hemiplegic gait Flashcards
what are the 2 phases of gait in the gait cycle?
-stance
-swing
what are the different stages of stance phase?
-loading response
-midstance
-terminal stance
-preswing
what are the different stages of swing phase?
-initial swing
-mid swing
-terminal swing
what are the characteristics of normal gait?
- symmetrical- even movements on both side
-automatic postural adjustments eg surface changes or narrower path
-trunk control
-LL & UL control
-weight transfer
-advancement of centre of gravity COG over base of support
what are the stance phase essential components?
-heel strike - ankle DF and PF
-knee flexion 15 degrees ar heel strike and extension
-hip extension end of stance essential for initiation of swing
-lateral tilt of pelvis and trunk
-single leg support
what are the essential swing phase components?
-knee flexion
-limb shortening
-early swing - hip flex, knee flex, ankle DF
-finaal swing - knee ext/ ankle DF
-postural adjustments
-lateral pelvic tilt
what are the motor causes of gait dysfunction after stroke?
-impaired motor control
-muscle weakness
-soft tissue adaption
-abnormal tone
-limited ROM
-abnormal co-ordination
other than motor causes of gait dysfunction after stroke, what are other causes?
-sensory loss
-decrease of postural adjustments
-loss of trunk or extremity control
-oedema in foot
-pain
what are examples of stance phase deficits in stroke?
-decrease in hip extension
-limited movement of trunk or pelvis over foot
-absence of knee flexion at the start of stance
-decrease in ankle DF for push off
-excessive lateral shift of the pelvis
what are examples of swing phase deficits seen in stroke patients?
-decrease in hip flexion
-decrease in knee flexion
-decrease in ankle DF
-flat foot
-decrease In step length
what are the key features of a hemiplegic gait?
-short step with affected leg
-asymmetrical posture
-asymmetrical weight bearing on lower limbs (ie more weight more on 1 side)
-circumduction (swing the leg around)
-foot - clawing, foot drop
what is equinovarus in the foot?
when the foot is rotated inward and downwards
what are the characteristics of a hemiplegic foot?
-abnormal tone
-difficulty accepting BOS
-toe curling or clawing
-eqiunus posture
-insufficient ankle dross flexion and push off
what is hemiplegic foot?
A hemiplegic foot refers to a condition in which one foot is affected by hemiplegia, a form of paralysis that typically impacts one side of the body, often as a result of stroke, brain injury, or certain neurological disorders.
how do we assess gait after stroke?
we OBSERVE them
what kind of things are we observing in the gait observation?
-swing and stance phase
-head, trunk, UL, LL
-symmetry and alignment
-weight transfer
-balance and stability
-BOS
-cadence
-quality of mvt
-describe compensatory patterns eg circumduction
what are example of outcome measures to use while assessing gait in stroke patients?
-dynamic gait index
-functional gait assessment
- functional ambulation category SPECIFIC FOR STROKE
-gait assessment and intervention tool
-dual tasking - talk with the pt while walking (see if they can do both)
what are the management principles for hemiplegic gait?
-stable sitting
-good trunk control before transition into standing
-transition to standing
-limb control - weight shift, alignment, sensorimotor rehab (making sure they can feel where they are eg can they feel bed, feet on ground)
-initail standing - hip and knee control, trunk and pelvic control, stability and WB in standing
-use mirror
-walking practice w/ parallel bars, use of aids etc
-progression to stepping
what are examples of exercises to enhance trunk and pelvic control ?
single bridging
unilateral bridging
lower trunk rotation
anteversion - retroversion
what are ankle foot orthotics used for?
-helps with foot drop
-helps with stability
-helps with symmetry
what is the RAMP principle of neurological rehab?
-R= restore motor control, strength, balance and co-ordination etc
-A- adaptation- adapting to new physical impairments eg orthotics
-M-Maintain
-P- prevent
what is the aim of functional electrical stimulation?
-provides the muscles with electric stimulation in the cases of a CNS lesion so that at the time of the stimulation the muscle contraction has a functional purpose
what is a dictus band?
-an orthosis to help people who have foot drop
-leather ankle strap with latex band that attaches to shoe
