toes

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2
Q

Define Center of Gravity

A

also called COM

point where mass of body is centered

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3
Q

Define postural control

A

maintenance of COM over BOS to control body’s orientation in space and stabilize head w/respect to vertical to orient gaze

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4
Q

what 2 responses enable postural control?

A

reactive (compensatory) response

proactice (anticipatory) response

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5
Q

what are reactive (compensatory) responses?

A

responses that occur as reactions to external forces that displace the body’s COM

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6
Q

what are proactive (anticipatory) responses?

A

responses that occur in anticipation of internally generated destabilizing forces

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7
Q

how much postural sway is normal?

A

7 mm during quiet stance

COP can be mapped to determine sway

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8
Q

what is the clinical relevance of postural sway?

A

increased sway = increase fall risk due to COM nearing/getting outside of BOS

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9
Q

what is the difference between sensory and mechanical perturbations?

A

sensory = may be caused by altering visual input

mechanical = displacement causing changes in the relationship of the body’s COM to BOS

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10
Q

what are muscle synergies/strategies (pertaining to postural control)?

A

centerally organized patterns of muscle activity that occur in response to perturbations of standing postures

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11
Q

what is the pattern for an ankle strategy? Hip strategy?

A

ankle = distal-to-proximal pattern

hip = proximal-to-distal pattern

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12
Q

what are 2 changes in support stategies?

A
  1. stepping strategies
  2. grasping strategies
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13
Q

what is the goal of changes in support strategies?

A

move/enlarge the body’s BOS so that it remains under the COM

it is the only strategy that is successful with large perturbations

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14
Q

how can you define equilibrium with respect to internal/external forces?

A

sum of internal and external forces equal to zero

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15
Q

what occurs if the line of gravity (LoG) passes through a joint axis?

A

no torque is created around the joint

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16
Q

what occurs if the LoG passes at a distance from the joint axis?

A

external gravitation moment

this results in rotation around the joint axis unless it is opposed by a counterbalancing internal moment/muscle contraction

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17
Q

Direction depends on the ________ of the ________ in relation to the ___________

A

location

LoG

joint axis

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18
Q

if the LoG is anterior to the joint axis, the external moment will cause what?

A

anterior motion of the proximal segment supported by that joint

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19
Q

what are 3 keys to a successful postural assessment?

A
  1. assess from multiple angles
  2. remove obstructive clothing
  3. observe more than the area of complaint
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20
Q

Long-term deviation of the LoG passing through/around joint axis will result in __________

A

structural changes

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21
Q

Describe the Ideal Standing Posture

A

ideal alignment palce the LoG:

  1. through external auditory meatus
  2. midway through shoulder
  3. slightly posterior to center of hip joint
  4. slightly anterior to axis of knee joint
  5. slightly anterior to lateral malleolus
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22
Q

As the LoG passes anterior to the lateral malleolus, what are the external and internal moments?

A

external = pulling into dorsiflexion

internal = coutner w/plantarflexion (no passive structures contribute, active contraction of solues and gastro)

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23
Q

as the LoG passes anterior to the knee joint, what are the external and internal moments?

A

external = pull into extension

internal = counter w/flexion

(prevent knee hyperextension by passive tension of posterior joint capsule and associated ligaments and active contraction of hamstrings and gastroc)

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24
Q

as the LoG passes posterior to the hip joint, what are the external and internal moments?

A

external = pull into extension

internal = counter w/flexion

(passive tension of hip ligaments and active contraction of hip flexors)

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25
Q

what is the ideal posture at the lumbosacral joint?

A

LoG passes through the body of the L5 causing a slight extension moment

creates shear force rather than a true torque

opposed by anterior longitudinal ligament, iliolumbar ligament, facet joint approximation

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26
Q

As the LoG passes through the external auditory meatus and anterior to the axis of the head, what are the external and internal moments?

A

external = flexion of cervical spine

internal = extension of cervical spine

(passive tension of ligamentum nuchae, tectorial membrane, and posterior facet joint capsules)

(active contraction of cervical extensors)

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27
Q

Describe the ideal standing posture from the posterior view

A
  1. Midline
    1. head
    2. spine
    3. feet evenly spaced
  2. Shoulder and scapulae
    1. scapulae lie flat on thorax
    2. approximately between T2-T7
    3. approximately 4 inches apart
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28
Q

describe the ideal standing posture from the anterior veiw

A
  1. alignment of knees
    1. patellae face directly forward
    2. slight physiological valgus
  2. alignment of ankles
    1. neutral, neither supinated nor pronated
  3. alignment of feet
    1. heels separated by ~3 inches
    2. out-toeing 8-10 degrees
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29
Q

what is the difference between a step and a stride?

A

stride = distance between 2 successive heel contacts of the same foot

step = distance between 2 successive heel contacts of 2 different feet

30
Q

define degree of toe-out

A

angle between line of progression of the body and a line intersecting the center of the heel and 2nd toe

normal = 5-7 degrees

31
Q

what are the 3 temporal descriptors of gait?

A
  1. stride time
  2. step time
  3. cadence
32
Q

what is considered a normal cadence for men and women?

A

men = 108 steps/min

women = 118 steps/min

33
Q

what is our spatiotemporal descriptor for gait?

A

gait speed/velocity

34
Q

T/F: gait speed is a very functional measurement of an individual’s walking ability?

A

TRUE

often called the 6th vital sign

35
Q

An individual’s gait speed can be predictive of what?

A
  1. future health status
  2. functional decline
  3. hospitalization rate
  4. mortality rate
36
Q

what are the 2 phases of the gait cycle?

A

stance phase (60%)

swing phase (40%)

37
Q

how much time in the gait cycle is spent in single-limb support?

A

80%

(double limb support = 20%)

38
Q

what system is used to describe the individual phases/parts of the gait cycle?

A

Rancho Los Amigos Terminology

39
Q

what are the stages of the stance phase of gait?

A
  1. initial contact
  2. loading response
  3. midstance
  4. terminal stance
  5. preswing
40
Q

what are the stages of the swing phase of gait?

A
  1. initial swing
  2. mid swing
  3. terminal swing
41
Q

what occurs in the Stance Phase: Initial contact (IC)?

A

the instant the foot hits the ground

critical event = heels first contact

42
Q

what is occuring on the opposite limb during stance phase: initial contact?

A

TSt and PSw

(terminal stance

43
Q

what are the relative joint positions during the Stance Phase: Initial contact?

A
  1. Hip = 20° flexion,
  2. Knee = 0-5° flexion
  3. Ankle = 0°
44
Q

What occurs in the Stance phase: Loading Response (LR)?

A

shock is absorbed as forward momentum is preserved. A flat foot position is achieved

critical event = hip stability, controlled knee flexion, and ankle PF

45
Q

What is occuring on the opposite limb during stance phase: loading response (LR)?

A

PSw

pre-swing

46
Q

what are the relative joint positions for the Stance Phase: loading response?

A
  1. Hip = 20° flexion
  2. Knee = 15° flexion
  3. Ankle = 5° PF
47
Q

Initial contact and loading response combine for what functional task?

A

weight acceptance, shock absorption, and providing a stable base for the body to progress over

absorb impact of GRF

period of dual-limb support

48
Q

What occurs in the stance phase: midstance (MSt)?

A

the body progresses over the foot in a controlled manner. First instance of single limb support

critical events = controlled tibial advancement

49
Q

What is occuring on the opposite leg during stance phase: midstance (MSt)?

A

ISw - MSw

(Initial swing to Midswing)

50
Q

what are the relative joint positions for stance phase: midstance?

A
  1. Hip = 0°
  2. Knee = 5° flexion
  3. Ankle = 5° dorsiflexion
51
Q

what occurs during stance phase: terminal stance (TSt)?

A

progression over the stance limb continues past the forefoot. Body is ahead of stance limb

critical events = controlled ankle DF with heel raise

52
Q

what is occuring on the opposite limb during stance phase: terminal stance (TSt)?

A

TSw

(terminal swing)

53
Q

what are the relative joint positions for stance phase: terminal stance?

A
  1. Hip = 20° extension
  2. Knee = 5° flexion
  3. Ankle = 10° dorsiflexion
54
Q

What occurs during stance phase: pre swing (PSw)?

A

rapid unloading of the limb with weight transfer to opposite limb, starting the second period of double limb support

critical events = passive knee flexion to 40°, Ankle PF, 60° of MTP extension

55
Q

what is occuring in the opposite limb during stance phase: pre swing (PSw)?

A

IC → LR

initial contact into loading response

56
Q

what are the relative joint positions for stance phase: pre-swing (PSw)?

A
  1. Hip = 10° extension
  2. Knee = 40° flexion
  3. Ankle = 15° plantarflexed
57
Q

what occurs during swing phase: initial swing (ISw)?

A

the thigh begins to advance as the foot leaves the floor

critical events = hip flexion, knee flexion

58
Q

what is occuring at the opposite limb during swing phase: initial swing (ISw)?

A

LR → MSt

(loading response into midstance)

59
Q

what are the relative joint positions during swing phase: initial swing (ISw)?

A
  1. Hip = 15° flexion
  2. Knee = 60° flexion
  3. Ankle = 5° plantarflexion
60
Q

what occurs during swing phase: mid swing (MSw)?

A

thigh continues to advance, knee begins to extend as foot clearance is maintained

critical events = continued hip flexion, foot clearance

61
Q

What is occuring in the opposite limb during swing phase: mid swing (MSw)?

A

MSt

midstance

62
Q

what are the relative joint positions for swing phase: mid swing (MSw)?

A
  1. Hip = 25° flexion
  2. Knee = 25° flexion
  3. Ankle = 0° dorsiflexion
63
Q

what occurs during swing phase: terminal swing (TSw)?

A

the leg reaches out to achieve step length

critical events = knee extension

64
Q

What is occuring on the opposite limb during swing phase: terminal swing (TSw)?

A

TSt

terminal stance

65
Q

what are the relative joint positions during swing phase: terminal swing (TSw)?

A
  1. Hip = 20° flexion
  2. Knee = 5° flexion
  3. Ankle = 0° dorsiflexion
66
Q

What are the 3 functional tasks of gait?

A
  1. Weight acceptance
  2. Single limb support
  3. Swing limb advancement
67
Q

When does weight acceptance occur within the gait cycle and what are it’s goals?

A

Occurs during: IC and LR

Goals:

  1. forward progression
  2. stability
  3. shock absorption
68
Q

when does single limb support occur within the gait cycle and what are the goals of this task?

A

occurs in: MSt and TSt

Goals:

  1. stability
  2. forward progression
69
Q

When does swing limb advancement occur within the gait cycle and what are the goals of this task?

A

occurs in: PSw, ISw, MSw, and TSw

Goals:

  1. foot clearance
  2. limb advancement
70
Q

What are some general tips to take into consideration when performing a gait analysis?

A
  1. Big picture first​
  2. Avoid tunnel vision​
  3. Do not let classification of gait dictate your treatment​
  4. Take your time, get it right​
  5. Understand what you are seeing before you try to fix it​
  6. Use anatomical and standard terminology​
  7. Let the patient choose their walking speed

Kinesiology (13 decks)

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