users.rowan.eduusers.rowan.edu/~kenned62/gait analysis.docx · web viewmovement analysis...
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Movement Analysis ProjectRyan KennedyKinesiology, 8-915Spring 2014
Demographics
Name: Ryan Kennedy
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Gender: Male
Age: 22
Height: 5’7
Weight: 162lbs
BMI: 25.4
Medical History
List Previous Medical Conditions:
-_Heart Murmur__________________________________________________
-_Kidney surgery_________________________________________________
-_L-knee Meniscal surgery_________________________________________
-_Severe R-Knee trauma__________________________________________
-_____________________________________________________________
Noteworthy Family Medical Conditions:
-_None_________________________________________________________
-______________________________________________________________
-______________________________________________________________
-______________________________________________________________
-______________________________________________________________
Briefly describe all physical activities in which you are involved regularly
-Ice hockey; skates at least twice a week______________________________
-Weight lifting; 2-3 times per week___________________________________
-______________________________________________________________Movement Goals
Please list all personal movement goals in as much detail as possible
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Improving overall flexibility, with a particular focus on the lumbar extensors
Improving and maintaining overall posture, standing and sitting, due to leg length discrepancy
Correcting muscular imbalance in right shoulder and scapula
Injury preventative exercise on hips, knees, and feet
Improving on ice skating stride
Summary
Ryan is a healthy, twenty two year old male who could use some lower extremity work in terms of flexibility, strength, and conditioning (including preventing future injuries). He may also benefit from some corrective upper-body exercise, more specifically exercises involving the right shoulder girdle and scapula. Ryan is a physically fit individual, with strength distributed well between his upper body, core, and lower body. His overall flexibility is already above average, but could still use work because of the type of activities in which he partakes. He has previous injuries that he has seemingly recovered well from. However, these areas should still be of primary focus in regards to injury preventative exercise.
Range of Motion Assesment
Degree Range of Motion Chart
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Cervical Spine: Neutral Position, Frontal View
Cervical Spine: Neutral Position, Sagittal View
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Cervical Spine: Flexion
Cervical Spine: Extension
Cervical Spine: Rotation
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Glenohumeral Joint: Neutral Position for Abduction/Adduction
Glenohumeral Joint: Neutral Position for Flexion and Extension
Glenohumeral Joint: Abduction
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Glenohumeral Joint: Extension
Glenohumeral Joint: Neutral Position for Internal and External Rotation
Glenohumeral Joint: Internal Rotation
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Glenohumeral Joint: External Rotation
Humeroulnar Joint: Flexion
Humeroulnar Joint: Extension
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Radioulnar Joint: Mid-Supination Neutral Position
Radioulnar Joint: Supination
Radioulnar Joint: Pronation
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Radiocaroal Joint: Neutral Position for Flexion and Extension
Radiocaroal Joint: Neutral Position for Ulnar and Radial Deviation
Radiocaroal Joint: Flexion
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Radiocaroal Joint: Extension
Radiocaroal Joint: Radial Deviation
Radiocaroal Joint: Ulnar Deviation
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Acetabulofemoral Joint: Abduction
Acetabulofemoral Joint: Flexion
Acetabulofemoral Joint: Internal Rotation
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Acetabulofemoral Joint: External Rotation
Tibiofemoral Joint: Extension
Tibiofemoral Joint: Flexion
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Summary of Findings The above photographs represent client Ryan Kennedy performing a full body ROM assessment. When comparing these findings to the client’s movement goals, it is evident that he does indeed have an imbalance in his right shoulder girdle. This may be slightly hindering his posture and can be seen on most of the images; on internal rotation of the glenohumeral joint in particular. Working through all the movements of the Glenohumeral joint will accomplish two of the clients goals: improving flexibility and posture, which will also subsequently prevent further injury. Additionally, working through the entire ROM of the Acetabulofemoral joint will likely address the client’s goal of improving his on ice skating stride.
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Postural Analysis
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Anterior
Lateral
Posterior
Summary of Findings An assessment of the client’s leg length was not done because of an already diagnosed discrepancy. Both of his left sided appendages are roughly 1-3 cm longer than those on his right. Seen more on the Anterior view but also in the Posterior view, the client’s feet are slightly turned out and, very minimally, everted. Despite having a documented, right sided appendage length discrepancy, any postural misalignment is difficult to notice without a quantitative analysis. With the very slight exception of the shoulders in the Anterior view, the client appears to have respectable posture despite his documented appendage discrepancy. This can also be seen on the Posterior view by focusing specifically on the hands, and how they fall in the anatomical position. The client also has documented, right sided Winged Scapula, as well as right shoulder impingement. This is difficult to see with the naked eye even when shirtless on this particular subject. These findings are consistent with the client’s goals for corrective exercise for maintaining posture despite a leg-length discrepancy, in addition to improving all around flexibility and strength.
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Over-head Squat Assessment
Anterior
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Lateral
Posterior
Summary of Findings Due to a documented leg-length discrepancy, there is minimal asymmetrical shift in the client’s hips. Although difficult to see in any of three views provided, it is very easily noticeable via quantitative analysis. The discrepancy causing the shift, however, is noticeable in all three views. It is best seen by focusing on the arm length in both the Anterior and Posterior views. The actual shift itself, although more difficult to pin-point, can be seen in the lower extremities by focusing on how the client’s shorts ride up the thighs as he depresses. As the client depresses his thorax into the deepest part of the squat, his feet begin to slightly evert or point outward. The client’s documented, right sided Winged Scapula is difficult to identify during this analysis, but is somewhat identifiable when performing a squat shirtless. These findings are consistent with the client’s goals for corrective exercise for maintaining posture despite a leg-length discrepancy, in addition to improving all around flexibility and strength.
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Gait Analysis
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Saggital View
Heel Strike
Foot Flat
Mid Stance
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Heel Off
Toe Off
Initial Swing
Mid Swing
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Terminal Swing
Posterior View
Heel Strike
Foot Flat
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Mid Stance
Heel Off
Toe Off
Summary of Findings
The above images show that the client has an average gait. Despite a documented leg length discrepancy, there appear to no identifiable irregularities in his gait through a qualitative, still image analysis alone. This seems consistent with the client’s current health; despite a documented leg length discrepancy, he reports no significant abnormalities throughout his lower extremities. The client’s primary issue requiring correction is the dysfunction in his right-shoulder girdle. Saggital images show normal flexion and extension of the hip and knee and dorsi and plantar flexion of the ankle through one full step or half stride. Posterior images reveal slight pronation from heel strike to mid stance. This is consistent with normal functioning of the lower extremities via the knee’s screw home mechanism. A real time recording of the client’s gait may reveal differing angles of movement on each extremity, as well as further asymmetrical shift clarification at the hip due to leg length discrepancy.
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Corrective Exercise Program
Below is a corrective exercise program for Ryan Kennedy, a Rowan University ice hockey player. This program is tailored towards correcting muscular imbalances of the right shoulder complex as well as improving strength, flexibility, and injury prevention of the core and lower extremities.
Warm Up
Posterior Deltoid Stretch
Apley Scratch Test
Pectoralis Minor Stretch
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Single Knee to Chest
Straight Leg Raise
The posterior deltoid stretch stretches the rhomboids, posterior capsule, and posterior deltoid. The Apley scratch test helps to stretch the internal rotators, capsule of involved arm, external rotators, and the posterior capsule of the arm behind the back. The primary function of the posterior deltoid stretch is the stretch the posterior capsule, while the Apley stretch helps increase both internal and external rotation of the shoulder. The Pectoralis Minor stretch assists the muscle from which it is named, and is beneficial for individuals with a protracted shoulder girdle. The single knee to chest stretches the gluteus maximus, hip adductors, and superficial erector spinae. The straight leg raise serves to stretch the hamstrings at both the hip and knee joints, and is excellent as identifying any passive insufficiency.
Exercises
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Ball Rolls Against Wall
Wall Slides
Internal Rotation
Single Leg Dead Lifts
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Partner Assisted Reverse Leg Curls
Ball Rolls help to stabilize the scapula, in particular the serratus anterior. It is an ideal exercise for stabilizing the muscles of the shoulder girdle. Wall slides help train the rhomboids, middle trapezius, posterior deltoid, and the external rotator cuff. It helps to strengthen the shoulder girdle retractors and the shoulder joint external rotators in one synchronized motion. This is especially beneficial for those with a protracted shoulder girdle. The Internal Rotation exercise targets the subscapularis. Strengthening the subscapularis this area helps depress the head of the humerus in abduction. This may prove beneficial for shoulder impingement. The partner assisted leg curl is an essential exercise for strengthening the hamstrings. It helps to protect the various ligaments of the knee, making it ideal for injury prevention. It also eccentrically trains the hamstrings, reducing the risk of injury to this area. The single leg dead-lifts train the hamstrings, gluteus maximus, gluteus medius, knee proprioceptors, quadriceps, and core. This helps to train the proprioceptors to maintain proper positioning of the knee, protects the ACL by strengthening the hamstrings, and also strengthens the core. It also stabilizes the pelvis, and trains the gluteus medius to resist valgus motions at the knee.