Gait and walking (Not on Midterm I think) Flashcards
a patient needs how much ankle mobility for para stance?
10 dorsiflexion
a patient needs how much hamstring length for parastance?
110
A patient needs how much hip mobility for parastance?
10 ext and full flexion
what are all of the 5 requirements for parastance?
UE WNL
Hip 10 ext, full flexion
Hamstring length 110
Knee full ext
Ankle 10 dorsiflexion
What ligaments provide stability in the front for parastance?
Y Ligaments, pt leans on these for stability
How much strength does a pt need to have for standing gait in KAFO as a paraplegic
must have 5/5 throughout UE, 50 dip rule!
T or F: you can use ASIA scale to assess someones strength for para-gait
F, don’t rely on asia alone it doesn’t cover all of the necessary muscles
What are the benefits of spasticity?
Maintains muscle
assist circulation
posture control
prevent weight gain
can indicate recovery
can assist with mobility
what are the Cons of spasticity?
PROM changes
interferes with orthosis use
can interfere with mobility
How much WC propulsion criteria is recommended for standing gait
1 mile in less than 20 mins
what bodyweight is recommended for standing gait
within 10% of ideal bodyweight
Patient must be able to ________________ in parallel bars in order to participate in paragait
stand in parallel bars for 60 minutes with stable BP and joints
Shepherd Center SCI program criteria for paragait
Pt with desire and realistic goal
PROM within normal limits (DF, Hip ext, SLR)
Skin intact
Stable vitals
Standing in parallel bars 60 mins
T12 and below (higher considered if other criteria met)
50 bodyweight dips
Pt compliance (KAFO training)
Independence with all transfers
1 mile in less than 20 mins in WC
Pt’s L2 and higher must be 6 months post injury
caregiver for assistance and training
A patient must be _________ with transfers in order to be considered for KAFO training
independent with all transfers
The WISCI-II index measures what
Mobility as it related to ADs, is the pt progressing to less restrictive ADs?
What does the SCI-FAI meausre?
Functional walking ability, measures the quality of gait
What is the SCIM III?
basically the FIM but specific for SCI, gives a rating of independence/dependence for different types of gait/mobility
C1-C8 pt’s will require __________ to do standing gait
total assist
What level of patients will require min A for KAFO gait?
which levels will require mod independence?
(think thoracic levels)
T1- T8
T9-T12
What is the lowest functioning muscle group for pt’s T1-T12
Abdominals
What is unique to L1 patients?
how will they use KAFOs?
What will they use for functional mobility?
pelvis control w/ quadratus lumborum
KAFO for exercise/household ambulation w/ AD (usually crutches)
wheelchair for functional mobility
What muscle do L2 patients retain function of?
Hip flexors
What SCI level can a pt expect to have potential for community ambulation with KAFOs
L3 (can use quads)
What SCI level is the highest that can potentially use AFOs?
L3
Will L4-L5 SCI patients need KAFOs?
no, they can potentially have functional community ambulation w/ AFOs and crutch/cane
theoretical benefits of standing:
Maintain PROM/prevent contractures
Regulate bowel and bladder
Decrease spasticity
Improve strength (of muscles that do work)
Decrease risk of pressure injury
increase circulation
compensate for impaired autonomic response
psychological benefits
prevents osteoporosis (controversial)
T or F: There is evidence that static standing will promote return
F
Pros and Cons of clunkers
Pros: Allows assessment of gait prior to ordering customs
Cons: Not customized, difficulty to put on, heavy
What gait pattern with KAFOs is the most inefficient and used for the weakest patients
Drag to
what gait pattern with KAFOs is the fastest
swing through
How many pts will use their KAFOs long term?
3/40, not very many
but most pts will continue to use standing frames
T or F: Independent function equals recovery
F, using braces, assistive devices and learning new movement strategies are compensations
What has research shown about Central Pattern Generators in humans
Subjects with complete SCI can take 3-10 steps but cannot sustain it
T or F: We should unload a pt w/ BW supported treadmill to allow repetitive practice of gait cycle
Maybe, we have to be careful how mcuh we unload because loading increases EMG amplitudes
What are the contraindications to BW supported treadmill training?
Sacral/ischial wounds
weight limit of 250lbs or 297 for lokomat
