CVA impairments part 4 (gait, modalities and assisted tech, orthotics) Flashcards
What are some spatial asymmetries seen in hemiplegic gait?
↓ Step length
↓ Stride length
Variable step width
↓ Step height in swing
what are some temporal asymmetries seen with hemiplegic gait?
↓ Single-limb stance time
↑ Double limb stance time
↑ Swing time
↓ Cadence
Study GAIT speed slide (slide 6)
:)
What hemiplegic gait abnormalities do we see with the UE?
Decreased or absent arm swing
What hemiplegic gait abnormalities do we see with the trunk?
-Decreased rotation
-Ipsilateral lateral trunk lean
-glute med weakness
Forward trunk lean
Common hemiplegic gait impairments in heel strike to mid stance at the pelvis?
↓ pelvic rotation
↓ hip flexion
↑ hip IR
↑ hip adduction
Trendelenburg
Common hemiplegic gait impairments in heel strike to mid stance at the knee?
3 common knee patterns:
- ↑ knee flexion (particularly at initial contact)
- ↓ knee flexion during the early-stance phase, followed by knee hyperextension in mid to late-stance
- Excessive knee hyperextension throughout most of the stance phase
Common hemiplegic gait impairments in heel strike to mid stance at the foot/ankle?
↓ tibial progression**
↓ ankle DF
Lack of heel strike
Foot flat initial contact
Foot slap after initial contact
Instability at foot/ankle complex inversion, supination
Pes planus
Common hemiplegic gait impairments in mid stance to terminal stance at the pelvis?
Decreased pelvic rotation
Decreased hip extension/terminal stance**
Hip flexion during forward progression
Common hemiplegic gait impairments in mid stance to terminal stance at the knee?
Decreased knee extension
Knee buckling
Delayed movement into knee flexion in preparation for the swing phase
Common hemiplegic gait impairments in mid stance to terminal stance at the foot/ankle?
May still see ↓ tibial progression (step-to pattern)
↓ heel off at terminal stance
Common hemiplegic gait impairments from initial swing to mid swing at the pelvis?
↓ hip flexion
Hip hiking
Circumduction
↑ compensatory ER
Common hemiplegic gait impairments from initial swing to mid swing at the knee?
↓ knee flexion
Common hemiplegic gait impairments from initial swing to mid swing at the foot/ankle?
Poor foot clearance**
Toe drag
↓ ankle DF
↑ inversion
Common hemiplegic gait impairments from mid swing to terminal swing at the pelvis?
↓ hip flexion
Hip hiking
Circumduction
↑ compensatory ER
Common hemiplegic gait impairments from mid swing to terminal swing at the knee?
↓ knee extension
Common hemiplegic gait impairments from mid swing to terminal swing at the foot/ankle?
Poor foot clearance
Toe drag
↓ ankle DF
↑ inversion
What other impairments from CVA can contribute to gait abnormalities?
Spasticity- jerky movements during gait
Hypotonia- buckling LE, floppy UE
Somatosensory deficits
variable foot placement at IC
variable joint placement through GAIT
Risk for ankle rolling
often visually reliant
