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E&M > Abnormal Gait > Flashcards

Abnormal Gait Flashcards

1
Q

Reliability of OGA

A

Low-moderate

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2
Q

How to improve reliability of OGA?

A

Videotape clients

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3
Q

OGA

A

Observational gait analysis

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4
Q

GARS

A

Gait assessment rating score

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5
Q

DGI

A

Dynamic gait index

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6
Q

Predicts risk of fall based on trunk pattern

A

GARS

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7
Q

Common dual task challenge that is a predictor of falls

A

Walking and talking

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8
Q

An example of a standardized walking and talking test is:

A

Reciting alphabet backwards while walking

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9
Q

Average onset of independent walking

A

11-15 mo

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10
Q

Age at which consistent heel strike is present

A

24 mo

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11
Q

At 24 mo, what is absent in the gait cycle?

A

Push off

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12
Q

When is reciprocal arm swing present?

A

30-36mo

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13
Q

Children usually have _____ BOS

A

Wide

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14
Q

Stance:swing for kids

A

80:20

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15
Q

When do children have a mature walking pattern?

A

4-5 years of age

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16
Q

EMGs show a lot of _____________ in kids 5-6 years of age

A

Cocontraction

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17
Q

How do children/elderly widen their stride? (2)

A
  1. Increase hip abduction

2. Toe out

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18
Q

Elderly pts have decreased ___________ at pelvis/trunk

A

Rotation

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19
Q

MCID gait speed for pts with hip fx

A

.1 m/s

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20
Q

5 pathological mechanisms of gait

A
  1. Deformity
  2. Muscle weakness
  3. Sensory loss
  4. Pain
  5. Impaired motor control
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21
Q

Main example of deformity

A

Contracture

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22
Q

Most common type of contracture

A

Ankle PF

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23
Q

Knee flexion contractures inhibit ______________

A

Advancement of thigh

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24
Q

Hip flexor contractures increase strain on these two structures

A
  1. Back

2. Hip extensors

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25
Q

A pt can get a 5/5 MMT and still have _______________

A

Gait deviations

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26
Q

2 common gait deviations caused by muscle weakness

A
  1. Dec speed

2. Substitutions

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27
Q

4 gait deviations caused by sensory loss

A
  1. Dec speed
  2. Substitute by locking knee
  3. Hitting floor loudly
  4. Visual monitoring of legs/feet
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28
Q

In someone with a unilateral LE injury, they will have more _______ on the painful side

A

Swing

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29
Q

Ankle resting position

A

15º PF

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30
Q

Knee resting position

A

30-45º flexion

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31
Q

Hip resting position

A

30º flexion

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32
Q

Swelling at a painful joint can cause _____________

A

Disuse atrophy

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33
Q

Extension synergy

A

IR, add, ext, PF

34
Q

4 types of impaired motor control gait deviations

A
  1. Spasticity
  2. Dec selective control
  3. Primitive locomotor patterns
  4. Impaired phasing
35
Q

Spasticity obstructs yielding quality of _______________ during stance

A

Eccentric muscle activity

36
Q

Part of gait that breaks up synergy and poses problem for patients

A

Mid-terminal swing

37
Q

___________ is related to velocity

A

Arm swing

38
Q

UEs assist with __________ during gait

A

Balance

39
Q

What MMT do hip flexors need to be sufficient in swing?

A

2+

40
Q

Limited hip flexion subsequently decreases _________

A

Knee flexion

41
Q

2 ways for a pt to advance “longer limb” in swing

A
  1. Hip circumduction

2. Hip hiking

42
Q

The body experiences the most ___________forces during swing

A

Shearing

43
Q

How does extension synergy cause toe drag?

A

Spasticity of PFs do not allow tib ant to eccentrically control DF

44
Q

How does weakness in soleus/gastroc affect IC?

A

Their normal job: hold tib back during weight acceptance

Weakness allows tibia to travel forward - causes too much hip and knee flexion

45
Q

4 degrees of excessive PF at IC

A
  1. Foot slap - weakness of tib ant
  2. Low heel strike - semi tight PF
  3. Flat foot contact - tight PF
  4. Forefoot contact - really tight PF
46
Q

Weak dorsiflexors cause _________ at IC

A

Foot slap

47
Q

In extreme hip flexion during loading, how does the body compensate to avoid falling forward?

A

Anterior pelvic tilt

48
Q

3 things to think every time you see a knee hyperextension problem

A
  1. Extensor synergy
  2. Plantar flexor range problem (compensation for PF contracture)
  3. Weak quads
49
Q

If the stance leg has a weak glut med,

  1. Which direction will the trunk lean be toward?
  2. Which side of the pelvis will drop?
A
  1. Trunk lean toward stance leg

2. Contralateral pelvic drop

50
Q

Weak glut max during stance causes pt to have (2)

A
  1. Backward trunk lean

2. Anterior pelvic tilt

51
Q

Weak plantarflexors will cause _____________ during stance. Why?

A

Excessive dorsiflexion - PFs need to be on to eccentrically control the tib throughout stance

52
Q

Name the abnormal gait pattern:

Stooped rigid posture with head and trunk flexed forward

A

Propulsive gait

53
Q

Name the abnormal gait pattern:

Short, rapid steps; rigidity with no arm swing, difficulty with initiation and termination

A

Parkinsonian gait

54
Q

Name the abnormal gait pattern:

Exaggerated hip and knee flexion with foot drop or slap

A

Steppage gait

55
Q

Steppage gait is mainly caused by _________

A

Ankle DF weakness

56
Q

Name the abnormal gait pattern:

Toes pointed out, wide BOS

A

Waddling gait

57
Q

Name the abnormal gait pattern:

Wide BOS, uncoordinated movements, lurching/staggering, variable foot placement

A

Ataxic gait

58
Q

Name the abnormal gait pattern:

Overactivity of hip adductors with narrow, crossing BOS

A

Spastic or scissoring gait

59
Q

Flexor synergy

A

Hip flexion, abd, ER, knee flexion, DF

60
Q

UE flexion synergy

A

Shoulder add, flexion of fingers, wrist, elbow

61
Q

Name the abnormal gait pattern:

Slow velocity, dec stance on involved limb

A

Hemiplegic gait

62
Q

Name the abnormal gait pattern:

Backward lurch of trunk just after IC; hyperext of hip with forward protrusion

A

Glut max gait (lurching)

63
Q

Describe uncompensated vs compensated trendelenbergs

A

Uncomp: contralateral pelvic drop at IC of affected side

Comp: lateral trunk flexion/lean, steppage gait

64
Q

Name the abnormal gait pattern:

Avoidance of WB on affected side

A

Antalgic gait

65
Q

In someone with hip pain, how will their hip be oriented during swing? Why?

A

Flexed, ER, abducted

Relaxes joint capsule

66
Q

If a pt avoids heel strike unilaterally, you can assume that they have _______

A

Pain

67
Q

If a pt has pain @ forefoot, they will avoid….

A

Toe off

68
Q

If pt has pain @ ankle or hindfoot, they will avoid…

A

Heel strike

69
Q

Toe walking is often seen in pts with ______ pain

A

Knee

70
Q

2 etiologies for propulsive gait

A
  1. CO2 poisoning

2. Drug side effects

71
Q

6 etiologies for steppage gait

A
  1. Deep peroneal n damage
  2. L5 herniation
  3. Polyneuropathy
  4. MS
  5. Polio
  6. Guillan-Barre
72
Q

3 etiologies for waddling gait

A
  1. Congenital hip dysplasia
  2. Muscular dystrophy
  3. Spinal muscular atrophy
73
Q

6 etiologies of scissoring gait

A
  1. CVA
  2. TBI
  3. SCI
  4. Meningomyelitis
  5. MS
  6. CP
74
Q

FMS

A

Functional mobility scale

75
Q

FAC

A

Functional ambulation categories classification

76
Q

3 things that DGI has but GARS doesnt

A
  1. Walking w head turns
  2. Walking w 180º
  3. Stepping over/around obstacles
77
Q

What 2 things does FMS measure?

A

3 distances and LoA for those distances

78
Q

2 classifications of FAC

A

Independent vs dependent gait

79
Q

Massed flex/ext is an example of which of the 5 pathologies?

A

Impaired motor control

80
Q

A loss in which of the 5 pathologies will affect a pts DGI score the most?

A

Sensory loss

81
Q

Explain the difference between crouch gait and steppage gait

A

Crouch: overlengthening of the heel cord causing excessive hip and knee flexion (CP pts); see excessive DF in stance

Steppage: crouch gait with foot drop

E&M (24 decks)

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