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1
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ุจุณู… ุงู„ู„ู‡ ุงู„ุฑุญู…ู† ุงู„ุฑุญูŠู… ุงู„ุตู„ุงุฉ ูˆุงู„ุณู„ุงู… ุนู„ูŠ ุณูŠุฏู†ุง
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ู…ุญู…ุฏ ูˆุนู„ูŠ ุฃู„ูŠ ูˆุตุญุงุจูŠ ุฃุฌู…ุนูŠู† ู‡ู†ุชูƒู„ู… ุงู„ูŠูˆู… ุงู„ู…ุญุงุถุฑุฉ
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ุงู„ุชุงู„ุชุฉ ุนู† ุงู„ gate ู‡ู†ุชูƒู„ู… ุนู† ุงู„ abnormal gate
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patterns ูˆ ู‡ู†ุดูˆู ู„ูŠุด ุจูŠุตูŠุฑ ููŠ ุนู†ุฏู†ุง deviation ููŠ
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ุงู„ gate ูˆ ู„ูŠุด ุจูŠุตูŠุฑ ููŠ ุนู†ุฏู†ุง limpingุฃุนุฏุงุฏ ูƒุจูŠุฑุฉ
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ูˆู…ุดุงูƒู„ ูƒุชูŠุฑุฉ ู…ู…ูƒู† ุงู†ู‡ุง ุชุตูŠุจ ุงู„ gate ุงูˆ ู…ู…ูƒู† ุชุชุฃุซุฑ
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ุนู„ู‰ ุงู„ gate ูŠุนู†ูŠ ู…ู…ูƒู† ุชุชุฑุงูˆุญ ู…ู† ankle sprain ู„
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stroke ูŠุนู†ูŠ ู…ู…ูƒู† ุชูƒูˆู† very mild ู„ุฏุฑุฌุฉ ุงู†ู‡ ูŠุนู†ูŠ ู„ูˆ
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ู†ู‚ูˆู„ ุดูƒุชู†ุง ุฏุจูˆุณ ู…ุตู…ุงุฑ ุฒุงุฒุง ุฌุฑุญุชู†ุง ุจุฑุฌู„ู†ุง ุงูˆ ุดูˆูŠุฉ
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ูˆุฌุน ููŠ ุฎู„ูŠู†ูŠ ู†ู‚ูˆู„ ููŠ ุงู„ ..
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ุฃูˆ ู…ู…ูƒู† ูŠูƒูˆู† ุงุดูŠ permanent ูˆ ุตุนุจ ุฒูˆุงู„ู‡ ุฒูŠ ู…ุซู„ุง ุงู†
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ุตุงุจ ุงู„ูˆุงุญุฏ ุจุงู„ stroke ุงูˆ ุจุงู„ hemiplegia ุงูˆ ุงู„ TBI
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ุงูˆ whatever ูŠุนู†ูŠ ุงูŠ neurological deficiency ู…ู…ูƒู†
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ุทุจุนุง ุงู„ .. ุงู„ gate ุนู†ุฏู†ุง great variation depending
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upon the severity of the problem ุฃูƒูŠุฏ ู‡ุชูุชู„ู
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ุงู„ู…ุดุงูƒู„ ุงู„ู„ูŠ ู…ู…ูƒู† ูŠุชุนุฑุถ ู…ู†ู‡ุง .. ู„ู‡ุง ุงู„ุดุฎุต ููŠ ุงู„ู…ุดูŠ
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ูˆ ู†ุชูŠุฌุฉ ุงู„ .. ูŠุนู†ูŠ ุทุจูŠุนุฉ ุงู„ู…ุดูƒู„ุฉ ุงู„ู„ูŠ ู‡ูˆ ุจุชุนุฑุถู„ู‡ุง
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ุฃูˆ ุงู„ู…ุดูƒู„ุฉ ุงู„ุตุญูŠุฉ ุงู„ู„ูŠ ุจุชุนุฑุถู„ู‡ุง ุฎุงุตุฉ ุจุชุฃุซุฑ ุนู„ู‰
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ุงู„ู„ูŠ ู‡ูˆ ุงู„ limbas with all causes of abnormal
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motion severity or degree of involvement will
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always result in range of variations ู…ู† minor ones
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ู„ major ones ุนุงุฏุฉthere are many methods of
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classification of abnormal gait ุงุญู†ุง ู‡ู†ุงุฎุฏ ู…ุซู„ ู…ู†
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ู‡ุฐู‡ ุงู„ู…ุดุงูƒู„ ุงู„ู„ูŠ ู…ู…ูƒู† ุงู†ู‡ุง ุชุตูŠุจ ูˆ ู‡ู†ุดูˆู ุงู„ general
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causes ู‡ู†ุฑูˆุญ ุงูƒุชุฑ ุนู„ู‰ ุงู„ general causes of
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abnormal gaitุทุจุนุง ุงุญู†ุง ู‡ู†ุฑูˆุญ ู„ุญุงุฌุฉ ุงุณู…ู‡ุง muscular
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weakness ุฃูˆ paralysis ู…ู…ูƒู† ูŠูƒูˆู† ููŠ ุนู†ุฏู†ุง joint ุฃูˆ
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muscle range of motion limitation ู…ู…ูƒู† ูŠูƒูˆู† ุนู†ุฏู†ุง
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neurological involvement ู…ู…ูƒู† ูŠูƒูˆู† ุนู†ุฏู†ุง pain ุฃูˆ
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leg .. leg length discurpancyู‡ุฐู‡ ุทุจุนุง ุงู„ major
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problems ุงู„ู„ูŠ ู…ู…ูƒู† ุชุตูŠุจ ุงู„ู†ุงุณ ุงู„ู„ูŠ ุชุฃุซุฑ ุนู„ู‰ ุงู„ get
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ุทุจุนุง ุงู„ amputation ูƒู…ุงู† ุณุจุจ ู…ู…ูƒู† ุงู„ artificial
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limbs ุงู„ .. ุงู„ calfos ูˆ ุงู„ aphos ูˆ ุงู„ุฃุดูŠุงุก ู‡ุฐู‡
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ุงู„ู„ูŠ ู…ู…ูƒู† ูŠูƒูˆู† ุงู„ุดุฎุต ุฃุฎุฏู‡ุง ู…ู† ูŠุนู†ูŠ ุจูŠุณุชุฎุฏู…ู‡ุง ู…ู†
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ุฃุฏูˆุงุช ู…ุซู„ุง ุฏู‡ ุฃูƒูŠุฏ ุจุชุฃุซุฑ ุนู„ู‰ ุงู„ .. ุงู„ get ุทุจุนุงู†ุฑูˆุญ
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ู„ู„ muscular ูŠุนู†ูŠ ุงู„ูŠูˆู… ู‡ุฑูƒุฒ ุนู„ู‰ ููŠ ู…ุญุงุถุฑุชู†ุง ู‡ุฐู‡
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ุนู„ู‰ ุงู„ muscular weakness ุฃูˆ paralysis ุนุงุฏุฉ ุจู†ุง
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ู†ูู‡ู… ุดุบู„ุฉ ุงู†ู‡ ุงุญู†ุง ุงุฐุง ููŠ ุนู†ุฏู†ุง muscle weakness
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ูƒูŠู ุงู„ุชุตุฑู ุงู„ุฌุณู… ุจูŠุตูŠุฑ ุนุดุงู† ูŠุนูˆุฏ ู‡ุฐุง ุงู„ weakness ูˆ
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ูŠู‚ู„ู„ ู…ู† ุงู„ torque ุงูˆ ุนุฒู… ุงู„ุงุฒุฏูˆุงุฌ ุงู„ู…ุคุซุฑ ุนู„ู‰
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ุงู„ุญุฑูƒุฉ ุงู„ู„ูŠ ู…ู…ูƒู† ู‡ูˆ ูŠุนู…ู„ูŠ ูŠุคุซุฑ ุนู„ู‰ ุงู„ movement
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ูุงู„ุนุงุฏุฉ ุงู†ู‡ ู„ู…ุง ูŠูƒูˆู† ููŠ ุนู†ุฏู†ุง weakness ุงู„ุฌุณู… ุจูŠุนู…ู„
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shifting ู†ุงุญูŠุฉ ุงู„ weak sideูŠุนู†ูŠ ุจูŠูˆุฏ ุงู„ center of
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gravity ุฏุงุฆู…ุง towards the weak side depending upon
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the cause or severity of muscle weakness can range
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from slight weakness to complete paralysis ุทุจุนุง
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ูŠุฎุชู„ู ุนู„ู‰ ุญุณุจ ุงู„ severity ุทุจุนุง ุฅุฐุง ูƒุงู† ุงู„ muscle
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ุฅุฐุง ูƒุงู†ุช weak ุฅุฐุง completely paralyzed ุจุฎุชู„ู ุงู„
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limbing ุงู„ู„ูŠ ุจุฏู‡ ูŠุตูŠุฑ ุฃูˆ ุงู„ุนุฑุฌ ุงู„ู„ูŠ ุจุฏู‡ ูŠุตูŠุฑ ุนู„ู‰
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ุงู„ lower limb ุนุงุฏุฉ ุฃูˆ generally with muscle
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weakness the body tends to compensate by shifting
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the center of gravity over or towards the part
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that is involved ูŠุนู†ูŠ ุนุงุฏุฉ ุจูŠุฑูˆุญ ูŠุนู†ูŠ ุฅุฐุง ุนู†ุฏูŠ
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gluteus maximus ู…ุซู„ุง weakness ูŠุจู‚ู‰ ุจุฏู‡ ูŠุฑูˆุญ ุงู„
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center of gravityููˆู‚ ุงู„ gluteus maxim ุฅุฐุง ุนู†ุฏูƒ
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gluteus medius ุจุฏูŠ ุฃุฑูˆุญ ุนู„ู‰ ุงู„ gluteus medius ุงู„
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weak ุฅุฐุง ุนู†ุฏูƒ quadriceps ุจุฏูŠ ุฃุฑูˆุญ ุนู„ู‰ ุจุฏูŠ ุฃุนู…ู„
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lean forward ูŠู…ุดูŠ ุนู„ู‰ ุฃุณุงุณ ุฅู†ู‡ ูŠุญุท ุงู„ center of
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gravity ููˆู‚ ุงู„ weak side ุนุดุงู† ูŠู‚ู„ู„ ู…ู† ุงู„ torque ู…ู†
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ุนุฒู… ุงู„ุฅุฒุฏูˆุงุฌ ุงู„ู„ูŠ ู…ู…ูƒู† ุฃูˆ ุฏุฑุงุนูŠ ุงู„ู‚ูˆุฉ ุงู„ู„ูŠ ู…ู…ูƒู†
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ู…ุคุซุฑ ุนู„ู‰ ุงู„ุญุฑูƒุฉุจุณูŠูƒุงู„ูŠ ู‡ุฐุง ูŠู‚ู„ู„ ุงู„ู…ุณู„ุณู„
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ุงู„ู…ุทู„ูˆุจ ู…ู† ุงู„ุนุถู„ุฉ ุญุชู‰ ุชุนู…ู„ ู‡ุงุฏูŠ ุงู„ุญุฑูƒุฉ ุฃูˆ ุงู„
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movement during a gameObviously, the portion of
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the gait cycle affected with the portion in which
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the muscle or joint have major role ุทุจุนุง ุฎู„ูŠู†ุง
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ู†ุดูˆู ุงุญู†ุง ู‡ู†ุชูƒู„ู… ุนู† ุฃูƒู… ู…ู† ุนุถู„ุฉ ู„ูˆ ุตุงุฑ ููŠู‡ู… ู…ุดูƒู„ุฉ
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ูˆ ู‡ุฏูˆู„ ุงู„ major muscles ุงู„ู„ูŠ ุจูŠูƒูˆู†ูˆุง contributing
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during the gait cycle ุฒูŠ ุงู„ gluteus maximus ูˆ ุงู„
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gluteus medius ูˆ ุงู„ quadriceps ูˆ ุงู„ hamstrings ูˆ
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ุงู„ ankle dorsiflexors ูˆ ุงู„ triceps and triceps
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00:05:00,860 --> 00:05:07,020
ูŠุนู†ูŠ ุงุด ู…ุตู…ู„ุฉ ู‡ู†ุชูƒู„ู… ุนู† ูƒู„ ุนุถู„ุงุช ุงู„ู„ูŠ ู‡ูˆู„ู…ุง ู†ุฑูˆุญ
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ุงู„ rock horse gate ูŠุนู†ูŠ ู‡ู†ุง ู‡ู†ูƒูˆู† ุจุชูƒู„ู… ุนู†
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weakness of the gluteus maximus ุณู…ูŠู‡ gluteus
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maximus gate ุทุจุนุง ุนุงุฏุฉ ู„ู…ุง ุงุญู†ุง ุจู†ู…ุดูŠ ุจู†ูƒูˆู†ุด
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00:05:19,520 --> 00:05:23,420
ุฑุงุฌุนูŠู† ุธุงู‡ุฑู†ุง ู„ูˆุฑุง ู…ุญุชุงุฌุด ุงู†ู‡ ู†ูˆุฏ ุงู„ center of the
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gravity ุชุจุนู†ุง ู„ูˆุฑุง ู„ูƒู† ู‡ู†ุง ุงุญู†ุง ู…ุถุทุฑูŠู† ู„ุฃู†ู‡ ุนู†ุฏู†ุง
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00:05:27,100 --> 00:05:30,360
ุงู„ gluteus maximus ุถุนูŠูุฉ ูุงู†ุง ุจุฏูŠ ุงูˆุฏูŠ ุงู„ center
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of the gravity ุงูˆ ุจุฏูŠ ุงูˆุฏูŠ ุงู„ weightูˆูˆุฑุง ุงู„
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gluteus maximus ุนุณู‰ ุณุฃู‚ู„ู„ ุงู„ turn ู‡ู†ุง this will
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shift the body posteriorly over the gluteus
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maximus movement moving in a line of force
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posterior to the hip ุจู†ูˆุฏูŠ ุงู„ line of force ุจุฏู‡
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ูŠุตูŠุฑ ูˆุฑุง ุงู„ hip ุงู„ with the foot in contact with
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the floor ุฒูŠ ู…ุง ุงุญู†ุง ุดุงูŠููŠู† requires ู„ุณู‡ strength
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to maintain the hip in extension during stance
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phaseุทุจุนุง this shifting ุจุชุณู…ู‰ ุงู„ rock horse ูŠุนู†ูŠ
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ุงู„ุญุตุงู† ุงู„ุฎุดุจ ุงู„ู‡ุฒุงุฒ ูƒูŠู ุงุญู†ุง ู„ู…ุง ุงู„ูˆุงุญุฏ ุจู‡ุฒ ุจุฑูˆุญ
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ู‚ุฏุงู… ูˆ ูˆุฑู‡ ู‚ุฏุงู… ูˆ ูˆุฑู‡ ู‚ุฏุงู… ูˆ ูˆุฑู‡ because of the
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extreme backward forward movement of the trunkูŠุนู†ูŠ
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ุทูˆู„ ู…ุง ู‡ูˆ ู…ุงุดูŠ ู‡ูˆ ุจูŠุฑุฌุญ ุฏู‡ุฑู‡ ู„ูˆุฑุงู‡ ูˆ ุทุจุนุง ุงุญู†ุง ูŠุง
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ุตุจุงูŠุง ูƒู„ ุงู„ movement ุงู„ up-normal ุฌุงุชู‡ุง ุฏูŠ ุญุชู‰ ุงู„
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normal ุฌุงุช ุงู†ุง ู‡ู†ุฒู„ูƒู…ูŠุง ููŠ ููŠุฏูŠูˆู‡ุงุช ุฎุงุตุฉ ู‡ุญุทู‡ุง ุงู†
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ุดุงุก ุงู„ู„ู‡ ุนู„ู‰ ุงู„ model ุนุดุงู† ุชุชุนุฑููˆุง ุนู„ู‰ ุงู„ normal
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ุฌุงุช ูˆ ุงู„ up-normal ุฌุงุช ุงุญู†ุง ู‡ู†ุดุฑุญู‡ุง ุดุฑูŠุญุฉ ู„ูƒู†
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ู‡ุชูƒูˆู† ู…ูˆุถุญุฉ ูƒู„ู‡ุง ููŠ ููŠุฏูŠูˆู‡ุงุช ุฎุงุตุฉ ุงู„ู„ูŠ ู‡ุชู†ุญุท ุนู„ูŠ
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ุงู„ model ุงู† ุดุงุก ุงู„ู„ู‡ุทุจุนุง ู‡ู†ุง ุงู„ู…ูุฑูˆุถ ุงู†ู‡ ุนู„ู‰ ุงู„
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powerpoint ุงู„ู„ูŠ ู‡ุนู…ู„ูƒู… ู‡ูŠ ุงู†ู‡ ูŠูุชุญ ุงู„ .. ุงู„ video
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ุจุณ ูŠุง ุงุจู†ู‡ ู„ุฃู†ู‡ ู‡ู†ุง ุจุงู„ุนุฑุถ ู…ุง .. ู…ุด ู‡ูŠุธุจุท ู…ุนู†ุงู‡
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ุงู†ุง ุจุฏูŠ ุงุญุงูˆู„ ุงู†ูŠ
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ุง .. ุงุทู„ุน ู…ู† ุงู„ .. ุงุญุงูˆู„ ุงูุชุญ ุงู„ video ุงู† ุดุงุก ุงู„ู„ู‡
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ูŠุง ุฑุจ ูŠุธุจุท
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Gluteus Maximus Gate.During mid stance, the
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itsilateral hip must be maintained in extension or
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the trunk would collapse forward.If there is
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weakness of the Gluteus Maximus muscle, the
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patient is required to thrust the trunk
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posteriorly resulting in an extensor lurch or
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Gluteus Maximus Gate.
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ุทุจุนุง ุจู†ุฑุฌุน ุงุญู†ุง ู„ู…ุญุงุถุฑุชู†ุง ุงู„ powerpoint ู„ู†ู‚ุฑุฃ
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ุงู„ุฑูˆุญ ู„ู„ gluteus medius ุฌูŠุช ุงู„ุดุฎุต ุจุฏูŠุฑูˆุญ over the
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affected side during the stance ุจูŠุฒ ุงุญู†ุง ุงุญู†ุง
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ุดุงูŠููŠู† ุงู† ุงู„ gluteus medius ุงู„ู„ูŠ ุนู„ู‰ ุงู„ left side
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ู‡ูŠ ุงู„ weak ุงู„ู„ูŠ ู‡ู†ุง ูุงู„ุดุฎุต ุจุฏุฑูˆุญ ู‡ูˆ ู…ุงุดูŠ ู‡ูŠุฑูˆุญ ุนู„ู‰
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ุงู„ู†ุงุญูŠุฉ ุงู„ูŠุณุงุฑ ููŠ ู‡ุฐุง ุงู„ figure ุงู„ left gluteus
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medius is weak causing two things to happen ุฃูˆู„
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ุญุงุฌุฉ ุงู„ุจุถู„ูŠู† over the left legduring stance phase
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of the left leg ูˆูƒู…ุงู† ุงู„ right side of the pelvic
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ุจุฏู‡ ูŠู†ุฒู„ ู‡ู†ุง ุจูŠุตูŠุฑ ููŠู†ุง drop ุงู„ู„ูŠ ุงุญู†ุง ูƒู†ุง ุงุชูƒู„ู…ู†ุง
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ุนู†ู‡ุง ู„ู…ุง ุงุชูƒู„ู…ู†ุง ุนู† ุงู„ get terminal ููŠ ุงู„ู…ุญุงุถุฑุฉ
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ุงู„ุณุงุจู‚ุฉ ุงู„ู„ูŠ trended in bergetูŠุจู‚ู‰ ู‡ู†ุง ุจูŠุตูŠุฑ ููŠ
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ุนู†ุฏู†ุง drop when the right leg leaves the ground
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and begin swing fast ุจูŠุตูŠุฑ ู‡ุฐู‡ ุงู„ุฑุฌู„ ู‡ู†ุง ุงู„ hip
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ุจูŠู†ุฒู„ ู„ุชุญุช ูˆ ูƒู…ุงู† ุงู„ุฌุณู… ูƒู„ู‡ ุจูŠุฑูˆุญ ุนู„ู‰ ุงู„ู†ุงุญูŠุฉ
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ุงู„ูŠุณุงุฑ do not confuse this with normal amount of
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dipping ุทุจุนุง ุงู† ุงู„ู„ูŠ ุงุญู†ุง ุงุชูƒู„ู…ู†ุง ุนู†ู‡ุง ููŠ ุงู„ get
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determinant ู‡ูŠ ุทุจูŠุนูŠุฉ ุจุณ ู„ู…ุง ูŠุตูŠุฑ ููŠ ุนู†ุฏู†ุง drop
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ูƒุชูŠุฑ ูุงุญู†ุง ุจู†ุฏุฎู„ุนู„ู‰ ุงู„ abnormal gain ุฎู„ูŠู†ุง ู†ุดูˆู ู…ุน
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ุจุนุถ ุงู„ููŠุฏูŠูˆ ุงู† ุดุงุก ุงู„ู„ู‡ ูŠูุชุญ abductor lurch or
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gluteus medius skate during mid stance the
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abductor muscles about the hip on the weight
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bearing side must contract to prevent the opposite
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pelvis from tilting down excessively this
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increases the pressure across the hip joint to
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more than that of just body weightูˆูŠู…ูƒู† ุฃู† ูŠู†ุชุฌ
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ุตุนูˆุจุฉ ุฃูƒุชุฑ ููŠ ูˆุฌู‡ุฉ ุงู„ู‡ูŠุจูˆุทูŠู†ูŠุฉ ุญูˆู„ ุงู„ู‡ูŠุจุท ูƒุฃู†
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ูƒูˆู…ุจูˆุณ ูƒุงู† ู‚ุงุฏุฑ ุนู„ู‰ ุชุญุณูŠู† ุทููˆู„ุฉ ุนู„ู‰ ู†ู‡ุงูŠุชู‡ุŒ ูŠู…ูƒู†
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ุฃู† ูŠุชุญุฑูƒ ุฃุญุฏู‡ู… ู…ุฑูƒุฒ ุงู„ู‚ูˆุฉ ุนู„ู‰ ู…ุฌู„ุฏ ุงู„ู‡ูŠุจูˆุท ูˆูŠุญุณู†
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00:10:03,820 --> 00:10:08,940
ู…ูˆุถูˆุน ุฌุณุฏู‡ ุนู„ู‰ ู…ุฌู„ุฏ ุญุฌู… ุฑุฃุณ ุงู„ู‡ูŠุจูˆุทุŒ ุจุฐู„ูƒ ุชุฎู„ุต ู…ู†
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00:10:08,940 --> 00:10:13,100
ุงู„ุญุงุฌุฉ ู„ุชุญุณูŠู† ุงู„ู…ุฌู„ุฏ ูˆุงู„ุชู‚ู„ูŠู„ ู…ู† ุงู„ู‚ูˆุฉ ุงู„ูƒุงู…ุฉ ุนู„ู‰
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00:10:13,100 --> 00:10:18,520
ุงู„ู‡ูŠุจุทู‡ุฐุง ูŠู†ุชู‡ูŠ ููŠ ุชุบูŠูŠุฑ ุงู„ุฌู„ุฏ ุงู„ุนู„ูˆูŠ ุฃูƒุชุฑ ู…ู† 1
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ุฅู†ุด ูˆูŠุนุฑู ูƒู€ Abductor Lurch ุงูˆ Gluteus Medius Gap
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ุฎุณุงุฑุฉ
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ุนู…ู„ูŠุฉ ุนู…ู„ูŠุฉ ุนู…ู„ูŠุฉ Gluteus Medius ู…ุซู„ู‹ุง ููŠ ุงู„ููˆู„ูŠูˆ
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00:10:30,700 --> 00:10:32,120
ุฃูˆ ุนู…ู„ูŠุฉ ุนู…ู„ูŠุฉ ุนู…ู„ูŠุฉ ุนู…ู„ูŠุฉ ุนู…ู„ูŠุฉ ุนู…ู„ูŠุฉ ุนู…ู„ูŠุฉ ุนู…ู„ูŠุฉ
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00:10:32,120 --> 00:10:32,700
ุนู…ู„ูŠุฉ ุนู…ู„ูŠุฉ ุนู…ู„ูŠุฉ ุนู…ู„ูŠุฉ ุนู…ู„ูŠุฉ ุนู…ู„ูŠุฉ ุนู…ู„ูŠุฉ ุนู…ู„ูŠุฉ
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00:10:32,700 --> 00:10:34,340
ุนู…ู„ูŠุฉ ุนู…ู„ูŠุฉ ุนู…ู„ูŠุฉ ุนู…ู„ูŠุฉ ุนู…ู„ูŠุฉ ุนู…ู„ูŠุฉ ุนู…ู„ูŠุฉ ุนู…ู„ูŠุฉ
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00:10:34,340 --> 00:10:37,560
ุนู…ู„ูŠุฉ ุนู…ู„ูŠุฉ ุนู…ู„ูŠุฉ ุนู…ู„ูŠุฉ ุนู…ู„ูŠุฉ ุนู…ู„ูŠุฉ ุนู…ู„ูŠุฉ ุนู…ู„ูŠุฉ
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00:10:37,560 --> 00:10:37,820
ุนู…ู„ูŠุฉ ุนู…ู„ูŠุฉ ุนู…ู„ูŠุฉ ุนู…ู„ูŠุฉ ุนู…ู„ูŠุฉ ุนู…ู„ูŠุฉ ุนู…ู„ูŠุฉ ุนู…ู„ูŠุฉ
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00:10:37,820 --> 00:10:37,820
ุนู…ู„ูŠุฉ ุนู…ู„ูŠุฉ ุนู…ู„ูŠุฉ ุนู…ู„ูŠุฉ ุนู…ู„ูŠุฉ ุนู…ู„ูŠุฉ ุนู…ู„ูŠุฉ ุนู…ู„ูŠุฉ
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00:10:37,820 --> 00:10:43,280
ุนู…ู„ูŠุฉ ุนู…ู„ูŠุฉ ุนู…ู„
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ุงู„ุดุฎุต ูŠุนุชู…ุฏ ุนู„ู‰ ู…ูุชุงุญ ุชุฑู†ุฏุงู„ูŠู†ุจูˆุฑุช ุจุฏู„ุง
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00:10:49,820 --> 00:10:53,040
ู…ู† ุชุฑู‚ุจ ุงู„ุฌู„ุฏ ูˆ ุงู„ุฌู„ุฏ ูŠุชุญุฑูƒ ู…ู† ุงู„ุฌุฏุฑุงู† ุนู„ู‰ ุงู„ุฌุฏุฑุงู†
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ููŠ ุชุฌุงุฑุจ ุงู„ุชุฌุงุฑุจ ููŠ ู…ูุชุงุญ ุชุฑู†ุฏุงู„ูŠู†ุจูˆุฑุช ุงู„ุดุฎุต ูŠุณู…ุญ
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00:10:57,860 --> 00:11:01,680
ุจุฌู„ุฏ ุงู„ุฌู„ุฏ ุนู„ู‰ ุงู„ุฌุงู†ุจ ุงู„ุนูƒุณูŠ ูˆู‡ูˆ ุงู„ุฌุงู†ุจ ุงู„ู…ุชุณู„ุณู„
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00:11:01,680 --> 00:11:07,180
ู„ู„ุชุณู„ุณู„ ุจุดูƒู„ ูƒุจูŠุฑ ุชุญุช ุงู„ู‡ูˆุฑุฒุงู†ุชุงู„ ูŠุฌุนู„ู‡ ูŠุฑูุน ุฅู„ู‰
156
00:11:07,180 --> 00:11:09,180
ู…ูุชุงุญ ุชุฑู†ุฏุงู„ูŠู†ุจูˆุฑุช
157
00:11:25,670 --> 00:11:29,070
ู†ูƒู…ู„ ุทุจุนุง ู„ู…ุง ูŠูƒูˆู† ููŠ ุนู†ุฏู†ุง weakness ููŠ ุงู„
158
00:11:29,070 --> 00:11:33,510
quadriceps muscle ููŠ ุนู†ุฏู†ุง different compensatory
159
00:11:33,510 --> 00:11:38,030
mechanism depending upon whether only quadriceps
160
00:11:38,030 --> 00:11:42,110
are weak ูˆ ู„ุง if ุฃู†ู‡ูŠ weakness ููŠ ูƒู„ ุงู„ extremity
161
00:11:42,110 --> 00:11:47,510
ู…ุซู„ุง ุฃูˆ ููŠ ุนู†ุฏู†ุง ู…ุดุงูƒู„ ููŠ ุงู„ุนุถู„ุงุชุฅุฐุง ูƒุงู†ุช ู„ูŠ
162
00:11:47,510 --> 00:11:50,950
quadriceps ููƒู„ ุงู„ู„ูŠ ุจูŠุตูŠุฑ ูŠุนู†ูŠ ูŠู…ูƒู† ุงุญู†ุง ุจุชุดูˆููˆุง
163
00:11:50,950 --> 00:11:54,450
ุจุชู„ุงุญุธูˆุง ููŠ ุจุนุถ ุงู„ู†ุงุณ ุงู„ู„ูŠ ุนู†ุฏู‡ู… polyomyelitis ู„ู…ุง
164
00:11:54,450 --> 00:11:58,330
ุจูŠุจู‚ู‰ ู…ุงุดูŠ ุจูŠุดูŠ ุฏุงูŠู…ุง ุจูŠู…ุดูŠ ูˆ ุจุญุท ุงูŠุฏู‡ ุนู„ู‰ ุฑูƒุจุชู‡
165
00:11:58,330 --> 00:12:02,150
ูŠุจู‚ู‰ ูˆ ุฏูŠ quadriceps weakness ู„ุงู†ุฏููŠุฏูŠูˆู‡ุงู„ ู…ุงูŠู„ูŠู†
166
00:12:02,450 --> 00:12:06,230
The body forward over the quadriceps muscle at the
167
00:12:06,230 --> 00:12:09,950
early part of stance phase ู‡ุฏุง ุงู„ weight ุจุฏู‡ ูŠุตูŠุฑ
168
00:12:09,950 --> 00:12:14,450
shifted on the stance leg ุงู„ weight ุจุฏู‡ ูŠุฌูŠ ุนู„ู‰
169
00:12:14,450 --> 00:12:20,430
ุงู„ุฑุฌู„ ุงู„ู„ูŠ ู‡ูŠ ุงู„ุณู„ูŠู…ุฉ ุงู„ู„ูŠ ุนู„ู‰ ุงู„ stance phase
170
00:12:20,430 --> 00:12:24,290
ุนุดุงู† ูŠุตูŠุฑ ุงู„ center of gravity ู‚ุฏุงู… ูˆ ูŠุธู„ ู…ุญุงูุธ
171
00:12:24,290 --> 00:12:27,690
ุนู„ู‰ุงู„ู„ูŠ ู„ูˆ ุจูŠุถู„ ุงู„ center of gravity ูˆุฑุง ู‡ู†ุง
172
00:12:27,690 --> 00:12:32,650
ูุจุชุตูŠุฑ club ูŠุนู†ูŠ ุจุชุตูŠุฑ ูƒุฃู†ู‡ ุงู„ .. ุงู„ุฑุฌู„ ุจุฏู‡ุง ุชู†ุชู†ูŠ
173
00:12:32,650 --> 00:12:36,050
buckling ุจูŠุณู…ูˆู‡ุง ุจูŠุตูŠุฑ ุจุฏู‡ุง ุชู†ุชู†ูŠ ุชุญุชู‡ ูู‡ูˆ ุจูŠุฌูŠุจ
174
00:12:36,050 --> 00:12:40,290
ุงู„ center of gravity ู‚ุฏุงู… ุนุดุงู† ูŠุถู„ู‡ุง ุงู„ leg ู‡ู†ุง ุจ
175
00:12:40,290 --> 00:12:44,580
extensionNormally at this time, the line of force
176
00:12:44,580 --> 00:12:47,940
falls behind the knee. Required quadriceps action
177
00:12:47,940 --> 00:12:51,220
to keep the knee from buckling.ุฅูŠุด ุงู„ buckling ุฅู†ู‡
178
00:12:51,220 --> 00:12:56,020
ูŠุตูŠุฑ ููŠู‡ ู‚ุฑูุตุงุก ุฃูˆ ูŠุตูŠุฑ ููŠู‡ ุชุงู†ูŠ ุนู„ู‰ ุงู„ุฑู‚ุจุฉ By
179
00:12:56,020 --> 00:13:00,080
leaning forward of the hip, center of gravity,
180
00:13:00,600 --> 00:13:05,110
shift forward ุจุตูŠุฑ ุงู„ line of forceู„ูˆ ู‚ุฏุงู… in
181
00:13:05,110 --> 00:13:08,310
front of the knee this will force the knee
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00:13:08,310 --> 00:13:12,350
backward into extension ุทุจุนุง in addition the
183
00:13:12,350 --> 00:13:16,870
person may physically push on the anterior thigh
184
00:13:16,870 --> 00:13:19,430
during stance with holding the knee in extension
185
00:13:19,430 --> 00:13:23,410
ูŠุนู†ูŠ ู‡ูˆ ุจูŠุฑูƒุฒู‡ุง ูŠุนู†ูŠ ู‡ูˆ ุจุฎุจุท ุงูŠุฏู‡ ูƒุฏู‡ ุนู„ู‰ ููˆู‚
186
00:13:23,410 --> 00:13:27,990
ุงู„ู†ูŠู‡ ุนุดุงู† ุงู„ู†ูŠู‡ ุชุธู„ ู‡ุงุฆุจ extension ุจูุฑุฏ ุฑุฌู„ู‡ ูŠุนู†ูŠ
187
00:13:27,990 --> 00:13:30,410
ู†ุดูˆู ุงู„ููŠุฏูŠูˆ ู…ุน ุจุนุถ
188
00:13:38,010 --> 00:13:41,510
Quadriceps weakness. At the time of heel strike,
189
00:13:41,870 --> 00:13:45,370
the knee is normally in full extension. If there
190
00:13:45,370 --> 00:13:48,070
is quadriceps weakness, thus not allowing the
191
00:13:48,070 --> 00:13:51,130
patient to maintain knee extension, the patient
192
00:13:51,130 --> 00:13:53,910
may attempt to push on the thigh in order to
193
00:13:53,910 --> 00:13:55,610
extend and lock the knee
194
00:14:12,360 --> 00:14:15,340
ุงู„ู‡ู…ุณุชุฑู†ุบุฒ ุงู„ู‡ู…ุณุชุฑู†ุบุฒ ู‡ู†ุง ุฒูŠ ู…ุง ุงุญู†ุง ุดุงูŠููŠู†ู‡ ูŠูƒูˆู†
195
00:14:15,340 --> 00:14:18,040
ููŠู‡ weakness ููŠู‡ู…ุณุชุฑู†ุบุฒ ุจุณ ููŠ ุญุงุฌุฉ ุงุณู…ู‡ุง generic
196
00:14:18,040 --> 00:14:22,900
of atom ุจุชุตูŠุฑ ุงู„ุฑุฌู„ ูˆูƒุงู†ู‡ุง ููŠ hyper extension if
197
00:14:22,900 --> 00:14:26,600
hamstring are weak two things may happen during
198
00:14:26,600 --> 00:14:30,540
sun phase the knee will go into excessive hyper
199
00:14:30,540 --> 00:14:36,050
extensionSometimes referred to as Genorequivate
200
00:14:36,050 --> 00:14:40,050
again ู„ุฃู† ู‡ู†ุง ุฅูŠุด ุงู„ู„ูŠ ุจูŠุตูŠุฑ during the
201
00:14:40,050 --> 00:14:45,590
deceleration ุชุจุน ุงู„ swing phase ุฅูŠุด ุงู„ู„ูŠ ุจูŠุตูŠุฑ ุฅู†
202
00:14:45,590 --> 00:14:49,450
ุงู„ู‡ู…ุณุชุฑู†ุฌ ุงู„ู…ูุฑูˆุถ ุชุนู…ู„ slow down ู„ู„ swing ุจุชู‚ู„ู„ ู…ู†
203
00:14:49,450 --> 00:14:54,800
ุงู„ snapping ู…ู† ุฃู† ุงู„ุฑุฌู„ ุชุจู‚ู‰ ู‡ูŠูƒ ุชุฑุท ูŠุนู†ูŠ ุชุฎุจุทูƒุฏู‡
204
00:14:54,800 --> 00:15:00,100
ู„ู‚ุฏุงู… ูุฅูŠู‡ ุงู„ู„ูŠ ุจูŠุตูŠุฑ ุฅู† ุงู„ hamstring weak ู…ุด
205
00:15:00,100 --> 00:15:04,300
ู‚ุงุฏุฑุฉ ุชุนู…ู„ control ุนู„ู‰ ุงู„ knee extension ูˆ ุชู…ู†ุน ุงู„
206
00:15:04,300 --> 00:15:08,360
snapping ูุจุชุตูŠุฑ ุจุงู„ุดูƒู„ ุงู„ู„ูŠ ุฅุญู†ุง ุดุงูŠููŠู†ู‡ ู‡ุฐุง
207
00:15:09,690 --> 00:15:14,450
weakness of the ankle dorsiflexors ุทุจุนุง ู‡ู†ุง ูŠุนู†ูŠ
208
00:15:14,450 --> 00:15:18,650
ูƒู„ู†ุง ุจู†ุนุฑู ุนู† ุงู„ drop foot ุจุณ ุทุจุนุง ู‡ู†ุง ุงู„ ankle
209
00:15:18,650 --> 00:15:23,130
dorsiflexors ูƒุชูŠุฑ ู…ู‡ู…ุฉ ููŠ ุงู„ stance phase ูˆ mainly
210
00:15:23,130 --> 00:15:26,350
ููŠ ุงู„ heel strike ุญุชู‰ ููŠ ุงู„ heel strike ููŠ ูƒู„
211
00:15:26,350 --> 00:15:32,350
ุงู„ู…ุฑุงุญู„ ุชู‚ุฑูŠุจุง ุงู„ stance phase ู„ุงุฒู… ูŠูƒูˆู† ููŠ ุฏูˆุฑ ู„ู„
212
00:15:32,350 --> 00:15:37,330
ankle dorsiflexorsุทุจ ู‡ู†ุง ุงุฐุง ูƒุงู† ููŠ ุนู†ุฏูŠ
213
00:15:37,330 --> 00:15:40,910
insufficient strength ูŠุนู†ูŠ ููŠ ุนู†ุฏูŠ ุงู†ุง ู‡ูŠ ุถุนูŠูุฉ
214
00:15:40,910 --> 00:15:46,410
ู„ูƒู† ูŠุนู†ูŠ ู…ุด ู‚ูˆูŠุฉ enough ุงู† ู‡ูŠ ุชุนู…ู„ูŠ ุงู„ control ุนู„ู‰
215
00:15:46,410 --> 00:15:51,790
ุงู„ .. ุนู„ู‰ ุงู„ food .. ู†ุชุฎู„ูŠ ุงู„ุฃูƒู„ ููŠ neutral
216
00:15:51,790 --> 00:15:55,690
positionIf there is insufficient strength to move
217
00:15:55,690 --> 00:15:58,570
the ankle into dorsiflexion at the beginning of
218
00:15:58,570 --> 00:16:02,970
stance phase, the foot will land fairly flat on
219
00:16:02,970 --> 00:16:03,370
the floor
220
00:16:13,110 --> 00:16:17,450
muscle of the .. of the ankle dorsiflexors ุงู„ู„ูŠ ู‡ูŠ
221
00:16:17,450 --> 00:16:21,850
ุงู„ tibialis anterior ูู„ุฃ ุจู†ุฒู„ ุงู„ุดุฎุต ุจุงู„ foot ูƒุงู…ู„ุฉ
222
00:16:21,850 --> 00:16:26,370
ุนู„ู‰ ุงู„ุฃุฑุถ ุฅุฐุง ูƒุงู†ุด ููŠ ุนู†ุฏู†ุง ankle dorsiflexors
223
00:16:26,370 --> 00:16:32,150
ุจุตูŠุฑ ููŠู‡ ุฅู†ู‡ ุงู„ุดุฎุต ุจูŠู†ุฒู„ ุฑุฌู„ู‡ ุจุงู„ toes ูŠุนู†ูŠ ุจูŠูƒูˆู†
224
00:16:32,150 --> 00:16:36,730
ููŠ ุนู†ุฏู‡ equinus ุจูŠุณู…ูˆู‡ equinus gap ูŠุนู†ูŠ ุฅู† ู…ุงููŠุด
225
00:16:36,730 --> 00:16:41,430
ุฅู…ูƒุงู†ูŠุฉ ุฅู†ู‡ุง ุชุฎู„ูŠ ุงู„ุฑุฌู„ ุจ neutral position ุฃูˆ ุญุชู‰
226
00:16:41,430 --> 00:16:47,440
ุจุดูˆูŠู‡ slidedorsiflexion ู‡ูŠู†ุฒู„ ุงู„ุฑุฌู„ ุจุฑูˆุณ ุงู„ุฃุตุงุจุน
227
00:16:47,440 --> 00:16:51,840
ูŠุนู†ูŠ ุจุฏู„ ู…ุง ูŠู†ุฒู„ ุจุงู„ู‡ูŠู„ ุจู†ุฒู„ ุจุฑูˆุณ ุงู„ุฃุตุงุจุน
228
00:16:54,560 --> 00:17:00,700
weak ankle dorsiflexors may not be able to support
229
00:17:00,700 --> 00:17:04,820
the body weight ู…ุงุจุชู‚ุฏุฑ ุชุชุญู…ู„ ุงู„ูˆุถุน ุจุนุฏ
230
00:17:04,820 --> 00:17:09,020
ุงู„ู‡ูŠู„ุณุชุฑุงูŠูƒ ูุงู„ู„ูŠ ุจูŠุตูŠุฑ ุงู†ู‡ ุงู„ุฑุฌู„ ุจุชู†ุฒู„ ุจุชุฒู‚ู ุฒูŠ
231
00:17:09,020 --> 00:17:12,960
ู‡ูŠูƒ ูŠุนู†ูŠ ูƒู„ ู…ุง ุจูŠู…ุดูŠ ุจูŠู…ุดูŠ ูˆูƒุฃู†ู‡ ุฑุฌู„ู‡ ุจุชุฒู‚ู ุนู„ู‰
232
00:17:12,960 --> 00:17:19,430
ุงู„ุฃุฑุถ ุจูŠุทุจ ููŠ ุงู„ุฃุฑุถ ุจู‡ุฐุงุงู„ุดูƒู„ ูŠุจู‚ู‰ ู‡ู†ุง ู…ุงู„ุชุตูŠุฑ ุนู†ุง
233
00:17:19,430 --> 00:17:22,730
ุนู„ู‰ ุทูˆู„ ุจุชู†ุฒู„ ุงู„ heel strike ูˆ ุจุชู†ุฒู„ ุงู„ุฃุฌุฑ ุนู„ู‰
234
00:17:22,730 --> 00:17:27,650
ุงู„ุฃุฑุถ ู…ุจุงุดุฑุฉ ูุจุณู…ูˆู‡ุง foot slap ุฃู…ุง ููŠ ุงู„ swing
235
00:17:27,650 --> 00:17:33,890
fast ุทุจุนุง ุงู„ุฑุฌู„ ู„ุงุฒู… ูŠุชุตูŠุฑ ููŠ ุนู†ุงู‡ูŠุจ ูู„ูŠูƒุดู† ูˆ ู†ูŠู‡
236
00:17:33,890 --> 00:17:37,650
ูู„ูŠูƒุดู† ูˆ ูƒู…ุงู† ูŠุตูŠุฑ ููŠ ุนู†ุฏู†ุง ankle dorsiflexion ุฃูˆ
237
00:17:37,650 --> 00:17:40,790
ุนู„ู‰ ุงู„ุฃู‚ู„ ุงู„ neutral position ุนุดุงู† ุชุฑุชูุน ุงู„ุฑุฌู„ ุนู†
238
00:17:40,790 --> 00:17:46,690
ุงู„ุฃุฑุถ ูˆ ู…ุงุชุดุญุชุด ุงู„ุฑุฌุงู„ ุดุญุช ุฃูˆ ุงู„ู„ูŠ ู‡ูˆ ุฃุตุงุจูŠุน
239
00:17:46,690 --> 00:17:51,580
ุงู„ุฑุฌู„ูŠู† ู…ุงูŠุดุญุชูˆุด ู…ุนุงู†ุง ุดุญุช ุนู„ู‰ุงู„ุงุฑุถ ูุฅูŠุด ุจุชุถุทุฑ
240
00:17:51,580 --> 00:17:56,220
ุงู„ุดุฎุต ุฃู†ู‡ ูŠุฒูˆุฏ ุงู„ hip ูˆ ุงู„ knee flexion ูุจุงู„ุชุงู„ูŠ
241
00:17:56,220 --> 00:18:00,780
ุจูŠุณู…ู‰ ูƒุฃู†ู‡ ุจุฏู‡ ูŠุทู„ุน ุณู„ู…ุฉ ูŠุนู†ูŠ ุจุฏู‡ ูŠุทู„ุน ุนู„ู‰ ุงู„ุฏุฑุฌุฉ
242
00:18:00,780 --> 00:18:04,680
ู‡ู†ุง ููŠ ู‡ุฐู‡ ุจูŠุณู…ูŠ ุงุญู†ุง ู‡ุฐุง ุงู„ุดุฎุต ุนู†ุฏู‡ drop foot ูˆ
243
00:18:04,680 --> 00:18:09,480
ุงู„ .. ูˆ ูƒูŠู ุจูŠู…ุดูŠ ุจูŠู…ุดูŠ ุจstepage gate ู„ูŠุด ูŠุณู…ู‰
244
00:18:09,480 --> 00:18:12,980
stepage gate ู‡ูˆ ูƒุฃู†ู‡ ุจูŠุฑูุน ุฃุฌุฑู‡ ูˆ ูƒุฃู†ู‡ ุจุฏู‡ ูŠ ..
245
00:18:13,280 --> 00:18:18,340
ุจุชูŠุฌูŠ ุฎุทูˆุฉ ุงูˆ ุจุฏูˆ ูŠุทู„ุน ุณู„ู‘ู…ุฉ ุทุจุนุง ู„ูˆ ุฑูˆุญู†ุง ู„ู„
246
00:18:18,340 --> 00:18:23,720
triceps ุณุฑุงูŠ muscle ุงูˆ ุงู„ gasrocnemius ุงู„ู„ูŠ ู‡ูŠ ุงู„
247
00:18:23,720 --> 00:18:27,220
calf muscle ุงุฐุง ูƒุงู†ุช weak ู…ุนู†ุงู‡ ุงู†ู‡ ุงุญู†ุง ููŠ ู…ุฑุญู„ุฉ
248
00:18:27,220 --> 00:18:31,920
ุงู„ push off ุงู„ู„ูŠ ุจุชุชูƒูˆู† ู…ู† ุงู„ tooth off ู‡ู†ุง ุจุชูƒูˆู†
249
00:18:31,920 --> 00:18:37,380
ููŠู‡ุง ู…ุดูƒู„ุฉ ู…ุงุจูŠู‚ุฏุฑ ุงู„ุดุฎุต ุงู†ู‡ ูŠู‚ุฏุฑ ูŠู†ู‡ูŠ ุงู„ stance
250
00:18:37,380 --> 00:18:43,780
fast ุจุงู„ push off ูุฅูŠุด ุงู„ู„ูŠ ุจูŠุตูŠุฑ ุงู†ู‡ุง ุจุชูƒูˆู†ุจูŠู‚ุตุฑ
251
00:18:43,780 --> 00:18:49,780
ุงู„ step ูŠุนู†ูŠ ุจูŠุทู„ุน ู…ู† ุงู„ mid distance ููˆุฑุง ู‡ูˆ ุจุฑูˆุญ
252
00:18:49,780 --> 00:18:54,660
ุฑุงูุน ุฑุฌู„ู‡ ูุจุชู‚ุตุฑ ุงู„ step ุนู†ุฏู‡ ุนู„ู‰ ุงู„ unaffected
253
00:18:54,660 --> 00:18:57,740
leg ูŠุนู†ูŠ ุงู„ุฑุฌู„ ุงู„ุณู„ูŠู…ุฉ ุงู„ step ุจุชุจุนุชู‡ุง ู„ุฅู† ู‡ูˆ
254
00:18:57,740 --> 00:19:03,340
ู…ุงุจูŠู‚ุฏุฑ ูŠุฑูุน ุฑุฌู„ู‡ ุจุฑุงุญุชู‡ ุนู„ู‰ ุงู„ุฑุฌู„ ุงู„ู…ุตุงุจุฉ ู‡ุฐุง
255
00:19:03,340 --> 00:19:07,720
ุจูŠูƒูˆู† ุจู†ุณู…ูŠู‡ sore foot limb ุฃูˆ ุงู„ู„ูŠ ู‡ูˆ ุงู„ pain ููŠ
256
00:19:07,720 --> 00:19:12,370
ุงู„ leg ู‡ูŠ ูƒุฏู‡ ุจุชุตูŠุฑ ููŠ ุงู„ .. ุงู„ machineูŠุนู†ูŠ ู„ู…ุง
257
00:19:12,370 --> 00:19:15,470
ุชูƒูˆู† ุงู„ูˆุงุญุฏ ุฑุฌู„ู‡ ุจุชูˆุฌุนู‡ ุจูŠู…ุดูŠ ุจู‡ุงุฏูŠ ุจู†ูุณ ุงู„ุทุฑูŠู‚ุฉ
258
00:19:15,470 --> 00:19:21,530
ุงู†ู‡ ุจูŠุฃุซุฑ ุงู„ู‚ุทูˆุน ุนู„ู‰ ุงู„ุฑุฌุงู„ ุงู„ุณู„ูŠู…ุฉ although this
259
00:19:21,530 --> 00:19:29,030
skit is noticeable on level ground ุนุงุฏุฉ becomes
260
00:19:29,030 --> 00:19:33,910
most pronounced ุจูŠุจูŠู† ุฃูƒุชุฑ ู„ู…ุง ูŠุจู‚ู‰ ุงู„ูˆุงุญุฏ ุทุงู„ุน
261
00:19:33,910 --> 00:19:39,410
ุนู„ู‰ ุทู„ุนุฉ ู„ุฅู† ู‡ูˆ ู…ุด ู‚ุงุฏุฑ ูŠุนู…ู„ ุงู„ tools off ุฃูˆ ุงู„
262
00:19:39,410 --> 00:19:45,130
push offู†ุฑูˆุญ ู„ุญุงุฌุฉ ุงุณู…ู‡ุง waddling gait commonly
263
00:19:45,130 --> 00:19:49,350
seen with muscular dystrophy ู…ุดุงูƒู„ ุงู„ weakness ู„ู…ุง
264
00:19:49,350 --> 00:19:52,290
ูŠูƒูˆู† ููŠู‡ ุงู†ู‡ุง general weakness ููŠ ุงู„ู…ุณูƒูˆู„ูŠุฉ ุงู„ุดุฑุทุฉ
265
00:19:52,290 --> 00:19:57,150
ุจุช ุงู„ุฌุณู… ูƒู„ู‡ุง ุงูˆ diffuse weakness of many muscle
266
00:19:57,150 --> 00:20:00,270
group ูŠุนู†ูŠ ู‡ุงู„ุฃุฏุง ู…ุด ุนุถู„ุฉ ู…ุญุฏุฏุฉ ููŠ ุงู„ waddling
267
00:20:00,270 --> 00:20:04,670
gait ูŠูƒูˆู† ู…ุนุธู… ุงู„ุนุถู„ุงุช ุจูŠูƒูˆู† ููŠู‡ุง weakness ุฎุงุตุฉ
268
00:20:04,670 --> 00:20:07,270
ุงู„ู†ุงุณ ุงู„ู„ูŠ ุจูŠูƒูˆู† ุนู†ุฏู‡ู… ุงู„ myopathies ุฒูŠ ุงู„ุฏุดู†
269
00:20:07,270 --> 00:20:13,280
ูˆุบูŠุฑู‡ ู…ู† ู…ุดุงูƒู„ ุงู„ุนุถู„ุงุชู‡ู†ุง ุงู„ person who stands
270
00:20:13,280 --> 00:20:17,040
with the shoulder behind ุฒูŠ ู…ุง ูƒู†ุง ูˆ ูƒุฃู†ู‡ ุนู†ุฏู‡
271
00:20:17,040 --> 00:20:22,680
bilateral gluteus maximus weakness ูˆ ุจูƒูˆู† ู…ุฑูƒุฒ
272
00:20:22,680 --> 00:20:27,490
ู…ุญู…ู„ ุนู„ู‰ ุงู„ iliofemoral ligament of the hipูŠุนู†ูŠ
273
00:20:27,490 --> 00:20:31,450
ุจูŠุจู‚ู‰ ูˆุงู‚ู ุนู„ู‰ ุงู„ heliofemoral ู„ุฌู…ุงู„ ูˆุนุงุฏุฉ ุงู„ู†ุงุณ
274
00:20:31,450 --> 00:20:35,050
ุงู„ู„ูŠ ุจูŠูƒูˆู† ุนู†ุฏู‡ู… paraparesis ุจูŠู…ุดูˆู‡ ุจู‡ุฐู‡ ุงู„ุทุฑูŠู‚ุฉ
275
00:20:35,050 --> 00:20:38,710
there is increased lumbar lordosis ูˆุทุจุนุง ููŠ ุนู†ุฏู†ุง
276
00:20:38,710 --> 00:20:41,590
pelvic instability ููŠ ุนู†ุฏู†ุง bilateral
277
00:20:41,590 --> 00:20:46,230
Trendelenburg sign ูŠุนู†ูŠ ุจูŠูƒูˆู† ุนู„ู‰ ุงู„ู†ุงุญูŠุชูŠู† ููŠ
278
00:20:46,230 --> 00:20:50,340
ุนู†ุฏู‡ูƒู…ุงู† weakness ู‡ูˆ ุจูŠู…ูŠู„ ุนู† ุงู„ูŠู…ูŠู† ูˆ ุจูŠู…ูŠู„ ุนู„ู‰
279
00:20:50,340 --> 00:20:55,460
ุงู„ูŠุณุงุฑ little or no reciprocal pelvis and trunk
280
00:20:55,460 --> 00:20:59,920
rotation occur ููŠ ุงู„ swing face ูˆ swing leg
281
00:20:59,920 --> 00:21:05,970
forward ูƒู„ ุงู„ุฑุฌู„ ุจุชูŠุฌูŠ ุจุชู†ุดุงู„ูˆ ูƒุฃู†ู‡ ุจูŠุญุฏุซ ููŠู‡ุง ุญุฏุซ
282
00:21:05,970 --> 00:21:10,030
ูŠุนู†ูŠ ุจูŠุดูŠู„ ุฑุฌู„ูˆู‚ ูˆ ุจูŠุญุฏุซ ููŠู‡ุง ุญุฏุซ ูƒู„ู‡ุง ุจูŠุตูŠุฑ ููŠู‡ุง
283
00:21:10,030 --> 00:21:16,750
swinging forward ุนุงุฏุฉ ุจูŠูƒูˆู† ููŠุด ุนู†ุฏู‡ู… ุงู„ right
284
00:21:16,750 --> 00:21:21,530
swings forward ุงู„ right arm ุจุชู…ุดูŠ ู…ุนุงู‡ุง ูŠุนู†ูŠ ุนู†ุฏู†ุง
285
00:21:22,430 --> 00:21:26,970
ูู‰ ุงู„ normally ุงุญู†ุง ุจู†ู‚ูˆู„ right arm ู…ุน left leg ูˆ
286
00:21:26,970 --> 00:21:32,130
left .. ูˆ left arm ู…ุน left leg ู„ูƒู† ู‡ู†ุง ุจูŠูƒูˆู† ู„ุฃ ุงู„
287
00:21:32,130 --> 00:21:36,990
right arm ุจุชู…ุดูŠ .. ุจุชู†ุญุฏุซ ู…ุน ุงู„ .. ุงู„ right leg ูˆ
288
00:21:36,990 --> 00:21:42,390
ุงู„ left arm ู…ุน ุงู„ left leg and add this to the
289
00:21:42,390 --> 00:21:45,590
axis of the trunk plane of Trendelenburg ุนู„ู‰
290
00:21:45,590 --> 00:21:49,470
ุงู„ูŠู…ูŠู† ูˆ ู„ู„ูŠุณุงุฑ ู„ุฃู†ู‡ ุจูŠูƒูˆู† ุนู†ุฏู†ุง bilaterally ุงู„
291
00:21:49,470 --> 00:21:58,340
gate bilaterallyุงู„ูˆุงุฏู„ูŠู†ุฌ ุฌูŠุช ุทุจุนุง ุจูŠูƒูˆู†
292
00:21:58,340 --> 00:22:02,240
ูˆุงุถุญ ูˆูƒู…ุงู† ู…ู…ูƒู† ูŠูƒูˆู† ููŠ ุนู†ุฏู†ุง stepage .. stepage
293
00:22:02,240 --> 00:22:06,640
ุฌุงุช ูŠุนู†ูŠ ุดูˆู ูˆุงุฏู„ูŠู†ุฌ ุฌุงุช ูˆ stepage .. ุงู„ูˆุงุฏู„ูŠู†ุฌ
294
00:22:06,640 --> 00:22:08,700
ุฌุงุช ุจุฏูŠ ูŠูƒูˆู† ููŠ ุนู†ุฏู†ุง bilateral, tendinum,
295
00:22:08,760 --> 00:22:12,560
dendroxide ูˆ stepage ุฌุงุช ูˆููŠุด ุนู†ุฏู†ุง ุงู„ reciprocal
296
00:22:12,560 --> 00:22:16,510
R movement ู…ุน ุงู„ lower .. ู…ุน ุงู„ lower limbูˆ ููŠ
297
00:22:16,510 --> 00:22:19,710
ุนู†ุฏู†ุง excess of the trunk ู„ูˆุฑุง ุจูŠูƒูˆู† ู…ุญู„ูˆู ุนู„ู‰
298
00:22:19,710 --> 00:22:23,170
ุงู„ุจุณุชูŠุฑูˆ ููŠ ุนู†ุฏู†ุง lordosis ููŠ ุนู†ุฏู†ุง instability
299
00:22:23,170 --> 00:22:26,630
ุทุจุนุง ุงู†ู‡ุง ุฏูŠ ููŠ ููŠุฏูŠูˆ ู‡ูŠูƒูˆู† ูˆุงุถุญ ุงู† ุดุงุก ุงู„ู„ู‡ ููŠ
300
00:22:26,630 --> 00:22:31,610
ู†ู‡ุงูŠุฉ ู…ุญุงุถุฑุงุชู†ุง ู„ู„ bio mechanics ู‡ู†ุฒู„ู„ูƒู… ูŠุง ููŠุฏูŠูˆ
301
00:22:31,610 --> 00:22:35,980
ุฑุงุฆุน ุงู†ุง ุนุงุฏุฉ ุจุฎุชู… ููŠู‡ ูƒู„ู…ุญุงุถุฑุงุช ุงู„ bio mechanic ูˆ
302
00:22:35,980 --> 00:22:40,080
ุจูƒูˆู† ุชู‚ุฑูŠุจุง ููŠ ุนู†ุฏู†ุง ุงุญุชูุงู„ูŠุฉ ููŠ ู†ู‡ุงูŠุฉ ู…ุญุงุถุฑุงุชู†ุง ูˆ
303
00:22:40,080 --> 00:22:44,120
ูƒู†ุง ู†ุชู…ู†ู‰ ุงู† ูŠูƒูˆู† ุงู„ุชุนู„ูŠู… ูˆ ุฌุงู‡ูŠุฉ ุนุดุงู† ุชูƒูˆู† ูŠุนู†ูŠ
304
00:22:44,120 --> 00:22:49,340
ู…ู† ุงู„ู…ุญุงุถุฑุงุช ุงู„ู„ูŠ ู‡ูŠ ูƒุชูŠุฑ ููŠู‡ุง fun ูˆ ููŠู‡ุง .. ููŠู‡ุง
305
00:22:49,340 --> 00:22:52,880
ุนู„ู… ูŠุนู†ูŠ ูƒุชูŠุฑ ุฑุงุฆุน ุงู†ุง ุจุตุฑุงุญุฉ ุจุญุจ ุงู„ bio mechanic
306
00:22:52,880 --> 00:22:59,940
ูˆ ุจุญุจ ุงู„ู†ุงุณ ุงู„ู„ูŠ ุจุชุญุจ ุงู„ bio mechanic ูƒู…ุงู† ุทูŠุจ
307
00:22:59,940 --> 00:23:01,860
ู†ุดูˆู ุงู„ููŠุฏูŠูˆ ู‡ุฐุง
308
00:23:11,610 --> 00:23:12,490
ุงู„ุฌุงู…ุนุงุช
309
00:23:39,320 --> 00:23:42,400
ุฒูŠ ู…ุง ุงู†ุชูˆุง ุดุงูŠููŠู† typical ูˆุงุฏู„ูŠู†ุฌุงุช
310
00:24:36,510 --> 00:24:40,950
ูˆุจู‡ูƒ ุงุญู†ุง ุจู†ูƒูˆู† ูˆุตู„ู‡ุง ู„ู†ู‡ุงูŠุฉ ู…ุญุงุถุฑุชู†ุง ู„ู„ูŠูˆู… ุงู† ุดุงุก
311
00:24:40,950 --> 00:24:44,750
ุงู„ู„ู‡ ุชุจู‚ู‰ ู…ุนุงู†ุง ู…ุญุงุถุฑุฉ ูˆุงุญุฏุฉ ู‡ู†ุชูƒู„ู… ููŠู‡ุง ุนู† ุงู„
312
00:24:44,750 --> 00:24:47,330
limitation of a joint