Control of Mobility Functions

Question 1

when you are walking down a hill, are you leaning forwards or backwards?

Answer 1

forwards, but less of a lean than if you are walking uphill or even on flat ground.

Question 2

what are the three requirements of any mobility task?

Answer 2

progression (sequence of steps)
posture (eqbm and orientation)
adaptation (different surfaces etc)

Question 3

what is the difference between step length and stride length? Can either be zero or even negative?

Answer 3

step length is from one foot to the other, while stride is one foot to the same one. Step length can be zero or negative, but never stride length (unless you are not walking!)

Question 4

in which plane are all four joints (ankle, knee, hip, and pelvis) used in walking seen to move?

Answer 4

sagital plane

Question 5

which two muscle groups are active during load response?

Answer 5

knee extensors and plantar flexors

Question 6

is our natural walking speed efficient for us?

Answer 6

yes

Question 7

why is it best to inject clonodine into the CSF rather than the blood? why would someone have this injection?

Answer 7

BBB would prevent as much Clonodine from entering brain, so creates more side effects of the NA agonist.

Clonodine is used for hypertension, but can also serve as a trigger + enjancer for our Central Pattern Generator so could help us walk.

Question 8

what is the MLR? what does it do?

Answer 8

mesencephalic locomotor region - speeds up walking

Question 9

why do we quickly shift weight to the foot we will lift when initiating walking?

Answer 9

for momentum

Question 10

is fast walking more efficient than running?

Answer 10

no

Question 11

using the three principles of mobility, describe getting out of bed in the morning

Answer 11

Progression: generate momentum to move body from bed to standing
Postural: control COM from laying in bed to sitting and finally to standing
Adaptation: heavy or thin sheets, height of bed, pillows, etc.

Question 12

name three gait outcomes that increase as we age

Answer 12

• gait variability *note: elderly can use less variety with other tasks such as getting out of bed compared to youth.
• time in double stance
• step width

Question 13

what is the cause of 47% of falls in older adults?

Answer 13

tripping

Question 14

wrt level of CNS involvement, would double vision be low, middle or high? what about subcortical disequilibrium? cerebellar?

Answer 14

low - peripheral
high - no sensory or motor involvement
middle - sensory and motor involvement

Question 15

grouping gait problems by pathophysiology, would loss of ROM be a primary or secondary impairment?

Answer 15

secondary - primary impairments are neuromuscular such as paresis or spasticity

Question 16

give an example of a goal incorporating all of the 8 domains

Answer 16

can be anything that includes distance, time, lighting, terrain, physical load, posture, attention, and collision avoidance/density
eg. ascend 25 or the carpeted stairs within 30 sec in the crowded movie theatre carrying popcorn and talking to a friend. Sit down at your seat.

Question 17

what is one funny way to get patients to walk faster?

Answer 17

tell them to act like they are trying to catch the bus