Division of Rehabilitation Sciences Occupational Therapy 7242 / Physical Therapy 7243 Control of Human Movement II Course objectives

Length-associated (mechanical) properties of muscle

1. Define elasticity and viscosity, and describe the effects of these mechanical properties on muscle force production.

2. Describe and give examples of four ways in which elasticity and viscosity are relevant to clinical or functional activities.

3. Draw and label a typical length-tension curve for an active muscle, and explain the reasons for the curve's characteristic shape.

Exercise to increase flexibility

1. Describe the advantages of increased muscular flexibility

2. Explain how stretching a muscle before vigorous exercise or activity can protect it from being injured or damaged by the development of large viscoelastic forces.

3. Describe circumstances under which flexibility can be excessive and interfere with function.

4. State the range of acceptable values for intensity, duration, and frequency of stretching that therapists use in prescribing stretching exercise.

5. Explain how commonly prescribed stretching exercise achieve their effects by modulating reflexes and producing changes in a tissue's mechanical properties.

6. Describe typical static, ballistic, and PNF techniques for increasing muscle flexibility.

7. Describe the factors that influence how long stretching exercises' effects persist in an individual.

8. Describe how a muscle and its length-tension curve change when the muscle's resting length is permanently altered by immobilization or by a chronic body posture. Explain how these changes result in either "stretch-weakness" or "adaptive shortening."

Tissue forces

1. Given a figure that includes a vector depiction (including a line of application) of a muscle force, and a drawing of a fracture site, illustrate and explain how the muscle force produces shearing and compression (or distraction) of the fracture site.

Exercise to increase endurance

1. Describe the advantages of increased cardiovascular endurance.

2. State the range of acceptable values for the intensity, duration, and frequency of an exercise program that is designed to increase cardiovascular endurance.

3. Explain the advantages of endurance training, and list any special considerations that are appropriate, for people with hypertension or type 2 diabetes mellitus.

4. Given a person's age and resting heart rate, calculate an appropriate training heart rate.

5. Give examples of activities that are effective in increasing endurance.

Exercise to increase strength

1. State the ranges of acceptable values for intensity, duration, and frequency in exercise programs that are designed to increase strength.

2. Define and give examples of "training volume," "overload," and "repetition maximum."

3. Explain the concept of "exercise specificity" in terms of the physiological variables for which exercise produces specific changes.

4. Compare and contrast Type I and Type II muscle fibers.

5. Distinguish between functional and structural changes that occur as a result of strengthening exercise.

6. Given information on a person's impairments (including decreased strength) and functional limitations, generate examples of activities that can increase strength.

Exercise prescription and specificity

1. Relate Davies' Law and Wolf's Law to exercise specificity.

2. Describe the difference in knee muscle activity during open and closed chain knee extension activities.

3. Explain how quadriceps and hamstring muscles can be simultaneously active as a subject arises from sitting. Discuss how therapists exploit this muscle synergy by designing closed-chain activities to rehabilitate people with knee ligament injuries.

4. Relate Winstein's research on weight-shifting tasks to the motor learning concepts of part-task and adaptive training.

5. Describe how the synergy between the rectus abdominus and the abdominal obliques changes depending on whether a trunk flexion task occurs in a closed or open chain.

Motor teaching and motor learning

1. Given a learning curve that displays the results of a motor learning experiment, interpret the curve by comparing two groups' performance in acquisition and retention or transfer.

2. State the three stages of learning, according to Fitts and Posner, and describe characteristics of learners during each stage.

3. Explain how motor learning research guides therapists to organize therapy sessions in terms of providing random or blocked practice.

4. Distinguish between open and closed tasks.

5. Distinguish between discrete, serial, and continuous tasks.

6. Expain how motor learning research guides therapists to manipulate the timing and frequency of the feedback that they provide to clients.

Gait kinematics

1. Distinguish between kinematic and kinetic measures of walking, and list the types of data obtained from the two approaches to gait analysis.

2. Name the phases of the gait cycle, and the beginning and ending point of each phase.

3. Describe the vertical and lateral displacements of the body's center of gravity during ambulation. Explain how pelvic and lower extremity joint motions conserve energy by minimizing these displacements.

4. Explain how pelvic and lower extremity joint motions prevent joint injuries that might otherwise result from the repetitive stresses that occur during gait.

5. Use an observational checklist to describe the gait patterns of videotaped subjects.

6. Explain how therapists can maximize the reliability of observational gait analysis.

7. List and define the distance and time measurements involved in stride analysis, and calculate them in a patient using simple stride analysis techniques.

8. List the maximum values for normal pelvic, hip, knee, and ankle motion and the corresponding gait events at which they occur.

Gait kinetics

1. Explain ground reaction forces and their effect on joint motion during each phase of the gait cycle.

2. Describe normal activity in the major trunk and lower extremity muscle groups during each phase of the gait cycle and explain how it contributes to stability, efficiency, or propulsion.

3. Identify and state possible reasons for these common gait deviations:
   • foot slap
   • foot flat contact
   • excessive toe-out during stance
   • knee hyperextension in stance
   • inadequate knee flexion in swing
   • forward trunk lean
   • backward trunk lean
   • lateral trunk lean
   • asymmetrical step length (decreased stance phase)

4. Predict the gait deviations that may result from decreased strength in the:
   • ankle plantar flexors
   • ankle dorsiflexors (pretibial muscles)
   • knee extensors (quadriceps)
   • knee flexors (hamstrings)
   • hip extensors (esp. gluteus maximus)
   • hip flexors (esp. iliopsoas)
   • hip abductors (esp. gluteus medius and minimus)

5. Predict the gait deviations that may result from decreased active or passive range of motion in the pelvis or any lower extremity joint.

Principles of lower extremity orthoses

Describe the orientation of the subtalar joint axis and the joint's triplane motion in either open or closed chain activities.

Describe and perform two static methods of estimating the subtalar joint's neutral position with the person positioned in prone.

Describe the structural foot deformities called rearfoot varus, forefoot varus, and forefoot valgus. Describe the compensations that people make when they display the deformity, the consequences for the compensations, and the type of orthotic insert that is intended to eliminate the compensations.

Describe how ankle equinus (either a structural or soft-tissue limitation in passive ankle dorsiflexion) leads to compensatory pronation during stance. Describe the consequences of the compensatory pronation, and suggest treatment approaches to eliminate the need for the compensation.

Explain the biomechanical reasons why an ankle-foot orthosis (AFO) can substitute for weak plantar flexors when a person walks. Explain why an AFO may be ineffective in substituting for weak plantar flexors if its ankle is hinged or articulated.

Explain how alterations in an AFO's design can influence the knee joint's motion when a person walks.

Changes in the gait pattern across the lifespan

1. Desribe the changes that normally occur in the gait pattern over a person's lifespan.

Energy and power during the gait cycle

1. List the major points in the gait cycle at which energy is generated or absorbed by the lower extremity muscles, as illustrated by energy and power analysis.

2. Given a power curve for the hip, knee, or ankle, distinguish between periods of eccentric and concentric muscle activity during the gait cycle, and infer which muscles might be active during each period.

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Last updated 11-26-01 ©Dave Thompson PT
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