Gait Eval (2) - Class 6 Flashcards
what will the info from the history help with
selecting appropriate tests and measures
what does selecting appropriate tests and measures turn to
helping us make a PT dx
tests and measures commonly applied to pt’s with gait dysfxn
anthropometric characteristics
ROM
muscle performance
joint integrity
mobility
pain
sensory integrity
motor fxn
ventilation and respiration/gas exchange
aerobic capacity and endurance
integumentary integrity
there is a …. but…
multitude of things we may have to look at but base it off their history
what does selection of tests depend on
purpose of the test and its
-reliability
-validity
-sensitivity
-specificity
-responsiveness or capacity to detect change
-appropriateness for a particular population
-ease of use
what should the therapist observe at minimum
walking from multiple perspectives
observing walking from multiple perspectives should determine
pt needs an AD
pt needs personal assistance w/ ambulation
walking should be observed
in a variety of environments
-level surface
-up/down curb
-ramp
-steps
-uneven surfaces
observational gait analysis
approach frequently used for the examination of gait dsyfxn in the clinical setting
why is observational gait analysis popular
relatively quick and easy to use
requires no equipment
can be performed in any setting
history and the results of the tests and measures should guide
the focus of your observational gait analysis
how should we observe changes in the sagittal plane
from R/L sides
focus on kinematic changes
kinematic changes in the sagittal plane
step and stride length
single and double stance times
vertical displacement of the COG
flexion and extension movements of the hip, knee and ankle
position of the head and trunk
how should we observe kinematic changes in the frontal plane
observe from the front and back
kinematic changes in the frontal plane
BOS during double stance
foot angle (toe in/toe out)
lateral (horizontal) displacement of the COG
varus/valgus deformities at the knees
alterations in normal hip ABD/ADD
position and movement of the subtalar joint (pronation/supination)
how should the therapist monitor changes in limb and joint segments
from each perspective, during each phase of gait
how the pt starts and stops walking and changes direction
research on observational gait analysis
reliability
validity
reliability
only has moderate intra-rater reliability for expert raters using observational gait analysis
validity
only few studies have looked into this
standardized tests and measures that rely on observational gait analysis
ranchos los amigos observational gait analysis
Wisconsin gait scale
gait abnormality rating scale
tinetti’s performance oriented mobility assessment
dynamic gait index
standardized tests and measures related to gait that do not rely on observational gait analysis
TUAG
emory fxnal ambulation profile
berg balance scale
activities-specific balance confidence scale
fxnal independence measure
we should analyze one segment throughout
all phases of gait cycle
what should we begin with
ankle foot and toes
how should we proceed our observation
proximally to the knee, hip, pelvis and lumbar spine
what should we observe the pt in
normal footwear
then inspect the footwear
what should we look for on footwear
wearing down
general condition of the shoe
creases or folds
