Movement Science Exam 2

What makes up a full gait cycle?

A gait cycle starts with heel contact of one foot 0% and ends with the contact of the same foot. 100%

At 50% of the gait cycle, we have heel contact of the opposite foot

What are the two main periods of the gait cycle?

1. Stance phase→ when foot is on floor, accounts for 60%

2. Swing phase→ when leg is swinging forward, accounts for 40%

What amount of flexion should knee have in stance phase?

slight flexion (20 degrees)

When knee flexion is exaggerated, there is _% more oxygen consumption

50

What are the key areas to evaluate with gait?

1. Arm swing in sagittal and transverse plane

2. Hip flexion/extension and transverse plane

3. Knee flexion/extension and frontal plane

4. Ankle mortise in sagittal plane

5. Calcaneus in frontal plane

6. Forefoot in frontal plane

7. 1st ray MTP in sagittal plane

8. Toe in/out in transverse plane

What are the individual components/phases of normal gait cycle?

1. heel strike

2. full forefoot load

3. heel lift

4. toe-off

What are major determinants of gait? What do they minimize? TQ

aim to minimize center of mas (CoM) movement and reduce energy expenditure

What is pelvic list/ hip drop? What does it minimize?

swing leg drops downward and can show gluteus medias weakness

minimizes vertical movement of CoMa

What controls the hip drop?

Gluteus medius

What does posterior pelvic rotation do?

reduces the braking phase of gait

What does talus do during pronation of subtalar joint?

talus moves with a medial rolling action upon the calcaneus

How many degrees of 1st ray MTP dorsiflexion is considered normal during walking gait?

more than 60 degrees

What is windlass mechanism?

the manner by which the plantar fascia supports the foot during weight-bearing activities

_ is crucial for windlass effect

1st ray dorsiflexion

What is considered normal ankle dorsiflexion?

40 degrees

How much ankle dorsiflexion is needed for walking gait?

10-20 degrees

Upper fibers of gluteus maximus control what plane?

frontal plane of motion

Low fibers of gluteus maximus control _ and_

sagittal and transverse plane of motion

What are common dysfunctions of gait?

1. Asymmetrical arm swing or excessive elbow flexion

2. Excessive center of mass vertical movement

3. Excessive contralateral hip drop (more than 4-6 degrees) or lateral translation ( more than 1 inch)

4. Inadequate hip extension (less than 10 degrees)

5. Excessive femoral anteversion (internal rotation) and adduction (leading to knee valgus)

6. excessive knee valgus (medial collapse/drift) more than 6 degrees

7. excessive (>25 degrees) or inadequate (<15 degrees) knee flexion during midstance

8. excessive toe-out (external rotation)

9. Inadequate ankle dorsiflexion (<10 degrees)

10. Excessive subtalar eversion from heel strike to end of midstance phase

11. Excessive forefoot pronation

12. Inadequate 1st ray dorsiflexion (<60 degrees)

What are the keys to gait evaluation?

1. use a clear level walkway at least 20 feet long

2. observe from all angles

When pain with gait is present, _

proceed with caution

Toe in loads _ more

iliopsoas

toe out clears the iliopsoas and gives more info on if its a _

labral or capsular issue

What is the first thing to look at when assessing a running injury?

individual’s training logs in conjunction with their running experience

Runners with low arches pronate more and are prone to _

soft tissue injuries and medial knee/ankle issues

Runners with high arches are prone to _

bony injuries like stress fractures and lateral foot/leg issues

_ runners have highest injury prevalence

very low arched

What impact does flexibility have on running injuries?

U shaped curve→ too flexible or not flexible increases risk of injury

Moderate flexibility is ideal for balance and function

If you take runners that normally stretch and give no stretch protocol, they are nearly _ as likely to sustain injury

twice

Runners who strength train exhibit _

significant reduced injury rates (33-50%)

What is neurodynamics?

Science of the relationships between mechanics and physiology of the nervous system

communication between different parts of the nervous system and its relationship to the MSK system

Neurodynamics evaluates _ and _ of the nervous system

length and mobility

Neurodynamic assessment relies on influencing _

pain physiology via the mechanical properties of neural tissues and non neural structures

Peripheral nerves may be chronically entrapped as a result of _

repetitive motion/activity, stresses, forces, compression

Peripheral nerves may be acutely entrapped by _

injury, trauma, or latrogenically

What is the role of a nerve?

enables a motor function

transmit sensory feedback

mediating reflex

supporting autonomic functions

How can symptoms of nerves be described? TQ

1. Numbness

2. Tingling

3. Burning

4. Pain→ radiating

If post surgical, nerve symptoms may occur _ or _

Immediately or weeks to years after

Nerve symptoms may be manifested as _

1. Local pain at entrapment site

2. Pain distal to the site of entrapment

3. Muscular weakness/atrophy

4. altered reflexes/ sensation

5. headache, backache, earache, stomachache

6. sciatica

7. foot pain

What is clinical neurodynamics?TQ

application of mechanics and physiology of the nervous system as they relate to each other and are integrated with musculoskeletal function

What is neurodynamic test? TQ

series of intentionally sequenced body movement that produces mechanical and physiological events in the nervous system according to the movements of the test

What is neurogenic pain? TQ

Pain that is initiated or caused by a primary lesion or dysfunction in the peripheral or central nervous system

What are the mechanical functions of a nerve?

1. Tension

2. Compression

3. Movement

What is a positive neurodynamic test?

provocation or reproduction of symptoms→ numbness, tingling, burning, radiating pain

What are the three functions that the nervous system must successfully execute to move normally? TQ

1. Withstand tension

2. Slide in its container

3. Be compressible

T/F nerves that have been previously compromised by compression may be more sensitive to smaller pressures producing neuropathic symptoms

true

What are the effects of tension on intraneural blood flow?

8% elongation→ blood starts to diminish

15% elongation→ all circulation of nerve is obstructed

prolonged tension can reduce nerve conduction and lead to ischemia

_ is important in neurodynamic testing. Small changes in technique can produce BIG changes in response

consistency

What is neurodynamic sequencing? TQ

performance of a set of particular component body movements so as to produce specific mechanical events in the nervous system

What is structural differentiation?

performed with all neurodynamic tests

achieved by moving the neural structures in the area in question without moving the musculoskeletal tissues in the same region

nervous system is emphasized when the relevant neural structures are moved without moving the adjacent musculoskeletal structures

What are some examples of structural differentiation?

Wrist symptoms→ contralateral neck flexion

Release neck flexion for lumbar symptoms

Events occur in what order during joint movement?

1. Taking up of slack early in the range

2. rapid neural sliding in the mid range

3. tension builds in the nervous system as nerve movement diminishes at the end range

What are the key components being tested with neurodynamic testing?

1. Tension

2. Compression

3. sliding

4. intraneural blood flow

5. inflammation

6. mechanosensitivity

What is ULNT1?

Median nerve and anterior interosseous nerve

C5-C7 nerve roots

What is ULNT2?

Median nerve, axillary nerve, and musculocutaneous nerve

C5-C7

What is ULNT3?

Radial nerve

C5-T1 nerve roots

What is ULNT4?

Ulnar nerve

C8-T1 nerve roots

What are the three lower limb neurodynamic tests?

1. Straight leg raise→ L4-S2 and sciatic nerve (most sensitive for L5 and S1)

2. Slump Test→ L4-S3, lumbar roots and sciatic nerve

3. Femoral nerve stretch test→ L2-L4 and femoral nerve, prone knee bend test

What are sliders?

“nerve flossing”

intended to produce a sliding movement of neural structures

performed by placing tension one end of the nerve and reducing tension the other end of the nerve in an alternating pattern

What are tensioners?

produces an increased tension in neural structures

relies on natural viscoelasticity of the nervous system

Does not pass elastic limit

performed by placing tension (elongating) both ends of the nerve simultaneously

The best audit for using neurodynamic tests is _

checking sensitivity before your tx of the neural structures and rechecking afterwards

Muscle imbalances result in _

inappropriate patterns of movement

Muscle imbalances are commonly caused by _

a sedentary lifestyle

What are global stabilizers?

large, long superficial muscles that span two or more joints

contraction creates tension to introduce stability

What are global movers?

large, long superficial muscles that span two or more joints

contraction creates movement with in a specific pattern

What are local stabilizers?

shorter smaller deep muscles

span single peripheral joint or a few spinal segments

contraction creates tension to produce stability

What are local movers?

shorter, smaller deep muscles

contraction produces movement within a specific movement patterns

What is reciprocal inhibition?

the neuromuscular phenomenon that occurs when a tight muscle decreases the neural drive to its functional antagonist

leads to compensation patterns and predictable injury patterns

What is synergistic dominance?

neuromuscular phenomenon that occurs when synergists ands stabilizers take over for the weak or inhibited primer mover

What is arthrokinetic inhibition?

neuromuscular phenomenon that occurs when a muscle is inhibited by joint dysfunction or the capsule that crosses the joint

What are crossed syndromes?

exposure of the human body to gravity forces and routine stability functions is necessary to ensure proper activity of the skeletal muscles

What is upper crossed syndrome? Which muscles are tight and weak? TQ

Tight→ upper trapezius, levator scapulae, pectoralis major and minor, anterior deltoid, SCM, Subscapularis, scalenes, rectus capitis

Weak→ deep cervical neck flexors, middle and lower trapezius, serratus anterior, posterior deltoid, rhomboids, infraspinatus, teres minor

T/F When muscle imbalance impairs function, it is considered pathological

true

What are some postural imbalances with upper cross syndrome?

1. Forward head posture

2. Increased cervical lordosis and thoracic kyphosis

3. elevated and protracted shoulder

4. rotation/abduction and winging of scapulae

What is lower crossed syndrome? What muscles are tight vs weak?

Tight→ Thoracolumbar extensors, hip flexors, iliopsoas, TFL, rectus femoris, quadratus lumborum, lateral hamstrings, lateral gastrocnemius, soleus

Weak→ Abdominals gluteal muscles, and local lumbo-pelvic stabilizers

What are some postural imbalances with lower crossed syndrome?

1. thoracic hyperkyphosis

2. lumber hyperlordosis

3. anterior pelvic tilt

4. slight hip flexion

5. slight knee flexion

Only _ and _ are present in newborns

primitive reflexes and spontaneous general movements

What are the three levels of motor control?

1. Spine and brain stem level

2. Subcortical level

3. Cortical level

What is the spine and brain stem level?

subconscious

responsible for primitive reflexes and inborn motor functions

What is the subcortical level?

subconscious

mature during first year of life

allows basic trunk stabilization→ allows for locomotor function of extremities

afferent info is integrated within postural-locomotor patterns

What is the cortical level?

conscious

responsible for learned motor functions

movement initiation

planning of movements

individual qualities

isolated segmental movement and relaxation

_ is responsbile for the fine tuning of movements TQ

Cerebellum

What are the three types of sensory input that our motor system receives and must interpret?

1. Proprioceptive→ info about body position and movement

2. Interoceptive→ internal body signals

3. Exteroceptive→ external stimuli from environment

What is developmental kinesiology?

development of motor functions after birth

as CNS matures, purposeful muscle function becomes increasingly activated

emphasizes existence of central locomotor control

provides framework to appreciate the regional interdependence and the interlinking of the skeleton, joints, and musculature during movement

Ideal posture is dependent on _

ideal motor development

The quality of postural ontogenesis is crucial for _

joint centration and optimal joint function

How does locomotor system dysfunction develop?

if balanced muscular co-activation is lost, dysfunction manifests in what would be otherwise normal muscular synergies

When dysfunction is present in the locomotor system, it manifests as _

characteristic postures

dysfunctional movement patterns

Why is DK important in practice?

specific motor patterns characteristic for certain developmental age

relationship between development during first year and pathology of the locomotor system in adulthood

Defines ideal posture

defines muscle cooperation and coordination which is ideal for joint loading

Important for Diagnosis and treatment of pain and injuries related to locomotor

What is motor control?

process of initiating, directing, and grading purposeful voluntary movements

ability to regulate mechanisms essential to movement

performance of motor skills

What is motor learning?

process of acquiring a skill by which the learner, through practice or experience and assimilation, refines and makes automatic the desired movement and capability for skilled behavior

set of internal neurologic processes that results in ability to produce a new motor skill

ability to refine and optimize the performance of motor skills to be more efficient

What is described as “necessary input, sufficiently processed, with an acceptable output?”

motor control

Motor learning is a change in the capability of a person to perform a skill that must be inferred from a _ improvement in performance

relatively permanent

Why should chiros care about motor control and motor learning?

we need to address motor control dysfunctions, as these are often the source or result of pain or injury

retraining motor control restores function, reduces injury risk, and enhances movement efficiency

The wadman experiement proved what?

study helped us understand that muscles do not have memory

all memories are stored in the brain

What are cognitive memories/skills?

core skills your brain uses

intellectual skills (math, language)

harder to retain long term without consistent use

What are motor skills?

involve precise movement of muscles with the intent to perform a specific act

most purposeful movement requires the ability to feel or sense what one’s muscles are doing as they perform the act

(riding a bike, playing a sport)

more enduring, even with long gaps in practice

Can we change a motor skill/pattern?

NO, existing motor patterns cannot be changed, but new motor patterns can be created

once new motor skill is learned, it becomes the dominant pattern

What is learning vs performance?

Learning→ acquisition of knowledge (assumptions about learning must be on lasting or permanent changes)

Performance→ action or process of carrying out or accomplishing an action ( changes that occur and give temporary success)

The only way to establish if a person learned is to do a _ TQ

retention test