Analysis of and Interventions for Gait Dysfunction

Question 1

How does gait speed affect a person and their participation?

Answer 1

• 100 cm/second is the cut off to safely ambulate the community
• slower gaits are more inefficient and use a lot of energy
• this could affect their participation for going places and traveling

Question 2

How can gait speed be examined?

Answer 2

• 10 meter walk test
• 6-minute walk test (can go slower/take breaks)
• technological evaluation (Zeno walkway or paper and paint)
• gait assessments: complex walking tasks, observational analysis

Question 3

samples of gait assessments

Answer 3

• complex task
• dynamic gait index: walking and doing another task
• walking while talking test: sometimes one needs ore attention so they stop
• functional gait assessment: walking backward (functional)

Question 4

How can gait assessments be used to predict disabilities from functional measures

Answer 4

• ability to change terrain
• avoid obstacles
• handle manual loads
• curbs are critical (not stairs- easier to avoid)
• many patients are limited in community ambulation due to speed (crossing a road)

Question 5

what do you look at when you are examining someone at the impairment level?

Answer 5

• ankle strength and ROM
• knee strength and ROM
• hip strength and ROM
• sensation: using somatosensory information
• cognition
• other motor and sensory impairments constraining mobility (tone, pain, neuropathy)

Question 6

Transition to treat of gait with
- long term goals
- short term goals

Answer 6

• long term goals (outcomes): pt will be able to walk independently…
• short term goals: anticipated goals - change underlying impairments, improve gait patterns , accomplishing interim steps toward long term goals

Question 7

What do interventions to improve gait have to have/be?

Answer 7

• challenging: in order to cause long term changes there needs to be a challenge
• progressive and optimally adapted: to continue to challenge them
• active participation
• postural alignment and stability
• progression

Question 8

Task- orient approach to treating gait dysfunction include what characteristics?

Answer 8

Therapeutic interventions that are task specific
- minimize impairments
- gait skill practice: can include treadmill
- use whole practice (sometimes can part practice)
- emphasis on varied task and environment

Question 9

interventions at the impairment level for gait dysfunction

Answer 9

MSK impairments:
- propulsion: ankle
- postural control: ankle, knee, and hip extensors

Question 10

Does changing impairments have an impact on functional gait

Answer 10

Therapeutic strategies:
- High-intensity resistance training
- resistance exercise
- strength training
*All strategies showed changes in strength but not always in functional gait

Question 11

Postural support and stability for gait

Answer 11

• control of upright posture
• extensor support movement
• foot placement at initial contact
• balance during double-and single limb support
• use of AD

Question 12

Progression of limb and its affect on gait

Answer 12

• energy generation to push and pull limb forward
• advancement of the swing limb: must work on increasing speed of gait

Question 13

Use of enhanced sensory cures during functional gait training

Answer 13

auditory cues:
- metronome: helps with cadence
- musical: musical feedback has better results that the use of metronome: often will match the tempo