L8 Neurologic Gait Assessment

Question 1

Common neurologic causes of gait dysfunction

Answer 1

nerve pathology/injury
guillain barre
CNS loss of central motor control
synergies, ataxia, or spasticity

Question 2

Common neurological disorders impairments

Answer 2

abnormal tone
lose selective motor control
sensory loss, tactile or proprioceptive
misalignment
balance/postural control
contractures
walking speed decreased
cognition
timing of muscular activation
coactivation
visual awareness/scanning decreased

Question 3

What pt needs to be able to do before initiating gait training

Answer 3

safety first!
ability to stand on involved limb and PWB
understand/follow directions
control trunk and head
equilibrium and righting responses

Question 4

Devices for gait training neuro pts

Answer 4

parallel bars: if involved limb is unstable
cane/quad: if indv can properly advance limb

Question 5

what side should you stand while gait training a neuro patient

Answer 5

involved side with a wide base of support and moving with the patient

Question 6

CVA gait deviations

Answer 6

IC: lose heel contact
loading response: wobbly knee
midstance: knee hyperextension
terminal stance: lose hip extension
toe off: no heel off or no knee flexion
IS/MS: lack knee flexion
TS: lose hip/knee ext and DF

Question 7

gait spatial temporal changes after CVA

Answer 7

reduced step.stride length
increased cadence
change step width

Question 8

most important determinants of gait post CVA

Answer 8

step length and velocity
1. SLS on affected side - work on increasing stance on involved side to increase step length
2. single limb advancement: want knee flexion in swing to clear floor and decrease swing duration
3. Pf ROM
4. standing balance

Question 9

Gait characteristics in PD

Answer 9

reduced step length
decreased arm swing
interlimb asymmetries
increased duration in double time
reduced gait width
later comes:
shuffling steps
freezing

Question 10

scissoring gait

Answer 10

hip and knee flexion causing legs to cross in front of another in pediatric gait

Question 11

crouch walking pediatric gait

Answer 11

excess knee and hip flexion, excess DF

Question 12

hyperextension low tone pediatric gait

Answer 12

low tone in the LE can lead to hyperextension in peds

Question 13

toe walking peds gait

Answer 13

not due to a CNS injury, children lack heel strike in IC

Question 14

Equinus gait deficits

Answer 14

unable to weight bear effectively
no balance/posture control
equinus is toe walking due to weakness and abnormal tone
forefoot contact
hip IR
tibial torsion