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Neuromuscular > abnormal mobility > Flashcards

abnormal mobility Flashcards

1
Q

paresis/weakness reduces the ability to?

A

generate force; huge contributor to disordered gait

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2
Q

true or false: paresis is a primary neuromuscular impairment

A

true

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3
Q

what does pauses affect?

A

number, type, and disagree frequency of motor neurons needed for force production in gait

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4
Q

true or false: paresis does not affect both neural and non neural components of force prooudction

A

false: it does affect both

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5
Q

what does paresis do to gait speed?

A

slows it down

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6
Q

true or false: paresis causes the loss of eccentric and concentric control

A

true

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7
Q

paresis/weakness of the ankle and knee causes (4)

A
  • reduced PF activation
  • reduced DF activation
  • knee hyperextension in stance phase
  • lack of knee flexion in swing phase
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8
Q

true or false: PF paresis is one of the factors leading to knee hyperextension in stance post stroke

A

true - PF are a 2 joint muscle where the plantar flexors should be able to help stabilize the knee and prevent hyperextension

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9
Q

paresis of the quadriceps leads to?

A
  • knee hyperextends during mid stance (gene recurvatum)
  • forward trunk lean (creates extensor moment at knee)
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10
Q

hyperextension compensation of the knee leads to

A
  • diminished knee flexion in swim
  • knee trauma over time
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11
Q

paresis of the hip flexors leads to

A
  • diminished knee flexion during swim
  • to clearance
  • shortened step length (impacts foot position at IC)
  • compensatory strategies
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12
Q

compensatory strategies of paresis of the hip flexors

A
  • hip hike (posterior pelvic tilt/abdominal contraction)
  • circumduction
    -vaulting
  • lateral lean
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13
Q

paresis of the hip extensors lead to

A
  • difficulty holding trunk erected (threatens stability)
  • causes. backward leaning to bring COM behind the hips
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14
Q

paresis of hip abductors leads to

A
  • drop of the pelvis on the contralateral side to the weakness (trendelenburg gait)
  • compensation
  • lateral shift of COM and lateral trunk lean over the stance leg
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15
Q

spasticity and its effects on gait

A
  • results in appropriate activation of the muscle at points during the gait cycle when it is being rapidly lengthened
  • it alters the technical properties of a muscle, producing increased stiffness
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16
Q

when in the gait cycle is the quad rapidly lengthened?

A
  • early stance phase during loading response
  • when the knee flexes during initial swing
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17
Q

when in the gait cycle does the hamstring is rapidly lengthened?

A

terminal swing

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18
Q

spasticity of the plantarflexor includes

A

-abnormal activation of the triceps sure during early stance phase (knee hyperextension)
- TS activation/stiffness in swig (toe drag)
- TS and posterior tibalis (equinovarus positioning)

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19
Q

spasticity of the quadriceps include

A
  • excessive knee extension in stance
  • quad spasticity leads to stiff-knee gait during swing phase (decrease knee flexion and hip circumduction during swing phase of gait)
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20
Q

spasticity of hamstrings include

A
  • excessive activation prevents knee from fully extending (knee flexion at IC)
  • excessive knee flexion persists throughout stance (couched gait pattern)
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21
Q

spasticity of the adductors include

A
  • adductor spasticity produces contralateral drop of pelvis and stance (femur drawn medially)
  • scissoring gait
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22
Q

loss of selective control and emergence of abnormal synergies

A
  • inability to recruit muscles selectively (associated with abnormal coupling of muscles)
  • sterotypical movement strategies ( abnormal synergies or synkinesia)
  • manifested in gait as total extension or total flexion patterns
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23
Q

coordination problems

A
  • non-stretch related muscle overactivity
  • poor segmental and intersegmental coordination (poor timing and scaling of muscle activity and coordination between the 2 LE or between the LEs and UEs)
  • coactivation of agonists/antagonists
24
Q

musculoskeletal impairments

A
  • weakest
  • loss of ROM and contractures
  • changes in alignment
25
Q

proprioceptive loss include

A

CVA and controls had vibration to the TA

26
Q

visual deficits

A
  • vision critical to proactive balance (anticipation of obstacles)
  • leads to reduced gait speed
  • in the blind, increases reliance on auditory cues
  • obvious impairments in route finding
27
Q

vestibular deficits

A
  • gait ataxia
  • impair gaze stabilization during gait
  • lead to reduce gait speed
28
Q

oscillopsia

A

world moving when it is not

29
Q

perceptual deficits

A
  • impaired body image or scheme (ipsilateral trunk lean towards stance leg)
  • unilateral spatial neglect (R CVA/L hemis)
30
Q

perceptual problems may include

A
  • spatial relations disorder
31
Q

topographical disorientation

A

antalgic gait

32
Q

what is spatial relations disorder

A

affects the ability to negotiate the environment, without bumping into obstacles (both walking and in wheelchair)

33
Q

what is topographical disorientation

A

inability to remember the relationship of one place to another

34
Q

what is antalgic gait

A

gait pattern that results from pain

35
Q

antalgic gait may include what kind of results

A
  • reduced weight bearing time on a painful limb
  • avoidance of impact loads
  • reduced joint excursion
  • minimized muscle activation across a joint
36
Q

impaired cogitation –> impaired dual task may include

A
  • posture, balance, and gait require attentional resources
  • attentional demands for postural control in stance and gait are greater in individuals with impaired balance compared to norms
  • important to evaluate walking function under more complex conditions, especially in neurological clients
37
Q

what factors limi participation in the mobility domain?

A
  • depression
  • fatigue
    balance/fall self efficacy
  • usual gait velocity
  • hemiparetic limb strength
38
Q

disorders of mobility (other than gait)

A
  • gait initiation
    ability to maintain balance while COM shifts Post?lat towards swing limb, then to stance limb and forward beyond BOS
  • anticipatory balance that control dynamic stability are critical to the complex process of gait initiation
39
Q

disorders of mobility continue pt2…. other than gait

A
  • stair walking (ascend, descend)
  • reduced anticipatory PF activation for energy absorption when descending
  • instability during longer periods of single limb stance
40
Q

disorders of mobility continue pt3… other than gait

A

-transfers and bed mobility
- STS
- Rise to walk

41
Q

true or false: use force control strategy or zero momentum strategy for those with cardiovascular problems (orthostatic hypotension), episodes of dizziness

A

true

42
Q

other mobility tasks - limitations with bed mobility may include

A
  • difficulty rolling away from a weak side
  • difficulty pushing from side lying to sitting on a weak side
  • difficulty lifting legs into bed moving from sitting to lying
43
Q

Functional Gait Assessment (FGA) fall risk score

A

less than or equal to 22 out of 30

<22/30

44
Q

cut off score for 5xSTS

A

12 seconds (roughly)

45
Q

cut off score for Gait velocity

A

1.13m/s (0.8 for community ambulatory)

46
Q

cut off scores for 6MWT

A

527meters =1,729 feet

47
Q

cicumduciton impairment may present as? treatment>

A
  • plantar flexion tightness
  • calf stretches
48
Q

genuine recurvatum impairment may present as? treatment

A
  • hamstring weakness
  • eccentric knee extension
49
Q

forward trunk lean imparment may present as

A
  • quad weakness
  • step ups/downs, quad strengthening
50
Q

scissoring gait impairment may present as? treatment?

A
  • adductor spasticity
  • stretch add, straddle line/central divider
51
Q

coactivation of muscles impariemtn may present as? treatment?

A
  • cerebellar ataxia
  • reverse walking downstairs
52
Q

lateral lean impairment may present as? treatment?

A
  • hip abductor weakness
  • standing hip abduction ex (monster walk)
53
Q

loss of balance turning impairment may present as? treatment?

A

anticipatory balance
- walking with lots of direction changes

54
Q

excessive knee flexion in stance impairment may present as? treatment?

A
  • LE proprioceptive loss
  • mirror for feedback, walk down hills
55
Q

foot drag impairments may present as? treatment?

A
  • DF weakness
  • seated toe taps
56
Q

poor endurance impairment may present as? treatment?

A
  • decreased conditioning
  • HIIT with limited resting, vital signs monitoring

Neuromuscular (3 decks)

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