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Special Populations > Assessing Gait In Older Adults > Flashcards

Assessing Gait In Older Adults Flashcards

1
Q

using the picture on the other side, review the gait cycle

A
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2
Q

what is considered the average gait velocity for healthy adults?

A
  1. men → 1.32 m/s
  2. women → 1.27 m/s
  3. healthy aging → 1.0 m/s
  4. needed to safely cross street → >1.2 m/s
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3
Q

what gait speed is considered a mark of fraility?

A

walking slower than 0.8 m/s

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4
Q

list the spatial and temporal parameters of gait

A
  1. spatial
    1. step length
    2. stride length
    3. step width
  2. temporal
    1. speed/velocity
    2. single and double support time
    3. swing/stance time
    4. cadence
    5. stride time
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5
Q

list common temporal gait changes with age

A
  1. decreased self-selected gait speed
  2. increased stance time and double-limb support time
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6
Q

list common spatial gait changes with aging

A
  1. decreased step and stride length
  2. increased step width (not a universal finding across studies)
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7
Q

list kinematic/postural gait changes with age

A
  1. decreased excursion of movement at lower extremity joints
  2. decreased reliance on ankle kinetics and power
  3. less upright posture
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8
Q

T/F: slower gait speed is a defining feature of fraility

A

TRUE

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9
Q

T/F: slow speed increases likelihood of CHI transitioning to MCI and CHI transitioning to death

A

TRUE

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10
Q

T/F: slower speeds have no predictive value pertaining to cognitive performance

A

FALSE

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11
Q

what is the impact of dual task on gait speed?

A

multiple studies show significant gait speed decrease in person with MCI and PD

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12
Q

what is the impact of complex dual tasks on gait parameters?

A
  1. sig decreased gait velocity
  2. increased stride time
  3. increased stride time variability in MCI and AD groups compared to healthy controls
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13
Q

list cognitive domains that have a critical impact on gait

A
  1. Attention
  2. memory/learning
  3. language
  4. executive function
  5. complex attention
  6. social cognition
  7. perceptual
  8. motor function
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14
Q

what is MCRS?

A

Motoric Cognitive Risk Syndrome → slowed gait and subjective cog impairment

2-3x more likely to develop dementia than those without MRCS

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15
Q

a gait speed of ≥1.2 m/s is predicative of what?

A

extremely fit

can cross street safely

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16
Q

a gait speed of ≥1.0 m/s is predictive of what?

A

healthy older population with lower risk of hospitalization or adverse health events

independent in ADLs

17
Q

a gait speed of <1.0 m/s is predicative of what?

A
  • increased risk for cognitive decline within 5 years
  • increased risk for death and hospitalization within 1 year
18
Q

a gait speed of <0.8 m/s is predicative of what?

A
  • increased risk of mortality and mobility/ADL disability at 2 years
  • limited community ambulator
19
Q

what is a gait speed of <0.7 m/s predicative of?

A
  • increased risk of death, hospitalization, institutionalization and falls
20
Q

what is a gait speed of <0.4 m/s predicative of?

A
  • functional dependence, severe walking disability
21
Q

what is a gait speed of <0.2 predicative of?

A
  • extremely frail
  • highly dependent
22
Q

T/F: clinical gait training must include more than walking from point A to B?

A

TRUE

23
Q

what to consider when assessing gait in your geriatric patients

A
  1. level ground walking vs stair negotiation
  2. gait speed
  3. other gait parameters
  4. outcome measures
24
Q

describe what is required in stair negotiation

A
  1. requires greater ROM and muscle strength
  2. ascending vs descending
  3. usual pace walking speed and SLS stance time best indicators of stair climbing speed
  4. increasing safety:
    1. handrails, step-to pattern, AD, physical assist
25
Q

how much of an increase in gait speed impacts disability?

A

an increase in as little as 0.1 m/s can reduce disability and mortality

26
Q

impact of backward walking and fall risk

A

backward walking slower than 4.0 m/s may increase fall risk

27
Q

impact of dual task on gait variability

A

dual task = increased gait variability which leads to decreased postural stability

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