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90 Cards in this Set
- Front
- Back
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Center of Gravity |
Point at which all parts are balanced. Skull-behind the 3rd eye Chest-several inches above the diaphragm but below the heart, anterior to T10 Pelvis-behind the belly button, in front of sacrum (lower in women b/c of lower pelvis) |
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Line of Gravity |
Gravitational pull along our body. Along one plane. Our standing posture is relatively sufficient. |
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Base of Support |
base upon which we stand (sitting=pelvis) CoG directly above BoS |
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Postural Sway |
nearly impossible to stand still. Upright-swaying forward->backward. Stretch reflex of posterior calf muscles, when we contract we go back. Diameter of 12in, 6in each way. If becomes more than 12in=neuro issue |
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Posture |
Ear lines up with mastoid, lines up anterior with shoulder joint, posterior to greater trochanter, anterior to femur but behind patella, and anterior to lateral malleolus |
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Spine |
Curved column to absorb more energy, more flexible to withstand loading pressures and compressions. Resist fractures |
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3 Spinal Curves |
Lordosis: curve is convex anteriorly -cervical & lumbar spine Kyphosis: curve is concave anteriorly -thoracic spine |
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Pelvis |
Component that disperses weight appropriately and evenly to each leg |
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Pelvis: Femurs |
Pelvis bones, sacrum |
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Pelvis: transmits force |
into spine and LEs |
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Pelvis: energy efficient stance |
legs parallel feet under hips |
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Shoulder |
Clavicle & scapula-horizontal (handle bars) UE-vertical (struts that hang down) Rib cage, spine, and head-forward, everything is off and no longer in one line |
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Head |
Must be centered over thorax. Any deviation will throw shoulders off balance and then all the way down. Ex: balancing something on your head |
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Optimal Posture |
Depends on muscular, skeletal, & nervous systems to maintain good, efficient posture |
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Optimal Posture: Skeletal system |
Passive restraints of ligaments/joint capsules in skeletal system. Postural muscles contract to hold the joints stable. Have additional work if ligaments & capsules are stretched. Easily put under passive insufficiency. |
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Optimal Posture: Muscular system |
Ligaments and joints have minimal contribution when we are upright, but must be intact to keep bones in proper alignment and keep muscles from having to work harder |
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Optimal Posture: Nervous system |
Neuromuscular control. Loss of ability to contract muscle may be due to SCI, nerve injury, or pain |
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Muscle Patterns |
Standing very efficient Constant muscle activity to maintain upright posture Slow sustained contractions Joint instability/bad posture go hand in hand Pain inhibits muscular control so they don't fire |
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Muscle Patterns: maintain upright posture |
Constant muscle activity: deep spinal muscles-erectors always firing tonic contractions iliopsoas-flexes hips, soleus-postural sway, posterior tibialis-postural sway, supraspinatus-shoulder joint, masseter & medial pterygoid-hold jaw up |
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Joint instability/bad posture |
Example: Patient had a stroke, they no longer have neuromuscular control of shoulder muscles. Humerus subluxes out of geno-humeral fossa. Lateral bending and the muscles on opposite side of shoulder are having to work harder to keep from going even further over |
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Postural Stabilizer: Primary |
Fire without movement Always firing Deep spinal muscles, Keep you upright (back, supraspinatus) Tonic contraction Slow twitch, contract a long time |
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Postural Stabilizer: Secondary |
Control the speed of movement Eccentric contraction, control forward flexion Medium fibers Glutes |
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Postural Stabilizer: Mobilizers |
Generate movement/locomotion Concentric, produce a lot of force Fast twitch |
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Postural Stabilizer: Glutes |
May act as all 3: primary, secondary, and mobilizers |
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Faulty Postures: Excessive lordosis |
Will also have other issues that go with this. May be in cervical or lumbar area, a lot of extra curve Sway back, ant pelvic tilt, shortened hip flexors, loss hamstrings |
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Faulty Postures: Excessive kyphosis |
Humpback |
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Faulty Postures: Scoliosis |
Abnormal lateral spinal curve Always a compensation somewhere. Lateral curve and torsion of vertebrae |
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Faulty Postures: Anterior pelvic tilt |
Shortened hip flexors and loose weakened hamstrings Ant pelvis tilts forward and "falls out front" |
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Faulty Postures: Posterior pelvic tilt |
Back of pelvis tilts backwards, less lordosis than you should pot pelvis tilts backward and "falls out back" Flat back |
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Postural Assessment: Covert observation |
can observe postural stuff as patient is walking into clinic, they do not know you are watching their movement |
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Postural Assessment: Front/back |
Level bony landmark |
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Postural Assessment: From side |
Both sides |
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Postural Assessment: In supine |
Look for tilts and rounded shoulders Post and ant tilt observable |
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Postural Assessment: adaptively shortened muscles |
Chronic Flexion |
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Postural Assessment: passively insufficient (stretch weakened) muscles |
Opposite side from adaptively shortened |
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Postural Assessment: Inhibited muscles |
Pain Neuromuscular issues |
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Postural Assessment: Determine source |
Injury/illness Habit Bony deformation |
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Guidelines for Assessing Posture |
1. Feet directly under pelvis and hips 2. knees and hip (except ankles) extended 3. legs are parallel 4. kneecaps face forward 5. weight is centered on each foot in the tripod between the heel, first toe, and fifth toe |
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Faulty Posture: Torticollis |
tilt, rotation, flexion of the head and/or neck |
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Stance |
Begins when foot hits ground, ends when same foot leaves ground. Body weight travels up over and across ankle/foot: Heel -> lat arch -> ball of foot Closed chain 60% of walking |
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Stance: 5 subphases |
Heel strike-heel contacts ground Foot flat-whole foot on the ground Midstance-weight of body directly over foot Heel off/terminal-heel begins to lift off ground Push off/toe off-arches begin to rebound, PF/DF begin to push us forward, rebound energy from arches |
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Swing |
Open chain-moving limb forward Femur & leg swing forward at pelvis 40% of gait cycle |
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Swing: 3 subphases |
Early swing/acceleration-concentric, LE just left the ground, foot in doward arc & everything coming forward with gravity moving everything forward Mid swing-weight right under the hip Late swing/decel-use eccentric muscles to plant, ankle DF, knee flx |
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Double-limb support |
both feet simultaneously on the ground, 20% of the 60% of stance |
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Step |
1 foot hits ground until other foot makes contact Ex: right heel strike distance to left heel strike |
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Step length |
Measured between the same location on one foot and on the other Avg 15-18 inches |
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Step width |
Distance between L & R heels Avg 2-4 inches |
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Stride |
2 steps |
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Stride length |
Same point on the same foot over 2 steps Avg 30-36 inches |
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Cadence: speed of gait |
Slow 70-90 steps/min Avg 100-120 steps/min Running 180 steps/min |
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Float Moment |
Both feet off the ground at the same time, during running |
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Faster walking= |
more time in swing phase |
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Running gait: 3 phases |
Stance-40% Swing-60% Float-20% in swing phase of gait cycle |
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Stance: Heel Strike Joint Activity |
Hip 30⁰ flexion to ext Knee ext to slightly flexed Ankle neutral 90⁰ Trunk rotated contralateral side Contralateral arm-forward Same side arm-back |
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Stance: Heel Strike Muscle Activity: Isometric |
Hip extensors-hold pelvis in place Erector spinae-hold trunk upright |
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Stance: Heel Strike Muscle Activity: Concentric |
Hip Flexors HS as hip extensors Knee Flexors-vastus muscles DF-toe up off ground Toe extenders-toe up off ground |
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Stance: Heel Strike Muscle Activity: Eccentric |
Hip extensors Knee flexors-rectus femoris-keep from kicking too far PF-decelerate overactive DF |
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Stance: Foot Flat Joint Activity |
Ankle PF 5⁰ Knee 20⁰ flexion Hip moves into extension Same side arm moves forward |
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Stance: Foot Flat Muscle Activity: Eccentric |
DF-prevent foot slapping |
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Stance: Foot Flat Muscle Activity: Concentric |
Knee flexors-stability |
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Stance: Midstance Joint Activity |
Ankle 5⁰ DF Knee 5⁰ flexion Hip extension full UEs parallel to body |
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Stance: Midstance Muscle Activity: Isometric |
Isometric-maintain static, upright structure Hip abductors-stabilize hip, prevent add Knee extensors-stabilize the ankle Plantarflexors-stabilize the ankle |
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Stance: Heel Off Joint Activity |
Ankle 10⁰ DF Toes hyperextend Ant pelvic tilt Knee extends Hip hyperextends Same side arm swinging forward Backward rotation of pelvis |
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Stance: Heel Off Muscle Activity: Concentric |
Plantarflexors-raise the heel Hip extensors Knee extensors |
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Stance: Push Off Joint Activity |
Toes hyperextend 90⁰ Knee neutral 0⁰ Hip hyperextends 20⁰ Same side UE forward |
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Stance: Push Off Muscle Activity: Concentric |
Plantarflexors Hip extensors Dorsiflexors-prevent foot dragging |
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Swing: Early Joint Activity |
Knee flexion 30⁰ Ankle 0⁰ neutral Forward rotation of pelvis Same side arm swing backward |
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Swing: Early Muscle Activity: Concentric |
Hip extendors Knee flexors DF -clear the foot |
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Swing: Early Muscle Activity: Eccentric |
Hip flexors |
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Swing: Midswing Joint Activity |
Hip flexion 20⁰ Knee flexion 60⁰ Ankle DF 10⁰ UEs parallel but moving in opposite direction |
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Swing: Midswing Muscle Activity: Concentric |
Knee flexors DF -foot clears the ground |
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Swing: Midswing Muscle Activity: Eccentric |
Hip extensors-decelerate motion |
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Swing: Late Joint Activity |
Hip flexion 30⁰ Knee neutral 0⁰ Ankle 15⁰ DF Forward rotation of pelvis Same side UE back Contralateral UE forward |
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Swing: Late Muscle Activity: Concentric |
Hip flexors Knee extensors -prepare for heel strike |
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Swing: Late Muscle Activity: Eccentric |
Hip extensors PF-place foot |
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Pelvis: Sagittal |
Ant/post pelvic tilt, rocking Heel strike to foot flat the pelvis will ant rotate or rise about 2cm Looking from the side |
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Pelvis: Frontal |
Lateral pelvic tilt Weight shifts from one foot to the other, the swing hip is abducting slightly to clear the floor, stance hip adducts to bring everything toward CoG *most common with hip abd/add muscle weakness Looking from back to front |
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Pelvis: Transverse/horizontal |
Forward rotation/backward rotation |
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UE Movements |
Swing in contralateral direction of LE Upper & lower body rotate in opposite direction-horizontal plane |
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Fall & Recovery |
Repeated process of losing balance and catching oneself using a step Uses reflex to step until gain muscle control Watch baby learning |
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Guidelines for Assessing Posture |
6. toes are extended and facing forward 7. shoulders are level 8. chest is wide in front and back 9. sternum is lifted. clavicles are horizontal 10. entire rib cage moves with respiration |
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Guidelines for Assessing Posture |
11. scapulae lie flat against ribs. medial borders of scapulae are parallel to the spine. scapulae are relatively vertical rather than tilted. 12. arms hand vertically along sides of body. palms face the body, thumbs forward. hands slightly in front of trunk |
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Guidelines for Assessing Posture |
13. cervical & lumbar spine normal lordotic curves. thoracic spine normal kyphotic curve. curves do not seem overly kyphotic or flattened. 14. head is centered over the neck and thorax. upper palate and occiput are level. jaw is relaxed. |
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Extensor Support Moment |
During mid stance. Prevents the lower limb from buckling as the body moves over the stance leg |
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Cross-extensor Reflex |
coordinates the simultaneous flexion of one leg with the extension of another. Ex: stepping on a nail, reflex causes person to jerk that limb away from the nail and extend the other leg for support |
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Isometric Contractions |
stabilize and support the lower limb in a static position, during stance |
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Concentric Contractions |
generate a propulsive force to accelerate lower limb motion, during swing
angle of ankle joint closing or static |
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Eccentric Contractions |
provide a restraining force to decelerate lower limb motion, during swing
angle of ankle joint opening |
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Stance: Push Off Muscle Activity: Eccentric |
hip flexors DF |
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Antalgic Gait |
shortened stance phase instinctive guarding around injured or pained areas of the body Ex: arthritis, headaches/whiplash, plantar fasciitis/heel spurs |
