GONIOMETER
The term of goniometr is derived from two Greek words,gonio meaning angle and metron, meaning measure.A goniometer is an instrument used to measure angle.With in the field of phisical therapy,goniometry is used to measure the total amount of avalible motion at a specific joint.
Goniometry can be used to measure both active and passive range of motion.goniometer are produce in a variety of size and shap and are usually constructed of either plastic or metal.
Goniometer a protractor like device commonly with a 180 degree range used to measure a joint’s position and accurately described abnormal fixed joint position.
TYPE OF GONIOMETER
Universal goniometer
Gravity depend goniometer or fliud goniometer
Pendulum goniometer
Electrogoniometer
UNIVERSAL GONIOMETER
It is designed by Mr. Moorethis very commonest variety.it is having stationary arm,movable and body.
GRAVITY DEPEND GNIOMETER OR FLIUD GONIOMETER
It is also called as pelvic inclinometer .it is designed by sehenkar in 1956.
.It is heaving gravity effecting pointer and the fluid filled chamber with the air bubbles .it is mostly used for the measuring the pelvic tilt or drop.
PENDULAR GONIOMETER
It is designed by Fax and Van breemen in 1934.it consist of 350 degree protractor with the wighed pointe
ELECTROGONIOMETER It is designed by karpovich in 1959.it has two arms.1 is attached with the proximal segment and another is attached with the distal segment of the measuring joint.[it is mostly used for the research purpose.
IMPORTANT OF COMPONENTS OF GONIOMETER
Ostiokinematics and Arthrokinematics of joint.
Axis and Plane of movement.
Types of ROM.
ROM of individual joint
End feel
Capsular and nun Capsular
ARTHROKINEMETICS
Movment of joint surface
OSTEOKINAMETICS
Movement of shafts of the bone
PLANE,AXIS AND MOVEMENT
The Sciences Of Human Movements,Go Kinesiology!
Sunday 9 April 2017
Sunday 26 March 2017
Starting and Derived Position
STARTING AND DERIVED POSITION
Starting position:
Sherrington stated that:
“Posture follows movement
like a shadow”.
Means every movement begins in posture end in posture.
The position which adopted, by the patients or individual to perform
exercise or movement to gain relaxation and stabilize their body. OR The
posture from which movement is initiated i.e. called starting position.
They may be either active or passive in character. Starting position is
applicable for day to day activities.
FOR EXAMPLE: Drinking bed tea. The person has to come out of the lying posture and attain sitting posture to drink the tea.
So every activity which we do our daily
life activity starts in one posture end in other posture.
TO MAINTAIN
STARTING POSITION
v To balance of force acting up on the
body.
v
Balance
muscular isometric contraction it means there is no change in length of
the muscle but change in muscle tension, starting position to maintain increase
in muscle tone.v Postural reflexes control the strength and distribution of muscle contraction.
TYPES OF STARTING POSITION
There are two types of starting
position.
1.
Derived
position
2.
Fundamental
position
1. DERIVED POSITION
Derived
position is derived from starting position. This position is used by
modification of arms, legs or trunk in each of fundamental position.
OBJECTIVES
1. To increase or decrease the muscle work
required to maintain their position by use of derived position.
2. To increase or decrease base of support
(BOS). If increase base of support it means increase area supported beneath the
object. Whenever BOS is more the stability will be more.
EXAMPLE: In standing the BOS is lesser because of
less area supported beneath the object.
In lying the BOS is greater because of
greater area supported beneath the object.
3. To gain local or general relaxation.
4. To increase or decrease of centre of
gravity (COG). If COG is more the stability will be more.
EXAMPLE: In standing
position COG is more because force of gravity is directly acted on centre of
body.
2. FUNDAMENTAL POSITION
Fundamental position is derived from
starting position.
There are five basic fundamental positions.
1.
Standing
2.
Sitting
3.
Lying
4.
Kneeling
OBJECTIVES
1. Maintain or improve posture.
2. Modify the effect of an exercise to improve
range of motion or strength.
3. Maintain or improve posture.
4. Utilize support essential for
relaxation.
1. STANDING POSITION
The whole body is supported by lower base
of support. So this position is most difficult to adopt for longer period. So
that a lot of co ordinate muscle activity to maintain posture in standing. The
position is not steady partly, because of base of support is small and centre
of gravity is high lie at the centre of body (COG). (COG lie between third and
fourth sacral vertebra).
POSITION:
·
Foot
is place together and toes place slightly apart.
·
Knee
is extended and straight.
·
Hip
is in neutral position and spine is erect.
DERIVED POSITION FROM STANDING
Many
of derived position can be derived from standing by alternating arm, trunk and
lower limb. This position can be performed different types of exercise to gain
relaxation and stability.
BY ALTERNATING LOWER LIMB
Many
of derived position can be derived from standing that are:
a.
High
standing
b.
Walk
standing
c.
Stride
position
d.
Step
position
a. HIGH STANDING
·
High standing is occurring
on the stool or any raised platform.
Movement as mentioned in standing. To perform upper and lower limb
exercise it is difficult posture to adopt longer period of time.
·
T
perform hanging, swinging the arm and the leg exercise.
EXAMPLE:
·
To
take some object from the high.
b.WALK STANDING
One leg is standing forward and other is
at their neutral position. One leg is forward means base is increase so
stability will be more in this position.
MOVEMENT:
·
Hip
flexion, knee extension and knee plantar flexion occur in this position.
·
Starting
position for jogging.
·
To
perform hip, knee, ankle and trunk muscles self stretching.
EXAMPLE:
·
Balancing
on rope or rod.
·
Walk
on the road.
c. STRIDE STANDING
Both foot kept apart in sideways. In
this position centre of gravity is high at centre of body that is why it stable
position for longer period of time. It gives lateral stability.
MOVEMENT:
·
In
this position Hip abduction and knee extension occur.
·
To
perform the trunk, hip knee exercises.
·
Help
to stretch the hip adductor.
EXAMPLE:
·
Sailors
standing position.
d. STEP STANDING
·
One
foot is kept on the stool or in height. Hip and knee is flexed.
·
This
is one of most stable position.
MOVEMENT:
· In this position hip flexion and knee
flexion.
· This position is useful for stretching
the knee, ankle, hip and trunk muscles.
EXAMPLE:
· Position adopted to tie the shoelace.
2. SITTING POSITION
The
position adopted while sitting on stool or the chair. Sitting is fundamental
position. The thighs and the legs are relaxed and foot is resting on the floor.
From the trunk to head the position is same as standing posture. The base of
support is more and centre of gravity lies down. Centre of gravity lies at
downward the position gets more stability than standing and the muscle work
required is also less.
·
Cross
sitting
·
Side
sitting
·
Crook
sitting
·
Long
sitting
·
Stride
sitting
·
Foot
sitting
3. LYING POSITION
Lying on the floor or on the bed in
supine position with arm by side of the body and legs are kept straight. It is
most stable position than other fundamental position due to lower placement of
the centre of gravity (COG). This posture can be adopted for longer period than
other starting position. In this posture the muscle work is minimal. But some
muscles are not relaxed that is:
·
Neck
side flexors counter balanced to keep the head in neutral position.
·
Flexors
of lumbar spine counteract with the spinal extensor to maintain the lumbar lordosis.
·
Medial
rotators of the hip keep the hip in neutral position.
DERIVED POSITION OF LYING
·
Prone
lying
·
Half
lying
·
Crook
lying
·
Side
lying
4. KNEELING POSITION
Kneeling
position is fundamental position of standing but weight is transmitted through
the knee joint due to right angle alignment of knee to the body. The leg is
resting on the floor and ankle is plantar flexed. The position is very
difficult position to maintain for longer period because centre of gravity fall
down and larger base of support. It is inconvenient to adopt due to the weight
transmitted through the knee joint.
· The
leg is relaxed except plantar flexors of the ankle, which keep the ankle in
plantar flexion state.
DERIVED POSITION OF KNEELING
·
Half
kneeling
·
Kneel
sitting
·
Prone
kneeling
·
Inclined
prone kneeling
5. HANGING POSITION
Hanging
position is fundamental position of standing. Total body is suspended by
grasping a horizontal bar with the hand.
MOVEMENT:
MOVEMENT:
· Shoulder
flexed, adducted and medially rotated.
· Elbow
is extended, fingers is flexed and grasping the rod.
· Adductor
and medial rotators of the shoulder work strongly.
· Flexors
of elbow carry more weight and also strain. Finger flexors work strongly and
grasping the bar.
· Plantar
flexors keep the ankle in plantar flexed position.
Saturday 25 March 2017
FRENKEL EXERCISE
Frenkel stated in his text book that while treating the patients by performing exercises, the sense of visualizing plays a great role, describing that it is necessary for the patients to watch their movements. He also suggested that by putting a timer while performing exercises for three minutes also helps in making the treatment less hectic for the patient. After three minutes, patients should take a gap for 15 minutes and do some other activities such as talking to someone or reading a book, as this gap provokes the development of new neural connections. These sets of exercises are suggested to be carried out every day for at least six months. A patient may perform the exercises but it is recommended that a physiotherapist must be present with the patient for the proper guidance so that the patient can watch his/her own movements and motivates the patient by talking and encouraging him/her. Apathy or the lack of motivation and clinical stress during treatment has been observed in cerebellar ataxic patients.
Frenkel exercises were formerly proposed in 1885 for the treatment of such patients facing difficulties of sensory ataxia leading to loss of proprioception. These exercises may be carried out in sitting, standing or walking position.
The fundamentals of Frenkel exercises
The fundamentals of Frenkel exercises are as follows:
Concentration or attentionIt is a set of exercises to promote patients to enhance their ability to tell the position of their arms and legs without looking.
General instructions for Frenkel exercises
1.Exercises are not developed for the strengthening, but only for coordination
2. Instructions given by the physiotherapist should be in slow voice, in a gradual manner and to the counting.
3.The area should be lit enough that the patient can watch the movements in their legs.
4. There should be some gap between each exercise and every exercise should be performed only four times.
5. Over stretching should be avoided.
6. The simple exercises should be performed first, followed by gradual transition into more difficult exercises
7. The exercises should be in smooth timing manner carried out at a slow pace by counting out a bit louder.
8. The uniformity of exercises should be maintained and a specific range can be focused.
9. Lying, sitting, standing and walking are the four basic positions to carry out exercises.
10. The part may be supported or unsupported, unilaterally or bilaterally.
11. The exercises are performed with eyes closed once the patient has voluntary control improvement.
Exercises for lower limb
Exercises for the legs in lying position
1. Stretch the leg by the heel and place it on the table.2. Abduct and adduct the hip smoothly with the knee bent placing the heel on the table.
3. Now abduct and adduct the leg with knee and hip protracted by placing the leg on table.
4. Stretch and extend the hip and knee with heel
5. Stretch and extend both legs together with the heel on table.
6. Stretch one leg and extend the other one.
7. Now stretch and extend one leg while abduct and adduct the other one.
8. Heel one limb to the other leg (toe, ankle, shine)
9. Heel one limb to other knee by sliding down the crest of tibia to ankle.
Exercises for the legs in sitting position
1. Lift one leg to place the heel on the marked area, while the other one is stretched to slide the heel on the mark on floor.2. Patient is asked to stand and sit again from a sitting posture.
3. Abduct and adduct the hip in sitting position.
Exercises for the legs in standing position
1. The weight of patient is transferred from one foot to another.2. Foot is moved forward and backward on a straight line.
3. The patient is asked to walk along a winding strip.
4. Walk between two lines.
5. Walk sideways by placing the feet on a mark.
6. Walk forward and come to the mark back again.
7. Walk and switch the directions.
Exercises for upper limb
The exercises performed for lower limb may be practiced for the upper limb in a way that the patient places his/her hands on the mark on the table or the board to improve coordination and movements in upper limb.
Wednesday 22 March 2017
HUMAN POSTURE
Human Posture
In this article we defined about human
posture. In our research we found that
What is posture?
Posture is a term used to describe a position
of the body or the arrangements of body parts relative to one another .
POSTURE has
been described by the American Academy of Orthopaedic Surgeons (1947).
\
Ideal postures are those assumed to perform an
activity in the most efficient manner utilizing the least amount of energy.
All activity begins with posture and ends with
a posture. The relationships between body parts can be controlled voluntarily
but to do this would require too much concentration.During normal functioning
one's postures and adjustments to postures are automatic and occur quickly you
are probably thinking that standing up straight is not easy.
Most people would intuitively consider
postural muscles as those that hold a body upright, standing, against gravity.
For perfectly erect standing, however, very little muscle activity is needed.
Joints are balanced on one another in such a way as to minimize the work
necessary to hold one upright against gravity. Posture in these terms is
thought of as static. How often do we just stand there?
People need to move to function and to work,
so I will talk of posture on this page as the positions we assume during the
day in preparation for other positions we assume. We are always preparing to
move whether beta pick up a mouse or walk to the store. In this way we can
think of posture as dynamic always changing. In order to function
optimally, muscles must work at their optimum length and be long enough to
allow for coordinated movement.
Obviously a muscle that is tight will not
allow a joint to move through its full range of motion. To avoid joint injury,
joints must work within a range that they can maintain stability.
As we move from one posture to another
we must learn to do it efficiently, within this stable range or risk injury. A
physical therapist will assess dynamic posture by examining each posture
assumed individually and observing how an individual transitions between each
posture. Why is examining dynamic posture important?
It is usually during these transitions
from one posture to another that injury occurs. Probably one of the most
important times for one to maintain good posture is during lifting. The chest
is up, feet shoulder width apart, head centered over the shoulders, the item to
be lifted close to one's base of support, and hips an angle so that one feels
like one is pushing through the floor. Deviation from takes one's joints and
muscles outside of their optimal range of performance and increase risk of
injury.
Posture requires coordination
The
movement between one static posture and another requires the coordinated timing
and recruitment of muscles specific
to the task at hand.
It is a programmed pattern of muscle activity
that the body counts on to maintain stability.
Some of these programmed patterns of movement
are hard wired in the central nervous system, others are learned.
For instance, when we open a heavy door there
is a coordinated sequence of muscle contractions in your abdominal, back and
lower extremity muscles that occurs even before you start pulling on the door
with your hand.
CNS needs to control multiple muscles
simultaneously based on corresponding Multi sensory inputs.
The
movements controlled by normal reflex mechanisms are very small alterations in
the position of the skeleton, shoulders, and pelvis.
Includes:-
1)
Vision input
☆ It can be
easily modified by opening & closing the eyes, results in changes in
posture stability.
2)
Vestibular input
☆ vestibular information transmitted to brain
provides the head orientation relative to gravity.
3)
Proprioceptive input
☆it gives
us information on the static & dynamic components of joint position
/orientation for posture control.
4)
Tactile somatosensory input
☆ tactile
cues are conveyed to the information from the soles of feet.
Information
is based on pressure on the sole,& center of pressure is very important cue
for the maintenance of stable stance.
☆Because of this we cannot look at
the muscles' functioning without looking at the sensory input.
Poor movement patterns can result from any of the following:
Causes Of Poor Posture
Joint dysfunction
Pain
Stress
Central nervous system disorder/injury
Overwork or over training
Prolonged postures or repetition of the same
activity
The movements
controlled by normal reflex mechanisms are very small alterations in the
position of the skeleton, shoulders, and pelvis.
These normal
reflex mechanisms are learned as an infant and become automatic reactions to
changes in posture.
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