exam 3: gait interventions for neuro injuries

Question 1

Recovery of walking is very _____ and tends to be the _____ goal for a patient with a neurologic injury.

Answer 1

salient; primary

Question 2

2/3rds of people who have a stroke cannot _____ require assistance.
An individual’s capacity to move from one location to another -

Answer 2

walk
locomotion

Question 3

Locomotion training leads to improvements in ________ capacity

Answer 3

aerobic

Question 4

How do we know when it is safe to begin gait?

Answer 4

trunk control
weight shifts and weight acceptance into the affected limb
attention to task
ROM at LE joints
stability of ankle
static/dynamic standing control

Question 5

The core measures of gait, balance, and transforms are recommended

Answer 5

6 MWT, Berg Balance Scale, Functional Gait Assessment

Question 6

Stroke Gait Deviations Listed:
The iliac crest on the opposite side (unaffected limb) drops lower than the iliac crest on the affected stance limb due to the inability to control loading:

Compensation for unaffected limb, due to hip drop to ______ back up. Elevation of one side of the pelvis above neutral:

Decreased DF of ankle, keeps foot flat prior to advancing limb. (terminal stance to initial swing):

Ankle PF on contralateral limb during swing. Rising on the forefoot of the opposite stance limb during limb advancement of the reference leg:

Answer 6

contralateral hip drop “trendelenburg sign”
“hike”; hip hiking
late or no heel off
contralateral valtuting

Question 7

What interventions are appropriate based on the following findings?

1. Short step length:
2. Strength in stand limb:
3. Weakness of hip flexors in swing limb:
4. Tight hip flexors decreasing ROM in terminal stance:
5. Fatigue or endurance deficits:
6. Knee buckling and poor quad motor recruitment:

Answer 7

1. Pregait stepping for target improvement.
2. Pregait stepping for target improvement in length.
3. Stepping up onto a step with affected limb.
4. Stretching exercises.
5. Body weight supported treadmill for repetition.
6. Functional Electrical Stimulation (FES) in stance, performing stepping.

Question 8

Functional strengthing of LEs - PT considerations:
Resistance training for this purpose should be at intensities lower than ______% of 1RM

Answer 8

60%

Question 9

Common impairments od hemiplegic ankle:

Answer 9

Ankle DF and Inapporioate Foot Contact

Question 10

Aircast: improves ankle ______ to improve weight acceptance and decrease fear of _______ ankle. Correct ______ is often seen in neurologic gait.

Answer 10

stability; rolling; supination

Question 11

Foot clearance assistance: True or False
Do not stabilize the ankle, foot clearance ONLY.
Options?

Answer 11

True
ace wrap, tape on toe/plastic sliders, theraband

Question 12

Pregait Task Analysis: Pregait is a ______ task, unlike the gait cycle.
Dynamic standing postural control in ________
Ability to weight shift toward therapist in _______
Overshooting or undershooting step length in ________

Answer 12

discrete
execution
initiation
termination

Question 13

Step through vs Step:
usually due to dependence on asymmetric AD =
PT should promote _______ gait pattern.

Answer 13

“step to”
step through

Question 14

For overground locomotor gait training is whole practice of part tasks more emphasized?

Answer 14

whole, due to continuous task

Question 15

Overground Locomotor Gait Traning: Phase of Recovery?

able to improve walking distance and walking ability but not balance:
able to improve balance and walking ability but not distance:
did not improve walking at all, maybe too challenging at this stage:

Answer 15

chronic
subacute
acute

Question 16

High-intensity training protocol required to improve Overground Locomotor Gait training such as _____________ which provides the highest intensity.

Answer 16

Treadmill Training

Question 17

Walking while holding a ball or carrying a tray is considered a ______ task

Answer 17

dual

Question 18

Body weight supported TT - is ______ loop training which is _____ degrees of freedom.

Answer 18

“closed-loop”; less

Question 19

Walking in kneeling is a good treatment for patients with ________ or _______

Answer 19

ataxia or LE extensor tone