Physiotherapeutic theory for neurological rehabili
Summary
Summary phys.theory: locomotion
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Physiotherapeutic theory for neurological rehabili
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Katholieke Universiteit Leuven (KU Leuven)
Summary of the locomotion lesson given by prof. V. Janssens of the course physiotherapeutic theory. It is a summary of the powerpoint slides and additional items noted during the lesson. The slides were in English and my own notes are always in Dutch as much as possible. It is therefore a mix of th...
Physiotherapeutic theory for neurological rehabili
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Physioth. Theory: locomotion
SUCCESFULL HUMAN LOCOMOTION
Postural control to support the body against gravity
Basic locomotor pattern/rythm which moves the body in the desired
direction central pattern generators
Adaptable to the needs of the individual and the demands of the
environment
Adaptability = supraspinal & peripheral efferents
Invloed supra spinal niveau & info van motor cortex
CHARACTERISTICS FOR LOCOMOTION
STABILITY: balance control
PROPULSION of the body in the intended direction.
ADAPTATION to potentially destabilising factors in an anticipatory way
- Voorspellende ractie
Dual tasking: Combinations with other movement
1. IN STANCE
STABILITY: provided through vertical forces supporting the body against gravity
PROGRESSION: through the generation of horizontal forces against the support surface to move the body
forward
ADAPTABILITY: strategies must be flexible enough to cope with changes in speed, direction or surface terrain
2. IN SWING
STABILITY: gained through the repositioning of the limb in preparation for loading
PROGRESSION is accomplished through the swing of the leg carrying it forward
ADAPTIBILITY: is evident in the ability to avoid obstacles with the swing leg
GAIT PHASES
Nala Melis Pagina 1
, Physioth. Theory: locomotion
Problems in stroke
- IC: foot flat (dropvoet)
- LR = double leg stance support
Weight shift
load the stance leg → not enough weight on the leg = insufficient loading
hip extension → stay in to much flexion or to hyperextension of the hip
Mid stance: alignment
- Absent in stroke -> no weightbearing -> no stance on one leg
Terminal stance: rise of the heel (one leg stance)
- Further hip extension → difficult for stroke patient
Heel off – propulsion
Pre-swing: double leg stance support
- Weight shift
- Push-off & toe-off → push-off absent in stroke, they pull their leg forward
Initial swing: start of swing phase
- Bringing the leg forward → pull leg forward & circumduction
- Not enough clearance when no control of foot
Mid swing: more forward movement
- Not enough ROM → pulling leg higher
Terminal swing
3 rockers
- Heel rocker
IC= hielcontact
Hiel= support
- Ankle rocker
Tibia over voet
- Forefoot rocker
Push off genereren
o Goede swing samen met heupextensie
- CVA= imbalance length & strength
Problemen 1&3 rocker
1. Observation casus patient B
R= hemi
Depressie R-schouder = hypotonische arm
trendelenburg
Nala Melis Pagina 2
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