sit to stand analysis

Question 1

what do we need to understand for clinical reasoning?

Answer 1

• kinematics
• kinetics

Question 2

what is kinematics?

Answer 2

• what movement is happening at what joint at what point

Question 3

what is kinetics?

Answer 3

• what creates the movement e.g., muscle contraction, gravity, momentum

Question 4

what are the two main stages of sit to stand?

Answer 4

• pre- extension phase
• extension phase

Question 5

do the stages have a break in-between?

Answer 5

• no break between phases
• continuous movement with overlap but different functions

Question 6

what is the pre- extension phase?

Answer 6

• involves moving the centre of mass forwards over the feet

Question 7

what happens if you can’t move weight?

Answer 7

• failure to move weight causes extension to happen too soon so extend into seat

Question 8

what are the two subsections of the pre- extension phase?

Answer 8

• flexion- momentum phase
• momentum transfer phase

Question 9

what does the flexion- momentum phase involve?

Answer 9

• start to flex forwards at the trunk

Question 10

what does the momentum transfer phase involve?

Answer 10

• lift off the chair via momentum generated

Question 11

what needs to be generated during the pre- extension phase?

Answer 11

• horizontal ground reaction force
• push back onto ground/ seat

Question 12

what does the extension phase involve?

Answer 12

• involves lifting and extending the centre of mass upwards

Question 13

what two subsections does the extension phase involve?

Answer 13

• extension phase
• stabilisation phase

Question 14

what is extension subsection?

Answer 14

• lift upwards

Question 15

what is the stabilisation subsection?

Answer 15

• makes sure the stand is steadily performed

Question 16

what force is involved in the extension phase?

Answer 16

• predominantly generate force through vertical ground reaction force

Question 17

what is invariant kinematic features?

Answer 17

• when the task changes, the amount of movement differs but the direction and type of movement would be similar (standardised)

Question 18

what is the invariant kinematic feature at the foot in the pre- extension phase?

Answer 18

• foot placement
• ankle positioned behind knee

Question 19

describe the kinetics of the foot placement in the pre- extension phase ; what created it?

Answer 19

• concentric hamstrings & iliopsoas
• lifts leg and bends knee

Question 20

describe the invariant kinematic feature that occurs at the trunk during pre- extension phase

Answer 20

• trunk leans forwards through flexion at hip
• with extended neck and spine

Question 21

what kinetics allows the trunk movement during the pre- extension phase ? (created/ controlled by)

Answer 21

• created by concentric contraction, iliopsoas initiates
• controlled by eccentric erector spine

Question 22

what is the invariant kinematic feature of the knee at pre- extension phase?

Answer 22

• knee moves forwards through dorsiflexion at ankle

Question 23

what kinetics allow the knee movement in the pre- extension phase? (created/ controlled by)

Answer 23

• created by concentric tibialis anterior & movement from trunk flexion
• controlled by eccentric soleus

Question 24

why does eccentric soleus occur during dorsiflexion?

Answer 24

• stops pulling too far forwards

Question 25

what is the invariant kinematic feature of the knees in the extension phase? what occurs at the same time?

Answer 25

- extension at knees starts whilst hips are still flexing (not extended at the same point)

Question 26

What kinetics control the movement of the knees in the extension phase?

Answer 26

- hip flexion deceleration by eccentric glutes & biceps femoris - quadriceps prevent knee flexion

Question 27

what is the invariant kinematic feature of the hip in the extension phase?

Answer 27

- hip extension to upright standing alignment

Question 28

what kinetics create the hip movement during the extension phase?

Answer 28

- concentric gluteus maximum and biceps femoris

Question 29

what does the knee do and what position does it achieve in the extension phase?

Answer 29

- knee extension to upright standing alignment

Question 30

what kinetics create the knee movement into the upright position?

Answer 30

- concentric quadriceps

Question 31

what is the invariant kinematic feature of the ankle in the extension phase?

Answer 31

- ankle plantarflexion to upright standing alignment

Question 32

what kinetics create the movement of the ankle during the extension phase?

Answer 32

- concentric soleus - gastrocnemius

Question 33

what are the five main steps of the reasoning process?

Answer 33

- observe - hypothesise - test hypotheses - seat goals - plan intervention

Question 34

what do we observe for the reasoning process?

Answer 34

- what is not happening that we would be expecting to? - any invariant factors that haven't occurred?

Question 35

what do we hypothesise in the reasoning process?

Answer 35

- what might be causing that e.g., controlling factor

Question 36

what is the test hypotheses of the reasoning process?

Answer 36

- refines our problem list e.g., tibialis anterior weakness

Question 37

what are the two different goals set in the reasoning process?

Answer 37

- at level of activity - at level of impairment

Question 38

what is an example of a goal at level of activity?

Answer 38

- complete STS independently

Question 39

what is an example of a goal at level of impairment?

Answer 39

- to strengthen quadriceps

Question 40

what are the two types of planning interventions?

Answer 40

- at level of activity - at level of impairment

Question 41

what is an example of planning an intervention at level of activity?

Answer 41

- how can you practice and progress the difficult bits

Question 42

what is an example of planning an intervention at level of impairment?

Answer 42

- what do you need to strengthen/ to stretch

Question 43

what are the four factors of sit to stand ICF framework?

Answer 43

- impairments - activity - participation - optimum set up

Question 44

give some examples of impairments of the framework

Answer 44

- muscle weakness - reduction of joint ROM - shortening of muscles

Question 45

what are the examples of activity in the ICF framework?

Answer 45

- independence - effort of sit to stand

Question 46

what is the participation factor of the ICF framework?

Answer 46

- can't join in with family film night as can't stand up from the sofa

Question 47

how do you optimally set up sit to stand?

Answer 47

- sitting closer to edge of chair so can easily transfer weight

Question 48

do we always want to use the optimum set up?

Answer 48

- might want a non- optimum set up to mimic real world