Higher Level Gait disorder Flashcards

1
Q

describe the upper body movement during the gait cycle

A

Trunk twists around a vertical axis
Pelvis rotates (12)
Upper trunk in opposite direction
Arms out of phase with legs

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2
Q

gait parameters

A

stance phase
swing phase
stance time
swing time
cadence
step length
stride length
step time
gait cycle
stride time
average gait velocity

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3
Q

function of Mesencephalic locomotor region

A

receives afferents from basal ganglia, limbic system, sensorimotor cortex, and connects spinal circuitry via reticulospinal tract.

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4
Q

function of Pontine locomotor regions

A

postural tone

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5
Q

function of subthalamic region

A

modulation of locomotor patterns

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6
Q

function reticular formation

A

temporal and spatial co-ordination of movement

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7
Q

purpose of basal ganglia

A

Initiation and termination of movement

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8
Q

purpose of cerebral cortex

A

Motor planning

Visuomotor
co-ordination

Cognitive aspects of motor control

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9
Q

gait pattern is the integration of what cognitive abilities

A

Attention, planning and memory
Integration of motor, perceptual and cognitive processes

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10
Q

what afferent feedback is received during gait

A

Somatosensory
Visual
Vestibular

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11
Q

what is reduced regarding age related changes in gait

A

Velocity (norm 1.5m/s)
Step/stride length
Arm swing
Pelvic rotation
Heel-strike
Reaction time

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12
Q

what is increased regarding age related changes in gait

A

Double support time (norm 60% gait cycle)
Cadence (norm 110 steps/min)
Time needed to travel

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13
Q

what is the anatomical correlation of higher level gait disorder

A

higher - cortex different patterns cautious, parkinsonian, ataxic,
higher -subcortical - spastic, magnetic, gait ignition failure, disequilibrium

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14
Q

characteristics of higher level gait disorder

A

Difficulties with initiation
Shuffling gait
Bradykinesia
Freezing
Demonstrate wide BOS +/-
Deteriorating postural responses/ balance
Tendency to retropulsion

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14
Q

higher level gait disorder descriptors

A

Gait apraxia
Frontal ataxia
Frontal disequilibrium
Frontal gait disorder
Subcortical disequilibrium
‘Marche a petit pas’
Vascular pseudoparkinsonism
Senile Gait
Lower body Parkinsonism
Ateriosclerotic Parkinsonism
Cautious gait
Isolated gait ignition failure

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15
Q

pathophysiology of higher level gait disorder

A

Vascular/Ischaemic processes
Disruption of the neural pathways
Frontal lesions
Diffuse cerebral disease
Multiple lacunar infarcts
Basal ganglia infarcts

16
Q

middle level gait disorder causes

A

Cerebellar disorders
Spasticity with corticospinal dysfunction
Bradykinetic, dystonic, and choreic gaits with basal ganglia disorders

17
Q

what gait patterns are middle level gait disorder

A

Paraplegic Gait
Hemiplegic Gait
Cerebellar ataxic Gait
Parkinsonian Gait
Choreic Gait
Dystonic Gait

18
Q

gait and balance assessment for gait disorder

A

Head, Trunk, UL, LL (hip, knee, ankle, foot).
Swing and stance phase (observe different components)
Turning: Balance / stability
Alignment / symmetry
Weight transfer
BOS
Cadence
Associated reactions
describe gait pattern
t/f
safety awareness

19
Q

what abnormalities may be detected in a gait analysis

A

Slowness of walking
Decreased stride length
En-bloc turning
Retropulsion
Shuffling gait
Inadequate heel strike
Inadequate foot clearance
Loss of arm swing

20
Q

implications for physio with gait disorder

A

strategies for gait initiation and turning difficulties
improve postural alignment and balance training - enhance balance reaction, core stability, postural alignment
gait traing - T/F, stepping practice

21
Q

dual task theory

A

People often have trouble performing two relatively simple tasks concurrently

Evidence from studies of healthy volunteers has suggested that there may be an identifiable cognitive function responsible for dual

22
Q

decerebrate model

A

Weight support

Active propulsion

Improved co-ordination of stepping patterns

Note- only when ES is applied to an important area in the brainstem- mesencephalic locomotor region

Cerebellum - vital for correction of central pattern generator activity

23
Q

decorticate model

A

External stimulus not required to produce locomotion

Reasonably goal directed

Cortex important in skills such as walking over uneven terrain/navigation- use of vision recognition pathways in the cortex