Functional Mobility and Gait

Question 1

How much ankle dorsiflexion ROM is necessary during the swing phase to clear the foot?

Answer 1

0 Degrees

Question 2

What is the knee maximal amount of flexion during the Gait Cycle?

Answer 2

60 Degrees

Question 3

What ARM do you want to (START) going towards when training supine to sit towards the involved side?

Answer 3

Start Movement using the STRONGER arm

• allows for overflow to weaker side

Question 4

When coming from supine to sit towards the involved side; how should we retrain breathing?

Answer 4

Cue patient to BLOW OUT when they come into sitting

Question 5

How long should we hold at end range to increase isometric contraction?

Answer 5

Hold for 6 SECONDS

Question 6

What are two general phases to consider when performing a sit to stands?

Answer 6

Pre-Extension Phase

and

Extension Phase

Question 7

Ways to increase LE activation while in supine?

Answer 7

Progress to FAST concentric contraction

and

Slow Eccentrics

Question 8

During a sit to stand what are things to consider the impact of:

Answer 8

Different Height Chairs

Not Using Hands

Feet in stride

Position of Spine and Pelvis

Question 9

During the Pre-Extension Phase of sit to stands; the trunk needs what type of alignment?

Answer 9

Stay Neutral with slight THORACIC EXTENSION

Question 10

During the Pre-Extension Phase of sit to stands; the pelvis needs what type of alignment?

Answer 10

Neutral Pelvis Progressing to Anterior Pelvic Tilt

(and hip flexion)

Question 11

Slight Thoracic Extension and pelvis progressing to anterior tilt allows for what motion during the Pre-Extension Phase of Sit - Stands.

Answer 11

Shift the weight forward and provide weight bearing through the LEs.

Question 12

During the Pre-Extension Phase the tibias need to do what (during sit to stands)

Answer 12

Translate forward with knees flexed until hips lift off the mat

Question 13

What 3 things can limit forward progression of the Tibia?

Answer 13

• Blocking the when standing
• AFO preventing dorsiflexion
• Tight Soleus

Question 14

During the extension phase of sit to stands what type of firing must occur and of what muscles?

Answer 14

Symmetrical firing of extensor muscles to provide the extension moment of hip/trunk and knee

Question 15

What types of compensation may be seen during the Extension Phase of Sit to Stands? (3 things)

Answer 15

• Leaning onto the Less Impaired (good side)
• Rotating in Trunk
• Pushing heavily through the UEs

Question 16

Ways to adjust interventions for sit to stands based on the following impairment:

Decreased ROM of Ankle DF (soleus) and hip flexion

Answer 16

Put the ankle and hip on stretch in standing on steps

Question 17

Ways to adjust interventions for sit to stands based on the following impairment:

Decreased power of hip abductors/extensors and knee extensors

Answer 17

Add resistance and perform fast concentric and slow eccentrics with theraband when standing

Question 18

Ways to adjust interventions for sit to stands based on the following impairment: Hypotonia in trunk and lower extremity

Answer 18

Pushing the therapist to increase activity

Question 19

Using what sitting position can increase activation of the Lower Extremities?

Answer 19

High Perch

Question 20

Ways to adjust interventions for sit to stands based on the following impairment:

Decreased Somatosensory

Answer 20

Stay on firm surface and do with eyes closed

Question 21

When training for strength deterioration of form should occur during the last (BLANK) REPS

Answer 21

LAST 2 REPS

Question 22

For Strength 60% threshold REPs and RPE?

Answer 22

15 REPS at RPE 12-13

Question 23

For Strength 80% threshold REPs and RPE?

Answer 23

10 REPS at RPE 15 - 17

Question 24

Ways to increase anterior pelvic tilt in sitting? (2 things)

Answer 24

Sitting backwards in a chair

or
Corner of mat

[also increasing Thoracic Extension)

Question 25

Phases during the Stance Phase of Gait

Answer 25

Initial Contact Loading Response Mid Stance Terminal Stance Pre-Swing

Question 26

What phase of gait does "double support" occur in?

Answer 26

Pre Swing

Question 27

What phases occur during the swing phase of gait

Answer 27

Initial Swing Mid Swing Terminal Swing

Question 28

What occurs during the at the hip during stance phase? Frontal Plane and Sagittal Plane (Muscle Activation)

Answer 28

Frontal = Glute Medius Sagittal = Glute Max

Question 28

Which is more of a priority? Stance or Swing Phase

Answer 28

Stance phase is the priority

Question 29

Majority of patients do not achieve what phases during the stance phase of Gait?

Answer 29

Do not get Mid to Terminal Stance

Question 30

What stepping pattern do we want to promote?

Answer 30

Step through gait pattern

Question 31

What are possible impairments limiting the stance phase of gait?

Answer 31

Strength of hip extensor and abductors PROM of hip extension PROM of hip extension and ankle DF with knee extended Position of the pelvis

Question 32

Control of forward progression of the tibia is from what muscle and activation

Answer 32

Eccentric Plantar Flexion Contraction

Question 33

Which phases do we need to be careful blocking during gait?

Answer 33

Midstance to terminal stance - need to cage the knee and move with the tibia

Question 34

What is the key component of pre-swing?

Answer 34

Hip Position in terminal stance is the key component of pre-swing

Question 35

What MMT grade is required of the hip flexors during the swing phase?

Answer 35

2+ of the Hip Flexors (2/3 of flexion for swing happens passively from quick stretch)

Question 36

MAX: PROM Required: Hip Extension

Answer 36

Extension 10-20 degrees Terminal Stance

Question 37

MAX: PROM Required: Knee Flexion

Answer 37

Flexion: 40 - 60 Midswing

Question 38

MAX: PROM Required: Ankle Flexion (DF):

Answer 38

Flexion: 10 degrees DF midstance to terminal stance

Question 39

MAX: PROM Required: MTP Extension

Answer 39

60 degrees hyperextension during preswing

Question 40

Muscle Activation: Stance-Hip

Answer 40

Glute Max (ECCENTRIC) Glute Med (ECCENTRIC) Hamstrings (ECCENTRIC)

Question 41

Muscle Activation: Stance-Knee

Answer 41

Eccentric Activation of: Hamstrings and Quads

Question 42

Muscle Activation: Stance-Ankle

Answer 42

Eccentric Activation of Plantar Flexors: Midstance Concentric Activation of Plantar Flexors: Terminal

Question 43

Muscle Activation: Swing-Hip

Answer 43

Concentric contraction of the iliopsoas

Question 44

Muscle Activation: Swing-Knee

Answer 44

Eccentric Contraction of the Hamstrings

Question 45

Muscle Activation: Swing-Ankle

Answer 45

Anterior tibialis Peroneal's

Question 46

Major activation occurs in the hip extensors during what phase of gait?

Answer 46

Loading Response

Question 46

Weakness of what muscles is the most common cause of falls during turning?

Answer 46

Hip Abductors

Question 47

Weakness of the quads leads to instability during what phase of gait?

Answer 47

Instability during loading response (and midstance) Loading response may be the more plausible answer

Question 48

Muscle activation of the plantar flexors is the major source of propulsive power

Answer 48

Eccentric control during stance AND Concentric control in pre-swing

Question 49

How far should a community ambulator be able to walk?

Answer 49

>1000 ft 1200-1800 ft for one errand