Determine in which phase are the following movement seen. 1. Movement of thighs forward as we build the momentum of propelling the body mass from sitting to standing 2. Flexion at the hips with trunk extended 3. Extension of hips and knees 4. Dorsiflexion of ankles 5. Initial foot placement A. pre-extension phase B. extension phase C. transition phase

1. A & C 2. A 3. B 4. B & C 5. A

S1_L3: STS and Walking Flashcards by MindMed Official

TRUE OR FALSE: Increasing walking speed, increases time spent in double support

False

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TRUE OR FALSE: Cadence is the number of steps per unit time

True

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TRUE OR FALSE: Stride length is the distance from one foot strike to the foot strike of the other foot.

False

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TRUE OR FALSE: In level walking, the path of the COM describes a sinusoidal cycle

True

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TRUE OR FALSE: Stance phase ends at heel strike

False

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TRUE OR FALSE: During push off, the ankle dorsiflexors are actively contracting concentrically.

False

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TRUE OR FALSE: Extension of the hip is essential in setting up the propulsion of push-off

True

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TRUE OR FALSE: Swing phase begins at toe off with ankle plantarflexion, knee flexion, and hip extension

True

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TRUE OR FALSE: The knee is in slight flexion upon heel strike

True

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TRUE OR FALSE: In pre-swing, there is 20 degrees of ankle dorsiflexion

False

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TRUE OR FALSE: At midstance, the pelvis shifts laterally 4-5cm toward the stance leg

True

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TRUE OR FALSE: Movement of the upper body over the stance hip is associated with some external rotation.

False

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CASE: A pt c chronic (R) hemiplegia came back for re-evaluation and continuation of physical therapy management secondary to persistent gait deviation. Pt states that he still has still difficulty walking. Upon examination you noted forefoot upon initial contact and inadequate hip extension at the end of stance.

The following are the most probable causes of the gait problem of the patient, EXCEPT:

A. tightness of soleus
B. early activation of gastrocnemius
C. weakness of rectus femoris
D. stiffness of calf

C. weakness of rectus femoris

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The following are the most appropriate therapeutic exercise intervention for the patient. (Choose how many answers are applicable)

A. heel raises on the edge of a short platform x30 reps
B. ball kicking outside parallel bars
C. supine hip extension with the foot on a chair
D. heel slides in sitting

C & D only

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_____ is the ability to move the body mass forward from over a large base of support to a small base of support and to extend the lower limb joints to raise the body mass over the feet

Sit-to-stand

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BOS in sitting starts from the (1)_____ to tip of (2)_____

tip of toe
ischial tuberosity

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Determine in which phase are the following movements seen.

Vertical movement of body mass
CKC dorsiflexion of ankles
HAT goes into extension
HAT goes into flexion
Feet move backward posterior to the knee joint

A. Pre-extension Phase
B. Extension Phase

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Enumerate the 5 critical components of STS.

Initial foot placement
Flexion at the hips with trunk extended
Thighs off
Dorsiflexion of ankles
Extension of hips and knees

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The STS phase is separated at the period of the ______.

thigh off

NOTE: However, there is actually no clear cut partition between the two phases, instead they form one continuous translatory movement of the body mass from horizontal to vertical movement without a pause.

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TRUE OR FALSE: The longer duration of the extension phase of sit-to-stand, the less muscle force is necessary to be generated.

False

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Determine in which phase are the following movement seen.

Movement of thighs forward as we build the momentum of propelling the body mass from sitting to standing
Flexion at the hips with trunk extended
Extension of hips and knees
Dorsiflexion of ankles
Initial foot placement

A. pre-extension phase
B. extension phase
C. transition phase

A & C
A
B
B & C
A

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Approximately how many degrees of trunk flexion at the hip is preferred in STS?

60 degrees

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How many degrees must DF be in STS relative to the anatomical position ?

0-10/15 degrees

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Extension of hip and knees happens in what kind of kinematic chain?

Closed

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Fill in the blanks. Mechanical requirements of STS are the following: 1. Generation of ____ & _____ momentum 2. Generation and sustaining of _____ limb joint forces 3. Postural stability at _______

1. horizontal and vertical 2. lower 3. thighs-off

Why is the good leg preferred to take the first step when a pt uses a cane?

This is to pre-stretch the iliopsoas, activating its spring component, and contract concentrically

TRUE OR FALSE: Quad cane does not provide a functional capability to stroke pts

True Reliance on these is not optimal. The end goal must be the removal of the quad-cane

Where must a PT guard its patient during STS exercises?

posterolateral to the affected side

TRUE OR FALSE: Standing up from the chair and sitting down are functional activities commonly performed on a daily basis. The coupled motion actions are essential for independent living and is a prerequisite for upright mobility.

True

TRUE OR FALSE: In standing, BOS is how big your foot is

True

The most significant adaptation seen in stroke patients is symmetrical weight bearing during both standing up and sitting down. Lack of independence in standing up and sitting down is a common source of falls. A. Both statements are correct B. Both statements are incorrect C. Only the 1st statement is correct D. Only the 2nd statement is correct

D. Only the 2nd statement is correct

STS phases: Weight shift, transition, lift A. Schenkmann B. Millington C. Rodowski D. Carr, Shepherd, Gentile

B. Millington

STS phases: forward hip thrust phase, extension phase A. Schenkmann B. Millington C. Rodowski D. Carr, Shepherd, Gentile

C. Rodowski

STS phases: Pre-extension and extension phase A. Schenkmann B. Millington C. Rodowski D. Carr, Shepherd, Gentile

D. Carr, Shepherd, Gentile

STS phases: Flexion momentum phase, Momentum transfer phase, Extension phase, Stabilization phase A. Schenkmann B. Millington C. Rodowski D. Carr, Shepherd, Gentile

A. Schenkmann

They are known as the Kings of Motor Learning (Motor Relearning Program)

Carr and Shepherd

Determine in which phase are the following movement seen. 1. Rotation of upper body (head, arms, trunk) forward 2. Forward movement of thighs 3. Shank (tibia and fibula) moves forward over the ankle A. pre-extension phase B. extension phase C. both

1. A 2. C 3. B

1. Happens in pre-extension phase 2. Happens in extension phase 3. Generated to move body mass forward over the feet 4. Posterior movement of the trunk 5. Anterior movement of the thighs A. Horizontal Momentum B. Vertical Momentum

1. A 2. B 3. A 4. B 5. B

Angular motions of the hip, knee, and ankle are critical in the development of _______ of the whole body during the later portion of STS

horizontal motion

Angular motions of the knee and hip is important in the development of _______ of the whole body during STS

upward or vertical velocity

In sitting, GRF is neutral. In sit-off, GRF decreases A. Both statements are correct B. Both statements are incorrect C. Only the 1st statement is correct D. Only the 2nd statement is correct

C. Only the 1st statement is correct

_______ is known as the force applied towards the ground

Ground Reaction Force

GRF varies when a person has a backpack or carries other weights. Nonetheless, the pattern remains the same. A. Both statements are correct B. Both statements are incorrect C. Only the 1st statement is correct D. Only the 2nd statement is correct

A. Both statements are correct

GRF enable the (1)______ of the body mass in the desired direction horizontally and vertically in standing up and the (2)_____ of the body mass during (3)______

1. propulsion 2. control 3. descent

Initial generation of ______ move the body mass forward over the new base of support (trunk)

HORIZONTAL (LINEAR) MOMENTUM

_______ propels the body mass upward (vertically) to standing position

VERTICAL MOMENTUM

What should be avoided during STS training of stroke pts? A. The use of hands B. The use of feet C. The use of head D. The use of shoulders E. None

A. The use of hands NOTE: It is only applicable for people who uses axillary crutches

Why should individuals with LE muscle weakness avoid standing up with feet forward during the initial phases of rehabilitation? A. Leads to an increase in movement duration and displacement and velocity of upper body flexion B. Results in increased distance the body mass must be moved forward C. All of the above D. None of the above

C. All of the above

Eccentric motion of trunk extensors A. Horizontal Momentum B. Vertical Momentum

A. Horizontal Momentum

Posterior movement of the lower legs A. Horizontal Momentum B. Vertical Momentum

B. Vertical Momentum Note: In the diagrams of vertical momentum, legs move posteriorly

concentric contraction of quadriceps A. Horizontal Momentum B. Vertical Momentum

B. Vertical Momentum

TRUE OR FALSE: Increase stress on the foot increases GRF.

True

STS requires asymmetric muscle activity to generate forces against both the seat and ground. Flexor muscle strength is a major contributor to successful performance. A. Both statements are correct B. Both statements are incorrect C. Only the 1st statement is correct D. Only the 2nd statement is correct

B. Both statements are incorrect

What muscle moves the feet back into DF?

Tibialis Anterior

In what manner does the Tibialis Anterior and Hamstrings contract for heel slides over a support surface?

concentrically

This muscle stabilize the pelvis and produce extension component in the hips

Gluteus Maximus

TRUE OR FALSE: If the soleus is tight, the pt will have a hard time in DF.

True

Erector Spinae contracts (1)_____ in extension phase and (2)_____ when sitting down to keep the trunk upright

1. concentrically 2. isometrically

TRUE OR FALSE: the position of the feet affects the distance the BM has to be moved forward

True

Determine the optimal position when standing up. A. Feet Forward B. Feet Backward C. Feet Preferred D. Feet Neutral

B. Feet Backward NOTE: Around 10 cm or 4 inches back is preferred

Determine the optimal position when standing up. A. Trunk neutral B. Trunk at 10 degrees extension at the hip C. Trunk at 30 degrees flexion at the hip D. Trunk at 60 degrees flexion at the hip

D. Trunk at 60 degrees flexion at the hip

Determine the wanted speed of movement in STANDING TRAINING. A. slow speed of movement B. fast speed of movement C. preferred speed of movement

B. fast speed of movement NOTE: In sitting down, it should be slow. However, the optimal speed is the patient's own preferred speed

Determine the IDEAL chair height in STS. A. Knee + 1/3 thigh B. Knee + 2/3 thigh C. Knee level D. Knee with arm rest

C. Knee level

Determine the OPTIMAL chair in STS. A. Knee + 1/3 thigh B. Knee + 2/3 thigh C. Knee level D. Knee with arm rest

D. Knee with arm rest This is to promote 90-90 hip knee + 90 deg elbow flexion

About how many centimeters should the feet be positioned backward to biomechanically obtain the effective foot position in STS?

10 cm

About how many degrees should the feet be positioned in DF to biomechanically obtain the effective foot position in STS?

AAOS:10-20 DF Carr & Shepherd: 70-75 degrees DF (relative to vertical position)

What kind of contraction happens d/t slowness of movement?

Eccentric

TRUE OR FALSE: It is easier to sit in a low chair.

False

If your muscle is in resting length position, it will give the optimal strength and cross-bridges. This concept is derived from what?

Length-tension relationship/ curve

TRUE OR FALSE: STS should be done with the arms augmented

False It is optimal when they are flexed forward

Difficulty generating and timing sufficient force in the lower limb extensor muscles to propel the body mass vertically may be attributed to the following, EXCEPT: A. Lack of extension of the knee B. Lack in extension of the trunk C. Weak quadriceps D. Weak tibialis anterior E. Problematic gluteus medius

D. Weak tibialis anterior

Failure to place one or both feet backward may be attributed to the following, EXCEPT: A. Tightness of the soleus B. Weakness of hamstring C. Weakness of tibialis anterior D. All of the above E. None of the above

E. None of the above

Failure to move the body mass sufficiently far forward at thigh-off may be attributed to the following, EXCEPT: A. vestibular or balance problem B. occluded vision C. weak abdominals D. fear of movement of the trunk forward E. None

B. occluded vision

Uncontrolled descent during SIT may be attributed to what? A. Quadriceps are not contracting eccentrically B. Hamstrings are not contracting eccentrically C. Gluteus Medius are not contracting eccentrically D. Gluteus Maximus are not contracting eccentrically E. None

A. Quadriceps are not contracting eccentrically

TRUE OR FALSE: Sitting down is the reverse of standing up

False

In sitting down, the Quadriceps should control the movement. How must it contract?

eccentrically

TRUE OR FALSE: Sitting down requires greater muscle strength and control at the hip

False It requires greater muscle strength and control at the knee

TRUE OR FALSE: In STS tx, the PT must discourage use of hands. There should also be no pauses between pre-extension and extension phase. A. Both statements are correct B. Both statements are incorrect C. Only the 1st statement is correct D. Only the 2nd statement is correct

A. Both statements are correct

TRUE OR FALSE: Practice of weight shifting may be done in sitting.

True

A tight soleus is stretch in a (1)_____ position, while the Gastrocnemius is stretched in a (2)___ position, using a/an (3)______ to further increase put the DF in a positional stretch.

1. sitting 2. standing 3. inclined wedge

Match the following compensatory strategies in STS. 1. Trade-off between stability and force requirements 2. Flexion the trunk prior to STS 3. For pts with hemiplegia who are very weak 4. Requires greater force generation from lower limb muscles 5. For patients with cerebellar pathology who have balance problems A. Momentum-Transfer Strategy B. Zero-Momentum Strategy

1. A 2. B 3. A 4. B 5. B

To design a treatment for STS, what must a PT start with?

looking for impairments that causes the lack of proper movement or proper fulfillment of the critical components of STS and address them

_______ is a complex, whole body skill that requires the cooperation of both lower limbs and coordination of a large number of muscles and joints to function together

Walking

__________ is the time interval or sequence of motions occurring between two consecutive initial contacts of the same foot

(human) gait cycle

1. Initial Swing 2. 60% of gait cycle 3. Terminal Swing 4. 40% of gait cycle 5. Occurs when the foot is not bearing weight and is moving forward A. Stance Phase B. Swing Phase

1. B 2. A 3. B 4. B 5. B

1. Occurs when the foot is on the ground and bearing weight 2. Support, balance, propulsion, and absorption 3. Toe clearance and foot trajectory 4. Pre-swing 5. Loading Response A. Stance Phase B. Swing Phase

1. A 2. A 3. B 4. A 5. A

TRUE OR FALSE: If the ankle isn't in relative DF, the gastrocnemius muscle isn't able to stretch and cannot contract optimally

True

The following is true about the critical components in STANCE, EXCEPT: A. 10-15 hip extension B. DF at heel contact C. PF to foot flat D. Medial horizontal pelvic shift E. None

D. Medial horizontal pelvic shift

The following is true about the critical components in STANCE, EXCEPT: A. 15º flexion at heel contact to absorb body weight and momentum B. 35-40º knee flexion at pre-swing C. Knee extension by midstance D. All of the above E. None of the above

E. None of the above

The following is true about the critical components in STANCE, EXCEPT: A. Tibialis anterior contract eccentrically in foot flat B. Dorsiflexors contract isometrically at heel contact C. Gastrocnemius contract eccentrically at push-off D. All of the above E. None of the above

C. Gastrocnemius contract eccentrically at push-off It contracts concentrically

The knee goes in extension by midstance. In here, in what manners does the quadriceps muscle contract?

concentrically

If swing phase is the problem a in gait assessment, the following are absent, EXCEPT: A. knee extension B. concentric contraction of quadriceps C. concentric contraction of iliopsoas D. concentric contraction of the tibialis anterior E. None

B. concentric contraction of quadriceps

TRUE OR FALSE: Training for swing phase uses CKC movements

False

The following is true about the critical components in SWING, EXCEPT: A. Hip flexion (pull-off) to swing lower limb forward B. Knee flexion to shorten lower limb C. Lateral pelvic list upward D. Rotation of pelvis about the vertical axis E. None

C. Lateral pelvic list upward

One of the most common effects of stroke, especially when reaching the stage of spasticity, is the _______ gait

circumduction

(1)_____ and disorders of (2)_____ are the primary impairments causing gait dysfunction

1. Muscle weakness 2. motor control

Choose the typical kinematic deviation in INITIAL STANCE A. Limited DF B. Lack of knee flexion C. Both D. Neither

C. Both

Choose the typical kinematic deviation in MIDSTANCE A. Lack of knee flexion B. Excessive lateral pelvic shift C. Both D. Neither

B. Excessive lateral pelvic shift

Choose the typical kinematic deviation in MIDSTANCE A. Limited hip flexion B. Limited ankle PF C. Both D. Neither

D. Neither

Choose the typical kinematic deviation in LATE STANCE/ PRE-SWING A. Lack of knee flexion B. Lack of ankle PF C. Both D. Neither

C. Both

Choose the typical kinematic deviation in EARLY/ MID SWING A. Limited hip flexion at toe-off and midswing B. Limited knee flexion C. Both D. Neither

C. Both

Choose the typical kinematic deviation in LATE SWING A. Limited ankle DF B. Limited knee flexion C. Both D. Neither

A. Limited ankle DF

The following are spatiotemporal adaptations in stroke pts, EXCEPT: A. Decreased walking speed B. Increased stride width C. Increased double support phase D. Dependence on support through the hands E. Long step and stride lengths

E. Long step and stride lengths

TRUE OR FALSE: Soft tissue stretching must be done prior to gait training

True

Walking requires greater lower limb strength and range of motion than standing up and stair climbing

False Standing up >

TRUE OR FALSE: An adaptation seen in stroke patients is asymmetrical weight bearing during standing up only

False This is seen in sitting as well

S1_L3: STS and Walking Flashcards

(106 cards)