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NS19 - Posture + Gait (i) (intro (gait = manner + style of walking,…
NS19 - Posture + Gait (i)
intro
gait = manner + style of walking
posture = relative arrange of different body parts
postural stability/balance = ability to maintain body in equilibrium (maintain COG with min sway)
centre of mass (COM) = distribution of mass equally in all directions
centre of gravity (COG) = distribution of weight equally in all directions
line of gravity = imaginary vertical line that transects COG
Postural Muscles
lat trunk
quadrates lumburom
int + ext oblique
hip abductors
glut med
tensor fascia latae
hip adductors
inverters
tibialis post
FDL
FHL
everters
peroneus longus + brevis
Normal posture control/balance sensors
1) vision
position + motion of head
movement
verticality
2 eyes together -> depth perception
visual cues modulate speed + direction of locomotion
helps us align body
2) vestibular system
semicircular canals operate vestibular ocular reflex
maintains central eye focus with head rotates
otoliths (utricle + saccule)
supply = vestibular N (VIII)
provides info about position + movement of head with respect to gravity-inertial forces
distinguishes exocentric (environment moving) + egocentric (you moving) movement
3) SS inputs
info about proprioception
joint angle (joint Rs)
muscle length (spindle) + tension (golgi app)
where limbs are in space + in relation to each other (cutaneous mechanics on skin)
3 afferent balance sensors -> CNS (all levels involved - integrates inputs, selects motor outputs, determines body position) -> motor neurons
Requirements for balance
ability to initiate movement
appropriate reaction time
co-ordination
normal strength/muscle tone
3 balance strategies
all motor responses
1) ankle strategy (tib ant + gastrocnemius)
2) hip strategy
3) step strategy
Romberg's test
can patient stand upright with eyes closed? (no swaying or falling)
+ve test - poor balance, impaired proprioception
Normal gait characteristics
rhythmical + symmetrical
COG moves with min energy expenditure
little muscle activity
progression (moving forward)
instability
80% of time on one limb
high COG, small support base
adaption to terrain, surroundings etc
Gait Parameters
velocity
distance/time
normal = 1.2 - 1.5 m/s (5k/hr)
cadence
steps/min
normal = 110-120
decreases in small stride lengths
cycle
start = point of initial heel contact
end = point of same heel contact again