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OTCA 2634 > Gait > Flashcards

Gait Flashcards

1
Q

name and define the stages of gait

A

Support stage (60%)
- period when the limb under consideration is in contact with the floor.
- begins with initial contact of foot with ground and ends with foot leaving ground
Swing ( 40%)
- period when the limb in consideration is not in contact with the floor
- begins with push-off/ toe-off and ends with heel-stike
Double stance
- period where both feet are in contact with the floor

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2
Q

name the components of ‘standing’ that you will assess during assessment of gait

A
  • standing endurance
  • foot arches
  • medial foot arch
  • lateral foot arch
  • transverse foot arch
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3
Q

What are the pre-functional factors of gait?

A
  • ROM
  • muscle strength
  • sensory factors
  • statesthesia
  • pain
  • kinesthesis
  • posture
  • equilibrium
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4
Q

What is the function of the lower limbs

A
  • maintain stability and balance
  • support body when standing
  • enable walking, the most common form of locomotion, propelling the body in any direction
  • perform other forms of locomotion such as hopping and jumping
  • take part in other activities of the lower limbs, such as kicking
  • enable UL to perform its skills and activities effectively
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5
Q

What must the locomotion system accomplish in order for a person to walk?

A
  • each leg in turn must be able to support the body weight without collapsing: alternating between the stance and swing phase
  • balance must be maintained statically and dynamically
  • the swinging leg must be able to advance to a position where it can take over the supporting role
  • sufficient power must be provided to make the necessary limb movements and to advance the trunk
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6
Q

3 requirements for successfull gait

A
  • ability to generate a rhythmical “stepping” pattern in order to move the body forward
  • postural control, in order to orientate and ensure stability
  • ability to adjust gait according to changing task and environmental requirements
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7
Q

Factors responsible for effective gait

A
  • CNS control with postural reflex activity playing an important role
  • normal weight bearing ability and alignment of bone
  • normal muscle strength and tonus of the lower limbs and trunk
  • joint mobility of the lower limbs
  • effective balance, gross and equilibratory coordination
  • normal sensation especially proprioception of the lower limbs
  • effective pelvic rotations, tilting and control
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8
Q

What is the assessment procedure for gait

A
  • ask pt to walk at a slower pace, fast pace and then turn around
  • observe pt walking on different surfaces, levels and around obstacles
  • assess pt with shoes on and off
  • observe pt from front, back and sides
    • general inpression
    • gait pattern (initiation, step-length, step-height, path deviation, heel strike, arm swing, push-off, hip ROM, trunk movement)
  • gait is often described with respect to temporal and distance parameters such as velocity, step-length, step frequency (cadance) and stride length
  • preferred step rates appear to be related to minimizing energy requirements
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9
Q

Precautions of gait assessment

A
  • ensure that the surface is not slippery
  • do not assess gait on a pt who cannot maintain a standing position
  • avoid falls
  • ensure safety of walking aids
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10
Q

What is the value of normal feet arches

A
  • no excessive strain bones, ligaments, tendons and muscles as well as neuro-vascular structures
  • effective w.r.t support function of feet
  • safe and effective during participation in activity
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11
Q

Impact of poorly aligned feet arches

A
  • sooner or later a problem will develop
  • with every step taken excessive abnormal force is acting on the supporting structures of the foot
  • average person takes 10 000 steps a day
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12
Q

Occupational impact of badly aligned feet arches

A
  • individuals fell pain pain the longer they stand and have to walk during activity participation
  • they require a longer time to complete activities and tasks due to rest breaks taken
  • the alignment of a person’s foot arches influences the rest of the proximal alignment
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13
Q

Standing endurance assessment

A
  • method: observation and testing
  • time standing on oth feet
  • foot preference
  • time standing on favored foot
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14
Q

Commenting on and recording of assessment findings

A
  • is pt bearing weight equally on both lower limbs
  • distance between 2 limbs- is ot compensating
  • causes of gait problems
  • trunk movement
  • arm swing
  • path deviation
  • velocity
  • changes in surface levels
  • distance walked
  • manual handling of loads
  • managing stairs
  • postural transitions
  • use of assisting devices
  • artificial limbs
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15
Q

Causes of gait problems

A
  • ROM
  • postural deformities
  • coordination
  • sensation
  • balance
  • muscle sensation
  • muscle tone
  • pain
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16
Q

Factors to consider when prescribing assisting devices

A
  • specify the type of assisting device used for gait purposes
  • circumstances used: when, where
  • pattern of use
  • care of assistive devices
  • safety and efficiency
17
Q

What do you consider when looking at position of steps

A
  • length of steps: heel aof back foot to heel of front foot (vertical measurement)
  • angle of step: big toe to back foot to little toe of front foot (diagonal movement)
  • width of step: big toe to heel of front foot (horizontal measurement)
18
Q

Integration of body movements

A
  • look at movement of legs and arms in relation to pelvic rotation and shoulders
  • left leg and pelvic moves forward, shoulder at left side moves down and backwards
  • arm swings diagonally/opposite leg
  • left arm swibgs forward, as the right leg moves forward
19
Q

Types of gait

A
  • ataxia gait
  • hemiplegic gait
  • parkinsonian (festinating) gait
  • steppage/ equinus gait
  • myopathic/ circumduction gait
20
Q

Characteristics of ataxic gait

A
  • wide-based, unsteady, staggering gait with tendency to veer towards side of the lesion
  • slurred speech and uncoordinated gait pattern
  • uneven step length, irregular width, absent rhythm and the feet are often lifted too high; there is reduced or no arm swing
21
Q

Characteristics of parkinsonian gait

A
  • shortened stride,decreased speed and increased number of steps
  • pt is observed to walk with short shuffling steps, uneven step length, a typical flexed posture, reduced arm swing, decreased angular displacement of the LL joints. Freezing either in the initiation or during gait
  • as the disease progresses there is also a progressive increase in speed and shortening of stride as if the pt is trying to catch up with their COG; this is termed festation
22
Q

What causes circumduction gait

A
  • paralysis of abductors
  • a stiff knee
  • equinous deformity of the feet
  • loss of selective movements
    Pt moves affected limb in circular motion when walking
23
Q

Characteristics of high step and flop gait

A
  • paralysis of abkle dorsiflexors
  • heel strike is absent and anterior portion of the foot strikes floor first
  • compensation takes place at hip and knee
24
Q

Characteristics of shuffling gait

A
  • paralysis of M. Flexor hallucis and or the ankle plantarflexors
  • gait characterized by absence of push off, and no picking up of the foot, a shuffling to or through
  • flattening of arches
25
Q

Characteristics of trendelenburg gait

A
  • sign is positive when abduction is impossible by reason of weakness of the gluteii or because their leverage is reduced
  • elicited by instructing pt to stand on affected leg and raise unaffected
  • normally, pelvis of raised leg is lifted to a higher level than that of the standing leg; when the sign is positive, the pelvis of the raised leg drops to a lower level than the other
  • weight is lowered carefully on the affected side, the knee bends slightly to absorb the shock, and the length and step is shortened so that weight can be taken off the leg quickly
  • trunk rolls across supporting foot at each step
26
Q

Characteristics of equinous gait

A
  • walking on toes
  • is caused by T.A shortening
  • pt walks on toes of affected leg

OTCA 2634 (17 decks)

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