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Clinical skills > sit to stand analysis > Flashcards

sit to stand analysis Flashcards

1
Q

what do we need to understand for clinical reasoning?

A
  • kinematics
  • kinetics
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2
Q

what is kinematics?

A
  • what movement is happening at what joint at what point
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3
Q

what is kinetics?

A
  • what creates the movement e.g., muscle contraction, gravity, momentum
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4
Q

what are the two main stages of sit to stand?

A
  • pre- extension phase
  • extension phase
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5
Q

do the stages have a break in-between?

A
  • no break between phases
  • continuous movement with overlap but different functions
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6
Q

what is the pre- extension phase?

A
  • involves moving the centre of mass forwards over the feet
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7
Q

what happens if you can’t move weight?

A
  • failure to move weight causes extension to happen too soon so extend into seat
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8
Q

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

A
  • flexion- momentum phase
  • momentum transfer phase
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9
Q

what does the flexion- momentum phase involve?

A
  • start to flex forwards at the trunk
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10
Q

what does the momentum transfer phase involve?

A
  • lift off the chair via momentum generated
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11
Q

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

A
  • horizontal ground reaction force
  • push back onto ground/ seat
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12
Q

what does the extension phase involve?

A
  • involves lifting and extending the centre of mass upwards
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13
Q

what two subsections does the extension phase involve?

A
  • extension phase
  • stabilisation phase
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14
Q

what is extension subsection?

A
  • lift upwards
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15
Q

what is the stabilisation subsection?

A
  • makes sure the stand is steadily performed
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16
Q

what force is involved in the extension phase?

A
  • predominantly generate force through vertical ground reaction force
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17
Q

what is invariant kinematic features?

A
  • when the task changes, the amount of movement differs but the direction and type of movement would be similar (standardised)
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18
Q

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

A
  • foot placement
  • ankle positioned behind knee
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19
Q

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

A
  • concentric hamstrings & iliopsoas
  • lifts leg and bends knee
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20
Q

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

A
  • trunk leans forwards through flexion at hip
  • with extended neck and spine
21
Q

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

A
  • created by concentric contraction, iliopsoas initiates
  • controlled by eccentric erector spine
22
Q

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

A
  • knee moves forwards through dorsiflexion at ankle
23
Q

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

A
  • created by concentric tibialis anterior & movement from trunk flexion
  • controlled by eccentric soleus
24
Q

why does eccentric soleus occur during dorsiflexion?

A
  • stops pulling too far forwards
25
Q

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

A
  • extension at knees starts whilst hips are still flexing
    (not extended at the same point)
26
Q

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

A
  • hip flexion deceleration by eccentric glutes & biceps femoris
  • quadriceps prevent knee flexion
27
Q

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

A
  • hip extension to upright standing alignment
28
Q

what kinetics create the hip movement during the extension phase?

A
  • concentric gluteus maximum and biceps femoris
29
Q

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

A
  • knee extension to upright standing alignment
30
Q

what kinetics create the knee movement into the upright position?

A
  • concentric quadriceps
31
Q

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

A
  • ankle plantarflexion to upright standing alignment
32
Q

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

A
  • concentric soleus
  • gastrocnemius
33
Q

what are the five main steps of the reasoning process?

A
  • observe
  • hypothesise
  • test hypotheses
  • seat goals
  • plan intervention
34
Q

what do we observe for the reasoning process?

A
  • what is not happening that we would be expecting to?
  • any invariant factors that haven’t occurred?
35
Q

what do we hypothesise in the reasoning process?

A
  • what might be causing that e.g., controlling factor
36
Q

what is the test hypotheses of the reasoning process?

A
  • refines our problem list
    e.g., tibialis anterior weakness
37
Q

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

A
  • at level of activity
  • at level of impairment
38
Q

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

A
  • complete STS independently
39
Q

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

A
  • to strengthen quadriceps
40
Q

what are the two types of planning interventions?

A
  • at level of activity
  • at level of impairment
41
Q

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

A
  • how can you practice and progress the difficult bits
42
Q

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

A
  • what do you need to strengthen/ to stretch
43
Q

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

A
  • impairments
  • activity
  • participation
  • optimum set up
44
Q

give some examples of impairments of the framework

A
  • muscle weakness
  • reduction of joint ROM
  • shortening of muscles
45
Q

what are the examples of activity in the ICF framework?

A
  • independence
  • effort of sit to stand
46
Q

what is the participation factor of the ICF framework?

A
  • can’t join in with family film night as can’t stand up from the sofa
47
Q

how do you optimally set up sit to stand?

A
  • sitting closer to edge of chair so can easily transfer weight
48
Q

do we always want to use the optimum set up?

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

Clinical skills (13 decks)

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