Lecture 9: Activity Level: Gait

Question 1

What is the DLS to SLS ratio?

Answer 1

1:3

Question 2

What is norms for gait speed?

Answer 2

men: 1.4 m/sec
women: 1.3/sec
elderly: 1.1 m/sec

Question 3

What are norms for stride length?

Answer 3

men-78 cm
women- 70 cm
elderly: decreases

Question 4

What are cadence norms ?

Answer 4

men- 100-120 step/min
women- 105-125
elderly- less than 100

Question 5

What speed is needed for community ambulation?

Answer 5

0.8 m/sec

Question 6

What speed is needed to be independent with ADL?

Answer 6

1.0 m/sec

Question 7

What is the job of UE during gait?

Answer 7

reciprocal arm swing serves to decrease energy demands, limits excursion of COG

Question 8

Which UE muscles are working during gait?

Answer 8

post and middle felt extend UE for posterior swing and eccentrically control forward swing

Question 9

What happens if the pelvis drops during gait?

Answer 9

harder for foot clearance, possible glute med /TFL weakness

Question 10

What are common issues at hip with gait in neuro pt?

Answer 10

reduced or increased hip flexion at IC, circumlocution during swing phase

Question 11

What are common issues at knee with gait in neuro pts?

Answer 11

knee hyper ext mid to late stance (possible lack of DF), limited knee flex during pre swing/initial swing, excessive knee flex stance

Question 12

What are common issues at ankle with gait in neuro pts?

Answer 12

toes or forefoot are point of IC, decreased eccentric control from IC to load response/foot slap, excessive PF at mid and terminal stance

Question 13

What are some neuromuscular reasons pt may have impaired gait?

Answer 13

motor control/ACOM, tone, coordination, sensation, perceptual defecits, vestibular

Question 14

What are some MS reasons pt may have impaired gait?

Answer 14

ROM, pain, length, strength, joint integrity

Question 15

What are some cardiovascular reasons pt may have impaired gait?

Answer 15

endurance, hemodynamic response, heart rate, OTN

Question 16

What are some temporal (timing) issues a neuro pt may have?

Answer 16

asymmetry, decreased gait speed, swing duration, increased DLS

Question 17

What are some spatial issues a neuro pt may have?

Answer 17

increased or decreased step width, step length, decreased stride length

Question 18

What are some issues a neuro pt may have during stance phase?

Answer 18

poor trunk alignment, knee hypertext, increase knee flexion, trouble with foot clearance due to lack of DF, decreased weight acceptance

Question 19

What are some issues a neuro pt may have during swing phase?

Answer 19

poor trunk align, decreased hip flexion, decreased knee flexion, decreased DF

Question 20

What is common in pts with hemiparesis gait?

Answer 20

circumduction, weight shift to strong hip, no knee flexion or DF

step to gait pattern

Question 21

What is common in patients with spastic diplegia?

Answer 21

a lot of IR, extreme PF which leads to 1/3 BOS and requires something to hold for balance

stuck in knee flexion

Question 22

What can help pts with PD walk ?

Answer 22

using external cues such as noise or visual cues

Question 23

What are different test to measure gait?

Answer 23

TUG, 10m walk test, DGI, FGA

Question 24

What is difference between DGI and FGA?

Answer 24

FGA- pt will close eyes, go backwards and tandem which makes it higher level than DGI

Question 25

What is score on DGI which could indicate fall risk?

Answer 25

19 or less in geriatric population

Question 26

What is score on FGA that could indicate a fall risk?

Answer 26

22/30