how many vertebrea in the spine?
29
how many cervical vertebrea?
7
how many thoracic vertebrea?
12
how many lumbar vertebrea?
5
how many sacral vertebrea?
5 - fused from sacrum
which region of the spine is the most mobile?
cervical spine
when a segment is more mobile you sacrifice what?
stability
ROM flexion cervical spine
0-45
chin to chest
ROM extension cervical spine
0-45
forehead parallel to floor
ROM L/R side-bending
0-45
ROM L/R rotation
0-80
which region of the spine is the most ridged?
thoracic spine
what is the main function of the thoracic spine?
protect the viscera
what’s the difference btw the corstovertebra jt and the costotransverse jt?
costovertebral : jt btw head of rib and lat side of vertebral body (1 rib touches 2 vertebral bodies)
costotransverse : jt btw rib and transverse process of the vertebrea
ROM flexion thoracic spine
20-45
ROM extension thoracic spine
15-20
ROM L/R side bending
25-45
ROM L/R rotation
35-50
which mvt of the spine comes mostly from the thoracic spine?
side bending
F or T
ROM flexion and extension of the thoracic spine does not depend on posture
FALSE
ROM lumbar flexion
first 60° from Lx and next 25° from hip = total 70-90
ROM Lx extension
30-50
ROM Lx side bending
30
ROM Lx rotation
35
what are the components oft the motion segment in the spine?
2 adj vertebrae that forms 3 jts (1 intervetebral jt and 2 z-joints)
how many pairs of facets joints in the spine?
24
what are the 2 major motions z-joints are capable of doing?
gliding upward (during spine flexion) gliding downward (during spine extention)
what happens if the mvt of the z-joints happen in the same direction bilaterally?
flexion or extension of the spine
what happens if the mct of the L and R z-joints happen in opposite direction? (i.e upward gliding on R side and downward gliding of L side)
side bending
btw which vertebrea can we find IV dics?
C2-S1
what increases concavity and stability in the hip joint? (2)
acetabular labrum
transverse acetabular ligament
what type of jt is the hip jt?
how many DOF?
what are tht mvt possible?
ball and socket
3 DOF
flex/ext, ABD/ADD, IR/ER
which is more stable : hip or shoulder?
hip
which is more mobile : hip or shoulder?
shoulder
what is the primary fct of hip jt?
WB : support weight of upper body in static (errect) and dynamic (walking, running) postures
Hip AROM/PROM
flexion
110-120
Hip AROM/PROM
extension
10-15
Hip AROM/PROM
ABD
45-50
Hip AROM/PROM
ADD
25-30
Hip AROM/PROM
IR (w/ hip at 90° flexion)
30-40
Hip AROM/PROM
ER (w/ hip at 90° flexion)
40-60
Hip EF
flexion
tissue approx or elastic
Hip EF
extension
capsular
Hip EF
ABD
elastic (tight ABD) or capsular (flexible ABD)
Hip EF
ADD
tissue approx or capsular
Hip EF
IR
capsular
Hip EF
ER
capsular
ROM hip
Normal gait
flex : 30°
ext : 10°
ABD/ADD : 5°
ER/IR : 5°
T or F
Activities such as walking of uneven surfaces, stairs, sitting cross legged require more ROM than normal gait at the hip?
T
Muscles hip
flexion
psoas illiacus sartorius TFL rectus femoris pectineus adductor brevis adductor longus adductor magnus glut med glut min
Muscles hip
extension
adductor magnus (post fibers) glut max glut med biveps femoris semimem semitend
Muscles hip
ABD
sartorius TFL piriformis glut mex glut med glut min gemellus sup gemellus ing obturator internus
Muscles hip
ADD
pectineus adductor brevis adductor longus gracilis adductor magnus glut max
Muscles hip
IR
TFL glut med glut min semimem semitend
Muscles hip
ER
psoas illiacus sartorius adductor brevis glut max glut med piriformis gemellus sup gemellus inf obturator internus obturator externus quadratus femoris biceps femoris
T or F
superior tibiofibular jt is part of the knee complex
F
major role of knee jt?
supporting the body during dynamic and static activities
AROM/PROM knee
flexion
135
AROM/PROM knee
extension
0-15 (>0 = hyperextension)
AROM/PROM knee
medial rotation
10
AROM/PROM knee
lateral rotation
10
EF knee
flexion
soft tissue approx (gastroc hit hamstring)
EF knee
extension
capsular
EF knee
medial rotation
capsular
EF knee
internal rotation
capsular
role of meniscus
increases the stability of the joint
help distribute WB forces by reducing friction btw jt
what is the role of ligaments in the knee?
stability considering the lack of body restraint to any knee mvt
what is a common MOI for samage to PCL?
fall on flexed knee
whats the terrible triad
medial menisci
ACL
MCL
what is a smtg that commonly happens during an ACL tear?
hear a pop
who am i?
i resist hyperextension of the knee (tibia going too anterior)
ACL
who am i?
i resist hyperflexion of the knee (tibia going too post)
PCL
who am i?
i resist valgus stresses at the knee
MCL
who am i?
i resist varus stresses at the knee
LCL
what ligaments at the knee are not repairable with Sx?
MCL and LCL
all ligaments at the knee all together restrain which mvt?
torsion stresses
Muscles knee
flexion
sartorius gracilis biceps femoris semi-mem semi-tend plantaris popliteus gastroc
Muscles knee
extension
rectus femoris
vastus lat
vastus intermedius
vastuc medialis
Muscles knee
IR
gracilis sartorius semi-mem semi-tend popliteus
Muscles knee
ER
biceps femoris
what is the least congruent jt in the body?
patellofemoral jt
what mostly controls the paterllofemoral jt?
quad ms
what is the primary role of the patellofemoral jt?
eccentric pully to reduce the friction btw the quad ms and the femoral condyles
why does the patella perform its functions w/o restricting knee motions?
its mobility!
what are the mvt possible at the patella?
med and lat tilting
med and lat rotation
med and lat glide
failure of the parella to glide, rotate or tilt appropiately can lead to : (3)
restriction in knee ROM
instability of the patellofemoral jt
pain caused by erosion/friction of the patellofemoral surfaces
Mvt of the patella
in full knee extension
sits on ant surface of distal femur
little or no contact w/ jt surface
Mvt of the patella
in knee flexion
slides distally on femoral condyles
seating btw the femoral condyles
diff parts of patella enter into contact w/ demur
Mvt of the patella
in full knee flexion
sinks into intercondylar notch
how many bones in ankle/foot complex?
28
how many articulations in ankle/foot complex?
55
what is the role of jts and ligaments of ankle/foot complex?
stabilizers
constantly adapt during WB activites
what are the bones of the rearfoot/hindfoot?
talus and calcaneus
what are the functions of the rearfoot?
convert torque of the LL
infleunce fct and mvt of midfoot and forefoot
what are the bones of the midfoot?
navicular
cuboid
3 cuneiforms
what are the fct of the midfoot?
transmits motion from the rearfoot to the forefoot promotes stability (adjusting to uneven surfaces)
what are the bones of the forefoot?
metatarsals
bones of the toes
what is the function of the forefoot?
mobility
what does the ankle/foot complex must meet?
stability and mobility
which mvt does the talocrural(ankle) jt permit?
DF
PF
ROM ankle
DF
20 from neutral
ROM ankle
PF
30-50 from neutral
EF ankle
DF
capsular
EF ankle
PF
capsular
what is the subtalar jt?
jt btw talus and calcaneus
what is the role of the subtalar jt?
inversion and eversion of hindefoot (50% of total apparent ankle inversion/eversion)
what is the anatomical characteristic of the subtalar jt?
3 articular surfaces provide a triplanar mct around a single joint axis
ROM ankle
inversion
0-35
ROM ankle
eversion
0-15
what is supination of subtalar jt?
combined mvt of inversion , PF and ADD of calcaneus
what is pronation of subtalar jt?
combined mvt of eversion, DF and ABD of calcaneus
what are the motions at the midtarsal jt complex?
rotation motion into inversion and eversion
forefoot DF/ADD
forefoot PF/ABD
what is the mistarsal jt complex?
talonavicular + calcaneocuboid articulations
who am i?
during gait, i permit adaptation of the foot to uneven terrain in early stance and i provide a stable foot during terminal stance.
midtarsal jt complex
what are the motion at the MTPs jt?
flexion/extension
ABD/ADD
what is the motion at the IPs joint?/
flexion/extensions
How many degrees of DF needed during normal gait?
60
How many degrees of DF needed during sprinting, deep squatting?
> 90
what is the roles of the big toe?
provide stability to medial aspect of foot
provide normal propulsion during gait
Muscles ankle
PF
gastroc soleus plantaris fibularis brevis tibialis posterior flexor digitorum longus flexor hallucis longus
Muscles ankle
DF
tibialis anterios
extensor digitorum longus
extensor hallucis longus
fibularis tertius
Muscles ankle
inversion
tibialis anterior extensor hallucis longus tibialis posterior flexor digitorum longus flexor halluces longus
Muscles ankle
eversion
extensor digitorum longus
fibularis longus
fibularis brevis
fibularis tertius
who am i?
i am flattened saclike structures that are lined w/ a synovial membrane and filled w/ synovial fluid and i allow smooth and frictionless motion btw continuous ms, tendons, bones, ligaments, skin.
bursae
signs and symptoms of bursitis?
inflammation localized tenderness warmth edema rednedd of the skin (if superficial) loss of function = pt will avoid contracting ms bcs it will cause pain in bursa
MOI of bursitis? (2)
too much mvt -> irritation
direct trauma on the bursa
common bursae that become inflamed
subacromial olecranon ilipsoas trochanteris ischial prepatellar infrapatellar anserine
tx for bursitis
- decrease inflammation (peace and love)
- once inflammatory phase finish : reassess strength, posture and mct patterns to determine why bursa is getting iritated
- tx to decrease risk of coming back
what is the difference btw tendon and ligament?
tendon will become taut or slack dependeing on whether it is shortened or lenghtened od the ms belly is contracted
ligament will remain taut thru-out all mvt
how to tendo transform w/ age?
become weaker and stiffer
who am i?
inflammatory rx to a tendon injury
microscopic teaing and inflammation of tendon tissue
commonly resulting from fatigue than direct trauma
tendinitis
who am i?
often happens in >35 y.o
degenerative process of tendon - tendon thickening
no inflammatory cells present
tendinosis
signs of tendon patho
strong but painful contraction of involved musculotendinous structure (RISOM strong and painful)
TOP
Tx tendon patho
- inflammatory phase = PEACE and LOVE
- when inflammatory phase done of w/ tendinosis = work on factors that may be causing pain (posture, weak ms)
MOI ligament patho
trauma (jt position during trauma gives you an idea of which ligaments may have been injured)
which structure is the last line of defence in the body in a MSK injury?
ligaments = often before they srained, ms aroung tried to prevent it but could not
objective signs of ligament sprain grade I
no bruising
min loss of fct
min loss of structural integrity
tx ligament sprain grade I
work on proprioception
objective signs ligament sprain grade II
significan structural weakening
bruising and swelling
tx ligament sprain grade II
PEACE
may need brace, taping (to protext from further injury)
proprioception
strengthen ms around jt to prevent re-injury
objective signs ligament sprain grade III
initially lots of pain
bruising and swelling
loss of structural integrity
marked abnormal motion
tx ligament sprain grade III
may need Sx (not for ankle tear)
proprioception
strengthening of surrounding ms
MOI ms strain?
fatigue
overuse or improper use
trauma
Signs 1st degree ms strain?
no or min loss of strength and restriction of mvt
minor swelling and discomfort
local tenderness may be present
tenderness increases when ms is stretched
pain with ms contractiong and stretching
RISOM = strong but painful
tx 1st degree ms strain?
pt can continue normal activity but monitored not to exacerbate the injury
inflammatory phase : PEACE
strenghen ms : eccentric, concentric, functional
proprioception
signs 2nd degree strain?
clear loss of strength pain when using the ms (stretching and contracting) moderate to severe pain brusing and swelling (major sign) some loss of fct and stability
tx 2nd degree ms strain?
3-28 days of rehab
inflammatory phase : PEACE
strenghen ms : eccentric, concentric, functional
proprioception
signs 3rd degree strain?
severe pain
loss of fct initually - no pain w/ contraction
once inflammatory phase id done may have to pain
pt unable to contract ms and uses synergist ms to move the jt
tx 3rd degree ms strain?
surgical intervention is often necessary
3 weeks - 3 months of rehab
educate about swelling and bruising
effleurage to help w/ bruising
signs of hypomobility? (2)
decreased ROM
early capsular EF
tx hypomobility? (2)
ROM exs
mobilisation
signs generalized hyperbomobility? (2)
multiple joitn hyperlaxity
increased ROM bila and at multiple jt
when does local hypermobility occur?
reaction to neighbouring stiffness (hypomobility) or injury
signs local hypermobility? (2)
increased ROM when compared to the other side
normal EF
tx local hypermobility? (3)
- find stiffness and work on hypomobility
- education pt not to stay at end range for prolonged periods
- strengthen ms around jt
what’s the difference btw the anatomical jt and the physiological jt?
anatomical jt = articular surfaces + jt capsule + ligaments + intra-articular structures = inert structures
physiological jt (jt complex) = anatomical jt + ms + tendons + nerves + blood vessels = contractile structures
what type of jts are synovial jts?
diarthrosis
in which types of jt can hypo/hypermobility occur?
diarthrosis
T or F
synarthrosis allows a lot of mvt
FALSE
how do we call a synarthrosis w/ fibrous tissue?
give an example.
syndesmosis
between radius ans ulna
how do we call synarthrosis w/ cartilage?
give an example.
synchondrosis
pubic symphysis
how do we call a synarthrosis w/ bone?
give an example.
synostosis
bones of the skull
who am i?
study of the mvt of one articular surface on another w/o regard to the mvt of the bone or the forces producing the mvt.
arthrokinematics
which mvt does arthrokinematics decribe? (4)
slides
glides
spins
swings
who am i?
study and measurement of motion of a bone in space (from the anatomical position)
osteokinematics
which mvt does osteokinematic decribe? (2)
osteokinematic rotaiton
translation
explain the convex-concave rule.
if convex bone moves on the concave bone : the convex bone will move in the opposite direction of the glide occuring at the jt
if concave bone moves on convex bone, the concave bone will move in the same direction of the gldide occuring at the jt
NB :distal bone always move on proximal bone
who am i?
i am a type of synovial jt that pairs together only one pair of articulating surfaces.
simple
eg : knee
who am i?
i am a type of synovial jt that includes more than one articulating pair in a single capsule.
compound
eg : elbow
who am i?
i am a type of synovial jt that has an articular disc.
complex
eg : sternoclavicular
who are the 2 only jts in the body that has 3 DOF?
shoulder
hip
how many DOF can allow a unmodified ovoid jt?
give an example.
3
hip
how many DOF can allow a modified ovoid?
give an example.
2
MCP
how many DOF can allow an unmodified sellar jt?
2
which jt is the only unmodified sellar jt in the body?
1st CMC
how many DOF can allow a modified sellar jt?
give an example.
1
IP jts
what patho/injury happens in the resting position commonly? why?
capsular or lgament sprains
this position causs the brunt of any external force to beb borne by the jt capsule or surrounding ligaments
in which position we do mobilizations?
resting position
what patho/injuries happen in closed packed position?
why?
fractures and dislocations
maximal stability of joint so no further motion is possible in that direction
in which position there is minimal jt volume?
closed packed position
in which position there is minimal jt surface contact?
resting position
in which position the jt capsule and ligaments are tight or maximally tensed?
closed-packed position
in which position there is maximal contact btw the concave and convex articualr surfaces?
closed-packed position
in which position the periarticular structures are most lax and allow the greatest ROM?
resting postition
in which position there is maximal jt volume?
resting position
what is the patient’s position of comfort (symptom-relieving)?
resting position
what are the major 2 systems that plays a role in balance?
visual and somatosensory
T or F
proprioception is dependent of vision
F
what triggers ms spindles in the body?
rapid/excessive ms lengthening
wha’ts the response of ms spindles?
whats the name of this reflex?
ms contraction
myotactic reflex
whats the main role of ms spindles clinically?
protective against acute injury = contracts muscles that has been lengthen too much to protect the fibers from tearing
what’s the trigger of golgi tendon organ?
excessive ms contraction OR passsive stretch
what’s the response of golgi tendon organ?
what’s the name of this reflex&
inhibition of the agonist and contraction of the antogonist
inverse myotactic reflex
what’s the main role of golgi tendon organs?
decreasing the tension on the agotnist ms
who am i?
i allow to relax an agonist muscle while contracting hte antoganist ms. i cam be done by ms spindles and goldi tendon organs. i allow smooth coordinated mvt of the body.
reciprocal inhibition
what’s the role of mechanoreceptor in proprioception?
by registering the speed and amount of deformation, they indicate position and mvt of their associated structures.
name 2 types of mechanoreceptors and where we can find them.
pacinian corpuscules = skin, connective tissues, ms and tendons
ruffini corpuscules = jt capsules
what’s the trigger of pacinian corpuscule?
vibration and deep pressure
what’s the trigger of ruffini corpuscule?
distortion of jt capsule
why is balance important in rehab?
dictates mvt strategies w/i the CKC
what are the 2 reasons that can explain why a person can have impaired balance CLINICALLY?
- position of COG relative to the base of support is not accurately sensed
- automatic mvt required to bring the COG to a balanced position are not timely or effectively coordinated
T OR F
Proprioceptive exercises should begin as early as possible in the rehab program even if NWB.
T
T or F
Proprioceptive exercises cannon reduce the rate of recurrence injuries.
F
T or F
It’s normal to feel pain when doing proprioceptive exercises.
F
What are the 3 phases of proprioceptive exercises?
- Static stabilization w/ CKC loading and unloading (weight shifting)
- Transitional stabilization X = stimulation of dynamic postural responses
- Dynamic stabilization X = jumping, running
give an example of weight shifting X for UE.
standing and leaning on a tx table
….
give an example of partiel WB LE X.
walking with support ensuring correct heel-toe mvt
….
what should proprioceptive X always include?
sudden alteration in jt positioning
which axis runs from left to right?
frontal
which axis runs in a dorsal-ventral direction?
sagittal
which axis runs in a cranial-caudal direction?
longitudinal
which plane divides the body into R and L halves?
sagittal
which plane divides the body into anterior and posterior halves?
frontal
which plane divide the body into cranial and caudal halves?
transverse
what’s the use of OP during AROM?
a) if ROM is full
b) if ROM is not full
a) screen for EF but not the real one
b) screen for pain with pressure
if AROM w/ OP is full, mandatory to do PROM?
no
what are the normal EF? (4)
bony
capsular
elastic (stretching of ms/tendon)
soft tissue approximation (eg : ms bump into ms)
what are the abnormal EF? (7)
ms spasm springy block loose/soft spongy early capsular hard empty
soreness in ms is normal for how much time after X?
24-48h
Rest time btw ea sets?
60-90 sec
rest time btw strengthening sessions?
48h
Any discomfort/reproduction of sx that lasts more than ___ after the intervention is unacceptable.
1-2hrs
*normal to go up 2 pts on VAS during X but should return to baseline line w/i 2hrs following the X
FOR ANY X (strengthening and flexibility)
Number of reps for low intensity strengthening exercise?
10-15
Number of reps for moderate intensity strengthening exercise?
8-10
Number of reps for high intensity strengthening exercise?
6-8
Modalities for isometric strengthening exercises?
Frequency : every day
Hold : 6 sec
Reps : 1-10
Intensity : low-moderate
when is isometric X used? (2)
- when jt mvt is restricted
2. to prevent atrophy and decrease go structures strength
Modalities to increase ROM following acute injury or painful condition?
Intensity : low
Duration : no hold or 0-5 sec
Reps : 5-10
Frequency : 2-5x/day
Modalities to increase ROM of hypomobile joint OR lexibility of relatively short ms?
Intensity : moderate senstaion of stretch Duration : 10-30 sec Reps : 2-6 Frequency : 2-3/week OP is needed
when is eccentric X used? (4)
- déconditioned or low endurance pt
- tendonitis presentations
- plateaus in strength gains
- late-stage rehab and performance training
for muscle endurance, how many reps per set?
> 20
what kind of dysfunction is this?
AROM and PROM painful and limited
RISOM not painful
Inert
when there’s pain and limitation in every direction and early caps EF, what pathology is it?
capsular pattern
True or False
Only joints that are controlled by ms can have a capsular pattern.
T
Characteristics of capsular pattern in wrist?
flexion and extension equally limited
Characteristics of capsular pattern in elbow
flexion limitation > extension limitation
Characteristics of capsular pattern in shoulder.
ER limitation > ABD > IR
Flexion/extension lightly limited
Hypermobility in one direction is a sign of what?
Ligament or capsule injury
RISOM painful and strong
minor, local lesion of ms/tendon (1st or 2nd degree strain)
RISOM painful and weak
major lesion of ms/tendon (3rd degree strain or avulsion fracture)
RISOM painless and weak
neuro lesion or complete rupture of ms/tenson
RISOM painless and strong
normal
how much time to achieve a short term goal?
1-2 weeks
how much time to achieve a long term goal?
4-6 weeks
what are the 5 components of a functional goal?
Actor Behaviour Condition Degree Expected time
who am i?
the contact of two bones is limiting the mvt
bony EF
who am i?
jt capsule provides firm limitation; hard arrest to mvt w/ sime give when the capsule or ligaments are stretched
capsular EF
who am i?
stretching of ms/tendon - more elastic feel
elastic EF
who am i?
tissues meet each other and stop the mvt
soft tissue approximation EF
who am i?
protection mechanism - feels jerky or shaky - injured tissue
muscle spasm EF
who am i?
bouncy stoppage that occurs prior to end range - usually torn cartilage, or foreign body in the jt
springy block EF
who am i?
abnormal motion is allowed where a ligament or joint capsule should prevent it
loose/soft EF
who am i?
squishy or boggy - indicating swelling in the jt
spongy EF
who am i?
bone contacts bone
hard EF
who am i?
hypomobility
early capsular EF
who am i?
produced solely by pain, PT feels no tissue resistance - indicative of serious patho
empty
if pain is present before resistnace or EF, the pt symptoms are considered____
irritable
signs of inert dysfunction (3)
- AROM and PROM are painful in same direction
- pain occurs as the end range approach
- RISOM can be painful if some compression appearing at the jts
when are capsular pattern assesed?
PROM and EF
signs of contractile dysfunction? (2)
AROM and PROM produce or increase pain ptomes and are restricted in opposite direction
RISOM prod or increase pain
what are the 2 most important and precise tx principles? when are they used?
- control pain and inflammation (acute)
2. promote and progress healing (subacute)
when pt is inflammed what is a sign with PROM?
pain inreported before tissue resistance is felt by clinician
when is PEACE used?
what does it stand for?
immediately following a soft tissue injury (1-3 days) P - protect E - elevate A - avoid anti-inflammatories C - compression (taping, bandages) E - educate
what are the goals during the inital phase of intervention for acute lesions? (6)
- decrease pain
- control edema and inflammation
- protect from further damage
- improve ROM
- reduce ms atrophy - isometric X
- maintain aerobic fitness
what is the best use of ice?
ice the structure for 10 mins after an irritation
when is LOVE used?
what does it stand for?
3-5 days post soft tissue injury L = load (don't wait for inflammatory phase to be done, start as soon as painhas reduced) O = optimism V = vascularisation = aerobic X E = exercise
The rehab procedures depend on … (3)
type of tissue involved
extent of the damage
stage of healing
in which phase of healing do we find these clinical findings?
- decrease pain and swelling
- increase in pain-free AROM and PROM
- pain and tissue resistnc occur at the same time during PROM
- ROM still not WNL
proliferative
when to we expect full ROM following a soft tissue injury?
3-4 weeks (proliferative)
in which phase of healing do we find this clinical finding?
- pain typically felt at the end of range w/ PROM, after tissue resistance has been encountered by clinician
remodelling
when does the inflammatory phase happen?
first 48-72hrs and up to 10 days
when does the proliferative phase happen?
from day 3 and last 3-6 weeks
when does the remodelling phase happen?
from day 9 and lasts 6 weeks to 12 months
pain occurs when in proliferative phase?
w/ activity or motion of involved area
pain occurs when in remodelling phase?
after the activity
if morning stiffness last <1h , what is the nature of pain?
mechanical
what are the 3 red flags?
cancer
cardiovascular system
neurological
gait patterns tends to be variable and irregular until __ y.o
7
what is a gait cycle?
what happens in 1 leg between 2 consecutive initial contact w/ the floor
what are the 2 phases of the gait cycle? and what are there proportions?
stance phase (60-65%) swing phase (35-40%)
in a gait cycle :
- how many single stance periods?
- how many double stance periods?
- 1
- 2
what are the 5 subphases of the stance phase? briefly describe them.
- initial contact = heel strike, period of double leg stance
- load response = flat foot, single-led stance
- midstance = single-leg stance
- terminal stance = heel off, double-stance
- preswing = toe push off, double-stance
what are the 3 subphases of the swing phase? briefly describe them.
- initial swing = acceleration, rapid knee flex and DF
- midswing
- terminal swing = deceleration, active quads to control knee ext, active hamstring to control hip flexion
what is the normal expected base/step width?
5-10 cm
what is the difference btw the step length and the stride length?
step : distance btw contact of R foot on the floor and L foot on the floor
stride = gait cycle = distance btw foot-to-floor contact of the same foot
what is the purposes og lateral pelvic shift during gait? (2)
- center the weight of body over the stance leg for balance
2. ADD of WB limb
if feet are farther apart what happens to lat pelvic shift?
increases
what is the normal expected step length?
72 cm
what is the normal expected stride length?
144 cm
what is the normal expected lat pelvic shift?
5 cm
what can be the reason of a high vertical pelvic shift?
pt unable to flex knee or DF foot to clear toes during swing pase
high pt of vertical pelvic shift happens during?
midtance
low pt of vertical pelvic shift happens during?
initial contact
if pat has early increased flexion at knee and early PF where is the gait problem?
initial contact -> relieve the stress on painful tissues at the heel
which gait phase is shortened bcs pt want to hurries thru this phase to decease pain if pt has painful hip, knee or ankle consition
midstance
what is the trendelenburg sign?
when glu med is weak, pt tilt the trunk on opposite side of weakness during mistance
if pt pushed off on lat aspect of foot, what gait phase is altered?
preswing
what can happens if PF is weak?
abscent preswing
what is the corect way to use a cane?
in the contraloat upper limb
cane need to touche the ground at the same time as the heel
what structure is weak if the pelvis is thrusted foreward during initial swing?
quadriceps ms
what is a step-page gait?
during midswing, the hip flexes excessively so that the toes can clear the ground bcs the DF are weak.
which structure is weak is heel stike is excessively harsh during terminal swing?
hamstring ms -> weak so cannont control the deceleration and slowly bring the knee into extension