Gait and posture 2 - clinical

Question 1

Clinical - evaluating gait

Answer 1

Top down approach, symmetry, orientation, timing of motions, specific tasks (stairs etc)

Question 2

Closed and open kinetic chain

Answer 2

Hand and arm - open kinetic chain, closed chain motions have proximal consequences

Question 3

Blount’s disease

Answer 3

Slippage of tibia epiphysis during growth, bowed legs, compression medial part of knee, lateral loading of feet

Question 4

Primary pathology or compensation

Answer 4

Abnormal positions, aches and pains, bony stress reaction, callosities at interface

Compensation - own implications

Question 5

Major pathologies in gait

Answer 5

Motor, sensory impairment, pain, physical restriction, lack of normal restriction (hyper-mobility)

Question 6

Ataxia

Answer 6

Loss of full body control/coordination (cerebral palsy)

Question 7

Hemiparesis

Answer 7

Secondary to stroke, arm across body and leg out/circumduction (stroke - extension)

Question 8

Festinating gait

Answer 8

(Parkinsons) Difficulty starting, turning and stopping, few small steps

Question 9

Antalgia

Answer 9

Avoid pain use 1 leg more than the other (osteoarthritis)

Question 10

Insensate gait

Answer 10

Heavy footed - don’t know feet are on the floor (diabetic neuropathy/leprosy)

Question 11

Weakness

Answer 11

Knee up higher to avoid foot dragging (damage perineal nerve - tibailais anterior)

Question 12

Contracture

Answer 12

Liberating effect move freely

Question 13

Hypermobility

Answer 13

Feet bow in, subtle, long standing RA/extreme demands

Question 14

Marfan’s

Answer 14

Connective tissue disorder (Elhos danlos), changes in CVD, muscles, face, generalised hypermobility

Question 15

Pes cavus

Answer 15

Gravity defying - high arch, neurological cause

Question 16

Pes planus

Answer 16

Gravity aided, flat foot, due to hypermobile joints

Question 17

Quantifying gait

Answer 17

Temporal and spatial parameters, pressure, force, joint kinematics, joint kinetics

Question 18

RA

Answer 18

Gait velocity/speed declines progressively,

Question 19

Wheelchair use

Question 20

Tests

Answer 20

• Force plate
• Kinematics - infrared pulse, computerize walk
• Markers - hi res - tweezers (mount of skin, moves relative to bones)
• Any body foot model (all 26 bones)
• Radiostereogrammetry/videofluoroscopy
• Ultrasound elastography (tissue stiffness)
• MRI/ultrasound combination

Question 21

Kinetic modelling

Answer 21

Inverse dynamics - measured kinematics, antropometrics, force, moments (bending), power (how hard can apply force)

Question 22

Clinical - evaluating gait

Answer 22

Top down approach, symmetry, orientation, timing of motions, specific tasks (stairs etc)

Question 23

Closed and open kinetic chain

Answer 23

Hand and arm - open kinetic chain, closed chain motions have proximal consequences

Question 24

Blount’s disease

Answer 24

Slippage of tibia epiphysis during growth, bowed legs, compression medial part of knee, lateral loading of feet

Question 25

Primary pathology or compensation

Answer 25

Abnormal positions, aches and pains, bony stress reaction, callosities at interface Compensation - own implications

Question 26

Major pathologies in gait

Answer 26

Motor, sensory impairment, pain, physical restriction, lack of normal restriction (hyper-mobility)

Question 27

Ataxia

Answer 27

Loss of full body control/coordination (cerebral palsy)

Question 28

Hemiparesis

Answer 28

Secondary to stroke, arm across body and leg out/circumduction (stroke - extension)

Question 29

Festinating gait

Answer 29

(Parkinsons) Difficulty starting, turning and stopping, few small steps

Question 30

Antalgia

Answer 30

Avoid pain use 1 leg more than the other (osteoarthritis)

Question 31

Insensate gait

Answer 31

Heavy footed - don't know feet are on the floor (diabetic neuropathy/leprosy)

Question 32

Weakness

Answer 32

Knee up higher to avoid foot dragging (damage perineal nerve - tibailais anterior)

Question 33

Contracture

Answer 33

Liberating effect move freely

Question 34

Hypermobility

Answer 34

Feet bow in, subtle, long standing RA/extreme demands

Question 35

Marfan's

Answer 35

Connective tissue disorder (Elhos danlos), changes in CVD, muscles, face, generalised hypermobility

Question 36

Pes cavus

Answer 36

Gravity defying - high arch, neurological cause

Question 37

Pes planus

Answer 37

Gravity aided, flat foot, due to hypermobile joints

Question 38

Quantifying gait

Answer 38

Temporal and spatial parameters, pressure, force, joint kinematics, joint kinetics

Question 39

RA

Answer 39

Gait velocity/speed declines progressively,

Question 40

Wheelchair use

Question 41

Tests

Answer 41

- Force plate - Kinematics - infrared pulse, computerize walk - Markers - hi res - tweezers (mount of skin, moves relative to bones) - Any body foot model (all 26 bones)

Question 42

Kinetic modelling

Answer 42

Inverse dynamics - measured kinematics, antropometrics, force, moments (bending), power (how hard can apply force)