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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
what is the ideal posture at the lumbosacral joint?
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
26
As the LoG passes through the external auditory meatus and anterior to the axis of the head, what are the external and internal moments?
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)
27
Describe the ideal standing posture from the posterior view
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
28
describe the ideal standing posture from the anterior veiw
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
29
what is the difference between a step and a stride?
stride = distance between 2 successive heel contacts of the same foot step = distance between 2 successive heel contacts of 2 different feet
30
define degree of toe-out
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
what are the 3 temporal descriptors of gait?
1. stride time 2. step time 3. cadence
32
what is considered a normal cadence for men and women?
men = 108 steps/min women = 118 steps/min
33
what is our spatiotemporal descriptor for gait?
gait speed/velocity
34
T/F: gait speed is a very functional measurement of an individual's walking ability?
TRUE often called the 6th vital sign
35
An individual's gait speed can be predictive of what?
1. future health status 2. functional decline 3. hospitalization rate 4. mortality rate
36
what are the 2 phases of the gait cycle?
stance phase (60%) swing phase (40%)
37
how much time in the gait cycle is spent in single-limb support?
80% | (double limb support = 20%)
38
what system is used to describe the individual phases/parts of the gait cycle?
Rancho Los Amigos Terminology
39
what are the stages of the stance phase of gait?
1. initial contact 2. loading response 3. midstance 4. terminal stance 5. preswing
40
what are the stages of the swing phase of gait?
1. initial swing 2. mid swing 3. terminal swing
41
what occurs in the Stance Phase: Initial contact (IC)?
the instant the foot hits the ground critical event = heels first contact
42
what is occuring on the opposite limb during stance phase: initial contact?
TSt and PSw (terminal stance
43
what are the relative joint positions during the Stance Phase: Initial contact?
1. Hip = 20° flexion, 2. Knee = 0-5° flexion 3. Ankle = 0°
44
What occurs in the Stance phase: Loading Response (LR)?
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
What is occuring on the opposite limb during stance phase: loading response (LR)?
PSw pre-swing
46
what are the relative joint positions for the Stance Phase: loading response?
1. Hip = 20° flexion 2. Knee = 15° flexion 3. Ankle = 5° PF
47
Initial contact and loading response combine for what functional task?
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
What occurs in the stance phase: midstance (MSt)?
the body progresses over the foot in a controlled manner. First instance of single limb support critical events = controlled tibial advancement
49
What is occuring on the opposite leg during stance phase: midstance (MSt)?
ISw - MSw | (Initial swing to Midswing)
50
what are the relative joint positions for stance phase: midstance?
1. Hip = 0° 2. Knee = 5° flexion 3. Ankle = 5° dorsiflexion
51
what occurs during stance phase: terminal stance (TSt)?
progression over the stance limb continues past the forefoot. Body is ahead of stance limb critical events = controlled ankle DF with heel raise
52
what is occuring on the opposite limb during stance phase: terminal stance (TSt)?
TSw | (terminal swing)
53
what are the relative joint positions for stance phase: terminal stance?
1. Hip = 20° extension 2. Knee = 5° flexion 3. Ankle = 10° dorsiflexion
54
What occurs during stance phase: pre swing (PSw)?
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
what is occuring in the opposite limb during stance phase: pre swing (PSw)?
IC → LR initial contact into loading response
56
what are the relative joint positions for stance phase: pre-swing (PSw)?
1. Hip = 10° extension 2. Knee = 40° flexion 3. Ankle = 15° plantarflexed
57
what occurs during swing phase: initial swing (ISw)?
the thigh begins to advance as the foot leaves the floor critical events = hip flexion, knee flexion
58
what is occuring at the opposite limb during swing phase: initial swing (ISw)?
LR → MSt | (loading response into midstance)
59
what are the relative joint positions during swing phase: initial swing (ISw)?
1. Hip = 15° flexion 2. Knee = 60° flexion 3. Ankle = 5° plantarflexion
60
what occurs during swing phase: mid swing (MSw)?
thigh continues to advance, knee begins to extend as foot clearance is maintained critical events = continued hip flexion, foot clearance
61
What is occuring in the opposite limb during swing phase: mid swing (MSw)?
MSt midstance
62
what are the relative joint positions for swing phase: mid swing (MSw)?
1. Hip = 25° flexion 2. Knee = 25° flexion 3. Ankle = 0° dorsiflexion
63
what occurs during swing phase: terminal swing (TSw)?
the leg reaches out to achieve step length critical events = knee extension
64
What is occuring on the opposite limb during swing phase: terminal swing (TSw)?
TSt terminal stance
65
what are the relative joint positions during swing phase: terminal swing (TSw)?
1. Hip = 20° flexion 2. Knee = 5° flexion 3. Ankle = 0° dorsiflexion
66
What are the 3 functional tasks of gait?
1. Weight acceptance 2. Single limb support 3. Swing limb advancement
67
When does weight acceptance occur within the gait cycle and what are it's goals?
Occurs during: IC and LR Goals: 1. forward progression 2. stability 3. shock absorption
68
when does single limb support occur within the gait cycle and what are the goals of this task?
occurs in: MSt and TSt Goals: 1. stability 2. forward progression
69
When does swing limb advancement occur within the gait cycle and what are the goals of this task?
occurs in: PSw, ISw, MSw, and TSw Goals: 1. foot clearance 2. limb advancement
70
What are some general tips to take into consideration when performing a gait analysis?
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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