Gait Deficits Flashcards
what is a major problem among persons of all ages with neurological pathologies such as CVA, TBI, MS, cerebellar disease, developmental delay, down syndrome, spina bifida, CP
falls
associated with impaired balance, loss of postural control mechanisms (impaired hip, stepping, and ankle strategies)
falls
pathologies can affect what aspects of gait
- sensory
- motor
- perceptual
- cognitive
what can result from sensory impairments on gait
- may result in gross ataxia
- may result in difficulty initiating certain phases of gait and inability to adapt to environmental demands (feedforward/feedback)
- may alter sensory weighting for postural control (vision, somatosensory, vestibular deficits; lack of success in certain environments)
- may alter body schema/spatial relations
- pain or perception of pain may alter gait quality
how can cognitive and perceptual deficits effect gait
- reduced cognitive reserve = reduce motor ability
- impair dual task ability
- impair safety awareness
dementia (cognitive deficits) may impair what
dual task ability and perception
CVA/TBI (cognitive deficits) may impair what
safety awareness (inability to assess safe walking conditions, lack of self-awareness into deficits)
what is correlated to falls
gait speed
the slower the gait speed =
the higher the risk of falls
what is the normal adult gait speed
1.3 m/s
pts with neurological injuries tend to ambulate slower due to
sensory or motor and/or cognitive or perceptual deficits
what other factors can predict community function besides gait speed
balance, self-efficacy, depression and fatigue (assessed via FGA, FES, depression scales)
what gait speed is needed to be a community ambulator
0.8 m/s
what time is used to determine how long it will take a pedestrian to cross a street when determine traffic signals
1.2 m/s
gait characteristics of cerebellar lesion
- wide BOS
- staggering/drunk
- path deviation
gait characteristics of PD (basal ganglia lesion)
- slow speed
- short, shuffling steps (festination)
- en bloc turning
- freezing episodes
uncoordinated gait
ataxia
common gait deviations in individuals with neurologic disorders at the foot and ankle
- toe contact with floor during swing (toe drag)
- inadequate DF with swing
- IC with forefoot
- M-L instability in midstance
common gait deviations in individuals with neurologic disorders at knee
- inadequate knee flexion in swing
- hyperextension of knee in stance to compensate for quad weakness or lack of motor control/stability of knee
- excessive knee flexion during stance
common gait deviations in individuals with neurologic disorders at hip
- ER
- hiking during swing to clear foot
- circumduction
- inadequate hip flexion in early swing
- inadquate extension in stance
- drop of unaffected side of pelvis during affected stance phase (glut med weak)
common gait deviations in individuals with neurologic disorders at pelvis
- pelvic retraction on hemiplegic side
common gait deviations in individuals with neurologic disorders at trunk
- forward flexion of trunk to compensate for weak knee extensors during stance
- lateral flexion of trunk to compensate for weak hip abductors during stance
ROM of hip needed for gait
- 25 def flexion (IC, LR, MSw, TSw)
- 15deg ext (TSt)
- some rotation and abd/add
ROM of knee needed for gait
- full ext 0deg
- 60deg knee flexion (initial swing)
