Gait Disorders and Fall prevention Flashcards

1
Q

Cerebellar gait description

A

ataxic or staggering wide based

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2
Q

symptoms associated with ataxic (cerebellar) gait

A

dysdiadochokinesia, dysmetria, nystagmus, Romberg sign

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3
Q

Causes of cerebellar gait

A

cerbellar degeneration, stroke, drug/alcohol, vitamin B12 deficiency

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4
Q

Gait apraxia description

A

magnetic (Freezing) gait with start and turn hesitation,

Sometimes called frontal gait

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5
Q

What is frontal gait?

A

another name for gait apraxia or magnet gait

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6
Q

What is associated with gait apraxia?

A

dementia, incontinence, frontal lobe signs

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7
Q

what causes gait apraxia?

A

frontal lobe degeneration, normal pressure hydrocephalus

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8
Q

Description of Parkinsonian gait

A

short steps, shuffling

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9
Q

What is associated with Parkinsonian gait?

A

bradykinesia, resting tremor, postural instability and decreased arm swing

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10
Q

What causes Parkinsonian gait?

A

Parkinson’s dx

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11
Q

Description of steppage gait

A

foot drop, excessive hip and knee flexion while walking, slapping quality and falls

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12
Q

What is associated with steppage gait?

A

distal sensory loss and weakness

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13
Q

what is causes steppage gait

A

motor neuropathy

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14
Q

vestibular gait description

A

unsteady falling to one side

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15
Q

vestibular gait is associated with

A

normal sensation, reflexes and motor strength and nausea and vertigo

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16
Q

What causes vestibular gait?

A

acute labyrinthitis

meniere’s dx

17
Q

What gait is foot drop associated with

A

steppage gait… and if has diminihsed senatio nof lateral leg and foot then consider common peroneal nerve injury.

18
Q

Treatment of peroneal nerve palsy

A

PT, or ankle foot orthotic, but surgical decompression may be needed.

19
Q

How do we diagnosis peroneal nerve palsy?

A

by clinical features.

20
Q

foot drop and back pain can be caused by?

A

L4-L5 disc herniation but would see back pain with foot drop

21
Q

Vitamin B12 deficency gait

A

ataxic wide based gait with impaired balance and neuropathy that is symmetric and slowly progressive. Not focal or acute.

22
Q

how to prevent falls:

A

Home safety assessment, exercise, medication modification and vitamin D

23
Q

what is done in a home safety assessment:

A

adequate lightening, hand rails, grab bars

slip resistant surfaces and shoes

24
Q

medication modification to reduce risk for falls

A

stop or reduce benzos, hypnotics, tricyclics, eliminate non essential medications

25
Common (broad categories) causes of dizziness include:
vertigo presyncope disequilibrium nonspecific
26
Vertigo's common causes are:
``` Benign paroxysmal positional vertigo vestibular neuritis meniere's dx migraine vertebrobasilar stroke ```
27
presyncope's common causes are
cardiac arrhythmias aortic stenosis orthostasis vasovagal event
28
disequilibrium causes are:
``` peripheral neuropathy sensory disturbances neuromuscular disorders - arthritis muscle weakness cervical spondylosis CNS disorders -Parkinsonism, visual impairment ```
29
non specific causes of dizziness are:
anxiety and other psychiatric disorders medications, substance abuse metabolic disorders
30
disequilibrium is best treated
regular exercise, physical therapy, and occupational therapy
31
What must be screened for when someone has disequilibrium
need to make sure it's not vertigo or a sense of spinning or presyncope.
32
Diagnosis of orthostatic hypotension
within 2-5 minutes of standing from supine position drop in systolic BP >20 drop in diastolic BP >10
33
orthostatic hypotension
seen in volume depletion (hypovolumia from hemorrhage, hyperglycemia, and diuretics) medication side effects (vasodilators and adrenergic blocking agents autonomic dysfunction (Parkinson's dx and Lewy Body dementia)
34
having orthostatic hypotension increases a patient's
all cause mortality | also puts eldelry at increased risk for recurrnt falls and decline in cognitive function