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Neuro PT 2 > Gait > Flashcards

Gait Flashcards

1
Q

decorticate system

A

dynamic stability

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2
Q

decerebrate system

A

improved coordination of activation patterns
>wt. support
>active propulsion

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3
Q

spinal prep

A

limb rhythm
modulates reflexes
executes rhythmic movements concurrently

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4
Q

motor control of gait

A 
initiate a step
steady state velocity
change speed or stop
recover from trip
walk-run transition
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5
Q

HOAC II Model

A

hypothesis oriented algorithm for clinical decision making
>patient oriented, use exam findings (outcomes measures) to devel. hypothesis about cause, decide what the cause is and how to address it

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6
Q

impaired heel strike causes

A

PF contractures, tightness
DF weakness
knee- quad weakness or hamstring tightness

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7
Q

foot slap

A

no ecc. ant. tib

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8
Q

excessive inversion

A

synergy patterns

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9
Q

excessive eversion

A

hypotonicity

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10
Q

impaired midstance

A

knee hyperextension, or lack of full knee extension, lack of hip extension

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11
Q

causes of knee hyperextension

A

can’t DF, stuck in PF, weak quads so ur relying on ligaments and bony structure to keep u up

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12
Q

how much DF do u need for normal knee flexion during gait?

A

5 degrees

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13
Q

what is caused by an AFO that locks u into DF?

A

a knee flexion moment, ppl with weak hammys

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14
Q

causes of too much knee flexion (crouched gait posture)

A

hypertonic/contracted hammys, weak quads cuz they don’t counteract ur hammys pulling u into flexion

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15
Q

what does ur hip do to correct knee weakness?

A

flexes to stay upright during recurvatum, etc.

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16
Q

impaired terminal stance

A

not enough hip ext. due to flxn contracture or hypertonicity or weak extensors, OR lack of PF due to weak PFers or being stuck in DF

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17
Q

inadequate foot clearance

A

lack of hip flexion
knee causes- weak hammys, hypertonic quads
ankle cause-insuff. DF, weak DFers
proprioception cause- impaired sensation, dont know its dragging

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18
Q

Excessive ER at hip

A

use stronger adductors to medial whip

19
Q

circumduction

A

use stronger abductors to circumduct and compensate for weak flexors

20
Q

hip hiking

A

use strong abductors on one side and then adductors on the opp side to advance the leg

21
Q

scissoring

A

hip adductor spasticity

22
Q

causes of poor foot placement

A

coordination from cerebellum, proprioception issues

23
Q

CVA gait disorders

A

dec. volocity due to weakness and synergy, inc. double support time, step asymmetry sue to dec. stance time on weak leg and short step length of strong leg

24
Q

PD gait disorders

A

shuffling, festinating, dec. arm swing and trunk motion, poor momentum control

25
Q

cerebellar gait disorders

A

slow, varied patterns, ataxic, WBOS, variable foot placement, high steppage (like a 1 year old walking)

26
Q

spastic diplegic CP gait disorder

A

crouched, IR, hip and knee flexion, ant. pelvic tilt, ankle PF

27
Q

level 4 outcomes measures

A

DGI
TUG
6 MWT
10 meter wt

28
Q

whats the one test u should always do with a stroke pt?!

A

10 m walk test! - predicts community mobility

29
Q

<0.4 m/sec

A

severe deficit, house bound

30
Q

0.4-0.8m/sec

A

limited community (regina)

31
Q

> 0.8 m/sec

A

full community

32
Q

average gait speed

A

0.42 m/s

33
Q

speed goal for household ambulation?

A

0.4 m/s

34
Q

speed goal for community ambulation

A

1.3 m/s

35
Q

distance goal for community ambulation?

A

1000 feet

36
Q

other aspects of community ambulation?

A

obstacles, carrying a load, busy sidewalks, opening doors, uneven terrian, curbs, slopes, disractions, etc.

37
Q

tx strategies for limb synergies or incoordination?

A

weight bearing, NDT of single joint, use of targets (start big and get small), timing and accuracy activities

38
Q

what can be used as temporary orthotics in acute care inpatient?

A

ace wraps!

39
Q

does weight shifting carry over to being better at walking?

A

NO!

40
Q

what is part practice?

A

a way to break down gait. practice one portion at a time, for instance single leg stance, then practice swing phase with reps of hip flexion,then practice forward and backward rocking into and out of heel strike, etc.

41
Q

what are the benefits of BWSTT in chronic, incomplete SCIs

A

increases walking speed and distance
improves limb coordination
improves strength and energy expenditure

42
Q

what are the benefits of BWSTT in complete SCIs

A

timing and pattern of EMG activity improves, CV endurance, massed practice, decreased fear, LE strength gains–>however, gains are small and not functional

43
Q

how does the BWSTT create change in complete SCI patients?

A

peripheral sensation input is processed by the CNS and the CPGs, residual connections in the damaged spinal cord are plastic and recover, this leads to LE strength gains.

Neuro PT 2 (12 decks)

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