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Division of Rehabilitation Sciences
Occupational Therapy / Physical Therapy 7143
Control of Human Movement
Course objectives
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Course coordinators may modify these objectives as the course progresses. Each objective's wording is important. Not only does it reflect the content that students must learn, it employs verbs that specify the level of knowledge for which students are responsible. Students may review the verbal categories, or levels of performance, in the cognitive, affective, and psychomotor domains of learning.
APPROACH TO THE STUDY OF FUNCTIONAL ANATOMY
- Students orient themselves to the study of each joint's functional anatomy by answering the following questions:
- If the joint is uniaxial, what is the orientation of its axis? If the joint is multi-axial, around what axes can it move?
- Given the joint's functional anatomy and axes of motion, what are its osteokinematics, that is, what movements are possible at the joint?
- What are the joint's arthrokinematics; how do the bones that articulate at the joint roll and glide with respect to one another when the joint moves?
- What is the joint's close-packed position?
- Which muscles cross the joint and can, therefore, produce joint movement?
- Presented with a human movement, students apply the following sequential technique to analyze the motion, identifying in order:
- the joint(s) at which movement occurs.
- the segment that moves and the segment that is stable.
- the joint motion that occurs.
- the location of gravity's force, and its effect on the motion.
- the muscles that interact with gravity's force to produce or control the joint motion.
- Applying this information, along with estimates of anthropometric measures that they are provided, students solve equations to estimate the forces and moments that produce the movement.
- Presented with a normal movement pattern, students:
- predict the effects of limited passive range of motion at any of the joints involved in the movement.
- predict the effect of disruptions in functional relationships or synergies among the muscles that contribute to the movement.
- predict the effect of alterations in alignment of muscles or segments of the body.
- write a clear and logical description of the movement pattern and of the forces that produce it.
GENERAL BIOMECHANICAL PRINCIPLES
- State the location of the center of mass of the human body in anatomical position.
- Estimate the locations of segmental centers of gravity on drawings, skeletons, and people.
- Explain how the relationship between a mass' center of gravity and its base of support contributes to the mass' relative stability or mobility.
- Identify the three cardinal planes in which movement occurs, the axis that defines each plane, and the movements that occur in each plane.
- Explain the functional classification of synovial joints and, given a joint, correctly classify it as uniaxial, biaxial, or triaxial.
- Given a joint, name the planes in which movement is possible, and the axis around which each movement occurs.
- Given a movement at a synovial joint, name the movement, name the plane(s) in which the movement occurs, name the axis or axes around which the movement occurs, and determine whether the movement occurs in an open or closed kinematic chain.
- List the forces that produce human movement. Illustrate gravitational and muscular forces as vectors, assigning them appropriate points of application, lines of application, and directions.
- Given a vector depiction of a force, define and measure its moment arm around a joint axis, and calculate the moment (or "moment of force" or "torque") that the force generates around the axis.
- Given a muscle, draw a vector that represents its force, and predict its action(s) based on the relationship of its line of application to the axis or axes of each joint it crosses.
- Presented with a movement, analyze gravity’s effect on the relevant joints. After defining gravity’s role in the movement, identify muscles that contribute to the movement and explain whether the muscles' action is isometric, eccentric, or concentric.
- Write the formula for rotational equilibrium, and use it to calculate the force developed by a given muscle to counter a known gravitational resistance.
- Explain how the force that is required of a muscle might change during a task.
- Describe joint movement's effect on two sensory receptors in muscle, muscle spindles and Golgi tendon organs. Explain how muscle spindles are involved in the stretch reflex and in reciprocal inhibition.
- Define "motor unit" and explain how motor unit recruitment occurs.
- State the relationship between a muscle's length and the amount of force (or tension) it can develop. Give examples of activities or tasks where a muscle's length influences its force production.
ADVANCED BIOMECHANICAL PRINCIPLES
- Describe the arthrokinematic movements of roll and glide. Given a joint, apply the rules of concavity and convexity to predict the direction in which the moving surface rolls and glides on the stable surface.
- Demonstrate the technique of vector composition to determine the resultant of forces when they are illustrated as vectors.
- Given a force vector and a reference line, demonstrate the technique of vector resolution, drawing two component vectors so that:
- one is perpendicular to the reference line
- the other is parallel to (directly on) the reference line
- Given a force vector and a reference line that represents a joint or other surface, interpret and explain the force's effect on
- compression or distraction in a direction that is perpendicular to the surface
- shearing or sliding in a direction that is parallel to the surface.
LOWER EXTREMITY
- State the axes and movements possible at the following joints:
- State the location of the following ligaments and the joint motions that they limit when elongated:
- hip:
- iliofemoral
- pubofemoral
- ischiofemoral
- knee:
- medial and lateral collateral
- anterior and posterior cruciate
- ankle:
- medial collateral (deltoid)
- lateral collateral
- plantar calcaneonavicular (spring)
- State the close-packed positions of the hip, knee, and ankle.
- Locate on yourself and on a partner the palpable structures that your text (Smith, Weiss, & Lehmkuhl, 1996) lists for the hip (pp.267-268), the knee (p.303), and the ankle and foot (pp.333-336).
- Locate in an anatomy atlas and on classroom skeletons the nonpalpable structures that your text (Smith, Weiss, & Lehmkuhl, 1996) lists for the hip (pp. 268-270), the knee (p.304), and the ankle and foot (p.336).
- For each muscle that your text lists for the hip (Smith et al., 1996, pp.279-288), the knee (pp.312-318), and the ankle and foot (pp.344-355), complete the following objectives.
- state which peripheral nerve innervates the muscle
- state the muscle's proximal and distal attachments
- list the joints that the muscle crosses
- locate the muscle's palpable portions, including its tendon
- palpate or visualize on diagrams and classroom skeletons the muscle's lines of application, concentrating on those portions that are close to the joints that the muscle crosses.
- predict the muscle's actions on the basis of the relationship of its lines of application to the axis or axes of each joint that it crosses.
- Define the functional relationship that exists between helping synergists at multi-axial joints, and give examples of helping synergies that involve muscles that cross the hip or the ankle-subtalar joint complex.
- Define the functional relationship that exists between an agonist and a stabilizer. Draw and label a diagram that illustrates how trunk muscles stabilize the pelvis so that specific hip muscles can produce effective hip movement.
- Explain how frontal plane equilibrium is achieved at the hip in unilateral stance. Relate the conditions of equilibrium to the clinical signs of hip abductor weakness, and explain how people with hip abductor weakness should use an assistive device to compensate for it.
- Use vector resolution to describe the compression and shear forces placed on the hip during unilateral stance by gravity and muscles. Relate these forces to clinical signs that indicate a person has hip pain, and explain how people with hip pain should carry loads.
- Describe the relationship between the gravity line (the line of application of gravity acting on the body's center of gravity) and the lateral axes of the hip, knee, and ankle joints when a person is standing erect.
- Define a true synergy. Name the multi-articular muscles that cross the ankle and subtalar joint. For a multi-articular muscle to produce movement at some but not all of the joints which it crosses, it must act in a synergy with at least one other muscle. Describe one example of a true synergy.
- Describe how hip or ankle motion indirectly influences knee motion in a closed kinematic chain.
- Given a movement in the hip, knee, ankle, or subtalar joints, state which muscles the movement passively elongates.
Intervertebral joints and trunk
- Identify the axes of movement and the movements that are possible at the:
- atlanto-occipital joint
- atlantoaxial joint
- intervertebral joints between C2 and S1
- Locate on yourself and on a partner the palpable structures that your text lists (Smith, Weiss, & Lehmkuhl, 1996, pp.365-367) for the trunk.
- Complete the following objectives for the trunk's anterior and posterior muscles:
- state which peripheral nerve innervates the muscle
- state the muscle's proximal and distal attachments
- list the joints that the muscle crosses
- locate the muscle's palpable portions, including its tendon
- palpate or visualize on diagrams and classroom skeletons the muscle's lines of application, concentrating on those portions that are close to the joints that the muscle crosses.
- predict the muscle's actions on the basis of the relationship of its lines of application to the axis or axes of each joint that it crosses.
- Given a closed chain movement of the pelvis, state the movements that must occur in the hip joint and the lumbar intervertebral joints.
- in the sagittal plane (anterior vs. posterior pelvic tilt)
- in the frontal plane
- in the transverse plane
- Describe how pelvic movement influences closed chain movements in the knee, ankle, and subtalar joints.
- Give specific examples of trunk and hip muscles that can act simultaneously to tilt the pelvis anteriorly or posteriorly.
- Define lordosis, kyphosis, and scoliosis. Distinguish between structural and functional scoliosis.
- State the location of the following spinal ligaments and spinal motions that they limit when they are elongated:
- anterior longitudinal ligament
- posterior longitudinal ligament
- ligamentum flavum
- interspinous ligament
- intertransverse ligaments
- supraspinous ligament
- ligamentum nuchae
- thoracolumbar fascia
- Explain how changes in intrathoracic volume and pressure contribute to inspiration and expiration during the act of breathing.
- Describe rib movement during respiration.
- List the primary muscles of expiration and inspiration.
- Given a secondary or accessory muscle of respiration, explain how its line of application contributes to either forced expiration or forced inspiration.
- Describe diaphragmatic movement during respiration and explain how diaphragmatic contraction increases the volume of the thoracic cavity.
- Given a movement of the cervical, thoracic, or lumbar spine:
- identify the effect of gravity on the movement.
- give specific examples of muscles that act as helping synergists.
- specify muscular or gravitational forces that stabilize the muscles' attachments, depending on the body's position.
WALKING
- Define the stance and swing phases of the gait cycle. Within the stance phase, define the two periods of double-limb support, which are termed "loading response" and "preswing."
- Describe the two points in the gait cycle, "push-off" and "pull-off, " when muscles add the greatest amount of energy to propel the body forward.
- Describe the interactions that occur among movements at the pelvis, lower extremity, hip, knee, and subtalar joints during the stance phase after loading response.
Biomechanics of lifting
- Given a lifting task, calculate the flexion and extension moments that are produced by gravity and by muscles around a given intervertebral joint.
- Explain how the gravitational moments on the spine during lifting are affected by the size (not the magnitude) of the mass being lifted, and by the posture that one assumes during the lift.
- Differentiate between lordotic and a flat-backed lifting postures in terms of their influence on compression and shear forces on the lumbar spine.
- Given a trunk muscle, state whether it can increase the spine's resistance to flexion moments during lifting. If the muscle can increase the spine's resistance to flexion moments, explain whether it does so by:
UPPER EXTREMITY
- State the axes and the movements that are available at the
- State the axes and the movements that are available at eacha of the shoulder girdle's three synovial joints, the sternoclavicular, acromioclavicular, and glenohumeral joints.
- Locate on yourself and on a partner the palpable structures that your text Smith, Weiss, & Lehmkuhl, 1996, pp. 224-226) lists for the shoulder girdle.
- For each muscle that your text lists (Smith, Weiss, & Lehmkuhl, 1996, pp. 236-252) for the shoulder complex, complete the following objectives.
- state which peripheral nerve innervates the muscle
- state the muscle's proximal and distal attachments
- list the joints that the muscle crosses
- locate the muscle's palpable portions, including its tendon
- palpate or visualize on diagrams and classroom skeletons the muscle's lines of application, concentrating on those portions that are close to the joints that the muscle crosses.
- predict the muscle's actions on the basis of the relationship of its lines of application to the axis or axes of each joint that it crosses.
- State the attachments of the following ligaments:
- interclavicular
- acromioclavicular
- glenohumeral
- coracoclavicular
- costoclavicular
- coracohumeral
- transverse humeral
- State the glenohumeral movements that elongate and tighten the glenohumeral ligament and the coracohumeral ligament.
- Define the various scapulothoracic movements, ways in which the scapula can move on the thorax.
- elevation/depression
- protraction/retraction
- upward/downward rotation
- winging
- tipping
- Define scapulohumeral rhythm, which occurs with shoulder elevation, as in the act of reaching overhead.
- Describe the sequence of movements that occurs in the sternoclavicular and acromioclavicular joints to permit upward scapular rotation during shoulder elevation.
- Draw vector diagrams that depict the synergy of serratus anterior and upper/lower trapezius in producing upward rotation of the scapula around:
- the sternoclavicular (SC) joint's AP axis, which passes through the base of the scapular spine
- the acromioclavicular (AC) joint's AP axis
- Describe the glenohumeral joint's arthrokinematics during open chain abduction.
- Resolve the vectors that represent the following muscles' forces to depict their effects on glenohumeral arthrokinematics, particularly upward or downward glide of the humerus on the glenoid fossa.
- deltoid
- supraspinatus
- infraspinatus
- teres minor
- subscapularis
- Describe how the deltoid and the "rotator cuff" act together to produce glenohumeral abduction.
- Locate on yourself and on a partner the palpable structures that your text lists for the wrist and hand (Smith, Weiss, & Lehmkuhl, 1996, pp.181-184), and for the elbow (Smith, Weiss, & Lehmkuhl, 1996, p.158).
- Locate in an anatomy atlas and on classroom skeletons the nonpalpable structures that your text lists for the elbow (Smith, Weiss, & Lehmkuhl, 1996, pp.158-159).
- For each muscle that your text lists for the wrist and hand (Smith, Weiss, & Lehmkuhl, 1996, pp.191-198) and for the elbow (pp.163-172), complete the following objectives.
- state which peripheral nerve innervates the muscle
- state the muscle's proximal and distal attachments
- list the joints that the muscle crosses
- locate the muscle's palpable portions, including its tendon
- palpate or visualize on diagrams and classroom skeletons the muscle's lines of application, concentrating on those portions that are close to the joints that the muscle crosses.
- predict the muscle's actions on the basis of the relationship of its lines of application to the axis or axes of each joint that it crosses.
- Describe the arthrokinematics and close-packed position of the following joints:
- Identify the structures that comprise the extensor mechanism on each phalanx. Based on their lines of application, predict the actions at the MP, PIP, and DIP joints of muscles that attach to the extensor mechanism.
- Describe the synergies (not just helping and true synergies) that occur between the wrist and hand muscles, and among the hand's extrinsic muscles, to optimize the muscles' length-tension relationships for gross motions like opening and closing of the hand.
- Describe or map the distribution of sensory innervation in the hand.
- Describe the anatomical structures involved in carpal tunnel syndrome.
- Define power grasp and precision grasp, and explain how to distinguish between the two. Given a task, determine the specific type of grasp that is appropriate.
- Identify, locate, and palpate the hand's three arches, and explain how they contribute to prehension.