Posture & Gait Flashcards

1
Q

What is posture?

A

Position of body parts in relationship to each other at any given time

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2
Q

What are the elements of ideal posture?

A
  • Minimises stresses on the body

- Requires muscular effort

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3
Q

What is posture affected by?

A
  • Structural factors

- Positioning factors

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4
Q

What are the normal spinal curves?

A
  • Cervical curvature (lordosis)
  • Thoracic curvature (kyphosis)
  • Lumbar curvature (lordosis)
  • Sacral curvature (kyphosis)
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5
Q

What are the results of positioning changes/static postures?

A
  • Pain or injury
  • Joint stiffness, muscle tightness or weakness
  • Poor ergonomic set up, environment
  • Task confines/repetitive movements
  • Habit or lack of awareness
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6
Q

What is ideal sitting posture?

A
  • Head centred on shoulders
  • Shoulders level & on top of pelvis
  • Hips & knees bent at 90 degrees
  • Feet flat on floor
  • Lower back curve maintained
  • Invisible line through ear lobe, shoulder, midline of trunk & hips down to floor
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7
Q

What is forward head posture?

A
  • Upper cervical spine in extension (around neck)

- Lower cervical spine in flexion (around shoulders)

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8
Q

What are some of the poor shoulder postures?

A
  • Shoulders slumped forwards, winging of scapulae

- Shoulders pulled back too far

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9
Q

What are some of the poor lumbar spine postures?

A
  • Slump: Decreased lordosis, posterior pelvic tilt

- Overextended: Increased lordosis, anterior pelvic tilt

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10
Q

What is the ideal standing posture?

A
  • Head & spine straight
  • Shoulders & pelvis level
  • Knees & ankles level
  • Line through ear lobe, shoulder, midway through trunk, greater trochanter, slightly anterior to knee & ankle
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11
Q

What is the difference between foot pronation & supination?

A

Pronation: Lowering of medial edge by turning it outwards
Supination: Raising of medial edge by turning it inwards

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12
Q

What ankle movements are pronation and supination a combination of?

A

Pronation: Eversion, abduction, DF
Supination: Inversion, adduction, PF

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13
Q

What are the arches of the foot formed & strengthened by?

A

Formed by position & shape of the foot bones & strengthened by tendons & ligaments

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14
Q

What are the functions of the arches of the foot?

A
  • Support body weight
  • Allow flexibly for movement & balance
  • Allow shock absorption & stored energy to be returned to movement (e.g. spring)
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15
Q

What is pes cavus and pes planus?

A
  • Pes canus: Excessive high arch with claw foot

- Pes planus: No or minimal arch with flat feet

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16
Q

What can poor posture lead to?

A

Muscle, joint & ligament strain causing pain & injury

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17
Q

What can postural correction help with?

A

Treatment & prevention of injuries relating to poor loading of the spine

18
Q

What is postural control?

A

Ability to control the body’s position in space for the purpose of orientation & stability

19
Q

What is the outcome of postural control?

A

Maintenance of upright head to:

  • Maximise sensory input
  • Maximise weight through proprioceptors, minimal sway, minimal energy requirements, linkage of adjacent musculoskeletal segments
20
Q

What is postural stability?

A

Ability to maintain centre of mass over base of support

21
Q

What does postural control involve the integration of?

A
  • Sensory & motor systems

- Autonomic & reflexive responses to stabilise, anticipate & react

22
Q

What are the feedback and feed forward mechanisms of postural control?

A
  • Feedback: Sensory inputs, processing & integration

- Feed forward: Motor control/effects

23
Q

How does the cognitive system affect postural control?

A
  • Attention
  • Adaptation
  • Anticipation
  • Confidence/fear
24
Q

What are the types of postural control?

A
  • Steady state (static): Control of COM relative to BOS at rest
  • Reactive: Ability to recover postural control when disturbed (e.g. push)
  • Proactive: Ability to modify postural control prior to disturbance or to avoid instability (e.g. kicking)
25
How does the motor, sensory and cognitive system affect steady state postural control?
- Motor: Alignment, control strength, joint range, tone - Sensory: Integration of sensory info - Cognitive: Attention, dual tasking, functional tasks
26
How does the motor, sensory and cognitive system affect reactive postural control?
- Motor: Synergy, fixed BOS strategies, changing BOS strategies - Sensory: Integration of sensory info - Cognitive: Attention, adaptation, anticipation
27
What are some of the strategies for changing BOS?
- Ankle - Hip - Stepping - Reaching
28
How does the motor, sensory and cognitive system affect proactive postural control?
- Motor: Similar to reactive, depends on direction, sped, force of planned movement - Sensory: Used to predict trajectory, estimate forces, scale response - Cognitive: Anticipation, feed-forward system
29
# Define: - Step length - Stride length - Step width - Foot angle
- Step length: L heel strike to R heel strike - Stride length: L heel strike to L heel strike - Step width: Distance between heel centre of two foot contacts - Foot angle: Degree of toe out
30
What are the two components of mobility functions?
- Gait (walk, run) | - Transfers (sit to stand, supine to sit)
31
What are the two phases of the gait cycle (1 stride)
- Stance phase: Heel strike - toe off (60% of cycle) | - Swing phase: Toe off - heel strike (40% of cycle)
32
When does double limb support occur in walking and running?
(Both feet on ground) - Walking: First 0-10% of gait cycle, then last 50-60% of gait cycle - Running: No double limb support
33
What is the normal positioning during the gait cycle?
- COM anterior to S2 - 5cm vertical displacement - 4cm medial-lateral displacement
34
What forces are involved during the stance phase?
- Horizontal: Against support surfaces, allows body to move forward - Vertical: Against gravity, supports body
35
What are the 4 phases of the stance phase?
- Loading response: Between initial contact & opposite toe off - Mid stance: Weight over mid foot, opposite toe off to heel rise - Terminal stance: Opposite foot in contact with ground - Pre-swing/toe off: Other foot in loading response
36
# Define: - Cadence - Stride time - Step time
- Cadence: Steps/min - Stride time: Time for full gait cycle - Step time: Time for completion of L or R step
37
What is the movement of glute max throughout gait?
- Eccentric activation at terminal swing | - Concentric activation at hell contact-mid stance
38
What is the movement of iliopsoas throughout gait?
- Eccentric activation prior to toe off | - Concentric activation at toe off and initial to mid swing
39
When are the abductors most active in the gait cycle/
During single leg support stance (control dropping of pelvis to side of swing leg through eccentric contraction)
40
What are the postural control outcome measures?
- Functional reach - Tinetti test - Berg's balance test - Timed up & go (TUG) - Trunk impairment scale - Motor assessment scale
41
What are the gait outcome measures?
- Time up & go (TUG) - 6 minute walk test (6MWT) - Rivermead mobility index (RMI) - 12 minute walk test (12MWT) - Dynamic gait index (DGI) - Functional gait assessment (FGA) - Stops walking when talking test (SWWTT) - Physical performance & mobility examination (PPME) - Emory functional ambulation profile