final Flashcards
(79 cards)
1
Q
posture
A
alignment of each body segment in relation to the adjoining segments w/ respect to gravity
2
Q
plumb line (lateral)
A
- slightly anterior to mastoid process
- anterior acromion process
- posterior to hip joint
- anterior to knee (lat epicondyle)
- anterior to lateral malleolus
3
Q
plumb line (posterior)
A
- straight down spine
- equidistant b/w scapulae, olecranon processes, greater trochanters, popliteal fossae, calcanei
4
Q
plumb line (anterior)
A
- straight down sternum, abdomen, pelvis
- equidistant b/w pectorals, cubital fossae, iliac crests/ASIS, greater trochanters, patellae, calcanei
5
Q
uneven shoulder height
A
- common in overhead athletes
- dominant shoulder is usually depressed
6
Q
upper quarter crossed syndrome
A
- tight (short): UT, levator scap, pectorals
- weak (long): deep neck flexors, rhomboids, LT, MT, SA
7
Q
forward head posture
A
- increased compression on anterior lower C-spine
- levator scap helps resist stresses
- shoulder protraction … GH/AC instability, posterior RC tightness
- more cervical flexion = more added stress
8
Q
swayback posture
A
- ↑ kyphosis, ↓ lordosis
- tight hip extensors
- weak hip flexors + lower abdominals
- genu recurvatum
- PPT
- increased stress/elongation of anterior hip and posterior T-spine
- shortening of posterior hip + anterior T-spine
- forward head + shoulders
9
Q
lordosis
A
- tight hip flexors + back extensors
- weak hip extensors + abdominals
- APT
10
Q
flatback
A
- ↓ kyphosis, ↓ lordosis
- forward head
- knee flexion
- PPT
- tight hip extensors
- weak hip flexors + back extensors
11
Q
excessive genu valgum
A
more common in females
12
Q
excessive genu varum
A
more common in males
13
Q
postural sway
A
- constant displacement + correction of position of COG w/in BOS
- anteroposterior (AP) sway = 5-7 mm
- mediolateral (ML) sway = 3-4 mm
14
Q
sitting posture
A
- weight should be distributed b/w two ischial bones
- knee + hip flexion w/ hips higher than knees
15
Q
types of sitting
A
- active “sitting up straight” requires muscular effort
- slouched sitting increases disc pressure
16
Q
ideal sitting posture
A
- elbows close to body + supported
- wrists in neutral
- viewing angle of screen should be 15 deg or less of forward-downward
17
Q
positions that has decreased lumbar disc pressure
A
- supine (least pressure)
- sidelying
- standing upright
18
Q
positions that increase lumbar disc pressure
A
- slouched standing w/ heavy object
- slouched sitting w/ heavy object (most pressure)
19
Q
hand held dynamometry strengths
A
- document force (N) value
- regular MMT has decreased reliability at higher grades
- more subtle improvements in strength (more sensitive to change)
- different muscles require more or less effort to move against gravity
20
Q
hand held dynamometry limitations
A
- spring-gauge … force may not be linear across entire spectrum
- difficulty w/ specific instructions
- clinician cannot provide adequate resistive force
- cost
21
Q
hand held dynamometry procedures
A
- position pt appropriately
- isometric force
- consistency in test position
22
Q
telehealth
A
- remote pt treatments
- be creative + concise
- HEP
- remote therapeutic monitoring
23
Q
why is balance important?
A
impaired balance > increased fear of falling > decreased activity participation > progressive weakness, decreased energy, decreased ROM
24
Q
high fall risk factors
A
- decreased ROM + strength in LE
- slow gait speed, increased sway
- decreased balance, coordination, reflexes
- change in vision + sensation
- decreased overall activity
- CNS dysfunction
- uses AD
- previous hx of falls, fear of falling
- medication use
- impaired cognition
- recent hospitalization
- CV conditions
- > 65 years old
25
which performance measures may indicate high fall risk
- decreased hand grip strength ... harder time using AD + support, generalized body weakness
- low score on timed chair stand tests
26
balance treatment - physical activity
ROM, strength, balance exercises
27
balance treatment - education
risk factors, home safety, medication management, physical activity, fall prevention
28
balance treatment - environment modifications
secure stairs, lighting, grab bars, rugs
29
systems for balance
1. visual
2. somatosensory
3. vestibular
30
ankle strategy
- small perturbations
- COM is shifted anteriorly > gastroc + hamstrings
- COM is shifted posteriorly > tibialis anterior + quads
31
hip strategy
- larger perturbations
- small support surface
- hips rapidly flex or extend to move COG back w/in BOS
32
stepping strategy
- when body's COG moves too quickly or too far outside BOS
- foot moves in response to perturbation
33
balance self-report measures
- activities-specific balance confidence (ABC) scale
- falls efficacy scale
- fear of falling avoidance behaviors questionnaire
34
balance performance measures
- static = rhomberg, single limb stance, nudge test (reactive), functional reach (proactive)
- dynamic = TUG, DGI, FGI, four square step test, BERG
35
UE observation tests
- bilateral shoulder flexion
- apley scratch test
- look for symmetry, abnormalities
36
LE observation tests
- squat ... 1/4, half, full
- single leg stance ... clear glute med weakness
- toe/heel walking
37
gait performance measures
- 6 MWT, 2 MWT, 2 minute step test
- 10 m WT, figure 8 walk test, DGI, FGA
38
gait cycle
initial contact > loading response > mid stance > terminal stance > pre swing > initial swing > mid swing > terminal swing
39
gait cycle - double limb support
- 20% of gait cycle
- beginning and end of stance phase ... IC, LR, PSw
40
gait cycle - single limb support
- 80% of gait cycle
- opposite foot in swing
41
arm swing during gait
- arm opposite swing leg should move forward to offset spinal rotation
- increases w/ increased gait speed + step length
42
stance vs swing phase
60% stance, 40% swing
43
initial contact
- heel strike ... foot contacts ground
- hip flexion
- 0° knee extension
44
loading response
- from IC to other foot lifting off ground
- weight shift occurs
- hip flexion
- knees slightly flex to unlock
- plantarflexion
45
mid stance
- from other foot off ground to midswing
- both ankles aligned in frontal plane
- pelvis is level
- knee extension
- 5° DF to clear ground
46
terminal stance
- from ankle alignment to just before IC of swing leg
- hip extension
- dorsiflexion
- foot changes from pronation > supination
47
pre swing
- from IC of swing leg to just before lift off of stance leg
- hip extension
- knee flexion
- plantarflexion
- great toe extension for push-off
48
initial swing
- lift stance leg from ground to max knee flexion
- PPT
- knee flexion
- acceleration ... leg will accelerate forward through air
49
mid swing
- from max knee flexion to vertical tibia position
- hip + knee flexion to clear ground
50
terminal swing
- from vertical tibia position to just before IC
- hip + knee flexion
- ankle neutral
- deceleration (by hamstrings)
51
movement of pelvis during gait
- small anterior-posterior displacement (3°)
- small rise-drop (tilt)
52
step length
distance foot advances in relation to the other
- from R > L or L > R
53
step width
horizontal distance b/w heels
54
stride length
distance from one foot to the same foot
- from R > R or L > L
55
cadence
steps/min
- average adult = 117 steps/min
56
velocity
speed of ambulation
- average adult = 1.2-1.4 m/s
57
trendelenburg gait
- weak gluteus medius
- pelvis drops excessively on contralateral leg
- compensated = upper body leans to ipsilateral side (waddle)
- uncompensated = ipsilateral pelvis rises/"juts" out
58
circumduction gait
- circumduct (swing) leg out to side of body to propel it forward
- trunk + pelvis rotate anteriorly
- swing leg is too long
59
foot drop
- loss of ankle DF (ie. compressed L4 nerve)
- toes drag against ground during swing phase
- compensated = excessive hip + knee flexion to clear swing limb
60
hemiplegic gait
- paralysis of weakness of entire side of body
- neurologic pathology ... stroke, TBI, cerebral palsy
61
antalgic gait
ambulating against or to avoid pain
(like stepping on a thorn)
62
ataxic gait
- unsteady, uncoordinated limb advancement in swing phase
- difficulty stabilizing trunk in single limb stance
- cerebellar dysfunction ... lack of coordination but ROM + strength are not compromised
63
scissor gait
- narrowing, crossing-over of legs
- abnormal muscle tone w/ tightness of hip adductors
- neurological pathology ... cerebral palsy
64
parkinsonian (festinating) gait
- shuffling of feet w/ flexion of trunk
- bodyweight on balls of feet/forefoot
- short step/stride, decreased cadence, small BOS
65
gait pattern - hip hiking
elevation of ipsilateral pelvis during swing
66
gait pattern - knee hyperextension
rapidly thrust knee into hyperextension after limb contacts floor
67
flexed knee gait
knees are flexed the entire gait cycle
68
vaulting gait
rapid ankle plantarflexion during stance to clear opposite limb
69
why should we perform functional capacity evaluations (FCE)?
- measure pt's physical ability
- develop a return to work treatment program
- measure pt progress
- identify possible secondary gain/malingering
- determine if injured worker is ready to return to work
70
FCE components
- physical exam = hx of injury, MMT, grip strength, endurance testing, validity tests
- functional tests = lifting, carrying, pushing/pulling, kneeling, squatting, reaching, sitting, standing
71
benefits of PT in the workplace
- early access to PT in event of injury
- workplace ergonomics and safety assessment
- injury prevention
- wellness initiatives
72
Y-balance test
- focus on form, not distance
- 3 directions = anterior, posterolateral, posteromedial
- measure leg length to normalize (compare) reach
- used to screen and predict injury
73
YBT asymmetry implication
if there is asymmetry in the anterior reach distance, there is a high probability of suffering from a non-contact injury
74
other functional tests
- 12" drop jump test
- single leg squat endurance test
- functional ankle DF in half-kneeling
- gait evaluation
- treadmill (walk, fast walk, jog)
75
limb measurements
- do for YBT and to assess symmetry
- leg = ASIS to medial malleoli
- arm = C7 to 3rd digit
76
hop tests
- use 1 leg
- start w/ toe at start of ruler and measure distance to heel of landing foot
- 4 = forward hop, triple hop, triple crossover hop, 6 meter timed hop
77
functional movement screen (FMS)
- screen for movements ... flexibility, strength, endurance, power
- 7 movement patterns that require mobility and stability
- identify weakness and imbalances
78
FMS movement patterns
1. shoulder mobility
2. hurdle step
3. trunk stability push up
4. active straight leg raise
5. deep squat test
6. rotary instability
7. inline lunge
79
selected functional movement assessment (SFMA)
1. cervical spine flex/ext
2. UE behind back reaching (both ER + IR)
3. multisegmental flexion
4. multisegmental extension
5. multisegmental rotation
6. single leg stance
7. overhead deep squat
