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Aging Adults > Gait in Aging Adults > Flashcards

Gait in Aging Adults Flashcards

1
Q

What physiological system changes can effect the gait of an aging adult?

What other physiological (non-systemic) factors can contribute?

A
  • MSK Changes
  • Higher level neural processes
  • Sensory and perceptual changes
  • Individual sensory systems

Non-systemic

  • Specific and individual pathologies
  • Adaptive and anticipatory mechanisms
  • Intricately related to balance responses
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2
Q

What psychological factors could contribute to the gait of aging adults?

A 
depression
self-efficacy/confidence
appearance
older adult's perception of his/her mobility
anxiety or fear
perceived risk of community mobility
access to barriers in community
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3
Q

How does speed differ in a normal aging gait compared to a pathological gait?

A

normally an aging adult can keep their ability to vary their gait under their own volition

In pathological gait a person loses their ability to speed up or slow down their gait speed on demand

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4
Q

How does step/stride length differ in a normal aging gait compared to a pathological gait?

A

normally an aging adult’s step and stride length becomes smaller but symmetrical

in pathological gait there is a significant shortening of step and stride length but the steps are non-symmetrical

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5
Q

How does step width differ in a normal aging gait compared to a pathological gait?

A

Normally the width averages 1-4 inches

In pathological gait width is either greater than 4 in or smaller than 1 in or there is a great amount of variability

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6
Q

How does toe clearance differ in a normal aging gait compared to a pathological gait?

A

there is little toe clearance normally

in pathological gait the toe clearance is either very large or they are tripping over their toe due to no clearance, sometimes both

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7
Q

How does single limb support differ in a normal aging gait compared to a pathological gait?

A

Normally there is equal stance time in both legs in an aging adult

Pathological single limb support would be unequal stance time (antalgic pattern) or short, shuffled steps

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8
Q

How do the ankle/foot joint mechanics differ in a normal aging gait compared to a pathological gait?

A

Normally there is a slight decrease in force at push off and/or slight decrease in plantarflexion and dorsiflexion ROM

Pathological mechanics would be too large/too small toe clearance (or both) as well as forefoot or flatfoor contact during initial contact (excess PF or DF)

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9
Q

How do the knee joint mechanics differ in a normal aging gait compared to a pathological gait?

A

Normal knee mechanics are 5 deg. of flexion during weight bearing to 60 deg of flex. during swing limb advancement

Pathologic: limited or excessive flexion, wobbling, extension thrust (weight bearing will increase valgus/varrus moments)

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10
Q

How do the hip joint mechanics differ in a normal aging gait compared to a pathological gait?

A

Normal: 15-20 deg flexion during weight acceptance and 15-20 deg of apparent hyperext. at terminal stance

Pathologic: limited flex or ext (past retract), meaning visible forward then backward movement of thigh during terminal swing, excessive abduction or adduction, excessive ER or IR

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11
Q

How do the pelvis joint mechanics differ in a normal aging gait compared to a pathological gait?

A

Normal: 5 deg fwd rotation during weight acceptance and 5 deg of bwd rotation at terminal stance/pre-swing (iliac crest on reference limb is greater than or equal to iliac crest on opposite side during mid-stance)

Pathologic: limited or excess rotation fwd or bwd (pelvic drop or hiking)

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12
Q

What gait speed correlates to the “function” zone of the aging adult? “Frail” zone? “Failure” zone?

A

Function- .9-1.4 m/sec

Frail- .3-.8 m/sec

Failure- under .3 m/sec

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13
Q

What 6 minute walk distance correlates to the “function” zone of the aging adult? “Frail” zone? “Failure” zone?

A

Function- 300-500 m

Frail- 200-299 m

Failure- under 200 m

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14
Q

What 30 second chair rise rep count correlates to the “function” zone of the aging adult? “Frail” zone? “Failure” zone?

A

Function- 8-14 steps

Frail- under 8 steps

Failure- unable to perform

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15
Q

What time to climb ten stairs correlates to the “function” zone of the aging adult? “Frail” zone? “Failure” zone?

A

Function- 9-30 sec. with or without rails

Frail- 31-50 sec. w/ rails

Failure- unable to perform

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16
Q

What floor to stand time correlates to the “function” zone of the aging adult? “Frail” zone? “Failure” zone?

A

function- 11-30 seconds with or without help

Frail- over 30 seconds with help

Failure- unable to perform

17
Q

What is the calculated critical speed for crossing a street?

A

1.14 m/s

18
Q

What functional tests can help asses gait speed?

A

TUG and Gait speed test

19
Q

What functional tests can help asses gait endurance?

A

6-minute and 2-minute walk tests

20
Q

What functional tests can help asses gait balance?

A

Tinetti
Berg Balance
4 square Step Test

21
Q

What functional tests can help asses gait dual tasking?

A

TUGcognitive and TUGmanual

22
Q

True or Fasle: Gait speed can be seen as a vital sign

A

True

23
Q

What is the objective use of a cane?

What are the consideration for prescribing a cane to a patient?

A

Objective: enhances stability through weight redistribution and compensates for losses in vision and proprioception

Consideration:

  • appropriate for pts who need balance and stability assist w/ minimal WB shift (up to 25%)
  • coordination needed to use effectively (may not be appropriate for older pt w/ cognitive or coordination impairments)
24
Q

What is the objective use of crutches?

What are the consideration for prescribing crutches to a patient?

A

Objective: permits significant WB shift from legs to arms

Considerations

  • permits more WB shift (50% or more) than a cane
  • less stable than a walker
  • requires good balance
  • can lead to brachial plexus injuries if misused
  • loftstrand crutches permit hand use and reaching
25
Q

What is the objective use of a walker?

What are the consideration for prescribing a walker to a patient?

A

Objective: offers great stability and significant WB shift from legs to arms

Considerations:

  • provides more WB shift (50% or more) than a cane but with more stability than crutches
  • difficult on stairs
  • great stability but hard to manuever
  • rearwheel is less stable but easier to propel for pts. with poor upper body strength
  • allows large BOS for patients w/ one functional arm
  • platform walkers are heavy and require a lot of energy but permit weight bearing thru the humerus
26
Q

What do multi-factorial impairment-based interventions focus on? How to they do this?

A

Focus on:

  • reducing deviation
  • improving gait efficiency, safety, and endurance

By incorporating:

  • specificity of training
  • task-orientated training
  • dual-tasking
  • task and environmental constraints
  • rehab of ALL the components
27
Q

What do flexibility training interventions try to achieve?

A

they try to change what you can and adapt/compensate for what you can’t and address obvious structural limitations caused by pathology or surgical procedures

28
Q

What do strength/power/agility training interventions try to achieve?

A
  • achieve mobility with stability prior to emphasizing increased velocity
  • target PF, DF, quads, abductors, and extensors; UE strength in lats and triceps when patient is using an AD
  • pre-gait activities can be done to focus on strength and control
29
Q

What is the definition of dual task training?

A

The concurrent performance of two tasks that can be performed independently and have distinct and separate goals

30
Q

What motor factors can be changed to increase dual-tasking in gait?

What cognitive factors can be changed?

A

Motor: multi-directional, balancing, external cueing, and carrying/picking up/reaching for an object

Cognitive: listening to music or radio, verbal fluency, answering autobiographical questions, subtracting by 3s, visual-spatial task of pattern matching

Aging Adults (19 decks)

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