We cover many aspects of human movement on this podcast, the topics are broad ranging on today's show, but they are worthy of your time in our opinion. Key words: arm swing, thoracic extension, scapular retraction, arch height, rear foot posting, forefoot loading, ankle dorsiflexion, ankle rocker, shoulder extension, SSEP, F-wave, EMG/NCV testing, gait ataxia Here are some key quotes from today's show: You may have the range of motion, but are you actually able to use it? You haven't truly injured yourself, you've just lost your ability to compensate. And we discuss a case study today, where the following paragraph is germane. "Abnormal gait changes might be the first signs of an early slow cooking neurologic disorder. Most, not all, pathology is afferent, yet most (not all) EMG/NCV testing is geared towards the efferent pathology (motor end organ disease, not sensory compromise), hence, testing can miss your client's pathology. We discuss a classic case where the client clearly had the beginnings of a neurologic disorder on our exam (clonus and joint position sense changes and clear ataxic gait) yet the testing "that was done" showed a normal study of this client. Much pathology is afferent, the input is the problem, so you need to consider requesting Sensory nerve action potentials, SSEP and F-wave testing, because they are difficult to elicit and good technique is paramount. Hence these extra components of the test are not done, and you need to ask for this in your testing. "Maybe it's not there because you are not looking". We have much more on this topic, come listen to Podcast 138 and get the full monty." ... https://www.youtube.com/watch?v=Fsu4OQjRVVo

Proprioceptive effects of aging: It's all in the details Here is a brief video of a gentleman that presented to us with neck discomfort and limited range of motion. Step through it several times before proceeding. Hopefully, you noted the following: Increased arm swing on the right (or, decreased on L) Pelvic shift to the left on L stance phase Decreased step length on the left Hip hike on L during r stance phase the patient does not have a leg length deficiency. We remember that there are 3 systems that keep us upright in the gravitational plane: 1. vision 2. vestibular system 3. proprioceptive system We also remember that as one of these systems become impaired, the others will usually increase their function to help maintain homeostasis. All these systems are known to decline in function with aging. So we have 3 systems breaking down simultaneously. Did you also note the head forward posture, to move the center of gravity forward? How about the subtle head tilt to the right and "bobble" right and left? Motions which have to do with the head are functions of the vestibular system. He is attempting to increase the input to these areas (by exaggerating movements) to increase input. How about the glasses? Presbyopia (hardening of the lens) makes it more difficult to focus. Movement (detected largely by rods in the eyes have a much higher density than cones, which are for visual acuity). By moving the head, he provides more input to the visual (and thus nervous system) Amplified extremity movements provide greater input to the proprioceptive system (mm spindles and GTO's, as well as joint mechanoreceptors). Think of the cortical implications (and effects on the cerebellum, the queen of motor activity and important component for learning). You are witnessing the cognitive effects of aging playing out on the ability to ambulate and its effect on gait. ... https://www.youtube.com/watch?v=e2BQtSgZRrE