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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
Festinating Gait
Decreased strength, Decreased arm movement, decreased foot pickup, decreased trunk rotation
26
Tabes Dorsalis
Foot Condition | Inversion
27
Ataxia
Decreased control during walking | Huntington's have poorly controlled movement
28
Aging
Downward Gaze Widened Decreased arm swing
29
Contracture
ll, mm, jt shortening | Prolonged time in shortened position
30
Equinus Gait
Toe Walking
31
Trendelenburg
Frontal Plane Problem Problem w/ glute medius Hip drops
32
Scissor Gait
Crossing midline | Hypertonic adductors
33
Drop Foot
Decreased tib anterior strength | Cant DF foot to move it for walking
34
Hip flexors deficiency
Used in swing phase, shortened limb during swing
35
Hip Abductors deficiency
Pelvic instability during stance
36
Hip extensors
Help w/ sagittal plane motion, propulse body over limb
37
Quadriceps
Hold LE stable during stance phase
38
Hamstrings
During midstance, eccentric control and isometric control
39
Dorsi Flexors weak
Foot drop, decreased clearance during swing
40
Plantar flexors weak
Decreased push off into swing
41
Impairment indicators for assistive device prescription
1. Structural deformity/loss, injury, disease that decrease ability to WB 2. Muscle weakness or paralysis 3. Inadequate balance
42
Assistive devices can..
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
Factors that may hinder patient learning
Pain Fatigue Ability to concentrate Time of day
44
Devices for gait training
Parallel bars Gait belt Assistive devices PTA
45
Landmarks for fitting walker
Ulnar styloid at handles
46
Landmarks for fitting crutches
45 degrees off foot about 6 inches 2-3 finger notch in armpit Ulnar styloid on lower handle
47
Guard on which side?
Stronger side | Allows you to pull them onto the strong side
48
WBAT
50-100 percent BW | Limited only by patient tolerance
49
Gait pattern
Number of contacts (assistive device and lower extremities that move independently from another) - 4 point - 3 point - 2 point
50
4 point gait pattern
Alternate pattern best simulates typical gait | Standard pattern is also an option
51
3 Point gait pattern
Tripod Drag-to - Bilateral crutches then good leg then drag bad - Move weaker first
52
2 Point gait pattern
Standard -R crutch/R extremity--->L crutch/L extremity Alternate Swing to Swing through
53
Prerequisites for ambulation aides
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
Sit to stand with crutches
Crutches on side of uninvolved LE Push off chair with hand on involved side Adjust crutch under involved side first
55
Sit to stand walker
Push off from stable surface | Get affected leg out of the way
56
Sit to stand cane
Push off from stable surface | Cane in affected hand
57
Turning with total hip replacement
Turn away from the side of the surgery because no IR is allowed
58
Turning normally
Towards strong side normally
59
Guarding for stairs
Infront for descent | Behind for ascent

PT 515 Musculo (18 decks)

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