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Nutation - Most stable position of the pelvis slight anterior tilt of the sacrum on the ilium Counter nutation - least stable position of the pelvis slight posterior tilt of the sacrum on the ilium Form closure - How well anatomical structures fit together, and is the shape of the articular surfaces. This means that a disruption can cause large changes to the function of the pelvic girdle Force closure - ability of muscles and soft tissue to apply active force via connective tissue (fascia) to compress joint surfaces, e.g.: abdominals, adductor on SIJ and ant pelvis; TA and multifidus Pelvic girdle dysfunction - presents as localised pain around SIJ or pubic symphysis. Can result from form or force closure dysruption. Alterations in passive tension, alterations in neuromuscular activation and control, or trauma can cause this. assessment of pelvis - lumbopelvic rhythm, what is moving on what, WB, SLS, SLR, STS, dynamic SLS activity Stork (Gillet) test - Compares movement between ilia and sacrum in SLS compared to when in WB Active SLR - body is having to stabilise trunk to transfer force to act on lower limb. Compare one side to the other. Look at deep abdominals. Assesses force closure of pelvis as well Hydrostatics - hydrostatic pressure, relative density, buoyancy, and equilibrium Hydrodynamics - drag, viscosity and turbulence Relative density - floating or sinking when compared to water, greater density than water (sinks) and less density (floats). human body is 0.86-0.97, so it FLOATS
thermoneutral - where hydrotherapy pools remain at 33 degrees, which means that there is no change to the core body temperature. this allows for more comfort for the patient relative density of body parts - lung tissue and fat tissue have a lower relative density, therefore they float more. Muscle and bone have higher density, therefore they sink more. Hydrostatic pressure - comes from the weight of the water, and increases with depth, therefore when standing, this is greater in the ankles than at the chest. Is useful for swelling, due to compression ability Buoyancy - The volume of your body displaces the same volume of water, which causes an apparent loss of weight equal to the fluid displaced. the force experienced as an upthrust which acts in the opposite direction to the force of gravity. Relates to % WB when at different depths of water. % WB increases with speed of walking and depth of water Buoyancy assisted - movement in water in an upwards direction, as buoyancy is an upthrust force so it assists upwards motion Buoyancy counter balance - across buoyancy exercises in sidelying Buoyancy resisted - movement downwards in water, against buoyancy as buoyancy is an upwards thrust force. Can add floats to increase resistance. Centre of buoyancy - Centre of the volume or shape of the displaced water. Point which would be the centre of gravity of the displaced mass of water if it occupied the volume and shape of the immersed part of the body. Metacentre - The place where all the lines of buoyancy intersect. if unequal and unaligned, caused by movement of limbs, will cause rotation. if you move left arm up in supine, the body will rotate TOWARDS that side. Viscosity - internal friction of a liquid + friction between layers of moving water drag - relates to viscosity and turbulence, is influenced by the speed and surface area of moving part. when velocity doubles, drag forces quadruple.
Symptoms of muscular dystrophy - progressive muscle wasting; postural changes, reduced function and mobility, contractures, fatigue and decreased endurance cycle of muscular dystrophy - muscle damage occurs, necrosis, incorrect fibre regeneration, muscle fibre fibrosis, replacement with fatty tissue, permanent muscle fibre damage. grade 1 ligament + muscle strains - mild injury involving tearing of only a few fibres; muscle: focal pain, typically no loss in strength; ligament: pain on applied stress/load, normal end feel grade 2 ligament + muscle strain - moderate injury involving a considerable portion of fibres; muscle: pain, swelling, loss of strength, pain reduced on mm contraction and stretch; ligament: pain on applied stress, possible increased joint laxity grade 3 ligament sprain and muscle strains - complete tear or rupture; muscle: often at musculotendinous juntion, usually very painful, loss of function, visual deformity; ligament: complete tear, gross joint laxity, empty or no end feel stages of soft tissure repair - stage 1: acute inflammatory stage 2: repair (reconstructive/proilferative stage) Stage 1 of soft tissue repair - acute inflammatory stage. lasts 2-3 days. injury damages capillaries and local haemorrhage occurs. Vasodilation and increased capillary permeability = plasma leakage. Redness, swelling and heat. Stage 2 of soft tissue healing - Repair stage. lasts from 2-3 days up to 2-6 weeks. Destruction of original clot framework by macrophages. Proliferation of capillaries and fibroblasts into damaged tissue. Fibroblasts migrate to the lesion and collagen is deposited - repair. Regeneration from surrounding cells begins. regeneration - restoration of tissue to previous function Repair - replacement of destroyed tissue with scar tissue Stage 3 of soft tissue repair - Remodelling (maturation) phase. 3 weeks - 6-12 months. continuation of reconstruction/regeneration. Reorientation of collagen fibrils and muscle cells in direction of loading. Collagen maturation.
Ataxia - describes abnormal coordination of movements. Can be errors of rate, amplitude, accuracy, or force, but NOT weakness. Due to lesions in: vestibular apparatus, cerebellum, peripheral sensory mechanisms. role of cerebellum - initiation and control of voluntary movement, timing of movement/muscle action, moment-to-moment correction of errors, compensating for lesions of cerebral cortex, motor learning and adaptive adjustments damage to midline cerebellar structures - will cause truncal ataxia damage to cerebellar hemispheres - symptoms ipsilateral to side of lesion cerebellar ataxia - dysmetria, rebound phenomenon, dysdiadochokinesia, intention tremor, dyssynergia, hypotonia dysmetria - inaccurate amplitude of movement and misplaced force rebound phenomenon - dysfunction in agonist/antagonist relationship; inability to 'brake' movement dysdiadochokinesia - difficulty in performing rapid alternating movements dyssynergia - breakdown in movement resulting in joints being moved separately to reach a desired target as opposed to moving in a smooth trajectory; decomposition of movement hypotonia - a condition in which there is diminished tone of the skeletal muscles features of ataxic movement - predominance of adaptive motor behaviour; proximal stabilisation to permit distal function, fixing with upper limbs in sit/stand, widen BOS in sit/stand/gait principles of physio intervention for ataxia - build up proximal control and core stability (smooth and slow); train control during functional tasks; cannot take away ataxic person's behaviour without giving something back
parathyroid hormone - role in regulating blood calcium levels. Has 3 regions of action: bones, to stimulate osteoclast; kidneys, to rpomote reabsorption of calcium from distal tubules; intestines, stimulates increased Vit D production to asssist absorption of calcium from food in intestine. Vitamin D - plays a role in calcium and phosphorous regulation in the blood stream. promotes calcium absorption from food. Inhibits secretion of parathyroid hormone. secondary osteoporosis - caused by pathology, ie prolonged bed rest, anorexia, other GI disorders, malignancy, and endocrine disorders. physio treatment for osteoporosis - exercise that stimulates osteoblasts, such as multidirectional exercises and things like basketball, tennis, or jump rope. Weight bearing, resistance, and balance. Avoid exercise that involves end range rotation of the spine. intrinsic risk factors for falls - LL strength, LL PROM, LL sensation, vestibular function, balance responses, cognitive issues, vision, medication extrinsic risk factors for falls - footwear, gait aid, glasses, home environment, community environment, lighting. tests for falls and balance - CTSIB, TUGT, Berg balance scale, functional reach, step test, 10m walk test, MiniBESTest quick tests for falls and balance - inability to pick up object off the floor; turn 360 degrees > 4 secs; turn 180 degrees > 4 steps; 10MWT > 12.5 secs, 21 steps; TUGT > 14.5 secs L2 myotome - hip flexion (iliopsoas) L3 myotome - knee extension (quadriceps) L4 myotome - ankle dorsiflexion with supination (tib ant) L5 myotome - great toe extension (extensor hallucis longus)
S1 myotome - ankle plantarflexion (gastroc) + ankle pronation (peroneals) S2 myotome - toe flexion (flecor hallucis longus) transtibial amputation (TIA) - amputation that occurs below the knee transfemoral amputation - above knee amputation through the knee amputation - knee disarticulation - removal of the knee
