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NMI > Posture & Gait > Flashcards

Posture & Gait Flashcards

1
Q

What is posture?

A

Position of body parts in relationship to each other at any given time

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2
Q

What are the elements of ideal posture?

A
  • Minimises stresses on the body

- Requires muscular effort

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3
Q

What is posture affected by?

A
  • Structural factors

- Positioning factors

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4
Q

What are the normal spinal curves?

A
  • Cervical curvature (lordosis)
  • Thoracic curvature (kyphosis)
  • Lumbar curvature (lordosis)
  • Sacral curvature (kyphosis)
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5
Q

What are the results of positioning changes/static postures?

A
  • Pain or injury
  • Joint stiffness, muscle tightness or weakness
  • Poor ergonomic set up, environment
  • Task confines/repetitive movements
  • Habit or lack of awareness
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6
Q

What is ideal sitting posture?

A
  • Head centred on shoulders
  • Shoulders level & on top of pelvis
  • Hips & knees bent at 90 degrees
  • Feet flat on floor
  • Lower back curve maintained
  • Invisible line through ear lobe, shoulder, midline of trunk & hips down to floor
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7
Q

What is forward head posture?

A
  • Upper cervical spine in extension (around neck)

- Lower cervical spine in flexion (around shoulders)

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8
Q

What are some of the poor shoulder postures?

A
  • Shoulders slumped forwards, winging of scapulae

- Shoulders pulled back too far

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9
Q

What are some of the poor lumbar spine postures?

A
  • Slump: Decreased lordosis, posterior pelvic tilt

- Overextended: Increased lordosis, anterior pelvic tilt

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10
Q

What is the ideal standing posture?

A
  • Head & spine straight
  • Shoulders & pelvis level
  • Knees & ankles level
  • Line through ear lobe, shoulder, midway through trunk, greater trochanter, slightly anterior to knee & ankle
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11
Q

What is the difference between foot pronation & supination?

A

Pronation: Lowering of medial edge by turning it outwards
Supination: Raising of medial edge by turning it inwards

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12
Q

What ankle movements are pronation and supination a combination of?

A

Pronation: Eversion, abduction, DF
Supination: Inversion, adduction, PF

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13
Q

What are the arches of the foot formed & strengthened by?

A

Formed by position & shape of the foot bones & strengthened by tendons & ligaments

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14
Q

What are the functions of the arches of the foot?

A
  • Support body weight
  • Allow flexibly for movement & balance
  • Allow shock absorption & stored energy to be returned to movement (e.g. spring)
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15
Q

What is pes cavus and pes planus?

A
  • Pes canus: Excessive high arch with claw foot

- Pes planus: No or minimal arch with flat feet

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16
Q

What can poor posture lead to?

A

Muscle, joint & ligament strain causing pain & injury

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17
Q

What can postural correction help with?

A

Treatment & prevention of injuries relating to poor loading of the spine

18
Q

What is postural control?

A

Ability to control the body’s position in space for the purpose of orientation & stability

19
Q

What is the outcome of postural control?

A

Maintenance of upright head to:

  • Maximise sensory input
  • Maximise weight through proprioceptors, minimal sway, minimal energy requirements, linkage of adjacent musculoskeletal segments
20
Q

What is postural stability?

A

Ability to maintain centre of mass over base of support

21
Q

What does postural control involve the integration of?

A
  • Sensory & motor systems

- Autonomic & reflexive responses to stabilise, anticipate & react

22
Q

What are the feedback and feed forward mechanisms of postural control?

A
  • Feedback: Sensory inputs, processing & integration

- Feed forward: Motor control/effects

23
Q

How does the cognitive system affect postural control?

A
  • Attention
  • Adaptation
  • Anticipation
  • Confidence/fear
24
Q

What are the types of postural control?

A
  • Steady state (static): Control of COM relative to BOS at rest
  • Reactive: Ability to recover postural control when disturbed (e.g. push)
  • Proactive: Ability to modify postural control prior to disturbance or to avoid instability (e.g. kicking)
25
Q

How does the motor, sensory and cognitive system affect steady state postural control?

A
  • Motor: Alignment, control strength, joint range, tone
  • Sensory: Integration of sensory info
  • Cognitive: Attention, dual tasking, functional tasks
26
Q

How does the motor, sensory and cognitive system affect reactive postural control?

A
  • Motor: Synergy, fixed BOS strategies, changing BOS strategies
  • Sensory: Integration of sensory info
  • Cognitive: Attention, adaptation, anticipation
27
Q

What are some of the strategies for changing BOS?

A
  • Ankle
  • Hip
  • Stepping
  • Reaching
28
Q

How does the motor, sensory and cognitive system affect proactive postural control?

A
  • Motor: Similar to reactive, depends on direction, sped, force of planned movement
  • Sensory: Used to predict trajectory, estimate forces, scale response
  • Cognitive: Anticipation, feed-forward system
29
Q

Define:

  • Step length
  • Stride length
  • Step width
  • Foot angle
A
  • Step length: L heel strike to R heel strike
  • Stride length: L heel strike to L heel strike
  • Step width: Distance between heel centre of two foot contacts
  • Foot angle: Degree of toe out
30
Q

What are the two components of mobility functions?

A
  • Gait (walk, run)

- Transfers (sit to stand, supine to sit)

31
Q

What are the two phases of the gait cycle (1 stride)

A
  • Stance phase: Heel strike - toe off (60% of cycle)

- Swing phase: Toe off - heel strike (40% of cycle)

32
Q

When does double limb support occur in walking and running?

A

(Both feet on ground)

  • Walking: First 0-10% of gait cycle, then last 50-60% of gait cycle
  • Running: No double limb support
33
Q

What is the normal positioning during the gait cycle?

A
  • COM anterior to S2
  • 5cm vertical displacement
  • 4cm medial-lateral displacement
34
Q

What forces are involved during the stance phase?

A
  • Horizontal: Against support surfaces, allows body to move forward
  • Vertical: Against gravity, supports body
35
Q

What are the 4 phases of the stance phase?

A
  • Loading response: Between initial contact & opposite toe off
  • Mid stance: Weight over mid foot, opposite toe off to heel rise
  • Terminal stance: Opposite foot in contact with ground
  • Pre-swing/toe off: Other foot in loading response
36
Q

Define:

  • Cadence
  • Stride time
  • Step time
A
  • Cadence: Steps/min
  • Stride time: Time for full gait cycle
  • Step time: Time for completion of L or R step
37
Q

What is the movement of glute max throughout gait?

A
  • Eccentric activation at terminal swing

- Concentric activation at hell contact-mid stance

38
Q

What is the movement of iliopsoas throughout gait?

A
  • Eccentric activation prior to toe off

- Concentric activation at toe off and initial to mid swing

39
Q

When are the abductors most active in the gait cycle/

A

During single leg support stance (control dropping of pelvis to side of swing leg through eccentric contraction)

40
Q

What are the postural control outcome measures?

A
  • Functional reach
  • Tinetti test
  • Berg’s balance test
  • Timed up & go (TUG)
  • Trunk impairment scale
  • Motor assessment scale
41
Q

What are the gait outcome measures?

A
  • Time up & go (TUG)
  • 6 minute walk test (6MWT)
  • Rivermead mobility index (RMI)
  • 12 minute walk test (12MWT)
  • Dynamic gait index (DGI)
  • Functional gait assessment (FGA)
  • Stops walking when talking test (SWWTT)
  • Physical performance & mobility examination (PPME)
  • Emory functional ambulation profile

NMI (9 decks)

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