what is force measurement?
studies forces acting on the body (internal and external)
what are EMG studies used for?
study electrical activity during muscle contraction
what are limitations of EMGs?
problems with cross-over or cross-talk which makes it difficult to determine which muscle is contracting
what is intramuscular pressure?
determines pressure within the muscle
accounts for both active and passive muscle tension
what does the clinician need to know about gait problems?
- is it structural?
- is it joint or soft tissue related?
- is it myopathic (muscular dystrophy)
- is it neurologic? (progressive or non)
what is a gait cycle?
activity that occurs between the heel strike of one leg all the way to the heel strike of the same leg
what is the stride length?
distance of the step in one gait cycle
what is the stance phase?
60% of the time during the gait
when the foot is in contact with the ground
what is the swing phase?
40% of the time during the gait
feet are swinging
what is the rest of the 20%?
when both feet are in contact with the ground
what is a step?
heel strike of left foot to heel strike of right foot
what is a stride?
heel strike of right foot to heel strike of right foot
what are 5 components of stance phase analysis?
- heel strike
- foot flat
what can cause a wider horizontal displacement?
balance problems to keep themselves from falling
what is a trendelenburg gate?
pelvic drop on one or both side
caused by gluteus medius weakness
side that drops is on the opposite side of weakness
what are the 5 main reasons for abnormal gait?
muscular weakness joint/muscle ROM limitations neurological problem pain leg length discrepancy
what is a sign of leg length discrepancy?
circumduction on the long side
how does gluteus maximus weakness manifest?
rocking horse gait
hand on affected hip to push the hip forward so they don’t fall
how does quads weakness manifest?
either pushing knee to lock or cocking knee to lock
how does hamstring weakness manifest?
genu recurvatum gait
hyperextension of the knee with each step
how does dorsiflexion weakness manifest?
foot slap gait
high steppage gait
how does triceps surae weakness manifest?
sore foot limp
shortened step length on the unaffected side
more pronounced when going up an ingline
what is a waddling gait?
seen in muscular dystrophy
a/w lumbar lordosis and a steppage gait
to swing the leg forward, the entire side of the body must swing forward
what is a hemiplegic gait?
lands flat-footed and no arm swing on affected side
what is ataxic gait?
usu. cerebellar involvement
what is the festinating gait of parkinsonism?
difficulty initiating, as it gets started, goes faster and faster
what is a crouch gait?
bilateral lower extermity involvement
excessive lordosis, anterior pelvic tilt, hip and knee flexion
exaggerated arm swing
what is an antalgic gait?
spend less time on the painful foot
shortened step length on uninvolved side
what is the gait compensation for a leg length discrepancy of up to 3”?
dropping pelvis on affected side (stresses low back)
what is the gait compensation for a leg length discrepancy of up to 3-5”?
equinnus gait, walks on ball of foot on shorter side
what is the gait compensation for a leg length discrepancy of up to 5”?
drop pelvis, equinnus gait AND flex uninvolved knee
what is a 4 point gait pattern?
at any time there are 4 points of contact on the ground
what is a 3-1 point gait pattern?
crutch stays with the affect leg and both crutches are used, which makes it partial weight bearing
what is a 3 point gait pattern?
non-weight bearing, two crutches swing through,
what is 2 point gait pattern?
using crutches as support, but walking normally. crutches used to balance and take some of the weight off
what is TTWB?
toe-touch weight bearing (can only do with crutches or walker)
what is WBAT?
weight bearing as tolerated
what is PWB?
partial weight bearing (25, 50, 75%)
what is FWB?
full weight bearing
why use a tilt table?
good for gradually accomodating to elevation for pts who have been lying supine for a long time
-must monitor for vital signs
when would you use parallel bars?
maximum support needed
how do you measure for crutches?
3 fingers below axilla
what position should the crutches be in?
what should you advice patients about using crutches?
don’t lean down on them
what is a platform attachment?
used when they have had a hand or arm injury (flexed elbow), a platform is used to fasten crutch to their arm in a way that allows them to use it
when would you use a cane?
pt who needs a little bit of balance help
should be fit to the base of the thumb
what should you remember about transferring?
always transfer toward the strong side
what is important to ask the pt when transferring?
what help do they need?
where should you stand on steps to support patients?
on the low side
if you are good you go up…
if you are bad, you go down