Lecture 9: Activity Level: Gait Flashcards
What is the DLS to SLS ratio?
1:3
What is norms for gait speed?
men: 1.4 m/sec
women: 1.3/sec
elderly: 1.1 m/sec
What are norms for stride length?
men-78 cm
women- 70 cm
elderly: decreases
What are cadence norms ?
men- 100-120 step/min
women- 105-125
elderly- less than 100
What speed is needed for community ambulation?
0.8 m/sec
What speed is needed to be independent with ADL?
1.0 m/sec
What is the job of UE during gait?
reciprocal arm swing serves to decrease energy demands, limits excursion of COG
Which UE muscles are working during gait?
post and middle felt extend UE for posterior swing and eccentrically control forward swing
What happens if the pelvis drops during gait?
harder for foot clearance, possible glute med /TFL weakness
What are common issues at hip with gait in neuro pt?
reduced or increased hip flexion at IC, circumlocution during swing phase
What are common issues at knee with gait in neuro pts?
knee hyper ext mid to late stance (possible lack of DF), limited knee flex during pre swing/initial swing, excessive knee flex stance
What are common issues at ankle with gait in neuro pts?
toes or forefoot are point of IC, decreased eccentric control from IC to load response/foot slap, excessive PF at mid and terminal stance
What are some neuromuscular reasons pt may have impaired gait?
motor control/ACOM, tone, coordination, sensation, perceptual defecits, vestibular
What are some MS reasons pt may have impaired gait?
ROM, pain, length, strength, joint integrity
What are some cardiovascular reasons pt may have impaired gait?
endurance, hemodynamic response, heart rate, OTN
What are some temporal (timing) issues a neuro pt may have?
asymmetry, decreased gait speed, swing duration, increased DLS
What are some spatial issues a neuro pt may have?
increased or decreased step width, step length, decreased stride length
What are some issues a neuro pt may have during stance phase?
poor trunk alignment, knee hypertext, increase knee flexion, trouble with foot clearance due to lack of DF, decreased weight acceptance
What are some issues a neuro pt may have during swing phase?
poor trunk align, decreased hip flexion, decreased knee flexion, decreased DF
What is common in pts with hemiparesis gait?
circumduction, weight shift to strong hip, no knee flexion or DF
step to gait pattern
What is common in patients with spastic diplegia?
a lot of IR, extreme PF which leads to 1/3 BOS and requires something to hold for balance
stuck in knee flexion
What can help pts with PD walk ?
using external cues such as noise or visual cues
What are different test to measure gait?
TUG, 10m walk test, DGI, FGA
What is difference between DGI and FGA?
FGA- pt will close eyes, go backwards and tandem which makes it higher level than DGI
What is score on DGI which could indicate fall risk?
19 or less in geriatric population
What is score on FGA that could indicate a fall risk?
22/30
