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Gait > Gait Test 2 > Flashcards

Gait Test 2 Flashcards

1
Q

Causes of impaired feedback (4)

A
  • Proprioceptive (joint position)
  • Vestibular, balance
  • Foot sensory
  • Visual
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2
Q

Mass flexor and extensor patterns

A

Lack of selective muscle control, loss of finely coordinated pattern
- Flexors or extensors all fire together, often post stroke

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3
Q

Spasticity, application to gait

A

Muscle overreacts to passive stretch (clonus, beating pattern twitching if stretched too quickly)
- Rapid knee flexion in pre swing stretches Rec Fem, overactivity can block knee flexion

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4
Q

Muscle weakness affects which phases?

- Dorsiflexors, Plantarflexors, Inverters

A
  • DF- loading response, swing phases
  • PF- mid and terminal stance, pre swing
  • Invertors - stance phases
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5
Q

15º plantar flexion contracture means??

A
  • most common ankle contracture, comfort position w lowest intraarticular pressure
  • can’t DF, can PF beyond 15º
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6
Q

Arthrogenic weakness

A
  • Swelling/pain increases intraarticular pressure in joint, reflex inhibition so can’t activate muscle
  • cause of quads weakness
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7
Q

Penalty of knee flexion contracture

A

Increased quads demand, fatigue, PFJ pain?

- 15º contracture, significantly increases demand!

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8
Q

hip flexion contracture - postural compensations

A
  • resting position 30-60º FL
  • 15º contracture not noticeable- increased lumbar lordosis and anterior pelvic tilt
  • Trunk flexion, lordosis, or mass flexion posture
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9
Q

Two highest muscle demands in gait

A
  • Isometric Hip extensors in loading response keep trunk upright
  • Eccentric Plantarflexors in terminal stance
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10
Q

Global observations of gait instability (3)

A
  • trunk movement
  • variable step length
  • variable foot placement
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11
Q

Global Compensations for Gait Instability (6)

A
  • Wide BOS, slow velocity, increased DLS time, reliance on vision, increased frontal plane motion, heavy reliance on assistive device
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12
Q

Consequences of weak calf (gastroc, soleus)

A
  • Excessive DF in MS, TS, PSw –> quads overuse, excessive lowering of COM
  • Inadequate knee extension in MS, TS –> quads overuse, decreased stance progression and stride length
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13
Q

Potential consequences of weak quads

A
  • Excessive PF in MS/TS- compensatory, push off –> decreases stance progression
  • Inadequate knee flexion in LR –> decreases shock absorption
  • Excessive knee extension in stance –> stresses post. knee
  • Inadequate knee extension in mid/terminal swing –> decreased limb adv, stride length, preparation for stance
  • Inadequate hip flexion in LR –> decreases shock abs, heel rocker
  • Excessive hip flexion in pre/mid swing- past retract maneuver –> hip FL overuse
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14
Q

General Causes of Abnormal Gait (5)

A
  • Decreased joint mvt (joint stiffness, elastic or rigid contracture)
  • Weakness (excessive motion or avoidance)
  • Pain (avoidance) / - Impaired feedback / - Impaired motor control
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15
Q

Excessive PF in IC - causes and penalty

A

Causes: DF weakness / contracture / excessive PF activity / reduce heel rocker 2º weakness or balance / heel pain
Penalty: reduce stance progression (lose heel rocker)

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16
Q

Excessive PF in midstance and terminal stance

Causes, penalty, compensations

A
  • Cause: short steps / contracture / excessive PF activity- pushing off to compensate for extensor weakness
  • Penalty: decreased stance progression (compensates w/ knee HE OR early heel rise OR midfoot pronation)
17
Q

Excessive PF in swing phases - causes, penalty, comp

A
  • Cause: DF weakness / contracture / excessive PF activity

- Penalty: decreased foot clearance –> will increase hip or knee FL

18
Q

Excessive DF in initial contact/loading response

Cause and penalties

A
  • Cause: AFO or prosthetic foot usu. set 5-8º DF

- Penalty: quads overuse/increased knee FL / increased heel rocker launches forward

19
Q

Excessive DF in mid/terminal stance and pre swing - cause, penalties

A
  • Cause: weak calf

- Penalty: quads overuse / excessive COM lowering

20
Q

Excessive pronation causes (5)

A
  • compensatory for limited DF or hypomobile subtalar
  • hypermobile rearfoot/midfoot
  • inverter weakness / - dynamic knee valgus / - structural rearfoot/forefoot varus
21
Q

Causes of limited pronation (4)

A
  1. hypomobile rearfoot 2. medial point of contact 3. dynamic splinting, holding self there 4. structural cavus foot
22
Q

Penalties of excessive pronation vs. limited pronation

A
  • Excessive: stress on inverters / plantar fascia / intertarsal ligs / hallux valgus / increased tibia rotation and stress on knee
  • Limited: poor shock absorption
23
Q

Inadequate knee flexion in loading response - causes and penalty

A
  • Causes: weak quad OR hip ext / pain avoidance / excessive quad activity / decreased heel rocker
  • Penalty: decreased shock absorption
24
Q

Inadequate knee flexion in pre and initial swing

A
  • Causes: weak hip flexors / pain avoidance / excessive quad activity
  • Penalty: decreased foot clearance
25
Q

Excessive extension in mid/terminal stance - causes and penalty

A
  • Causes of HE: weak quads / pain avoidance / excessive quad activity / compensation for excessive PF
  • Penalty: stresses posterior knee
26
Q

Excessive knee flexion in pre/initial swing - causes and penalty

A
  • Cause: compensation for excessive PF / abnormal motor control, flexor pattern
  • Penalty: overuse of hip flexors, BF short head
27
Q

Inadequate knee extension in mid/terminal stance - causes and penalties

A
  • Causes: contracture of knee OR hip / excessive DF 2º weak calf / excessive hamstring activity
  • Penalties: quads overuse / decreased stance progression, stride length
28
Q

Inadequate knee extension in mid/terminal swing - causes and penalties

A
  • Cause: contracture of knee / weak quad / excessive hamstring activity / purposefully reduce heel rocker 2º weak/balance/heel pain
  • Penalty: decreased preparation for stance / limb advancement / stride length
29
Q

Dynamic valgus in stance - cause/penalty

A
  • Cause: weak hip ABD or ER

- Stresses knee - PFJ, MCL, pes anserine, IT Band

30
Q

Dynamic varus in stance - cause/penalty

A
  • Cause: pelvic drop 2º weak hip ABD

- Stresses knee - LCL, IT band, medial compression

31
Q

Excessive knee rotation in stance - cause/penalty

A
  • Cause: excessive pronation OR weak hip ER making whole leg internally rotate
  • Stresses knee - PFJ, MCL, pes anserine, IT band
32
Q

Inadequate hip flexion in loading response - cause/penalty

A
  • Cause: weak quads or hip ext / decreased heel rocker

- Penalty: decreased shock absorption

33
Q

Inadequate hip flexion in pre to terminal swing - cause/penalties

A
  • Cause: weak hip flexors / pain avoidance
  • Penalties: decreased limb advancement / stride length / foot clearance
  • may compensate with excessive knee flexion or circumduction
34
Q

Excessive hip flexion in pre to mid swing - cause/penalty

A
  • Cause: past-retract maneuver (weak quad/amputee) / compensate for excessive PF or inadequate knee FL to clear foot
  • Penalty: hip flexor overuse
35
Q

Inadequate hip extension in mid/terminal stance - cause/penalty/compensation

A
  • Cause: contracture of knee or hip, tight hip flexors
  • Penalty: decreases stride length
  • Compensate- excessive ant pelvic tilt and backward rotation, circumduction
36
Q

3 possible effects of weak hip ABDuctors in stance

A
  1. Excessive hip Add, knee valgus –> stresses ITB, medial knee, lateral hip
  2. Pelvic drop –> knee varus stress, spine stress (facet compression, paraspinal/QL overuse)
  3. Trunk lean over weak side –> facet compression on concave weak side, ecc muscle overuse on convex side
37
Q

Average Comfortable Gait Speed from 20’s to 70’s

A

About 80 m/min

38
Q

Why does slow gait speed require more muscular effort? (5 reasons)

A
  • more active swing phase
  • lose stabilizing influence of arm swing
  • larger frontal plane COM excursion
  • more variable foot placement
  • increased dynamic instability- need postural muscle synergies
39
Q

Minimum gait velocity for household ambulation, limited community ambulation, full community

A
  • household 48 m/min

Gait (2 decks)

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