k & b ii final

secondary causes of inadequate knee flex (pre swing/ initial swing)

inadequate hip flexion, hip ext in term stance, "no heel off" in term stance

secondary causes of excess flexion/inadequate ext of THIGH

excess knee flexion and excess DF posture

primary causes of excess flexion/inadequate extension of THIGH

hip joint effusion, hip pain, joint arthrodesis, abnormal hip flexor activity, hip flexion contracture hypomobility

when does excess flexion/inadequate extension of the THIGH occur

IC, LR, mid stance, term stance

primary causes of inadequate thigh flex

skeletal deformity & motor control

compensatory cause of inadequate thigh flex

decrease demand on weak hip extensors in LR

when does inadequate thigh flex occur

IC and LR

secondary cause of excess CL knee flex

intentionally lower shorter reference swing limb to ground for IC

which of the following are NOT primary causes of excess CL knee flex 1. knee extension contracture 2. knee flexion contracture 3. abnormal knee flexor activity 4. abnormal knee extensor activity 5. knee pain

1 & 4

what is extensor thrust and what period does it occur

rapid movement toward flex: stance & swing

compensatory cause of extensor thrust during mid/term swings

ensure knee ext in term swing in prep for IC when quads are weak

when can inadequate ext occur during the swing phases

mid and term swing

primary causes of inadequate knee extension during mid/term swing

weak quads, knee flexion contracture/hypomobility, abnormal knee flexor activity, knee pain, joint effusion

when does excess flexion occur

pre swing and initial swing

primary & compensatory causes of excess knee flex

abnormal hip/knee flexor activity; assure toe clearance

primary causes of inadequate knee flexion during pre swing/ initial swing

skeletal deformity, tibiofemoral and/or patellofemoral pain, abnormal rec fem/knee extensor activity

which of the following phases does inadequate knee flex NOT occur

mid swing

secondary causes of inadequate knee flex. (LR)

abnormal pf activity, forefoot/flatfoot contact, pf posture

compensatory cause of inadequate knee flex. (LR)

ACL deficiency

primary causes of inadequate knee flex. (LR)

weak quads, abnormal quad acitivity, impaired proprioception, tibiofemoral and/or patellofemoral pain, skeletal deformity

which is NOT a cause of varus/valgus thrust

degenerative joint changes

which of the following is a secondary cause of valgus but not varus

ipsilateral trunk lean

primary causes of knee varus and valgus

skeletal deformity, joint instability/ ligamentous laxity, degenerative joint changes

what is valgus

abd of distal tibia relative to femur

what is varus

add of distal tibia relative to femur

when does wobble occur and what are the primary causes

stance; impaired proprioception and motor control

what is wobble

repeated alternating flexion and extension

compensatory cause of hyperextension and extensor thrust

increase limb stability with weak quads and pfs

primary causes of hyperextension and extensor thrust

weak quads, abnormal quad activity, impaired proprioception

secondary cause of hyperextension & extensor thrust

pf posture

what phase can hyperextension occur

stance

which of the following stance phases can inadequate knee ext NOT occur

loading response & pre swing

what are the secondary causes of inadequate knee ext

excess DF & hip flexion postures

primary causes of inadequate knee extension 1. joint effusion 2. knee pain 3. abnormal knee flexor activity 4. knee extension contracture/hypomobility 5. knee flexion contracture/hypomobility 6. excess hip flexion postu

1, 2, 4, 5

secondary causes of toe drag

abnormal rec fem/knee extensor activity which decreases knee flexion on IP leg, tibiofemoral/patellofemoral pain, decreased knee flexion on CL leg

secondary causes of no heel off 1. forefoot pain 2. inadequate toe flexion 3. inadequate toe extension 4. knee hyperextension due to lack of tibial advancement

1, 3, 4

examples of skeletal deformities for excessive eversion

hindfoot valgus & uncompensated forefoot valgus

weak inverters for excess eversion during stance phase

TA and TP

which of the following is a pro of using OGA 1. can perform anywhere 2. allows for change in surface 3. does not require equipment 4. requires minimal time and space

all of the above

what are examples of motor system impairments 1. coordination impairments 2. muscle weakness 3. proprioception 4. state of the motor neuron pool

1, 2, 4

secondary causes for inadequate mtp ext

to avoid forefoot & toe rockers and heel off does not occur

primary causes of inadequate mtp extension

hallus rigidus & abnormal FHL & FDL activity

when does inadequate mtp ext occur

terminal stance and pre swing

primary causes of excess IP flexion (clawed) during stance 1. skeletal deformity, 2. toe contractures, 3. abnormal FDL & FHL, 4. abnormal EDL & EHL 5. weak intrinsics muscles 6. weak extrinsic muscles

1, 2, 3, 5

compensatory cause for excess IP flexion during stance

increase pf force to control tibial advancement due to weak soleus

compensatory cause of excess eversion

limited ankle df ROM to preserve forward progression

which is not a secondary cause for excess eversion during stance

genu valgum

primary causes of excess eversion

weak inverters and skeletal deformities

additional primary cause of excess inversion during swing phases

flaccid paralysis of pretibialis (TA, EHL, EDL)

secondary causes of excess inversion

genu varum & hip rotational deformities

which is not a primary causes of excess inversion

skeletal deformity such as hindfoot varus and uncompensated forefoot varus

secondary cause of early heel off

excess knee flexion

secondary cause of excess df during mid/term stance

excess hip/knee flexion

primary causes of no heel off

1 & 2

what mmt grade are the pfs considered weak

less than 4/5

what mmt grade is considered weak for the dfs during IC

less than 3/5

which of the following does not happen during IC

foot slap

primary cause of toe drag

weak dfs

what is toe drag

contact of foot w/ ground during mid swing

what is CL vault

Excess ankle pf with prolonged forefoot weight bearing of the CL stance limb during reference limb swing limb advancement

compensatory causes to CL vault

voluntary CL pf to lengthen stance limb when there is a longer swing limb, inadequate knee flexion during IS, and inadequate df in mid swing

what is flat foot contact

initial ground contact make with both hindfoot and forefoot

which of the following can occur during swing phases

inadequate df and CL vault

primary causes of inadequate df during swing phases

abnormal pf activity, weak dfs, pf contracture

secondary causes of toe drag

improve CL knee flexion, pain in tibiofemoral/patellofemoral, decreased knee flexion

when does toe drag occur

initial swing

when does no heel off occur

terminal stance

compensatory causes for excess df during mid/term stance

lower CL limb from IC

when can excess dorsiflexion occur; 1. mid stance, 2. terminal stance, 3. pre swing, 4. initial contact

1 & 2

primary cause excess df during mid/term stances

underactive pfs

compensatory causes of inadequate df during mid/term stance

to avoid ankle rocker secondary to weak pfs

when does inadequate df occur

initial conatct

primary cause of inadequate df during mid/term stance;

skeletal deformity, pf spasticity, pf contracture

what can happen at mid and terminal stance (ankle)

inadequate df and excess df

compensatory cause of early heel off

voluntary pf to compensate for short reference limb

primary cause of early heel off

overactive pfs, PF contracture, skeletal deformity

when does early heel off occur

mid stance

what causes inadequate pf

abbreviated or absent heel rocker

when does foot slap occur

loading response after after heel strike

when does abbreviated heel contact occur

initial contact

when does flat foot contact occur

initial contact

when does forefoot contact occur

right after initial contact

when does inadequate pf occur

loading response

what is knee flexion always associated with in static posture

ankle DF

what is the primary cause for foot slap

weak dorsiflexors when heel contact at IC occurs

what is the primary causes of BOTH forefoot contact and inadequate dorsiflexion; 1. weak dorsiflexors 2. abnormal plantar flexion activity 3. PF contracture/hypomobility 4. ankle pain/joint effusion

all of the above

which of the following are examples of compensatory causes to flatfoot contact

reduce or avoid effects of heel rocker due to weak quads

which of the following are examples of compensatory causes to forefoot contact

To accommodate for a shorter limb & to avoid heel pain

what are the secondary causes of forefoot contact; 1. inadequate knee extension in terminal swing 2. knee flexion contracture 3. abnormal knee flexor activity 4. abnormal hamstrings activity

1, 2, 4

what is the primary cause of flatfoot contact; 1. weak dorsiflexors (MMT < 3/5) 2. abnormal plantar flexion activity 3. PF contracture/hypomobility 4. ankle pain/joint effusion

1, 2, 3

what are the secondary causes of forefoot contact; 1. weak dorsiflexors 2. knee flexion contracture 3. abnormal knee flexor activity 4. knee pain, joint effusion

2, 3, 4

what is abbreviated heel contact (ABB HC)

interval of heel only is shortened

what is foot slap

rapid PF after heel strike, often audible as forefoot hits ground

what is forefoot contact

initial gound contact made with forefoot

what are sensory system impairments: 1. somatosensory deficts (touch and proprioception) 2. visual/vestibular defects 3. state of motor neuron pool

1 & 2 only

which is NOT an example of cognitive and perceptual impairments

timing impairments

example of secondary deviation

Excess dorsiflexion in mid stance due to a knee flexion contracture rather than weak calf muscles

what are the 4 major impairment categories for observational analysis

deformity, weakness, impaired motor control, pain

what is impairment

loss or abnormality of physiological, psychological or anatomical structure or function at the organ system level.

what is walking often impaired by

musculoskeletal and neurological pathologies, requiring a comprehensive clinical evaluation