sit to stand analysis Flashcards
what do we need to understand for clinical reasoning?
- kinematics
- kinetics
what is kinematics?
- what movement is happening at what joint at what point
what is kinetics?
- what creates the movement e.g., muscle contraction, gravity, momentum
what are the two main stages of sit to stand?
- pre- extension phase
- extension phase
do the stages have a break in-between?
- no break between phases
- continuous movement with overlap but different functions
what is the pre- extension phase?
- involves moving the centre of mass forwards over the feet
what happens if you can’t move weight?
- failure to move weight causes extension to happen too soon so extend into seat
what are the two subsections of the pre- extension phase?
- flexion- momentum phase
- momentum transfer phase
what does the flexion- momentum phase involve?
- start to flex forwards at the trunk
what does the momentum transfer phase involve?
- lift off the chair via momentum generated
what needs to be generated during the pre- extension phase?
- horizontal ground reaction force
- push back onto ground/ seat
what does the extension phase involve?
- involves lifting and extending the centre of mass upwards
what two subsections does the extension phase involve?
- extension phase
- stabilisation phase
what is extension subsection?
- lift upwards
what is the stabilisation subsection?
- makes sure the stand is steadily performed
what force is involved in the extension phase?
- predominantly generate force through vertical ground reaction force
what is invariant kinematic features?
- when the task changes, the amount of movement differs but the direction and type of movement would be similar (standardised)
what is the invariant kinematic feature at the foot in the pre- extension phase?
- foot placement
- ankle positioned behind knee
describe the kinetics of the foot placement in the pre- extension phase ; what created it?
- concentric hamstrings & iliopsoas
- lifts leg and bends knee
describe the invariant kinematic feature that occurs at the trunk during pre- extension phase
- trunk leans forwards through flexion at hip
- with extended neck and spine
what kinetics allows the trunk movement during the pre- extension phase ? (created/ controlled by)
- created by concentric contraction, iliopsoas initiates
- controlled by eccentric erector spine
what is the invariant kinematic feature of the knee at pre- extension phase?
- knee moves forwards through dorsiflexion at ankle
what kinetics allow the knee movement in the pre- extension phase? (created/ controlled by)
- created by concentric tibialis anterior & movement from trunk flexion
- controlled by eccentric soleus
why does eccentric soleus occur during dorsiflexion?
- stops pulling too far forwards
what is the invariant kinematic feature of the knees in the extension phase? what occurs at the same time?
- extension at knees starts whilst hips are still flexing
(not extended at the same point)
What kinetics control the movement of the knees in the extension phase?
- hip flexion deceleration by eccentric glutes & biceps femoris
- quadriceps prevent knee flexion
what is the invariant kinematic feature of the hip in the extension phase?
- hip extension to upright standing alignment
what kinetics create the hip movement during the extension phase?
- concentric gluteus maximum and biceps femoris
what does the knee do and what position does it achieve in the extension phase?
- knee extension to upright standing alignment
what kinetics create the knee movement into the upright position?
- concentric quadriceps
what is the invariant kinematic feature of the ankle in the extension phase?
- ankle plantarflexion to upright standing alignment
what kinetics create the movement of the ankle during the extension phase?
- concentric soleus
- gastrocnemius
what are the five main steps of the reasoning process?
- observe
- hypothesise
- test hypotheses
- seat goals
- plan intervention
what do we observe for the reasoning process?
- what is not happening that we would be expecting to?
- any invariant factors that haven’t occurred?
what do we hypothesise in the reasoning process?
- what might be causing that e.g., controlling factor
what is the test hypotheses of the reasoning process?
- refines our problem list
e.g., tibialis anterior weakness
what are the two different goals set in the reasoning process?
- at level of activity
- at level of impairment
what is an example of a goal at level of activity?
- complete STS independently
what is an example of a goal at level of impairment?
- to strengthen quadriceps
what are the two types of planning interventions?
- at level of activity
- at level of impairment
what is an example of planning an intervention at level of activity?
- how can you practice and progress the difficult bits
what is an example of planning an intervention at level of impairment?
- what do you need to strengthen/ to stretch
what are the four factors of sit to stand ICF framework?
- impairments
- activity
- participation
- optimum set up
give some examples of impairments of the framework
- muscle weakness
- reduction of joint ROM
- shortening of muscles
what are the examples of activity in the ICF framework?
- independence
- effort of sit to stand
what is the participation factor of the ICF framework?
- can’t join in with family film night as can’t stand up from the sofa
how do you optimally set up sit to stand?
- sitting closer to edge of chair so can easily transfer weight
do we always want to use the optimum set up?
- might want a non- optimum set up to mimic real world
