B6.075 Prework 2: Gait and Balance Disorders in Older Adults

Question 1

characteristics of gait associated with aging

Answer 1

reduction in velocity
reduction in stride length
increased stance width
increased time with both feet on the ground
bent posture
less vigorous push off

Question 2

what types of diseases correlate with senile gait patterns

Answer 2

psych conditions
cardio
infectious/metabolic
MSK disorders
neuro disorders
sensory abnormalities
recent surgery / hospitalization

Question 3

relationship between meds and gait disorders

Answer 3

use of 4+
specific classes
can lead to increased fall risk

Question 4

most common problems identified in those with difficulty walking

Answer 4

arthritis

orthostatic hypotension

Question 5

why is it important to evaluate gait and balance disorders

Answer 5

major causes of falls

consistently predict future falls

Question 6

guidelines on fall prevention

Answer 6

ask annually about falls
ask about / examine gait at least once
comprehensive assessment for those who present after falls
inquire about environmental hazards
review meds

Question 7

functional ambulation classification scale

Answer 7

assesses mobility status

includes degree of assistance needed to ambulate and types of surfaces a patient can navigate

Question 8

gait assessment methods

Answer 8

Timed Up and go
Berg Balance Scale
Performance-Oriented Mobility Assessment

Question 9

description of Timed Up and Go

Answer 9

reliable diagnostic tool
quick to administer
pts timed as they rise from a chair without using their arms, walk 3 meters, return to the chair, and sit down
<10 s is normal
>14 is abnormal as associated with increased fall risk

Question 10

description of functional reach test

Answer 10

reliable, valid, quick test to evaluate balance and postural stability
stand w feet shoulder width apart and raise one arm 90 degrees to the front
without moving feet, patient should reach forward while still maintaining stability
<7 in is predictive of falls

Question 11

approach to treatment of gait disorders

Answer 11

multifactorial
require several modes of treatment
usually not reversible, but can make modest improvements and impact functional outcomes

Question 12

specific interventions for fall prevention

Answer 12

surgery in some specifc cases
pacemakers for carotid sinus hypersens
eye cataract surgery
reduce # of meds
taper off psychotropic meds
mobility aids
home safety programs
exercise and PT