NM Exam 2

Quadriceps, gastrocnemius - soleus complex, tibialis anterior, Hamstrings, abdominals

Gastrocnemus-Soleus complex, tibialis anterior, Hamstrings, eretor spinae

Gastrocnemus-Soleus complex, tibialis anterior, gluteus medius, TFL, thoracic spinae

Ankle Strategy

Hip Strategy

Stepping Strategy

Jumping Strategy

Medial-Lateral Strategy

Anterior-posterior strategy

Hip Strategy

Stepping Strategy

Jumping Strategy

Ankle Strategy

Hip Strategy

Stepping Strategy

Jumping Strategy

Ankle Strategy

Hip strategy

Stepping strategy

Jumping Strategy

Ankle Strategy

Small Perturbations on a firm support surface

Large Perturbation on a compliant surface

Muscles Fire Proximal to Distal

Muscles Fire Distal to Proximal

Muscles firing in forward sway: Gastrocnemius > Hamstrings > Para spinals

Muscles Fire in a Forward sway: Abdominals > Quadriceps

Muscles fire in Backward induced sway: Para spinals > Hamstrings

Muscles fire in Backward induced sway: Tibialis anterior > Quadriceps > Abdominal muscles

Initial Contact

Heel Strike

Loading Response

Foot Flat

Midstance

Terminal Stance

Heel Off

Pre Swing

Toe Off

Basal Ganglia

Pons

Cerebellum

Right and Left Hemispheres

Provides brain with inforation about position of movement of the head with respect to gravity and inertial forces.

The Semicircular canals sense angular acceleration.

Otoliths sense vertical and horizontal acceleration of the head.

Is the Strongest of the 3 inputs

Being in the dark inhibits or comprimises the vestibular input.

Somatosensory, Visual

Visual, Somatosensory

Vestibular, Somatosensory

Somatosensory, Vestibular

60 %

40 %

20 %

10 %

Progression, Stability, Adaptation

Progression, Adaptation, Movement

Proprioception, Progression, Adaptation

40 %

60 %

20 %

80 %

The distance from initial contact of one foot to initial contact of the other foot. Normal young adult step length is 76.3 cm (30 inches)

The distance covered from initial contact of one foot to the following initial contact by the same foot

Horizontal distance between the middle heel of one foot and the middle heel of the opposite foot.

The number of steps per unit of time (usually steps per minute). Normal young adult mean cadence is 112.5 steps/min or 1.9 steps/second

The distance from initial contact of one foot to initial contact of the other foot. Normal young adult step length is 76.3 cm (30 inches).

The distance covered from initial contact of one foot to the following initial contact by the same foot.

Horizontal distance between the middle heel of one foot and the middle heel of the opposite foot

The number of steps per unit of time (usually steps per minute). Normal young adult mean cadence is 112.5 steps/min or 1.9 steps/second

Horizontal distance between the middle heel of one foot and the middle heel of the opposite foot.

The number of steps per unit of time (usually steps per minute). Normal young adult mean cadence is 112.5 steps/min or 1.9 steps/second

The distance covered from initial contact of one foot to the following initial contact by the same foot

The distance from initial contact of one foot to initial contact of the other foot. Normal young adult step length is 76.3 cm (30 inches).

Initial Contact - 0 degrees

Loading Response 0-15 degrees

Mid Stance 15 degrees PF, 10 degrees DF

Terminal Stance 10 degrees DF to 0 degrees

PreSwing 0-20 degrees PF

Initial Swing 20-10 degrees PF

Mid Swing 10 degrees PF to 0 degrees

Terminal Swing 0 degrees

Initial Contact 30 degrees flexion

Loading Response 30 degrees flexion

Mid Stance 30-0 degrees

Terminal Stance 0-10 degrees extension

Pre swing 10 degrees extension to 0 degrees

Initial Swing 0-20 degrees Flexion

Mid Swing 20-30 degrees flexion

Terminal Swing 30 degrees flexion

Initial Contact 0 degrees

Loading Response 0-15 degrees

Mid Stance 15-0 degrees

Terminal Stance 0 degrees

Pre Swing 0-35 degrees Flexion

Initial Swing 35-60 degrees Flexion

Mid Swing 60-30 degrees Flexion

Terminal Swing 30-0 degrees

As the swing leg advances, the pelvis rotates forward 5 degrees in the horizontal plane to increase the relative leg length. This strategy minimizes downward displacement of the COM.

Lateral pelvic tilt: At midstance the contralateral pelvis drops in the frontal plane to lower the body and thus minimize upward displacement of the COM.

The motion of the pelvis helps ‘smooth out’ gait so there is less up and down (vertical) motion.

Knee flexion during swing lengthens the length of the leg allowing the foot to clear the ground thus also increasing upward displacement of the COM.

During terminal stance, the lower extremity is elongated via ankle plantarflexion (i.e. heel rise).

For individuals with impaired balance, an increase in step width will decrease stability and sacrifice energy efficiency.

Lateral pelvic/hip motion: Reducing step width minimizes the medial-lateral displacement of the COM (i.e. during weight shifts).

An individual dx with Parkinson's Disease will have a delayed activation of postural synergies.

Coactivation occurs when both the anterior and posterior synergy muscles Fire simultaneously.

An individual with a cerebellar lesion has difficult scaling amplitude

Hypermetric scaling problems occur do to LMN.

Individuals with a UMN that are engaged with dual tasks will have a decrease in postural sway.

Being able to maintain one's COM within their BOS independently in a static position.

Can only be done in a seated position

Measure only anticipatory postural control.

Measures both anticipatory and adaptive postureal control

Clinical acceptance is being able to hold their balance for 15 sec .

Clinical acceptance is being able to hold their balance 30 sec.

Refers to the individuals ability to maintain their COM over their BOS, or independently be able to recover when the COM approaches their limits of stability.

Is when an individual is unable to recover when the COM approaches their limits of stability.

Can be used to asses anticipatory and adaptive postural control

Is done is only standing

Can be done in both standing and seated

Horizontal pelvic rotation: As the swing leg advances, the pelvis rotates forward 5 degrees in the horizontal plane to increase the relative leg length. This strategy minimizes downward displacement of the COM.

Lateral pelvic tilt: At midstance the contralateral pelvis drops in the frontal plane to lower the body and thus minimize upward displacement of the COM.

Knee flexion during stance and swing phase: Knee flexion during stance phase limits the maximum upward displacement of the COM. Knee flexion during swing shortens the length of the leg allowing the foot to clear the ground thus also minimizing upward displacement of the COM

Ankle rotation (dorsiflexion-plantarflexion): At heel contact the protruding calcaneous makes contact with the ground and functionally elongates the leg length. In addition, during terminal stance, the lower extremity is elongated via ankle plantarflexion (i.e. heel rise). Thus at both ends of stance phase downward displacement of the COM is minimized.

Circumduction

Hip-Hiking

Vaulting

Vaulting

Circumduction

Hip Hiking

Circumduction

Hip Hiking

Vaulting

Ipsilateral

Contralateral

Anterior

Posterior

None of the above