Kinesiology and Occupational Therapy Overview

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Questions and Answers

Which of the following are domains of the OTPF-5?

Performance Patterns (correct)

Client Factors (correct)

Performance Skills (correct)

Intervention

Evaluation

Context and Environment (correct)

Areas of Occupations (correct)

What are the three steps in the OT process?

Evaluation (correct)

Intervention Plan

Intervention (correct)

Targeting of Outcomes (correct)

Occupational Profile

Occupational Analysis

What are the three steps in the OT evaluation?

Assessment

Occupational Analysis (correct)

Intervention Plan (correct)

Occupational Profile (correct)

Intervention

Which two therapeutic kinesiology approaches are discussed?

Rehabilitative Signup and view all the answers

What is the primary focus of the biomechanical approach to kinesiology treatment?

Range of motion, strength, and endurance required to perform an occupation. Signup and view all the answers

What is the primary focus of the rehabilitative approach to kinesiology treatment?

Adapting or modifying activities so they can still be done regardless of physical limitation. Signup and view all the answers

What is kinesiology?

The scientific study of human movement. Signup and view all the answers

What is biomechanics?

Applying mechanics to the living body: static and dynamic movement and forces. Signup and view all the answers

What is kinetics?

The study of forces associated with the motion of a body. Signup and view all the answers

What are frames of reference?

Processes for change from dysfunction to function. Signup and view all the answers

What are the four components of a frame of reference?

<ol> <li>Where the theory derives from, 2. Describe dysfunction, 3. Assessment of dysfunction, 4. How to treat it.</li> </ol> Signup and view all the answers

What are the four components of the biomechanical frame of reference?

<ol> <li>Theory based in kinematics and kinetics, 2. Deficits in nerves, musculoskeletal, integumentary and/or cardiopulmonary systems, 3. Assessment measures muscle strength, ROM, and endurance, 4. Treatment includes purposeful activity and exercise.</li> </ol> Signup and view all the answers

What is the focus of the rehabilitation frame of reference?

Client's ability to return to full functioning. Emphasis on current abilities + technology or equipment. Signup and view all the answers

How does understanding kinematics and movement help OTs?

They will be able to document progress, see movement substitution. Signup and view all the answers

What is displacement?

Movement can be: straight, change direction, or curvilinear. Signup and view all the answers

What are degrees of freedom in terms of joint movement?

Which planes can a joint move in? Signup and view all the answers

How many degrees of freedom does the elbow have?

1 Signup and view all the answers

How many degrees of freedom does the shoulder have?

3 Signup and view all the answers

In which plane does abduction and adduction occur?

Coronal plane Signup and view all the answers

In which plane does rotation occur?

Horizontal plane Signup and view all the answers

In which plane does flexion and extension occur?

Sagittal plane Signup and view all the answers

What is rotary motion?

Movement of the bones around a fixed axis. Signup and view all the answers

What is curvilinear motion?

Combines linear and rotary. Signup and view all the answers

Is a person walking linear motion?

False Signup and view all the answers

What is angular movement?

Translation, the result of several rotations linked together. Signup and view all the answers

What is compression force?

Bringing together. Signup and view all the answers

What is tension force?

Pulling apart. Signup and view all the answers

What is shear force?

Opposing forces that result in a sliding motion. Signup and view all the answers

What are uniaxial joints?

Hinge or pivot joints with one degree of freedom. Signup and view all the answers

Saddle joints (like the thumb CMC joint) can allow for greater or less adduction and abduction compared to condyloid joints (like the MCP joint)?

Greater Signup and view all the answers

What is an open kinematic chain?

Combination of several joints uniting successive segments. Signup and view all the answers

What is joint play?

Joint motion of sliding, rolling or spinning which can contribute to overall joint movement. Signup and view all the answers

What characterizes an ovoid joint surface?

One surface is convex and one surface is concave. Signup and view all the answers

If a convex bone moves on the surface of a concave bone, in which direction does the surface of the convex bone move?

Opposite direction of the bone segment. Signup and view all the answers

If a concave bone moves on the surface of a convex bone, in which direction does the surface of the concave bone move?

Same direction as the bone segment. Signup and view all the answers

What is the closed-packed position of a joint?

Point at which joint pairs match each other perfectly. Signup and view all the answers

The loose packed position of a joint has more congruency than the closed packed position.

False Signup and view all the answers

Give an example of a rolling or rocking motion.

Shoulder abduction. Signup and view all the answers

Give an example of a sliding or gliding motion.

Carpals. Signup and view all the answers

Give an example of a spinning motion.

Rotating in place. Signup and view all the answers

What characteristics does a synovial joint possess?

All of the above Signup and view all the answers

What are the types of synovial joints?

All of the above Signup and view all the answers

What is a plane joint?

Allows only a limited amount of sliding. Signup and view all the answers

What is a ball and socket joint?

Convex/concave principle. Signup and view all the answers

What is a condylar joint?

Shallow ball-and-socket joint with limited mobility. Signup and view all the answers

What is an ellipsoid joint?

Flatter convex portion. Signup and view all the answers

What is passive range of motion (PROM)?

Therapist moves joint. Signup and view all the answers

What is active assistive range of motion (AAROM)?

Patient starts to move and therapist assists. Signup and view all the answers

What does it suggest if PROM > AROM?

Muscle weakness. Signup and view all the answers

What is the difference between kinetics and kinematics?

Kinetics studies forces that affect motion, while kinematics studies characteristics of motion. Signup and view all the answers

What are the four sources of force?

<ol> <li>Gravity, 2. Muscles, 3. Externally applied resistance, 4. Friction.</li> </ol> Signup and view all the answers

State Newton's first law of motion.

An object at rest remains at rest and an object in motion remains in motion unless and until a force acts upon it. Signup and view all the answers

State Newton's second law of motion.

The greater the force, the greater the acceleration. Signup and view all the answers

What is a lever in biomechanics?

A rigid bar that is free to move around a fixed point. Signup and view all the answers

What is mechanical advantage?

The ratio of the output force to the input force. Signup and view all the answers

What are the axis, force, and resistance in a lever system within the body?

Axis: Joint, Force: Muscle, Resistance: Weight of body part or applied resistance. Signup and view all the answers

What is a first-class lever?

Axis in the middle of force and resistance. Signup and view all the answers

Explain how scissors function as a first-class lever.

The axis is the pivot point where the blades of the scissors meet, the force is applied by the user's fingers, and the resistance is the object being cut. Signup and view all the answers

What is a second-class lever?

Axis at the end, resistance in the middle. Signup and view all the answers

What is torque?

A twisting force. Signup and view all the answers

In order to manual muscle test the deltoid of a strong person, where should the resistance be placed: closer to the deltoid or closer to the elbow?

Closer to the elbow Signup and view all the answers

What axis corresponds to the coronal plane, and what movements occur in that plane?

Sagittal axis; abduction and adduction. Signup and view all the answers

What axis corresponds to the sagittal plane, and what movements occur in that plane?

Coronal axis; flexion and extension. Signup and view all the answers

How do you screen for AROM limitations?

Ask the client to perform all active movements at the joint. Signup and view all the answers

Study Notes

OTPF-5 Domains

Areas of Occupations
Client Factors
Performance Skills
Performance Patterns
Context and Environment

OT Process Steps

Evaluation
Intervention
Targeting of outcomes

Evaluation OT Steps

Occupational Profile
Occupational Analysis
Create Intervention Plan

Kinesiology Tx Approaches

Biomechanical & Rehabilitative

Biomechanical Approach

Focuses on range of motion, strength, and endurance required for occupations

Rehabilitative/Compensation Model

Adapts or modifies activities to accommodate physical limitations.
Changes context/environment, not the client.
Often the first intervention in occupational therapy.

Kinesiology

Scientific study of human movement

Biomechanics

Applying mechanics to the living body.
Including static and dynamic movement and forces.

Kinetics

Study of forces associated with body movement.
Includes osteokinematics (bones) and arthrokinematics (joints).

Frames of Reference (FOMs)

Processes for change from dysfunction to function.
Same as approaches (hypothetical).
Example: Sensory integration

4 Components of a FOM

Theory source
Description of dysfunction
Assessment of dysfunction
Treatment methods

Biomechanical FOM

Kinematics & kinetics-based theory
Deficits in nerves, musculoskeletal, integumentary, and/or cardiopulmonary systems
Muscle strength, ROM, and endurance assessment
Purposeful activity, and exercise treatment

Rehabilitation FOM

Client's ability to return to full function.
Emphasizes current abilities plus technology or equipment.

Kinematics

Study of visible/measurable movement.
Not the science of forces, but the description of movements.
Includes joint angles, speed, acceleration, and direction of movement.

Kinesiology and Movement Understanding for OTs

Documenting progress
Identifying movement substitutions

Displacement

Movement can be straight, varied direction, or curvilinear.

Degrees of Freedom

Joint movement planes: sagittal, coronal, horizontal.
More degrees of freedom = greater mobility.

Elbow Degrees of Freedom

1 (flexion/extension)

Wrist Degrees of Freedom

2 (flexion/extension, radial/ulnar deviation)

Shoulder Degrees of Freedom

3 (only ball-and-socket joints have 3)

Abduction/Adduction Plane

Coronal plane

Rotation Plane

Horizontal plane

Flexion/Extension Plane

Sagittal plane

Rotary Motion

Bone movement around a fixed axis (proximal moves less than distal).
Example: shoulder flexion/extension

Linear Motion

Movement in a straight line.
Example: scapula protraction/retraction

Curvilinear Motion

Combination of linear and rotary movements.
Most functional activities.

Walking Linear?

No, lower extremities use reciprocal angular movements.

Angular Movement

Result of linked rotations.

Compression Force

Bringing parts together.
Example: Knees when standing.

Tension Force

Pulling parts apart.
Example: Opening a door

Shear Force

Opposing forces causing sliding motion.
Example: Skin sliding on a table

Torsion Force

Twisting forces.
Example: Twisting a doorknob

Bending Force

Force on forearm when flexing the elbow with a dumbbell.
Bones don't bend, only flexible structures.

Uniaxial Joints

Hinge or pivot joints, one degree of freedom.
Forearm, elbow, and knee.

Biaxial Joints

Two degrees of freedom.
Wrist and metacarpophalangeal (MCP) joints.

Saddle Joints vs Condylar Joints

Saddle joints (e.g., thumb carpometacarpal joint) allow greater abduction/adduction than condylar joints (e.g., MCP joints)
Saddle joints are unique with greater ball-and-socket-like movements

Multiaxial Joints

Three degrees of freedom.
Ball-and-socket joints (e.g., shoulder, hip).

Open Kinematic Chain

Combination of multiple joints, uniting successive segments.
Distal segments may have higher degrees of freedom.
Proximal skeleton relatively stable, distal end moves.
Example: trunk, shoulder, elbow, forearm, wrist and fingers.
The more distal segments can have higher degrees of freedom than the proximal ones, increasing versatility

Closed Kinematic Chain

Distal segment fixed, proximal segment in motion.
Example: Squats, push-ups
Proximal stability for distal mobility.

Joint Play

Sliding, rolling, or spinning joint movements that contribute to overall joint movement, influenced by surrounding structures.
Examples are shoulder abduction related to scapular lowering, or the humerus head sliding down while the glenoid cavity moves.

Ovoid Joint Surface

One surface convex, one surface concave.

Convex Bone on Concave Bone Movement

Convex bone surface moves in the opposite direction of the bone segment.

Concave Bone on Convex Bone Movement

Concave bone surface moves in the same direction as the bone segment.

Congruency: Closed-Packed Position

Perfect joint surface match in a specific position.
Ex; arms by side in shoulder, or MCP joint flexion.

Loose vs Closed Packed Position

Loose packed = Less congruency, surfaces not fitting perfectly.

Rolling/Rocking Motion Example

Each point on a joint surface contacts a new point.
Example: Shoulder abduction

Sliding/Gliding Motion Example

Carpals (wrist bones)

Spinning Motion Example

Rotation in place.

Synovial Joints

Joint cavity with synovial fluid
Synovial membrane enclosing the fluid
Hyaline cartilage covering articular surfaces of bones.

Types of Synovial Joints

Plane, hinge, pivot, condyloid, saddle, ball-and-socket

Plane Joints

Limited sliding between nearly flat surfaces.
Example: Carpal bones.

Ball-and-Socket (Spherical) Joint

Hip and shoulder joints.
Exhibit convex/concave principle

Condylar Joint

Shallow ball-and-socket with limited mobility; lots of ligaments.
Two degrees of freedom.
Example: Metacarpophalangeal (MCP) joint

Ellipsoid Joint

Flatter convex portion.
Example: Radiocarpal (wrist) or back of head.

Pivot (Trochoid) Joint

One bone acts as a pin, others rotate around it.
Example: Proximal radioulnar joint (pronation/supination)

Sellar (Saddle) Joint

Only in thumb carpometacarpal joint.
Ball and socket-like w/o significant rotation.

Hinge Joint

Elbow and knee; one degree of freedom (flexion/extension).

Passive ROM

Therapist moves joint.

Active ROM

Patient moves joint.

Active-Assistive ROM

Patient initiates, therapist assists.

PROM > AROM

Muscle weakness

PROM < AROM

Muscle guarding from pain

Kinetics vs. Kinematics

KINETICS: Forces affecting motion (gravity, ground reaction force, muscle).
KINEMATICS: Characteristics of motion (joint movement, limb acceleration, describing motion).

4 Sources of Force

Gravity
Muscles
Externally applied resistance (e.g., weights, therabands)
Friction

Newton's First Law (Inertia)

Objects at rest stay at rest; objects in motion stay in motion unless acted on by force.

Newton's Second Law (Mass & Acceleration)

Greater force, greater acceleration.
Greater force needed for larger mass movement.

Newton's Third Law (Action/Reaction)

Equal and opposite reaction for every action. - Example: Foot pushing back to move forward.
Splints need equal reaction force to avoid breaking
Wheelchair seat pushes back on body weight.

Levers

Rigid bar moving around a fixed point (axis).
Three forces: axis, resistance, force.

Mechanical Advantage (MA)

Ratio of output (exerted) force to input force.
Longer force arm or shorter resistance arm = greater MA.

Levers of the Body (Axis, Force, Resistance)

Axis: Joint
Force: Muscle
Resistance: Body part weight or resistance.

1st Class Lever

Axis in the middle of force & resistance.
Examples: See-saw, scissors, neck joint

Scissors as 1st Class Lever Example

The paper cuts with sufficient strength relative to the force exerted.
The longer the cutting edge from the pivot, the lower the force necessary to cut. This is an application and will assist in practical tools.

2nd Class Lever

Axis at end, resistance in middle.
Examples: Wheelbarrow, car-jack.
Mechanical advantage (longer force arm).
Less ROM.

3rd Class Lever

Axis at end, force in middle, resistance at other end.
Examples: Tweezers, most body joints.
Range of motion (ROM) advantage.
Advantage in ROM rather than mechanical advantage.

Torque

Twisting force, greatest at 90-degree angle.

MMT Deltoid Resistance Placement

Place resistance closer to elbow for larger resistance arm.
Place resistance closer to deltoid for shorter resistance arm = less force needed.

Coronal Plane Axis & Movements

Sagittal axis
Abduction & adduction

Sagittal Plane Axis & Movements

Coronal axis
Flexion & extension.

Horizontal Plane Axis & Movements

Vertical axis
Rotation

Assessing AROM Limitations

Ask patient to move in all directions at that joint.

Assessing PROM Limitations

Move joint passively through full range.
Observe quality of movement, end-feel, pain levels, and compare with the non-injured side, if possible.

Physical Disabilities and Limited ROM Causes

Skin contractures
Arthritis
Fractures
Burns
Trauma
Bony obstructions
Soft tissue shortening (tendon, muscle, ligament)
Muscle weakness
Pain
Edema
Spasticity.

Determining Typical ROM

Establish norms for each person using uninvolved part.
Use literature-based averages when an uninvolved side is unavailable.

Visual ROM Assessment

Observe client performing AROM.
Look for compensatory motions, posture, muscle contours, skin condition, and skin creases.
Compare to non-injured side.
Therapist moves part to feel joint movement.

Palpation

Feeling body parts with hands to assess texture, size, consistency, and location.
Locate bony landmarks for goniometer placement.

Functional ROM

Required joint movement for daily activities without special equipment.

End Feel Types (3)

Hard: Bony (e.g., elbow extension).
Firm Bony (e.g., wrist extension).
Soft : Contact between soft tissues (elbow flexion).

Pathological End Feel

Abnormal end-feel or location, for example, empty end-feel from pain associated with motion where AROM > PROM.

Lever Recall (FRE)

1st class: Fulcrum (axis) in the middle.
2nd class: Resistance in the middle.
3rd class: Effort in the middle.

Muscle Operations

Muscle operation (shortening) is the only active way it operates.
Contraction: Muscles can contract up to 53% of their length.

Skeletal Muscle Functions (3)

Movement
Posture maintenance
Heat production

Muscle Types (3)

Skeletal
Cardiac
Smooth

Posture

Maintaining body position through sustained muscle contraction against gravity.
Muscles in posture have higher tone, continuous contraction and less fatigue, and hold body up against gravity.

Muscle Tissue Characteristics (5)

Contractility
Conductivity
Irritability
Extensibility
Elasticity

Origin

Relatively fixed attachment during contraction.
Tend to be proximal.

Insertion

Attachment that moves the most during contraction.
Tend to be distal.

Range of Contraction Dependence

Muscle length.

Muscle Power Dependence

Number of muscle fibers.

Agonist

Muscle contracting (main player).

Synergist

Assisting muscles to agonist (sidekick).

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Explore the essential concepts of Kinesiology and Occupational Therapy, focusing on evaluation processes, treatment approaches, and the domains of OTPF-5. This quiz will test your knowledge of various methodologies used to enhance client outcomes and performance skills through systematic assessments and interventions.