MSPT I > GAIT--Knee > Flashcards

GAIT--Knee Flashcards

(54 cards)

Study These Flashcards
1
Q

Put in knee motion in sagittal plane chart from Notability!!!!

A

see chart

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2
Q

Knee motion sag. plane

IC

A
  • motion== neutral
  • quantity==neutral
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3
Q

Knee motion sag plane

LR

A
  • motion== flexing
  • quanitity== 0-20deg
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4
Q

Knee motion sag. plane

MSt

A
  • motion== EXT
  • quantity== 20-0deg
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5
Q

Knee motion sag plane

TSt

A
  • Motion== Holding
  • Quantity== Neutral
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6
Q

Knee motion Sag plane

PSw

A
  • Motion== flexing
  • quant== 0-40deg
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7
Q

Knee motion sag plane

ISw

A
  • Motion== Flexing
  • quant== 40-60/70deg
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8
Q

Knee motion sag plane

MSw

A
  • motion== EXT
  • quant== 60/70– 30deg
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9
Q

knee motion sag plane

TSw

A
  • Motion== EXT to FULL EXT
  • quant== 30–0deg (neutral)
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10
Q

Knee Flex Contracture

Step length==

A

DECd ipsilateral step length

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11
Q

Knee flex contracture

Cadence

A
  • No change UNLESS pt makes effort to maintain velocity
    • ​this req’s quicker steps to make up for step length
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12
Q

knee flex contracture

Velocity

A
  • DECd due to less distance covered w/ ea step/stride ​
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13
Q

Knee flex contracture

Stride Length

A
  • Shortened stride UNLESS Contralat. limb compensates w/ longer step
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14
Q

GRF @ IC

*NOTE: knee ext in TSw created by momentum of limb

A
  • IC—> GRF
    • ANT to knee ==== EXT moment
    • ​Quads act minimally to stabilize knee & control momentum
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15
Q

GRF @ LR

A
  • GRF shifts from ANT @ IC to POST @ LR as HAT continues forward over flexed foot
    • ​=== External knee FLEX moment
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16
Q

Quads activity in LR

A
  • External knee flex moment OPPOSED by Quad activity as an Internal knee EXT moment
    • ​ESP Vasti muscles!!!
      • ​Mostly VL
    • NOTE: rec fem only in SWING
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17
Q

Hamstrings in LR

A

NONE

  • undesired
  • could cause excess FLEX or Jt compression
    • ​HS and Quads @ same time===co-contraction==jt. loading
      • ​== lig injury, meniscus injury, OA
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18
Q

GRF during Stance

LR

Gastroc

A
  • despite being 2jt mm====> gastroc rel. silent @ LR
    • ​Soleus helps to control tibia advancing forward
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19
Q

PF Spasticity

LR–> MSt

A
  • patho. gait pattern often seen in pts post-CVA
    • spastic PFs===knee hyperext
      • ​== Extensor Thrust
    • As limb loads—> excess PF spasticity drives tibia POST
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20
Q

Knee Discomfort in MSt

3 Factors:

A
    1. Contralat limb is in swing, therefore 100% of WB occurs on involved limb
      * ​HAT creates rel. ADD moment
    1. Transverse plane rotation b/w tibia and femoral condyles
    1. MAY see Varus Thrust as degenerated medial compartment approximates
      * == Lat. tension (stretching)
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21
Q

Knee ROM during gait

MOST during where

A

SWING

*indiv. tries to shorten limb for clearance

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22
Q

HIP compensation for knee and Clearing limb

Study These Flashcards
A
  • IF knee is unable to flex=== becomes functionally longer
  • now Limb Clearance is an issue=== compensatory strategies BEFORE swing OR @ ISw
  • @ Hip/Trunk you will observe:
    • ​CONTRALAT. trunk lean
    • IPSILAT hip hike
    • Circumduction
    • others or combo of above
23
Q

30deg Knee Flex contracture

Step Length

24
Q

30deg Knee flex contracture

IC

Study These Flashcards
A
  • IC likely on forefoot as pt PFs to functionally lengthen
    • ​TRUE heel strike is UNLIKELY
      • ​due to lack of Knee EXT advancing tibia and foot past knee
25
30deg Knee flex contracture ## Footnote **Persistent knee flex creates\_\_\_\_\_\_\_**
* persistent knee flex creates **persistent external knee FLEX moment** * **​INCd** distance from knee jt axis to GRF vector POST to knee * **Quad activation must INC** to prevent collapse into FLEX
26
30deg Knee flex contracture ## Footnote **If uncompensated for elsewhere=====**
* Trunk will **likely lean TOWARDS shorter limb (contracture side) in order to put foot on ground**
27
MAX amt **Knee flexion in STANCE**
20deg
28
MAX amt **Knee Flex in SWING**
60-70 deg
29
Talocrural motion during Gait sag plane ## Footnote **IC**
* motion== Hold * quant== neutral
30
Talocrural motion sag plane ## Footnote **LR**
* motion== PF * quant== 10deg
31
Talocrural motion sag plane ## Footnote **MSt**
* motion== DF * quant== 5-15deg
32
Talocrural motion sag plane ## Footnote **TSt**
* Motion== into MORE DF * quant== 10-15 (MAX DF)
33
Talocrural motion sag plane ## Footnote **PSw**
* Motion== PF * quant== ~20deg
34
Talocrural motion sag plane ## Footnote **ISw**
* Motion== DF **back toward neutral** * quant== FROM 20deg PF TO 5deg PF
35
Talocrural motion sag plane ## Footnote **MSw**
* Motion== DF **back to neutral** * quant== 5deg--0deg (neutral)
36
Talocrural motion sag plane ## Footnote **TSw**
* motion== HOLD * quant== Neutral
37
Ankle **upon IC**
NEUTRAL * quickly moves into **PF during IC** * foot slightly **inverted (SUPINATED) for Stability @ IC** * **​**remember **supinated foot==RIGID foot** * **​this is when we NEED rigid foot!!!**
38
@ IC ankle joint axis
* loc'd **obliquely** thru malleoli @ IC * **vector from GRF passes POST to the axis**
39
IC--LR ankle mm activity
* **Tib Post (most active)** * **​Ecc. controls Eversion (pronation)** * **​remember we need the rigid (supinated) foot\*\*\*\*** * **Tib Ant** * **​**Ecc. controls PF
40
MSt ankle mm activity
* Gastroc * Ecc. controls DF
41
Ankle mm activity ## Footnote **TSt**
* Fibularis/Peroneus Longus * **Ecc. Counter inversion (supination)**
42
Ankle @ **IC--\> LR**
* Subtalar moving from **supinated or neutral** to **more pronated pos. @ end of LR** * **​accomodating TO floor** * **​need to SLOW this down** * ====**Tib Post**
43
Ankle @ **LR**
* Vector from GRF passes **thru heel---\> moving ANT from LR--\> MSt** * **​== DF moment**
44
Ankle @ **MSt===**
PFs * Contract **Ecc.** to SLOW the **forward progress of tibia as it moves over a fixed foot**
45
TSt begins w/\_\_\_\_\_\_
**Heel Rise\*\*\*\*\***
46
Ankle @ **TSt**
* Begins w/ **heel rise\*\*\*\*** * Ankle pos'd in **15deg DF moving TOWARDS PF in prep for PSw** * **PFs contract CONC. w/ 1st MTPJ on floor** **to INVERT calcaneus (supinate) & lift heel off the floor**
47
PSw will be MOST affected by\_\_\_\_\_
Hallux Rigidus \***we need 55deg of 1st MTPJ EXT here**
48
Ankle what muscle MOST active during SWING?
Tib Ant
49
Tib Ant MOST active during **SWING**
* **Conc. to DF foot and clear floor** * **EHL and EDL also act Conc. to ASSIST w/ DF, BUT in normal gait====\> Tib Ant MOST active**
50
Ankle in **PSw**
* ankle **PF to 20deg** * **THIS IS MOST NEEDED PF PHASE!!!**
51
MOST needed PF phase
PSw
52
Paralyzed OR Severe Weakness of DF's
* **Footslap @ IC +** * **Toe Drag @ MSw w/out compensation**
53
Severe weakness of **IPSILAT DF's**
* MOST LIKELY cause **excessive flexion in hip and knee** in order to clear **PF'd foot and avoid tripping** * **MOSTLY in MSw**
54
MSPT I
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