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PT 515 Musculo > Gait Training > Flashcards

Gait Training Flashcards

1
Q

Rquirements for gait

A

Trunk control

LE strength

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2
Q

Five main functions of Gait

A
  1. Support head, arms, and trunk
  2. Maintain upright posture and balance
  3. Controls the foot to allow it to clear obstacles; allows gentle heel or toe landing
  4. Generates mechanical energy by concentric muscle contraction to initiate and maintain forward velocity
  5. Provides shock absorption and stability and decreases forward velocity
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3
Q

Gait and age

A

Irregular and variable until about age 7

Toddlers learn to walk and the elderly typically resemble one another

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4
Q

Functional tasks in gait

A

Forward progression
Balance
Support of the upright body

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5
Q

Gait cycle

A

Time interval or sequence of motion occurring between two consecutive initial contacts of the same foot
-Measured as stride length

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6
Q

Traditional gait cycle

A

1 cycle: Heel strike–>foot flat–> heel off–> toe off–>acceleration–>midswing–>deceleration

2 Phases: Stance 60% and Swing 40%

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7
Q

Normal Stride Length

A

70-82cm

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8
Q

Normal Step Length

A

35-41cm

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9
Q

Normal Base Width

A

5-10cm

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10
Q

Normal Foot angle

A

5-18 degrees

Fick angle

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11
Q

Normal Cadence

A

90-120 steps per minute

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12
Q

Normal Gait Speed

A

Approximate 1.4m/sec

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13
Q

Center of Gravity

A

Typically 5cm or 2 in anterior to the second sacral vertebrae
Wider stance lowers COG

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14
Q

Observation of gait

A

Anterior view- Frontal plane motion
Lateral view- Sagittal plane motion
Posterior view- Frontal plane motion
Footwear wear patterns

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15
Q

Objective Functional Tests

A

Timed up and go test
Performance oriented balance and mobility assessment
Standardized walking obstacle course

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16
Q

3 Main reasons for Gait deviations

A
  1. Pathology or injury to specific joint
  2. Compensations for injury or pathology in other joints on the same side
  3. Compensation for injury or pathology on the opposite limb
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17
Q

Specific factors leading to gait deviations

A 
Pain/Discomfort during WB
Muscle weakness/tone abnormalities
Limitation of joint ROM
Incoordination of movement
Changes in bone or soft tissue
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18
Q

Ankylosis

A

Fusing/Stiffening of joint

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19
Q

Joint instability

A

More than hypermobility

Reduces shock absorption ability

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20
Q

Antalgic

A

Painful

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21
Q

Arthrogenic

A

Clumsy, hobbling due to stiffness

Joint origin

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22
Q

Hemiplegia

A

Decreased use of one side, paralysis

EX: vaulting on one side to clear weak side

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23
Q

Cerebral Palsy

A

Congenital Condition
Lower or upper or both extremities affected
Doesnt change over time

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24
Q

Parkinson’s Disease (basal ganglia)

A

Tremors, movement not smooth

25
Q

Festinating Gait

A

Decreased strength, Decreased arm movement, decreased foot pickup, decreased trunk rotation

26
Q

Tabes Dorsalis

A

Foot Condition

Inversion

27
Q

Ataxia

A

Decreased control during walking

Huntington’s have poorly controlled movement

28
Q

Aging

A

Downward Gaze
Widened
Decreased arm swing

29
Q

Contracture

A

ll, mm, jt shortening

Prolonged time in shortened position

30
Q

Equinus Gait

A

Toe Walking

31
Q

Trendelenburg

A

Frontal Plane Problem
Problem w/ glute medius
Hip drops

32
Q

Scissor Gait

A

Crossing midline

Hypertonic adductors

33
Q

Drop Foot

A

Decreased tib anterior strength

Cant DF foot to move it for walking

34
Q

Hip flexors deficiency

A

Used in swing phase, shortened limb during swing

35
Q

Hip Abductors deficiency

A

Pelvic instability during stance

36
Q

Hip extensors

A

Help w/ sagittal plane motion, propulse body over limb

37
Q

Quadriceps

A

Hold LE stable during stance phase

38
Q

Hamstrings

A

During midstance, eccentric control and isometric control

39
Q

Dorsi Flexors weak

A

Foot drop, decreased clearance during swing

40
Q

Plantar flexors weak

A

Decreased push off into swing

41
Q

Impairment indicators for assistive device prescription

A
  1. Structural deformity/loss, injury, disease that decrease ability to WB
  2. Muscle weakness or paralysis
  3. Inadequate balance
42
Q

Assistive devices can..

A
  1. Increase BOS and provide additional support
  2. Provide larger area for patient to shift COG without loss of balance
  3. Redistribute support within a wider BOS
43
Q

Factors that may hinder patient learning

A

Pain
Fatigue
Ability to concentrate
Time of day

44
Q

Devices for gait training

A

Parallel bars
Gait belt
Assistive devices
PTA

45
Q

Landmarks for fitting walker

A

Ulnar styloid at handles

46
Q

Landmarks for fitting crutches

A

45 degrees off foot about 6 inches
2-3 finger notch in armpit
Ulnar styloid on lower handle

47
Q

Guard on which side?

A

Stronger side

Allows you to pull them onto the strong side

48
Q

WBAT

A

50-100 percent BW

Limited only by patient tolerance

49
Q

Gait pattern

A

Number of contacts (assistive device and lower extremities that move independently from another)

  • 4 point
  • 3 point
  • 2 point
50
Q

4 point gait pattern

A

Alternate pattern best simulates typical gait

Standard pattern is also an option

51
Q

3 Point gait pattern

A

Tripod Drag-to

  • Bilateral crutches then good leg then drag bad
  • Move weaker first
52
Q

2 Point gait pattern

A

Standard
-R crutch/R extremity—>L crutch/L extremity

Alternate

Swing to

Swing through

53
Q

Prerequisites for ambulation aides

A

Ability to stand erect with head and neck upright
Ability to move LE forward with hip flexors
Sufficient strength and load tolerance to bear weight through LE
Strength of UE to push down and lift aide
Sufficient psychological/ mental preparation capacity

54
Q

Sit to stand with crutches

A

Crutches on side of uninvolved LE
Push off chair with hand on involved side
Adjust crutch under involved side first

55
Q

Sit to stand walker

A

Push off from stable surface

Get affected leg out of the way

56
Q

Sit to stand cane

A

Push off from stable surface

Cane in affected hand

57
Q

Turning with total hip replacement

A

Turn away from the side of the surgery because no IR is allowed

58
Q

Turning normally

A

Towards strong side normally

59
Q

Guarding for stairs

A

Infront for descent

Behind for ascent

PT 515 Musculo (18 decks)

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