abnormal mobility Flashcards
(56 cards)
paresis/weakness reduces the ability to?
generate force; huge contributor to disordered gait
true or false: paresis is a primary neuromuscular impairment
true
what does pauses affect?
number, type, and disagree frequency of motor neurons needed for force production in gait
true or false: paresis does not affect both neural and non neural components of force prooudction
false: it does affect both
what does paresis do to gait speed?
slows it down
true or false: paresis causes the loss of eccentric and concentric control
true
paresis/weakness of the ankle and knee causes (4)
- reduced PF activation
- reduced DF activation
- knee hyperextension in stance phase
- lack of knee flexion in swing phase
true or false: PF paresis is one of the factors leading to knee hyperextension in stance post stroke
true - PF are a 2 joint muscle where the plantar flexors should be able to help stabilize the knee and prevent hyperextension
paresis of the quadriceps leads to?
- knee hyperextends during mid stance (gene recurvatum)
- forward trunk lean (creates extensor moment at knee)
hyperextension compensation of the knee leads to
- diminished knee flexion in swim
- knee trauma over time
paresis of the hip flexors leads to
- diminished knee flexion during swim
- to clearance
- shortened step length (impacts foot position at IC)
- compensatory strategies
compensatory strategies of paresis of the hip flexors
- hip hike (posterior pelvic tilt/abdominal contraction)
- circumduction
-vaulting - lateral lean
paresis of the hip extensors lead to
- difficulty holding trunk erected (threatens stability)
- causes. backward leaning to bring COM behind the hips
paresis of hip abductors leads to
- drop of the pelvis on the contralateral side to the weakness (trendelenburg gait)
- compensation
- lateral shift of COM and lateral trunk lean over the stance leg
spasticity and its effects on gait
- results in appropriate activation of the muscle at points during the gait cycle when it is being rapidly lengthened
- it alters the technical properties of a muscle, producing increased stiffness
when in the gait cycle is the quad rapidly lengthened?
- early stance phase during loading response
- when the knee flexes during initial swing
when in the gait cycle does the hamstring is rapidly lengthened?
terminal swing
spasticity of the plantarflexor includes
-abnormal activation of the triceps sure during early stance phase (knee hyperextension)
- TS activation/stiffness in swig (toe drag)
- TS and posterior tibalis (equinovarus positioning)
spasticity of the quadriceps include
- excessive knee extension in stance
- quad spasticity leads to stiff-knee gait during swing phase (decrease knee flexion and hip circumduction during swing phase of gait)
spasticity of hamstrings include
- excessive activation prevents knee from fully extending (knee flexion at IC)
- excessive knee flexion persists throughout stance (couched gait pattern)
spasticity of the adductors include
- adductor spasticity produces contralateral drop of pelvis and stance (femur drawn medially)
- scissoring gait
loss of selective control and emergence of abnormal synergies
- inability to recruit muscles selectively (associated with abnormal coupling of muscles)
- sterotypical movement strategies ( abnormal synergies or synkinesia)
- manifested in gait as total extension or total flexion patterns
coordination problems
- non-stretch related muscle overactivity
- poor segmental and intersegmental coordination (poor timing and scaling of muscle activity and coordination between the 2 LE or between the LEs and UEs)
- coactivation of agonists/antagonists
musculoskeletal impairments
- weakest
- loss of ROM and contractures
- changes in alignment
