Gaittraining And Walking Recovery After Spinal Cord Injury Flashcards

1
Q

What is the LE requirements to attain “PARA- stance”
Hip
Hamstring length
Knee
Ankle

A
  • Hip: 0-10º of extension and full flexion
  • Hamstring length: 0-110º for knee ankle foot orthoses KAFOs) or reciprocating gait orthosis (RGO) users
  • Knee: full extension
  • Ankle: 0-10º of dorsiflexion (more than neutral
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What is the UEs requirement for a patient to attain para stance

A

WNL, especially shoulders

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

When doing the para stance position how does the pt lean for stability

A

Sufficient ankle DF , hip extension , and lumbar extension PROM .. pt leans into anterior hips Y ligaments for stability

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

For a functional gait what does the patient need to show throughout UE

A

5/5 strength

Scap must be stable and strong mm
50 dip rule - do 50 dips but dont get fatigue

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Should u rely on ASIA alone to help w graving specifications for gait

A

No u need to do true MMT to test all their muscles

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What are the pros for spasticity for gait

A

 Can help to maintain muscle
bulk
 Can assist in circulatory
function
 Can assist with postural control
 Can help prevent weight gain
 May be indicative of recovery
potential
 Can assist with
mobility/standing/ambulation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What are the CONS for have spasticity during gait

A

 Can interfere with mobility,
standing, ambulating

 PROM changes
 Can interfere with orthosis
use

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

According to the clinical exam example for the criteria for long leg bracing program

❑ Patient has desire to ambulate with ___ and ___ goals
❑ Patient within ___ of ideal body weight
❑ Patient must be able to stand in parallel bars for ___ min with stable BP/joints
❑ ___ body-weight dip
❑ ____ with all transfers/WC mobility
❑ WC propulsion: ___ ___ in less than ____ min

A

Specific and realistic
10%
60 mins
50
Indepednce
1 mile than 20 mins

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

How is the functional independence measure for locomotion measured

A

Levle surfaces and stairs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What is the area of assessment for walking index for spine cord injury (WISCI-11)

A

Functional mobility and gait

Amount of physcial assistance needed as well as devices required

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What does the spinal cord injury functional ambulation inventory (SCI-FAI)

A

Assesses functional walking ability in ambulatory individuals with SCI

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Which ASIA score has the best prognosis for walking

A

ASIA D

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

During the POC u want to decide which intervention route u will use what are 2 u could use

A

 Compensatory movement patterns
 Recovery of normal movement patterns

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What are some risks we need to consider in the POC

A

Fx to proximal femur and tibia

Overuse of UE/LE
Cost/benefit ratio of energy expenditure

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

C1-C8 AIS A has what kind of voluntary motor function

A

Inadequate motor function for functional ambulation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

How much assist with C1-C8 AIS A need to stand

A

Total assist

17
Q

What kind of varying control does T1-T12 AIS A have

A

Trunk and pelvic control

18
Q

What is the lowest functional mm group for T1-T12 AIS A

19
Q

What kind of AFO would be good for children and some adults for exercise/househil ambulation with assistive device from T1-T12 ASIA A

20
Q

What level can have modified indepdennt in parallel bars

21
Q

What does L1 AIS A have control of and deficits of

A

Pelvic control - quad lum

Sensory deficits

22
Q

What does L2 AIS A have control of and deficits of

A

Hip control- iliopsoas

Sensory deficits

23
Q

What does L3 AIS A have control of and deficits of

A

Knee control - quads

Sensory deficits

24
Q

What does L4-5 AIS A have control of and deficits of

A

Knee and some foot control - anterior tibialis

Sensory deficits

25
What are the pros and cons of training braces for KAFO
Pros: • Allows assessment of patient’s ability & training prior to ordering Cons: • Not customized • Difficult to control amount of DF • Heavy/ugly
26
What is the “para stance” position
• Ankles dorsiflexed – fixed • Knees extended • Hips extended, leaning into Y ligament • Lumbar extension
27
What kind of pre gait is the most inefficient for weakest pateints and/or early training for Para stance
Drag 2
28
Where should ur hand be when. Guarding a complete SCI during KAFO training
On back and on shoulder
29
T/F: Subjects with “clinically complete” SCI can generat stepping patterns on treadmill, but cannot sustain it (3- 10 steps).
True
30
What does teh use of partial body weight support decrease and allow
 Decreases biomechanical & equilibrium constraints.  Allows for repetitive practice of complex gait cycles.
31
What are the 3 beneifits of body weight support treadmill for locomotor training
– Provide earlier intervention to ↓ secondary complications – Provide task specific training, sensory input, and repetition – Minimize compensation
32
How does the Body weight support treadmill for locomotor training minimize compensation
• ↑ LE weight-bearing, ↓ UE weight-bearing • Promote good trunk, pelvic, and limb kinematics • Promote upright posture and balance
33
What are the disadvantages for manual body weight support treadmill training
Requires up to 3-4 trainers. • Patients with severe spasticity can be very difficult • Trainer fatigue and experience level (injuries) can alter results • Inconsistent seating systems for the trainers • Weight limit: 250 lbs
34
What are the advantages for manual body weight support treadmill training
• Fall-free environment • Patient is more active, esp. at hips and trunk • Allows for manual facilitation by trainer • Allows for active arm swing • Can use FES and/or orthotics • Manual facilitation
35
What are the clinical considerations prior to locomotor training with body weight supported treadmill
- spinal stability - weightbearing status - joint PROM - balance - comorbidities - pain -CV status - pulmonary status
36
Clinicians should perform what CPG for improving walking function in ambulatory chronic CVA, iSCI, TBI
- walking training at moderate to high aerobic intensities - walking training with virtual reality
37
Clinicians MAY perform what CPG for improving walking function in ambulatory chronic CVA, iSCI, TBI
- strength training at > 70% 1 rep max - circuit training , cycling or recumbent stepping at 75-85% - balance training with VR
38
Clinicians SHOULD NOT perform what CPG for improving walking function in ambulatory chronic CVA, iSCI, TBI
- static or dynamic standing balance activities including pre gait - BWSTT with emphasis on kinematics - robot assisted gait training
39
Clinicians SHOULD NOT perform what CPG for improving walking function in ambulatory chronic CVA, iSCI, TBI