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Neuromuscular Practice 3.1 > 2 Gait Abnormalities > Flashcards

2 Gait Abnormalities Flashcards

1
Q

What do you observe in inadequate shock absorption?

A
  • Instability in early stance
  • Knee Extension or buckling
  • Forward trunk lean
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2
Q

What are the impairments related to shock absorption?

A
  • Excessive activation of Gastroc/soleus for controlled ankle (spasticity)
  • Impaired activation of quads for controlled knee flexion
  • Excessive Activation of quads
  • impaired simting of glutes medius, glute max, and hamstrings for hip stability
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3
Q

What are some interventions to promote shock absorption with the Gastroc/soleus?

A
  • EMG (gastroc)
    • Visual feedback
    • reduce or increase graph size
  • FES (TA)
    • Excitating sensory and motor neurons of DF muscle
    • TA activation can help with eccentric contol
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4
Q

What interventions would help with the Quads for impaired shock absorption?

A
  • FES to quad and hamstring
    • Quad - eccentric contrl knee flexion in LR
  • BWSTT with manual guidance
    • faster speed allows to target eccentric control
    • community ambulation speed
  • Practice stepping to target
  • Whole practice walking (floor ladder)
  • EMG to quads for activty
    • visual feedback
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5
Q

Interventions for glute med, max, and hamstring?

A
  • BWSTT (timing and sequencing)
  • Approximation or compression (weighted vest/ compression garmet = timing and sequencing)
  • Backwards walking on treadmill
  • Walking with wider steps for ABductors
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6
Q

What are the critical events for LR?

A
  • Hip stability, controlled kne flexion, controlled ankle PF
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7
Q

What are the critical events for MSt?

A

Tibial Advacnement

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8
Q

What is observed during inadequate single leg support?

A
  • Instability in early and mid stance
  • Short step on uninvolved leg
  • Late heel lift
  • Lack of push off in Pre Swing
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9
Q

What are the impairments related to inadequate single limb support?

A
  • Impared Activation of gastroc soleus
  • Imparired proprioception of ankle
  • Impaired activation of glute med
  • Impaired flexibility of iliopsoas
  • Impaired upper body and lower body coordination
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10
Q

Intervention for SLS for gastroc soleus?

A
  • FES to gastroc
  • Part Practice in staggered stance with mirror feedback
    • fade to intrinsic feedback

Gastroc soleus is needed to maintain upright posture

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11
Q

What are interventions to promote SLS from impaired sensation of the ankle/foot?

A
  • Visual target to increase step length
  • Sensory E stim
    • sub motor threshold, no visual contraction
  • Mental imagery
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12
Q

What are some interveions to promote SLS due to impaired glute med activation?

A
  • Mental imagery for hip ABduction?
  • FES to glute med
  • Unilateral treadmill stepping
    • affected limb is stationary
  • wider steps with abduction band
  • part practice with INCREASED step length
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13
Q

What are interventions to promote SLS from impaired iliopsoas flexibility

A
  • HEP
  • Part practice with visual target
  • taking full step will stretch opposite side
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14
Q

Describe the imapired upper body in coordination for SLS

A
  • Upper vody stays righted with gravity and lower body responds to the surface
  • Arm swing and trunk rotation have a tight conenction with coordinated gait
    • stroke affects input from involved leg does not trigger arms
  • Arm can improve gait
    • Balance improvements using the arm for reach to grasp in stading
  • Intervention
    • Facilitaing trunk rotation via UE swing
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15
Q

What do you observe in inadequate forward propulsion?

A
  • Reduced trailing limb posture in pre-swing
  • lack of push off
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16
Q

What impairments are related to inadequate forward propusion?

A
  • impaired gastroc soleus power
  • impaired activation of iliopsoas, rectus femorus, and adductor longus
  • Impaired proprioception at the hip
  • Excessive activation of quadriceps
17
Q

What interventions for Forward propulsion that affect gastroc soleus?

A
  • FED for gastroc timing an dpower
  • Jump training
  • BWSTT - FAST speed, Variable speed, backwards walking
  • VR (biofeedback)
    • Sensory component

POWER more important that strength

18
Q

What are interventions for forward propulsion for impaired activation of iliospoas, rectus femoris, adductor longus?

A
  • Part practice with rapid hip and knee flexion to a taret
  • Treatmill training
    • fast walking with or without BWSTT
    • Fast unilateral stepping on a treadmill
  • Marching fast (quickly)
  • walking to stretch spindles and activate flexors (trailing limb posture)
19
Q

What are interventions for forward propulsion from impaired proprioception in the hip?

A
  • Whole body vibration
  • Manual cues to facilitage stretch of iliopsoas on treatmil
  • Visual targets for increase step length - (trailing limb posture)
20
Q

What are interventiosn to promote forward propulsion for weak quadriceps?

A
  • backwards walking - trailing limb
  • EMB to quads
21
Q

What do you observe with inadequate foot clearence?

A
  • Toe drag/catch
  • Hyperextension in stance
  • Impaired knee flexion in preswing
  • Circumduction in Swing leg
  • Decreased angle of hip flexion
22
Q

What causes inadequate foot clearance?

A
  • Lack of PF power in stance/preswing
  • Slowed hip flexion power results in DECREASED knee flexion in early swing and less toe clearance
  • impaired Proximal distal sequencing of TA and hip Flexors
  • Hip Flexion power is critical
23
Q

What are the impairments related to inadequate foot clearance?

A
  • Reduced power of hip felxors
  • impaired activation of iliopsoas and adductor longus
  • Excessive Activation of Quads
  • Reduced power of PF
  • Excessive activation of Gastroc soleus
  • Impaired timing of TA
  • Impaired ankle proprioception
24
Q

Foot clearance intervention fos reduced hip flexion power

A
  • BWSTT
  • VR

Emphasize trailing limb posture for more power (inc spindles)

25
Q

Foot clearance for impaired activation of iliopsoas and adductor longus?

A
  • Part pratice with rapid hip and knee flexion
  • Uilateral stepping on treadmill (affected limb is on the belt)
  • Marching in place or overground
  • Factiltage iliopsoas ( t badn, kinesiotape)
26
Q

Inadequate foot clearance for excessive quads interventions?

A
  • Part practice with rapid hip
  • EMG to quads
  • TT with manual facilitation
27
Q

Inadequate foot clearance for reduced PF power interventions?

A
  • Auditory cues (push foot, leg back quickly)
  • Fast TT
  • Fast PF n PSw
  • FES to ankle PF

EMG for excessive gastroc

28
Q

Inadequate foot clearance for impaired timing of TA interventions?

A
  • Treadmill training
    • TT and BWSTT variable speeds
    • FES + TT
    • Fast TT with FES
  • Auditory cues
  • Stepping over obstacles
  • FED on DF/PF
  • Circuit training
  • Kinesiotape
29
Q

Inadequate foot clearance for impaired ankle proprioception interventions?

A
  • Sensory electrical stimulation
  • FES to TA
  • Kinesiotape to TA

Neuromuscular Practice 3.1 (15 decks)

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