9.0 Pathological Gait Knee

Question 1

When is Articular pressure greatest in the Quads?

Answer 1

When Quads are Weakest, or after Anesthesia

Question 2

What is a knee flexion contracture?

Answer 2

The knee is stuck at a certain angle and can only flex beyond that angle, but not extend.

Question 3

When is Intra articular pressure greatest in Knee Flexion?

Answer 3

at 0°

at 90-120°

Question 4

What is the relationship between Quadriceps demand and Knee Flexion Angle?

Answer 4

As Knee Flexion increases, Quadricep demand increases

Question 5

This is failure to achieve normal amount of flexion

Answer 5

Inadequate Flexion

Question 6

This is extension beyond neutral (Hyperextension)

Answer 6

Excessive Extension

Question 7

Being able to flex the knee more than normal range is known as…

Answer 7

Excessive Knee Flexion

Question 8

This is persistent knee flexion when the knee should be extending

Answer 8

Inadequate Extension

Question 9

What are potential causes of inadequate knee flexion during Loading Response?

Answer 9

1. Quadricep Weakness
2. Hip Extensor Weakness
3. Muscle or Joint Pain (Avoidance)
4. Excessive Quadricep Activity
5. Decreased Heel Rocker

Question 10

Limited Knee Flexion ALWAYS limits ________

Answer 10

Limits Hip Flexion

Question 11

What are the penalties associated with inadequate knee flexion during Loading Response?

Answer 11

Decreased Shock Absorption

-(Increased Bone and Cartilage Loading)

Question 12

During Pre-Swing and Initial Swing, Inadequate knee flexion could be caused by…

Answer 12

1. Muscle or Joint Pain (Avoidance)
2. Excessive Quadriceps Activity
3. Hip flexor Weakness
4. Knee Flexion Weakness

Question 13

During Pre-swing and Initial Swing, the penalty for Inadequate Knee Flexion is…

Answer 13

Decreased foot clearance

Question 14

During Loading Response, Mid stance, and terminal stance, ONLY IF RANGE IS AVAILABLE, the potential causes for Excessive Extension are…

Answer 14

1. Quadricep Weakness
2. Muscles or Joint Pain (Avoidance)
3. Excessive Quadriceps Activity
4. Excessive Ankle Plantar Flexion

Question 15

What is the penalty associated with Excessive Extension from Loading-Response to Terminal Stance?

Answer 15

Penalty

-Posterior Knee Joint Stress

Question 16

During Pre-swing and Initial-Swing, excessive knee flexion can be caused by

Answer 16

1. Compensatory action to assist in foot clearance due to excessive plantar flexion
2. Abnormal Motor Control (Flexor Pattern)

Question 17

What is the penalty associated with Excessive Knee Flexion during Pre-swing and Initial-swing?

Answer 17

Increased energy expenditure related to muscle overuse

• Hip Flexors
• Biceps Femoris Short head

Question 18

What stages are you likely to experience inadequate knee extension

Answer 18

Mid-stance and Terminal-Stance

Question 19

What are the potential causes of Inadequate knee extension in Mid stance and Terminal Stance?

Answer 19

1. Knee flexion Contracture
2. Hip flexion Contracture
3. Excessive Dorsiflexion (Calf Weakness)
4. Excessive Hamstring Activation

Question 20

What are the penalties associated with Inadequate Knee Extension in Mid and Terminal Stance?

Answer 20

1. Increased Energy Expenditure related to muscle overuse (Quadriceps)
2. Diminished forward progression
3. Decreased Stride Length

Question 21

What swing phases is one likely to see Inadequate knee extension?

Answer 21

Mid swing and Terminal Swing

Question 22

What are the potential causes of Inadequate knee extension in Mid and Terminal SWING?

Answer 22

1. Quadricep Weakness
2. Knee Flexion Contracture
3. Excessive Hamstring Activation
4. Purposeful Strategy to reduce heel rocker
   - Weakness
   - Poor balance/Instability
   - Heel pain

Question 23

What are the penalties associated with Inadequate knee extension during Mid and Terminal SWING?

Answer 23

1. Decreased preparation for Stance
2. Decreased limb Advancement
3. Decreased stride Length

Question 24

What is the leading potential cause for Dynamic Knee Valgus in the stance phases?

Answer 24

1. Excessive Hip Adduction
2. Excessive Hip Internal Rotation
   - Both related to weak hip abductors and/or external rotators

Question 25

What are the penalties associated with Dynamic Knee Valgus in the stance phases due to A. Excessive Hip Adduction B. Excessive Hip Internal Rotation

Answer 25

1. Knee Joint Stress/Strain - MCL Stress - Pes Anserine Strain - IT Band Strain 2. Patellofemoral Joint Stress

Question 26

What is the potential cause of dynamic knee varus during the stance phases?

Answer 26

Pelvic Drop owing to hip Abductor weakness

Question 27

What are the penalties associated with Dynamic knee Varus during the stances phases, due to pelvic drop owing to hip abductor weakness?

Answer 27

Knee joint stress and strain - LCL Strain - IT Band Strain - Medial Compartment Compression

Question 28

What are the causes for excessive knee rotation during the stance phases?

Answer 28

1. Excessive Pronation | 2. Weakness of Hip External Rotatorss

Question 29

What are the penalties associated with Excessive Knee rotation during the stance phases due to excessive pronation and/or weakness of hip external rotators?

Answer 29

1. Knee Joint Stress/Strain - MCL Stress - Pes Anserine Strain - IT Bane Strain 2. Patellofemoral Joint Stress

Question 30

What is the influence of muscle weakness in the sagittal plane for knee weakness?

Answer 30

Quadriceps