gait Flashcards
in swing phase you have; pre swing
the position limb for swing
the initial swing swing is when?
foot clearance of the floor
limb advancement from trailing position
what is when the limb advance and foot clears the floor
mid swing
a complete limb advancement and preparation for stance
terminal stance
in the stance phase what is the inital contact?
position of the limb start to stance
when in stance phase what is shock absorption, weight-bearing stability, and forward progression
loading phase
what is the progression of COG over BOS and limb and trunk stability?
mid stance
what is terminal stance in when there is progression of COG beyond BOS and supporting foot
terminal stance
gait is typically impaired following CVA why?
weakness, sensory loss, impaired balance, and loss of confidence
*Important to observe ankles, knees, hips, trunk, UE from all planes of movement
*Time, distance, cadence, velocity should all be measured and recorded
Gait speed is used in predicting a patient’s ability to ambulate in different environments
what are common gait deviation post-stroke; abnormal gait?
-Slow speed
-Asymmetrical, uneven step and stride lengths
-Reduced stance time on affected limb
-Decreased push-off force on affected limb
-Use of synergy patterns to advance limb
-Impaired balance with UE and LE posturing
-Reliance on adaptive equipment
-Spasticity requiring compensatory advancement
what are some classifications of walking handicaps after a stroke?
-Physiological walker
Walks for exercise only either at home or in therapy
-Limited household walker
Relies on walking for home activities
Requires assist for other walking activities
-Community walker
Unlimited distance outside
look to Power point for chart
what abnormal gait:
paresis is a primary contributor to disordered gait?
-Affects the number, type and frequency of motor neurons essential for force production for gait
-Primary impairment after corticospinal pathology
why does the Muscles act concentrically to generate movement and force and eccentrically to control the motion?
Ability to propel the body forward and control the body going forward
what are two ways spasticity can impact gait?
-Inappropriate activation of a muscle at points during the gait cycle when it’s rapidly being stretched
Produces increased stiffness and the freedom of the muscle to move rapidly
Inability to selectively recruit muscles is a contributing factor to abnormal gait why
-Associated with abnormal coupling of muscles resulting in abnormal synergies which manifest as either total extension or total flexion
-Synergistic patterns are associated with reduced stability and poor locomotion
Overactivity of muscles unrelated to?
spasticity can affect progression in gait and postural control
HS overactivity is common
Inability to time and scale muscle activity during gait can
can give way to ataxic gait which
is
Staggering, veering, irregular stepping, and high steppage
or
Delay in movement of the knee and ankle through the gait cycle
Coactivation of antagonist muscles during gait is common post CVA and is
Is seen in both paretic and non paretic limb
Impaired reactive balance strategies contributes to
instability in gait and stance (see previous lecture)
*Impaired proactive balance strategies are impaired
Decreased ability to modify gait characteristics in response to terrain and slope changes are
-Slower gait speed and increased variability in gait
When walking downhill, people with stroke shorten their step length which causes reduced walking speed
Not able to increase step length when walking up hill
what are some abnormal sensory input can result in ataxia
Can be due to peripheral or central proprioceptive pathways
Person has no awareness of where their leg(s) are in space
Reduced modulation of reflex activity throughout the gait cycle
Vision is critical to balance strategies during gait how does it leads to abnormal gait
Individuals with vision impairment tend to walk slower and use more auditory cues
Hemianopsia can have an impact on the person’s ability to perceive potential threats to stability
Loss of vestibular input in adulthood can produce gait ataxia and difficulty stabilizing the head in space due to?
Longer double stance support
Can cause impaired vision and oscillopsia
what can body image deficits cause?
Ipsilateral trunk lean towards the stance leg
Inappropriate foot placement and difficulty in controlling the COM relative to the changing BOS of the feet
Unilateral spatial neglect tend to veer to the opposite side or bump into objects on the affected side