Abnormal Gait Flashcards
1
Q
Reliability of OGA
A
Low-moderate
2
Q
How to improve reliability of OGA?
A
Videotape clients
3
Q
OGA
A
Observational gait analysis
4
Q
GARS
A
Gait assessment rating score
5
Q
DGI
A
Dynamic gait index
6
Q
Predicts risk of fall based on trunk pattern
A
GARS
7
Q
Common dual task challenge that is a predictor of falls
A
Walking and talking
8
Q
An example of a standardized walking and talking test is:
A
Reciting alphabet backwards while walking
9
Q
Average onset of independent walking
A
11-15 mo
10
Q
Age at which consistent heel strike is present
A
24 mo
11
Q
At 24 mo, what is absent in the gait cycle?
A
Push off
12
Q
When is reciprocal arm swing present?
A
30-36mo
13
Q
Children usually have _____ BOS
A
Wide
14
Q
Stance:swing for kids
A
80:20
15
Q
When do children have a mature walking pattern?
A
4-5 years of age
16
Q
EMGs show a lot of _____________ in kids 5-6 years of age
A
Cocontraction
17
Q
How do children/elderly widen their stride? (2)
A
- Increase hip abduction
2. Toe out
18
Q
Elderly pts have decreased ___________ at pelvis/trunk
A
Rotation
19
Q
MCID gait speed for pts with hip fx
A
.1 m/s
20
Q
5 pathological mechanisms of gait
A
- Deformity
- Muscle weakness
- Sensory loss
- Pain
- Impaired motor control
21
Q
Main example of deformity
A
Contracture
22
Q
Most common type of contracture
A
Ankle PF
23
Q
Knee flexion contractures inhibit ______________
A
Advancement of thigh
24
Q
Hip flexor contractures increase strain on these two structures
A
- Back
2. Hip extensors
25
A pt can get a 5/5 MMT and still have _______________
Gait deviations
26
2 common gait deviations caused by muscle weakness
1. Dec speed
| 2. Substitutions
27
4 gait deviations caused by sensory loss
1. Dec speed
2. Substitute by locking knee
3. Hitting floor loudly
4. Visual monitoring of legs/feet
28
In someone with a unilateral LE injury, they will have more _______ on the painful side
Swing
29
Ankle resting position
15º PF
30
Knee resting position
30-45º flexion
31
Hip resting position
30º flexion
32
Swelling at a painful joint can cause _____________
Disuse atrophy
33
Extension synergy
IR, add, ext, PF
34
4 types of impaired motor control gait deviations
1. Spasticity
2. Dec selective control
3. Primitive locomotor patterns
4. Impaired phasing
35
Spasticity obstructs yielding quality of _______________ during stance
Eccentric muscle activity
36
Part of gait that breaks up synergy and poses problem for patients
Mid-terminal swing
37
___________ is related to velocity
Arm swing
38
UEs assist with __________ during gait
Balance
39
What MMT do hip flexors need to be sufficient in swing?
2+
40
Limited hip flexion subsequently decreases _________
Knee flexion
41
2 ways for a pt to advance "longer limb" in swing
1. Hip circumduction
| 2. Hip hiking
42
The body experiences the most ___________forces during swing
Shearing
43
How does extension synergy cause toe drag?
Spasticity of PFs do not allow tib ant to eccentrically control DF
44
How does weakness in soleus/gastroc affect IC?
Their normal job: hold tib back during weight acceptance
Weakness allows tibia to travel forward - causes too much hip and knee flexion
45
4 degrees of excessive PF at IC
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
Weak dorsiflexors cause _________ at IC
Foot slap
47
In extreme hip flexion during loading, how does the body compensate to avoid falling forward?
Anterior pelvic tilt
48
3 things to think every time you see a knee hyperextension problem
1. Extensor synergy
2. Plantar flexor range problem (compensation for PF contracture)
3. Weak quads
49
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?
1. Trunk lean toward stance leg
| 2. Contralateral pelvic drop
50
Weak glut max during stance causes pt to have (2)
1. Backward trunk lean
| 2. Anterior pelvic tilt
51
Weak plantarflexors will cause _____________ during stance. Why?
Excessive dorsiflexion - PFs need to be on to eccentrically control the tib throughout stance
52
Name the abnormal gait pattern:
Stooped rigid posture with head and trunk flexed forward
Propulsive gait
53
Name the abnormal gait pattern:
Short, rapid steps; rigidity with no arm swing, difficulty with initiation and termination
Parkinsonian gait
54
Name the abnormal gait pattern:
Exaggerated hip and knee flexion with foot drop or slap
Steppage gait
55
Steppage gait is mainly caused by _________
Ankle DF weakness
56
Name the abnormal gait pattern:
Toes pointed out, wide BOS
Waddling gait
57
Name the abnormal gait pattern:
Wide BOS, uncoordinated movements, lurching/staggering, variable foot placement
Ataxic gait
58
Name the abnormal gait pattern:
Overactivity of hip adductors with narrow, crossing BOS
Spastic or scissoring gait
59
Flexor synergy
Hip flexion, abd, ER, knee flexion, DF
60
UE flexion synergy
Shoulder add, flexion of fingers, wrist, elbow
61
Name the abnormal gait pattern:
Slow velocity, dec stance on involved limb
Hemiplegic gait
62
Name the abnormal gait pattern:
Backward lurch of trunk just after IC; hyperext of hip with forward protrusion
Glut max gait (lurching)
63
Describe uncompensated vs compensated trendelenbergs
Uncomp: contralateral pelvic drop at IC of affected side
Comp: lateral trunk flexion/lean, steppage gait
64
Name the abnormal gait pattern:
Avoidance of WB on affected side
Antalgic gait
65
In someone with hip pain, how will their hip be oriented during swing? Why?
Flexed, ER, abducted
| Relaxes joint capsule
66
If a pt avoids heel strike unilaterally, you can assume that they have _______
Pain
67
If a pt has pain @ forefoot, they will avoid....
Toe off
68
If pt has pain @ ankle or hindfoot, they will avoid...
Heel strike
69
Toe walking is often seen in pts with ______ pain
Knee
70
2 etiologies for propulsive gait
1. CO2 poisoning
| 2. Drug side effects
71
6 etiologies for steppage gait
1. Deep peroneal n damage
2. L5 herniation
3. Polyneuropathy
4. MS
5. Polio
6. Guillan-Barre
72
3 etiologies for waddling gait
1. Congenital hip dysplasia
2. Muscular dystrophy
3. Spinal muscular atrophy
73
6 etiologies of scissoring gait
1. CVA
2. TBI
3. SCI
4. Meningomyelitis
5. MS
6. CP
74
FMS
Functional mobility scale
75
FAC
Functional ambulation categories classification
76
3 things that DGI has but GARS doesnt
1. Walking w head turns
2. Walking w 180º
3. Stepping over/around obstacles
77
What 2 things does FMS measure?
3 distances and LoA for those distances
78
2 classifications of FAC
Independent vs dependent gait
79
Massed flex/ext is an example of which of the 5 pathologies?
Impaired motor control
80
A loss in which of the 5 pathologies will affect a pts DGI score the most?
Sensory loss
81
Explain the difference between crouch gait and steppage gait
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
