number of steps per unit of time                                       

 (e.g. 60steps/1min.)

distance walked per unit of time        

  (e.g. 25ft./1min.)

linear distance between one foot and the opposite foot;

rehab hospital in California that has does research on GAIT along with other things

Impact of the limb contacting the ground and sccpting weight is absorbed by muscular action.

• Knee flexion
• Subtalar jt pronation

Determined by the alignment of the body weight vector and mus activity.

• the body in neutral alignment
• the ground reaction force and ligamentous structure of the jts provide passive stability

• Force posterior to knee causes?
• Quads must control this motion

• Force is anterior to the knee causing?
• Joint structure is controlling the motion

• limb must work to move the body forward through space
• forward progression
• primary force is forward fall=mobility with restraint
• =rockers or 3 pivots at the ankly and foot

• Calcaneous is the fulcrum
• the foot and tibia move forward toward the ground

• the arc of the ankle allows the tibia to advance over the stationary foot

• The body moving forward through space is the momentum generated by the forward swing of the limb contralateral to the weight bearing limb

• minimization of displacement of the COM from the normal smooth sinusoidal pathway
• passive posturing and momentum

The pelvis drops in the coronal plane          on the swing side

purpose is to lower the base of the head, trunk and pelvic unit

• Hip 20 degree flexion
• Knee 5 degrees flexion
• Ankle at 0 degrees

Hip 20 degrees flexion- extensors restrian flexion, abductors preventing pelvic drop

Knee 15 degrees flexion - quads restrain knee flexion

Ankle 5 degrees plantar flexion- pretibials to restrain plantar flexion

Diffuse connective tis. dz

systemic inflammatory process

multiple jts and organ systems

exacerbations and remission periods

Loss of structural integrity= jt deformity, secondary to weakened tendons, lig, and jt capsules

• non systemic- localized to affected jt
• usually non inflammatory
• destruction of articular cartilage and bone formation at the jt margins
• Deformities result from altered transmission of forces through the jt and secondary abnormal alignment stresses

1.Avoid deforming postures

• When lying in supine, use a firm mattress and lie flat on your back with hips and knees straight

 –Do not put weight on fists or hands to push up

 Internal forces: forces derived from muscle contraction that causes a pull

forces derived from an object that acts on the body

using a hammer

Alternate method: to use a hammer, grasp the handle close to the head of the hammer so that the handle is perpendicular to the MCP joints;  stabilize wrist and hammer by flexing and extending the elbow

 In acute stage, joint motion is kept to a minimum with frequent rest periods but MOTION MUST BE MAINTAINED

**Active or active-assisted motion is best because the patient can assess his/her own pain & range better than someone who is passively moving a joint

• perform at functional joint angles
• avoid maximal effort:  £ 70% one MVC (maximum voluntary contraction)
• only a 6 second hold
• exhale during muscle contraction
• do not contract more than two muscle groups at a time

Avoid activities that produce excessive pain and fatigue. 

Short bouts throughout the day of greater value than one long bout per day

Exercise to the point of pain; cease activity when or if pain occurs

If pain persists, decrease the amount of time and/or the intensity of the activity

 Moist superficial heat: hot packs, aquatics, paraffin

Deep heat with OA but not RA, especially in acute stages of RA

Deep heat increases plastic stretch of ligaments which are already weakened with RA and may cause degradation of collagen

Cold except with someone with Raynaud’s phenomenon or cryoglobulinemia