Summary phys.theory: locomotion

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




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, 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




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