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Heel strike - ankle position
0 deg - neutral DF
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Heel strike - knee position
5 flexion
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Heel strike - hip position
30 flexion
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Midstance - ankle position
5 DF
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Midstance - knee position
5 flexion
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Midstance - hip position
5 flexion
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Terminal Stance (Heel-off/Toe-off) - ankle position
15 DF - 20 PF
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Terminal Stance (Heel-off/Toe-off) - knee position
30 flexion
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Terminal Stance (Heel-off/Toe-off) - hip position
10-20 hyperextension
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Mid-Swing - ankle position
Neutral
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Mid-Swing - knee position
30 flexion
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Mid-Swing - hip position
30 flexion
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Mid-Swing - MM peak activity - 3
- Tibialis anterior - ECCENTRIC
- Quads - CONCENTRIC
- Gluteus maximus - ISO/CONCENTRIC
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Midstance - MM peak activity - 3
- Gastroc/soleus - ECCENTRIC
- Quads - ISO/CONCENTRIC
- Glute medius - CONCENTRIC
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Terminal Stance (Heel-off/Toe-off) - MM peak activity - 2
- Gastroc/soleus - CONCENTRIC
- HS - Biceps femoris (peaks) - CONCENTRIC
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Mid-swing - MM peak activity - 4
- Tibialis anterior - CONCENTRIC
- Quads - CONCENTRIC
- Hip flexors - CONCENTRIC
- HS - CONCENTRIC than ECCENTRIC
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Stance phase of gait - Weight distribution along foot
- Pronation to supination
- Heel strike - supination (rigid)
- Foot flat - pronation (adapting to support surface)
- Toe-off - supination (rigid foot - to push off of)
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Heel strike - position at ankle, knee, hip
- Ankle - neutral DF
- Knee - 5 flexion
- Hip - 30 flexion
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Midstance - position at ankle, knee, hip
- Ankle - 5 DF
- Knee - 5 flexion to full extension
- Hip - 5 flexion
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Terminal Stance (Heel-off/Toe-off) - position at ankle, knee, hip
- Ankle - 15 PF
- Knee - 30 flexion
- Hip - 10-20 hyperextension
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Midswing - position at ankle, knee, hip
- Ankle - neutral
- Knee - 30 flexion
- Hip - 30 flexion
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During quite standing - in what mms is EMG activity daily continuous?
- Soleus & gastrocnemius
- Bc these mms oppose the DF moment that exists at ankle as a result of line of gravity, which falls slightly anterior to lateral malleolus
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Two-point gait - describe
One crutch & opposite extremity move together, followed by the opposite crutch & extremity
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Three-point gait - describe
Both crutches & involved leg are advanced together, then uninvolved leg is advanced forward
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Four-point gait - describe
A slow gait pattern
- One crutch is advanced forward & placed on floor
- Followed by advancement of opposite leg
- Remaining crutch is advanced forward
- Followed by opposite remaining leg
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Swing-to gait - describe
- Both crutches are advanced forward together
- Weight is shifted onto hands for support & both legs are then swung forward to meet crutches
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Swing-through gait - describe
- Both crutches are advanced forward together
- Weight is shifted onto hands & both legs, which are swung forward beyond point of crutch placement
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Ascent on stairs - describe
- Uninvolved leg always goes up first
- Followed by crutches (or cane) & involved leg together
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Descent on stairs - describe
Crutches (or cane) & involved leg go down first, followed by uninvolved leg
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To use ambulatory aids, pts must use which mms to elevate slightly & DEC amount of WB on LE? - 3
Shoulder depressor mms (lower trapezius, pectoralis major, & latissimus dorsi)
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Canes - measurement; indications (3); Quad cane does what? (2)
- 20-30 deg of elbow flexion
- Measure from greater trochanter to 6 in to side of toes
- Indications:
- Narrow BOS to improve balance
- Provide limited stability & unweighting (can unload forces on involved extremity by 30%)
- Can be used to relieve pain, antalgic gait
Quad cane - INC stability but slows gait; No stairs
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Crutch measurement - elbow flexion of how many degrees? measure length how? forearm crutches
20-30 deg of elbow flexion
For standing patients, (-) 16" from patient's height or measure from a point 2 inches below axilla to a point 6 inches in front & 2 inches lateral to foot
Forearm crutches - cuff should cover proximal 1/3 of forearm, 1-1.5" below elbow
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