Functional Upright Mobility Deficits in Neuromuscular Disorders Flashcards

Question

Equinus Gait (Heel Does Not Touch Ground) =

Answer 1

Occur in: Midstance to Terminal Stance heel does not make contact with the ground, and in terminal stance, the heel remains elevated deviation affects the ability to perform a normal heel strike and can impair propulsion heel remains elevated, and the foot lands on the toes or forefoot caused by spasticity or shortening of the calf muscles (gastrocnemius and soleus) or weakness in the dorsiflexors During heel strike? - Stays in PF, contracture of PF

Answer 2

Occur in: Terminal Stance to Pre-Swing during the terminal stance phase when the heel is supposed to lift off the ground to push off = reduced or absent heel off impacts forward propulsion heel does not lift off the ground, or the push-off phase is significantly reduced = often results from weakness or spasticity in the calf muscles Reduces forward propulsion and gait efficiency, which can lead to a slower walking speed and reduced mobility

Answer 3

Occur in: Initial Swing to Terminal Swing foot cannot be lifted properly, causing it to drag on the ground = due to weakness in the dorsiflexors and impacts foot clearance Difficulty in lifting the foot during the swing phase, leading to the foot dragging on the ground Increases the risk of tripping and falling, and requires compensatory strategies like high-stepping or hip hiking to clear the foot Weak DF, spastic/contracture of PF, excessive hip/knee extension

Answer 4

Occur in: Initial Swing to Terminal Swing foot remains in a plantarflexed position throughout the swing phase, which may require high-stepping or hip hiking to clear the foot from the ground foot remains in a plantarflexed position (toes pointing downward) throughout the swing phase, similar to the stance phase can be caused by spasticity or contractures in the calf muscles Leads to a high-stepping gait or increased hip flexion to clear the foot, impacting gait efficiency and potentially causing compensatory movements that can lead to joint stress

Answer 5

stance - Excessive knee flexion - Hyperextension swing - Decreased flexion (initial/mid swing) - Inadequate knee extension at terminal swing/initial contact

Answer 6

Occurs in: Midstance to Terminal Stance knee is excessively bent during the stance phase, more than what is typically observed weak knee extensors (quads), spastic flexors (hamstrings) can lead to instability and difficulty in bearing weight properly

Answer 7

Occurs in: Midstance to Terminal Stance knee extends beyond its normal anatomical position, resulting in a hyperextended knee Weakness in the quadriceps or hamstring muscles, combined with reduced proprioception and impaired control, can lead to hyperextension can cause instability, increased risk of falls, and excessive stress on the knee joint and surrounding structures

Answer 8

Occurs in: Initial Swing to Mid Swing making it difficult for the foot to clear the ground Weakness in the knee flexors (hamstrings) or spasticity in the extensors (quadriceps) can lead to decreased knee flexion. can result in foot drag or a compensatory high-stepping gait, increasing the risk of tripping and reducing walking efficiency

Answer 9

Occurs in: Terminal Swing to Initial Contact knee does not fully extend during the terminal swing phase, resulting in a lack of proper knee straightening at initial contact Weakness in the quadriceps or inadequate control of the knee extensors can prevent full knee extension can lead to an abnormal gait pattern with reduced stability at heel strike, affecting the smooth transition from swing to stance and potentially causing gait instability

Answer 10

stance - poor hip position - trendelenburg gait swing - decreased hip flexion - hip hike - abnormal substitutions (circumduction, scissoring)

Answer 11

Occurs in: All Stance Phases (Initial Contact, Loading Response, Midstance, Terminal Stance) may be positioned incorrectly, such as being in excessive flexion, extension, or adduction during the stance phase = can affect the alignment and stability of the hip joint can be due to muscle weakness, spasticity, or abnormal muscle tone affecting the hip muscles (e.g., iliopsoas, gluteals) can lead to inefficient weight-bearing, reduced stability, and potential discomfort or pain

Answer 12

Occurs in: Midstance to Terminal Stance dropping of the pelvis on the side opposite to the stance leg, resulting in an abnormal gait pattern = due to weakness in the gluteus medius and minimus muscles on the stance side Weakness or dysfunction in the hip abductor muscles pelvis drops on the side of the non-stance leg, which can lead to a noticeable hip drop or tilt, impacting overall gait stability and balance

Answer 13

Occurs in: Initial Swing to Mid Swing making it difficult for the leg to advance properly. Weakness in the hip flexors (e.g., iliopsoas) or spasticity in the hip extensors (e.g., gluteus maximus) results in reduced leg swing, potentially causing foot drag or a compensatory high-stepping gait to clear the ground

Answer 14

Occurs in: Initial Swing to Mid Swing abnormal lifting of the pelvis on the swing side to help clear the foot from the ground = compensatory mechanism to address foot drop or insufficient hip flexion Reduced hip flexion or foot drop can lead to hip hiking to ensure adequate foot clearance during the swing phase helps with foot clearance but can lead to an inefficient gait pattern and potential overuse of the lower back and hip muscles

Answer 15

Occurs in: Initial Swing to Terminal Swing compensatory movement where the leg swings in a circular motion away from the body to clear the ground often used when there is reduced hip flexion or foot drop Adds complexity to the gait pattern and can lead to increased energy expenditure and gait inefficiency

Answer 16

Occurs in: Mid Swing to Terminal Swing = when the legs cross in front of each other gait pattern where the legs cross in front of each other during the swing phase can occur due to spasticity or increased tone in the adductor muscles or poor coordination Causes a narrow base of support, increasing the risk of tripping and instability

Answer 17

stance: - Increased trunk flexion - Lateral trunk lean - Pelvic drop swing: - Decreased (forward) pelvic rotation - Backward trunk lean

Answer 18

Occurs in: Midstance to Terminal Stance Excessive forward bending of the trunk Weakness in the hip extensors, trunk extensors, or poor control of the trunk due to muscle imbalances or spasticity compensatory mechanism for reduced propulsion or poor balance deviation can reduce stability, affect forward progression, and increase energy expenditure during walking

Answer 19

Occurs in: Midstance to Terminal Stance trunk leans excessively to one side, typically towards the weak or affected side Weakness in the hip abductor muscles (e.g., gluteus medius) on the stance side, or a compensatory strategy to maintain balance due to muscle weakness or spasticity deviation can impair balance and stability, and may lead to increased risk of falls

Answer 20

Occurs in: Midstance to Terminal Stance noticeable dropping of the pelvis on the side opposite to the stance leg Weakness in the hip abductors on the stance leg side (e.g., gluteus medius), often associated with Trendelenburg gait can affect gait stability, increase the risk of falls, and result in an inefficient gait patter

Answer 21

Occurs in: Initial Swing to Mid Swing Reduced rotation of the pelvis forward relative to the trunk and legs during the swing phase Reduced hip flexion or poor coordination of the trunk and pelvis, often due to muscle weakness or spasticity can limit stride length, decrease gait efficiency, and affect overall walking speed

Answer 22

Occurs in: Swing Phase, particularly Terminal Swing Excessive backward leaning of the trunk Weakness in the hip flexors or excessive hip extension, sometimes as a compensatory mechanism for poor forward propulsion or trunk control deviation can affect balance, reduce efficiency in leg swing, and contribute to an abnormal gait pattern

Answer 23

Decreased weight-bearing over hemiparetic leg  Unequal step/stride length; narrow BOS  Decreased cadence/abnormal timing

Answer 24

Reduced amount of weight supported by the affected (hemiparetic) leg compared to the non-affected leg Weakness, spasticity, pain, or impaired proprioception in the hemiparetic leg patient may avoid putting full weight on the affected side due to fear of instability or discomfort Occurs in: All Phases of the gait cycle, but most noticeable during the Stance Phase when the leg is supporting the body's weight = more pronounced weight shift to the unaffected leg.

Answer 25

Discrepancy in the length of steps or strides between the affected and unaffected legs hemiparetic leg may have a shorter step/stride length causes: Decreased range of motion, reduced strength, or impaired motor control on the affected side Occurs in: Swing Phase and Stance Phase Shortened step length can be observed as the affected leg swings forward and during stance when the leg is bearing weight.

Answer 26

distance between the feet is reduced, leading to a narrower stance width causes: Poor balance or coordination Occurs in: All Phases, but most noticeable during Stance Phase as the feet are in contact with the ground.

Answer 27

Reduced number of steps taken per minute, leading to a slower walking speed causes: Weakness, reduced muscle control, or pain in the hemiparetic leg Patients may have difficulty maintaining a normal cadence due to the effort required to move the affected leg Occurs in: All Phases, but the overall effect is seen in the decreased speed of the gait cycle

Answer 28

Disruption in the normal timing of the gait cycle phases, leading to irregularities in the rhythm of walking causes: Motor control issues, muscle weakness, or spasticity affecting the timing and coordination of the gait cycle Occurs in: All Phases, with irregularities often observed throughout the Stance and Swing Phases as the gait pattern becomes less smooth

Answer 29

Propulsion – reduced speed/symmetry Stance control – buckling, hip/knee collapse Limb advancement/swing – limited paretic step length/speed Postural/Lateral stability – balance difficulty, reduced speeds

Answer 30

leads to slower walking speed and less symmetrical gait patterns can affect the efficiency and fluidity of walking, making it harder for the patient to maintain a consistent pace Evaluate the effectiveness of the push-off phase and the overall power generated during gait = Assess symmetry of propulsion between legs and observe the ability to maintain or increase walking speed

Answer 31

Focus on strengthening the muscles involved in propulsion, such as the calf muscles (gastrocnemius and soleus) and the hip extensors (gluteus maximus) Implement techniques to improve the push-off phase during the stance phase, such as toe raises and progressive weight-bearing activities Use orthotics or shoe inserts to improve push-off and reduce asymmetry Include exercises that simulate walking on various surfaces and inclines to improve propulsion and speed

Answer 32

can lead to instability and difficulty maintaining an upright posture often results from weakness or poor control of the muscles that stabilize the joint Observe stability and control during the stance phase > Look for signs of knee or hip buckling, uneven weight distribution, and overall balance while standing and transitioning weight

Answer 33

Target the muscles responsible for joint stability, including the quadriceps, hamstrings, hip abductors (gluteus medius), and hip extensors Engage in exercises that improve balance and proprioception, such as standing on unstable surfaces or performing weight-shifting activities Practice controlled weight-bearing activities and retrain proper stance mechanics to prevent knee or hip collapse Consider using braces or orthotics to provide additional support and reduce the risk of buckling

Answer 34

Limited step length and speed on the affected (paretic) side can lead to an asymmetrical gait and difficulty in achieving a smooth and efficient walking pattern Measure the length and speed of the swing phase of the affected limb > evaluate the ability to advance the limb and clear the ground during swing

Answer 35

strengthening the hip flexors (iliopsoas) and improving the range of motion of the hip and knee to facilitate better limb advancement functional gait training techniques such as treadmill walking with body-weight support, high-step walking drills, and stride length exercises stretching exercises to improve flexibility and reduce muscle tightness that may limit limb advancement Functional Electrical Stimulation (FES): Implement FES to stimulate the muscles involved in limb advancement and enhance swing phase performance

Answer 36

Difficulty maintaining balance and reduced walking speeds are common issues This can lead to an increased risk of falls and reduced mobility Assess overall balance and stability during walking > look for deviations in posture and lateral stability, and evaluate the ability to maintain an upright position and control body sway

Answer 37

Engage in exercises that improve static and dynamic balance, such as standing on one leg, walking on uneven surfaces, and performing balance board exercises Strengthen core muscles and lower extremity muscles to enhance overall stability and control Incorporate activities that improve coordination and proprioception, such as agility drills and task-specific training Implement gait training that focuses on improving walking speed and stability, including treadmill training and over-ground walking exercises with varying speed

Answer 38

Initial motor symptom in ~ 13% to 33% of patients Resting Tremor Bradykinesia (Slowness of Movement) Rigidity = increase m. tone Postural Instability Unilateral symptoms (eventually become bilateral)

Answer 39

Reduced arm swing with asymmetry Festinating gait (anteropulsive/retropulsive) Shuffling gait Freezing of gait (FOG) Difficulty turning or changing directions

Answer 40

Limited or absent swinging of the arms while walking Rigidity and bradykinesia affect the ability to swing arms naturally > deviation can lead to reduced balance and coordination can affect overall gait stability and efficiency

Answer 41

Progressive increase in walking speed with increasingly shorter steps, often accompanied by a forward-leaning posture Difficulty in controlling the speed of movement, often due to impaired postural control and bradykinesia Can lead to a loss of balance and difficulty stopping or changing direction

Answer 42

Small, rapid steps with minimal heel-to-toe movement Difficulty in initiating and maintaining movement due to bradykinesia and rigidity. Feet may appear to drag or remain close to the ground Increases the risk of tripping and falls, and reduces walking speed

Answer 43

Brief, sudden inability to move the feet forward, often described as feeling "stuck" or "glued" to the floor Related to motor planning difficulties and disturbances in the basal ganglia circuits that are involved in initiating and maintaining movement Increases fall risk and significantly impairs mobility

Answer 44

Problems with initiating and executing turns while walking Rigidity and bradykinesia make it hard to coordinate body movements and shift weight effectively during turns Can lead to hesitation, unsteady movements, and increased fall risk during turns

Answer 45

Gait changes secondary to muscle weakness, spasticity, fatigue, altered sensation, impaired balance, visual problems, and/or FEAR OF FALLING Toe drag, genu recurvatum, circumduction Staggering, uneven steps; poor foot placement; uncoordinated limb movements (“drunk gait”) Scissoring gait pattern Walking is more energy consuming and slow

Answer 46

front part of the foot drags on the ground during the swing phase of gait Weakness in the dorsiflexor muscles (e.g., tibialis anterior) or spasticity can lead to insufficient lifting of the foot Increases the risk of tripping and falling, reduces walking efficiency, and can cause foot and toe injuries

Answer 47

Hyperextension of the knee joint during the stance phase, causing the knee to bend backward Muscle weakness, particularly in the quadriceps or hamstrings, or spasticity can lead to instability and hyperextension Causes instability and can lead to knee pain and increased fall risk

Answer 48

swinging motion of the leg outward during the swing phase, often involving a wide arc of movement Weakness or spasticity in the hip flexors or knee extensors, or a compensatory strategy to lift the foot clear of the ground Results in a less efficient gait pattern and can contribute to increased fatigue and difficulty with coordination

Answer 49

Unsteady and irregular gait with noticeable swaying or weaving, often described as a “drunk gait" Impaired balance and coordination, potentially due to cerebellar involvement or sensory disturbance Increases fall risk and reduces overall gait stability and efficiency

Answer 50

Asymmetry in the length and placement of steps, with noticeable variations in step length and width Muscle weakness, spasticity, and poor coordination can lead to irregular step patterns and variability in foot placement Contributes to an unstable gait and difficulty in maintaining a consistent walking pattern

Answer 51

Difficulty in placing the foot accurately during walking, leading to missteps or uneven footfalls Sensory deficits or coordination problems can affect the ability to place the foot correctly Increases the risk of tripping, stumbling, and falling

Answer 52

Erratic and uncoordinated movements of the limbs, often resembling an intoxicated gait Impaired motor control and coordination, commonly due to cerebellar dysfunction or lesions affecting motor pathways Results in a highly unstable and inefficient gait, with increased fall risk and difficulty in performing everyday tasks

Answer 53

legs cross over each other during walking, often resulting in a narrow base of support and difficulty in leg clearance Spasticity in the adductor muscles of the thighs, leading to excessive internal rotation and crossing of the legs Causes a characteristic gait pattern that can be inefficient and contribute to tripping and difficulty navigating through spaces

Answer 54

Can be quite variable in incomplete SCI speed modulation of specific gait parameters (e.g., step length, cadence), up to a point, may be preserved Different from observations in conditions affecting supraspinal motor centers Absent or Reduced Arm Swing Hip Hiking Circumduction Hypertonia Impaired Gait Speed Unsteady gait Reduced or Absent Trunk Control

Answer 55

Limited or no movement of the arms during walking May result from impaired trunk control and balance or compensatory strategies for lower limb weakness Affects overall gait stability and can lead to inefficient movement patterns

Answer 56

Elevated hip on the affected side during swing phase to facilitate foot clearance Weakness or paralysis of the hip flexors and knee extensors may necessitate compensatory hip hiking Can lead to an inefficient gait pattern and increased energy expenditure

Answer 57

Outward swinging of the leg during the swing phase Similar to hip hiking, this compensatory mechanism helps clear the foot from the ground due to weakness in the hip flexors and knee extensors Reduces gait efficiency and can result in fatigue

Answer 58

Weakness in specific muscle groups leads to deviations such as knee buckling or difficulty in maintaining a stable gait Loss of function in muscles innervated below the level of injury Can lead to instability, increased fall risk, and compensatory gait patterns

Answer 59

Increased muscle tone leading to stiffness and potentially abnormal postures Spasticity resulting from injury-induced changes in spinal cord pathways Can cause stiff, jerky movements and affect gait fluidity and efficiency

Answer 60

Difficulty adjusting gait speed in response to different walking conditions or tasks Residual function in incomplete SCI may preserve some speed modulation, but not as effectively as in able-bodied individuals Limits adaptability in various walking environments and tasks

Answer 61

Uneven gait patterns with differences in step length, cadence, or weight-bearing Variable function of the lower limbs and trunk control depending on the level and completeness of the injury Can lead to inefficiencies in walking and increased risk of falls

Answer 62

Difficulty maintaining an upright posture and controlling trunk movements during gait Loss of motor control and strength in trunk muscles Affects overall balance and coordination, leading to unsteady gait and increased fall risk

Answer 63

Unsteady or Jerky Movements = irregular or discontinuous, with noticeable jerks or hesitations Inconsistent Step Length = Variation in the length of steps taken Difficulty in smoothly transitioning between phases of the gait cycle due to poor coordination unsteady gait = increases the risk of tripping and falling Poor Foot Placement = difficulty in placing the foot accurately on the ground, leading to missteps and uneven contact with the floor Arm swing may be exaggerated or diminished due to difficulty in coordinating upper and lower body movements Excessive elevation of the hip on the swing side to clear the foot or insufficient hip hiking due to coordination problems

Answer 64

Reduced Gait Speed = Insufficient force generation during both the stance and swing phases of gait, leading to decreased propulsion and slower movement shorter strides = Inability to generate enough force to propel the body forward effectively Difficulty with Push-Off = Weak plantar flexors or insufficient muscle activation during the push-off phase Excessive Hip Flexion = compensate for weak ankle dorsiflexors or plantar flexors Knee Hyperextension or Buckling = Weak quadriceps or insufficient control of knee flexor/extensor muscles, leading to instability and difficulty maintaining knee alignment compensatory movements such as excessive hip hiking, circumduction, or lateral trunk lean to aid in foot clearance and forward propulsion

Answer 65

Involuntary Muscle Contractions (Spasticity) = Excessive muscle contractions and stiffness, leading to reduced flexibility and difficulty in smooth movement Problems with the precise control of movements, affecting coordination = uneven or irregular gait patterns, and difficulty in making precise adjustments during walking, such as avoiding obstacles Elevated muscle tone, especially in the lower limbs, leading to a stiff gait Inadequate Foot Clearance = Spasticity in the calf muscles or weakness in the dorsiflexors affects foot lift Unpredictable and jerky movement patterns during gait Slower walking speed due to difficulty in generating smooth, coordinated movements

Answer 66

Increased Risk of Falling = Difficulty in perceiving and maintaining vertical alignment affects balance and stability Deviations from a normal gait pattern, such as uneven step length or asymmetric stride Forward Lean or Backward Lean = Impaired perception of vertical alignment can cause individuals to adopt compensatory postures to maintain balance Shuffling or Cautious Gait = Fear of falling and difficulty in maintaining balance may lead to a more conservative and less dynamic gait pattern Reduced Arm Swing = compensatory strategy to stabilize the body Unsteady or Wobbly Gait Difficulty with Navigation = Impaired perception of vertical orientation affects spatial awareness

Answer 67

Facilitate lost movement = Restore or improve the ability to perform movements that have been compromised or lost due to neurological impairments. Improve efficiency = Enhance the effectiveness and efficiency of movement to reduce fatigue, improve speed, and optimize overall mobility.

Answer 68

Task-specific training functional electrical stimulation (FES) to activate muscles and enhance motor learning Resistance training targeting specific muscle groups that are weak or impaired Passive or active-assisted ROM Balance and coordination exercises to refine motor skills and movement patterns

Answer 69

gait retraining exercises to focus on smoother, more coordinated movement patterns strategies to manage and conserve energy during activities Simulation of daily activities (e.g., walking to the store, climbing stairs) to practice and refine functional skills Enhance mobility and independence through the use of devices Incorporation of aerobic exercises to improve cardiovascular fitness

Answer 70

Overground Walking: Practice walking in a controlled environment to simulate real-world conditions. Treadmill Training: Use a treadmill with or without body weight support to focus on walking mechanics and endurance. Walking in Different Environments: Practice walking on various surfaces (e.g., uneven terrain, inclines) to enhance adaptability. Incorporate drills that focus on specific aspects of walking, such as foot clearance, step length, and cadence Create a course with various challenges (e.g., cones, steps) to improve navigation and maneuverability

Answer 71

1) task complexity - Multistep Exercises - Functional Tasks - Progressive Overload - Task Variation 2) task specificity - Task-Specific Training - Fine Motor Tasks - Coordination Drills - Simulation of Real-Life Tasks 3) task difficulty - Gradual Intensity Increase - Interval Training - Functional and Challenging Activities - Exercise Variety - Environmental Variation

Answer 72

Individual Patient Factors Exercise and Activity Variables Safety and Risk Management Progress Monitoring and Adaptation Environmental and Contextual Factors

Answer 73

Diagnosis and Severity Functional Abilities Comorbidities Motivation and Psychological Factors

Answer 74

Intensity Duration Frequency Type of Activity

Answer 75

Fall Risk Injury Prevention Medical Stability

Answer 76

Assessment and Feedback Goal Setting Program Adaptatio

Answer 77

Home Environment Accessibility Support Systems

Answer 78

Encourage the patient to consciously scan their environment more thoroughly visual markers or cues to draw attention to important areas of the visual field

Answer 79

Challenges in recognizing or attending to stimuli, which can affect spatial awareness and movement planning Focused Attention Exercises: Use exercises designed to improve attention to specific tasks or environments Create structured and clutter-free environments to minimize distractions and focus attention

Answer 80

Cognitive issues like distractibility or psychological factors like anxiety can impact concentration, learning, and performance Provide simple, clear, and concise instructions. Break tasks into smaller, manageable steps Use of Reminders: Employ visual or auditory cues to help the patient stay on track. Minimize environmental distractions and provide a calm, supportive setting to reduce anxiety and improve focus

Answer 81

Difficulty understanding or producing speech can affect the ability to follow instructions or express needs Use short sentences and simple language. Avoid jargon or complex terminology Incorporate visual aids or demonstrations to supplement verbal instructions Repeat instructions as needed and ask for confirmation to ensure understanding

Answer 82

Pain can limit movement, reduce participation, and impact overall treatment effectiveness Regularly assess the patient’s pain levels and adjust activities accordingly Adjust the intensity, duration, or type of activities to accommodate pain levels. Avoid activities that exacerbate pain Utilize pain management techniques such as heat/cold therapy, relaxation techniques, or medication

Answer 83

compensation restoration prevention

Answer 84

adapt to their impairments by using external aids, modified strategies, or assistive devices AFO’s (Ankle-Foot Orthoses) = Provide support and stability to the ankle and foot, correct foot drop, and improve gait mechanics Assistive devices = Enhance mobility and function by providing external support Altered gait strategies = Modify walking patterns to accommodate functional limitations or improve gait efficiency

Answer 85

restore lost function and improve physical capabilities through targeted exercises and training Strengthening = Resistance training, weight-bearing exercises, and functional strength exercises Gait/balance (motor control) retraining = Improve motor control, gait mechanics, and balance to enhance walking ability and prevent falls CV training = Aerobic exercises such as walking, cycling, or swimming

Answer 86

prevent complications, injuries, and deterioration of function Fall risk reduction strategies = Remove trip hazards, install grab bars, and improve lighting = Exercises designed to improve balance and strengthen key muscle groups = Teach patients and caregivers about fall prevention techniques and safety measures Activity restriction = Advise on adjusting or avoiding specific activities that pose risks

Answer 87

good: mod to high-intensity gait training; VR gait training] okay: (strength training; combined strategies; VR balance activities) High-intensity gait training has been shown to improve gait speed, endurance, and overall walking ability in individuals with chronic stroke VR gait training has shown positive outcomes in improving gait performance, balance, and mobility Strength training can help improve muscle strength and functional mobility, which may contribute to better gait performance Combining various strategies, such as gait training with strength training or balance activities, may offer additional benefits compared to single-modality

Answer 88

good/okay: aerobic exercise, balance/resistance training; gait training; external cueing; community-based exercise Aerobic exercise has been shown to improve cardiovascular fitness, endurance, and functional mobility, which can indirectly enhance gait performance Gait training, particularly when done with moderate to high intensity, has robust evidence supporting its efficacy in improving gait speed, endurance, and functional mobility

Answer 89

good: (exercise training) okay: (VR – positive impact on gait/balance & cognitive function; TM training; balance-based torso weighting) Exercise training, particularly when involving strength, endurance, and functional tasks, has been shown to significantly improve gait parameters such as speed, endurance, and overall mobility VR interventions have shown positive impacts on gait, balance, and cognitive function. They provide engaging and interactive environments that can enhance motor learning and rehabilitation outcomes Treadmill training is effective for improving gait speed, endurance, and walking patterns

Answer 90

good: mod to high-intensity gait training = improves gait performance, walking ability, and overall functional mobility > Typically involves repetitive walking practice with high intensity, including treadmill training with or without body-weight support, and over-ground walking okay: strength training; acute intermittent hypoxia = positive effects on muscle strength, endurance, and functional mobility > strengthening key muscle groups involved in gait, such as the lower limbs and core

Answer 91

Engage in high-intensity gait training and task-specific exercise to improve walking speed, endurance, and overall gait function Incorporate strength training to enhance muscle strength and endurance, which supports gait function Implement balance training exercises to address postural control and stability Utilize assistive devices (e.g., AFOs, canes) as needed to support mobility and safety

Answer 92

Perform moderate to high-intensity gait training to enhance walking ability and functional mobility Engage in strength training to improve muscle strength, which supports locomotor function Use treadmill training with or without body-weight support to facilitate walking practice Incorporate balance and coordination exercises to enhance overall stability and movement control

Answer 93

Engage in task-oriented training focused on specific motor tasks and functional activities Implement gait training interventions, including over-ground and treadmill training, to improve walking patterns Include balance and coordination exercises to address deficits and improve functional outcomes Use multimodal interventions combining physical therapy, cognitive training, and occupational therapy for comprehensive rehabilitation

Answer 94

Importance, definition, application & monitoring of intensity particularly effective for individuals with chronic stroke and incomplete SCI involves treadmill walking with varying speeds and inclines, or over-ground walking with added resistance or intensity

Answer 95

Focuses on improving gait specifically through high-intensity walking exercises. Effective in enhancing gait speed and endurance.

Answer 96

A broader approach that includes various high-intensity exercises to improve overall fitness and functional mobility.

Answer 97

Involves alternating between high-intensity and low-intensity intervals to maximize cardiovascular and muscular benefits in a time-efficient manner.

Answer 98

Increase Walking Speed Incorporate Inclines and Hills Add Intervals Increase Duration and Frequency Use Weighted Vest or Ankle Weights Incorporate Functional Tasks Add Resistance Training Use External Cues and Feedback

Answer 99

During the terminal stance phase, the push-off from the forefoot is strong and occurs at the appropriate time, providing sufficient forward propulsion Proper heel-off occurs in the stance phase, facilitating smooth transition to the swing phase The swinging leg clears the ground sufficiently to avoid dragging or tripping = proper knee and ankle flexion Smooth weight transfer from heel strike to toe-off, with minimal lateral or forward/backward sway upright posture and balance throughout the gait cycle

Answer 100

Propulsion Errors: Inadequate push-off, excessive foot drag, or delayed heel-off. Limb Swing Errors: Poor leg clearance, abnormal swing timing, or excessive hip flexion. Stance Control Errors: Buckling of the knee, hip collapse, or instability during weight-bearing. Postural Stability Errors: Excessive lateral sway, forward or backward lean, or frequent balance loss.

Answer 101

Assess the efficiency of push-off, heel-off, and overall forward propulsion Look for abnormal swing patterns, such as excessive hip flexion or foot drag Check for knee buckling, hip collapse, or unsteady weight transfer Observe for excessive lateral sway, forward lean, or loss of balance Consider their willingness to adhere to the program and their psychological readiness for challenging exercises

Answer 102

propulsion stance control limb advancement stability and balance

Answer 103

3 groups (36 sessions of 90 minutes each for 12-16 weeks) Early LT (2 months post-stroke) Late LT (6 months post-stroke) HEP (2 months post-stroke; limited walking) No focus on trying to achieve/maintain higher heart rates during LT (*intensity) No difference between groups! timing of intervention (early vs. late) or the type of intervention (long-term therapy vs. home exercise) did not lead to significantly different outcomes study did not focus on maintaining higher heart rates or intensity during the long-term interventions may imply that intensity could be a crucial factor in improving outcomes