hemiplegic gait

Question 1

what are the 2 phases of gait in the gait cycle?

Answer 1

-stance
-swing

Question 2

what are the different stages of stance phase?

Answer 2

-loading response
-midstance
-terminal stance
-preswing

Question 3

what are the different stages of swing phase?

Answer 3

-initial swing
-mid swing
-terminal swing

Question 4

what are the characteristics of normal gait?

Answer 4

• 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

Question 5

what are the stance phase essential components?

Answer 5

-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

Question 6

what are the essential swing phase components?

Answer 6

-knee flexion
-limb shortening
-early swing - hip flex, knee flex, ankle DF
-finaal swing - knee ext/ ankle DF
-postural adjustments
-lateral pelvic tilt

Question 7

what are the motor causes of gait dysfunction after stroke?

Answer 7

-impaired motor control
-muscle weakness
-soft tissue adaption
-abnormal tone
-limited ROM
-abnormal co-ordination

Question 8

other than motor causes of gait dysfunction after stroke, what are other causes?

Answer 8

-sensory loss
-decrease of postural adjustments
-loss of trunk or extremity control
-oedema in foot
-pain

Question 9

what are examples of stance phase deficits in stroke?

Answer 9

-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

Question 10

what are examples of swing phase deficits seen in stroke patients?

Answer 10

-decrease in hip flexion
-decrease in knee flexion
-decrease in ankle DF
-flat foot
-decrease In step length

Question 11

what are the key features of a hemiplegic gait?

Answer 11

-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

Question 12

what is equinovarus in the foot?

Answer 12

when the foot is rotated inward and downwards

Question 13

what are the characteristics of a hemiplegic foot?

Answer 13

-abnormal tone
-difficulty accepting BOS
-toe curling or clawing
-eqiunus posture
-insufficient ankle dross flexion and push off

Question 14

what is hemiplegic foot?

Answer 14

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.

Question 15

how do we assess gait after stroke?

Answer 15

we OBSERVE them

Question 16

what kind of things are we observing in the gait observation?

Answer 16

-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

Question 17

what are example of outcome measures to use while assessing gait in stroke patients?

Answer 17

-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)

Question 18

what are the management principles for hemiplegic gait?

Answer 18

-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

Question 19

what are examples of exercises to enhance trunk and pelvic control ?

Answer 19

single bridging
unilateral bridging
lower trunk rotation
anteversion - retroversion

Question 20

what are ankle foot orthotics used for?

Answer 20

-helps with foot drop
-helps with stability
-helps with symmetry

Question 21

what is the RAMP principle of neurological rehab?

Answer 21

-R= restore motor control, strength, balance and co-ordination etc
-A- adaptation- adapting to new physical impairments eg orthotics
-M-Maintain
-P- prevent

Question 22

what is the aim of functional electrical stimulation?

Answer 22

-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

Question 23

what is a dictus band?

Answer 23

-an orthosis to help people who have foot drop
-leather ankle strap with latex band that attaches to shoe