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PTRS 853 Midterm > Mobility_PL > Flashcards

Flashcards in Mobility_PL Deck (31):
1

List categories of mobility (4)

1. Walking/Gait

2. Transfers

3. Bed Mobility

4. Stair Walking

2

List the 3 Essential Requirements for Successful Locomotion

1. Progression

2. Postural Control 

3. Adaptation

3

Term: the need to initiate and terminate locomotion and move the body in the desired direction

Progression

4

Term: maintain the body upright and stable in a dynamic environment

Postural Control

5

Term: alter gait in response to a dynamic environment and changing goals

Adaptation

6

Describe the forces that need to be generated during stance (2)

1. horizontal forces to keep the body moving forward

2. vertical forces to support the body against gravity

7

Describe what needs to be accomplished during swing (3)

- advance the swing limb

- position the swing limb so it's ready to accept weight

- avoid contact with the ground/obstacles 

8

Describe the gait cycle

Symmetrical alternating gait pattern that provides the greatest dynamic stability with minimal control demands

 

There is a phase lag between limbs of a half cycle

9

List the % time spent in stance vs. swing and single vs. double stance

60% stance; 40% swing

40% single stance; 20% double stance

10

List the subphases of stance and swing

Stance: initial contact, loading, midstance, terminal stance, preswing

Swing: initial, mid, terminal 

11

List the temporal and distance factors affecting gait (4)

- velocity

- step length (can ID asymmetry)

- step frequency or cadence (steps/min)

- stride length (heelstrike to heelstrike on same foot)

12

List the normal young adult speeds

1. Gait

2. Cadence

3. Step Length

1. 1.46 m/s

2. 1.9 steps/sec

3. 76.3 cm or 30.05 in

13

Describe how gait velocity is selected

Step rate and gait velocity is related to trying to minimize energy output/energy expenditure

 

** Swing phase doesn't require much EE in normal gait 

14

List 2 factors essential for normal gait

1. Sensory information from periphery

2. Descending control

15

Describe reactive equilibrium control 

This type of control is used in response to perturbation and involves the somatosensory, visual, and vestibular systems

vision: control of velocity; vertical alignment

vestibular: control of gaze, head stabilization

somatosensory: distal to proximal sequence w/slips

 

16

Describe how the body responses to a slip in early vs. late swing

early: elevating strategy of swing limb by increased flexion of swing limb and early heel rise of stance limb

 

late: lowering strategy with PF of swing foot to reach the ground

17

Describe proactive equilibirium control 

This is the use of vision to identify and avoid or accommodate for obstacles.  Predictions are made based on our past experiences.

 

simple terrain = visual sample 10% of the time

uneven terrain = visual sample 30% of the time 

18

Describe how gait is initiated (3)

- begins with relaxation of mm (gastroc/soleus) from quiet stance

- has appearance of falling forward

- shifts COP from toward swing limb and then to stance limb 

19

Describe the 2 turning strategies

1. spin-turn (turn to R, R foot forward, body spins around R foot)

2. step-trun (turn to L, R foot forward, weight shifted to R foot, L hip ER, weight transfers to L foot)

20

Describe the differences between stair ascent and descent

Ascent: requires forces 2x of that needed in level walking, knee extensors generate the most energy to move forward, greatest instability with contralateral toe-off when the ipsilateral leg takes all BW and limb is flexed

 

Descent: eccentric contraction is key

21

List 2 key components of adapting stair walking patterns

1. foot clearance

2. foot placement

 

**depend largely on visual input 

22

List the essential characteristics of moving from sitting to standing (3)

- Generating sufficient joint torque to rise 

- Ensuring stability by moving COM from 1 BOS to BOS defined by feet

- Ability to modify movement strategy depending on environment

23

Describe the 4 phases of the momentum transfers strategy to move from sit to stand

1. Weight Shift/Flexion Momentum: flex trunk, body stable, COM is moving within BOS of the chair seat

2. Beginning to lift: butt leaves seat, horiztonal and verticla motion must coordinated (unstable phase)

3. Lift/Extension: extension of hips/knees, most movement is vertical

4. Stabilization: body stability is achieved

24

Describe the zero momentum strategy for moving from sit to stand (3)

- Flex trunk, put COM over feet

- Increased foce of LE to lift

- More stable throughout

25

Describe the arm rest strategy for moving from sit to stand (3)

- Increased stability

- Assists increased force generation requirements of zero-momentum strategy

- No always feasible for pt.

26

List the primary contributor to stable walking and major factor affecting loss of independing mobility in older adults

Primary contributor to stable walking = balance control 

Major factor affecting loss of independent mobility = decreased balance control

27

Describe how proactive adpatation is altered in elderly individuals

Increased visual sampling, more variable step length, slower velocity, decreased stability 

 

28

List factors critical for recovery from a trip (2)

Quick reactions of: 

- hip flexors of swing leg

- PF of stance leg

29

Describe the gait changes in balance impaired older adults (2)

- decreased stride length and walking speed

- increased stride time, step width, and variability

30

List the pathologies that contribute to age related gait changes (5)

 

- standing balance

- cognition

- increased fear of falling

- sensory impairments

- mm weakness

31

Describe age related changes to the following 

1. gait initiation

2. stair walking

3. sit to stand

1. keep COP and COG more closely aligned to minimize unsteadiness

2. larger foot clearance with descent

3. increased trunk flexion, higher movement velocity, lower forces, increased time to rise