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DPT 620: Neuro > Locomotion-Assessment and Intervention In Persons w/Brain Injury > Flashcards

Locomotion-Assessment and Intervention In Persons w/Brain Injury Flashcards

1
Q

what are the typical structures impaired in pw stroke?

A

SMA, pre-motor cortex

M1 motor cortex (+/-BS)

sensory cortex

frontal lobe

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2
Q

when the pre-motor cortex is impaired in pw stroke, what is the impairment?

A

they can’t figure out how to set their posture to take a step

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3
Q

what structure is responsible for the motor plan of gait?

A

SMA and pre-motor cortex

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4
Q

what structure is responsible for the motor output for gait?

A

the M1 motor cortex

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5
Q

what system functions are typically impaired in pw stroke?

A

motor fxn

sensory fxn

postural alignment

gait patterns impairment

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6
Q

what motor fxn impairments are typical in pw stroke?

A

dec active, fractionated (isolated) motor control

abnormal tone, typically hypertonicity and clinical hypertonicity

chronic learned non-use and secondary MSK impairments, weakness

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7
Q

what sensory fxn impairments are typical in pw stroke?

A

hemisensory deficits

proprioception and kinesthesia in a % if the primary somatosensory cortex is affected

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8
Q

what postural alignment impairment is typical in pw stroke?

A

asymmetrical WB in standing

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9
Q

what gait patterns impairments are typical in pw stroke?

A

typical “classic” stroke gait deviations

increased clinical hypertonicity

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10
Q

t/f: bc the MCA is the most commonly affected artery in stroke, gait tends to look very similar in pw stroke in the acute phase

A

true

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11
Q

t/f: walking is mediated by complex neural systems both automatic and voluntary

A

true

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12
Q

t/f: damage to all BS descending pathways and corticospinal tracts decrease fractionated mov’t

A

true

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13
Q

what is the postural alignment of the limbs in pw stroke?

A

assymetrical WB bw limbs

involved limb in relative ER and adduction w outtoeing

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14
Q

what is often the cause of relative ER and adduction w outtoeing in the acute phase in pw stroke?

A

often from retraction

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15
Q

what is often the cause of relative ER and adduction w outtoeing in chronic phase in pw stroke?

A

often from ROM deficits

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16
Q

what is the postural alignment of the trunk on the involved side in pw stroke?

A

trunk shortening

scap depression and Retraction

pelvic retraction

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17
Q

what is often the only active muscle control in pw stroke?

A

adductors

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18
Q

t/f: pw stroke will often use the adductors to advance the limb forward in gait

A

true

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19
Q

in the acute phase, what are postural alignment impairments likely due to?

A

lack of activation

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20
Q

in the chronic phase, what are postural alignment impairments likely due to?

A

likely due to sitting a lot and getting stuck like that

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21
Q

what muscles are often the strongest in pw stroke?

A

extensor synergy muscles

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22
Q

t/f: in pw stroke, the trunk leans towards the involved side w/scap and pelvic retraction

A

true

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23
Q

what is the problem with unilateral ADs in pw stroke?

A

it promotes even more lean to the uninvolved side

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24
Q

what is the locomotor central pattern generator (CPG)?

A

a complex network of spinal interneurons to generate rhythmic, alternating activities of flexion and extension at the hips and knees

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25
Q

what are the 2 inputs to the CPG?

A

afferent input from stretch receptors

jt loading at IC

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26
Q

the afferent input stretch receptors facilitates what?

A

flexion

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27
Q

t/f: stretch of the hip flexors in gait facilitates hip flexion

A

true

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28
Q

jt loading at IC drives what?

A

extension

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29
Q

step length on the ____ side is key in facilitating hip flexion

A

uninvolved

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30
Q

what are 3 steps in activating the CPGs in pw stroke?

A

alignment of the foot facing forward

taking a big step with the uninvolved leg to get a good stretch of the hip flexors

make sure to get good heel strike and repeat

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31
Q

what can we work on in pregait to get a good swing phase on the involved side?

A

work on getting a good big step w/the uninvolved leg

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32
Q

why do we care about the CPG?

A

bc we set up our pts to use automatic gait patterns generators to our advantage to make interventions easier

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33
Q

what are the 2 most important phases in gait for facilitating gait recovery in stroke?

A

heel strike/initial contact

terminal hip ext/terminal stance phase on the trailing limb

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34
Q

what is the importance of effective heel strike/IC?

A

maximizing IC at the ankle maximizes sensory input and facilitates LE extension to stance

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35
Q

what is the importance of terminal hip ext/terminal stance phase?

A

the trailing limb in good hip extension maximizes sensory input through stretch of the hip flexors to facilitate hip flexion for swing

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36
Q

why are CPGs so important in interventions?

A

lots of our interventions will be focused on terminal limb ext

we can try to regain ROM in chronic pw stroke

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37
Q

if we want to intervene on gait with less degrees of freedom (DOF), what can we do?

A

have the pt in kneeling on the involved limb and lunging into it to get the stretch of the hip flexors

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38
Q

when we see clinical hypertonicity come into play, what might this tell us?

A

what we are doing doesn’t have enough stability or is too difficult for the pt

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39
Q

t/f: there is a typical set of gait deviations and resultant biomechanical adaptations that we can expect in pw stroke

A

true

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40
Q

what are the typical kinematic deviations at initial contact (heel/foot contact and loading)?

A

limited ankle DF

lack of knee flexion (knee hyperextension)

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41
Q

in the acute phase, what is the cause of limited ankle DF at IC?

A

decreased activation of ant tib muscles

contractile block of advancement (hypertonicity of calf muscles)

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42
Q

in the chronic phase, what is the cause of limited ankle DF at IC?

A

consider jt immobility/PROM, contracture, contractile block

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43
Q

what are the causes of lack of knee flexion (knee hyperextension) at IC?

A

contracture of soleus paired w/limited control of quads at 0-15 deg

contracture a/or hypertonicity of calf muscles w/premature activation

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44
Q

what are the typical kinematic deviations at midstance?

A

knee hyperextension

lack of knee extension (knee remains flexed 10-15 deg w/excessive ankle DF)

excessive lateral pelvic shift

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45
Q

what are the mechanical causes of knee hyperextension at midstance?

A

failure to progress body mass forward over the foot due to limited tibial advancement (DF) and terminal hip extension

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46
Q

in the acute phase, what are the mechanical causes of knee hyperextension at midstance?

A

decreased activation of ant tib muscles

contractile block of advancement-contracture and/or hypertonicity of calf muscles

mechanical block of advancement created by an orthosis

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47
Q

in the chronic phase, what are the mechanical causes of knee hyperextension at midstance?

A

contractures, jt immobility, and PROM

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48
Q

what is the behavioral cause of knee hyperextension in midstance?

A

fear of limb collapse due to weakness of muscles controlling the knee as an adaptation

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49
Q

t/f: normally the tibia advances over the foot going forward w/a little knee flexion

A

true

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50
Q

what are the causes of lack of knee ext in midstance?

A

synergistic activation of the LE musculature (flexor synergy or co-contraction)

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51
Q

what are the causes of excessive lateral pelvic shift in midstance?

A

decreased ability to activate stance hip abductors and control hip and knee extensors

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52
Q

what are the typical kinematic deviations in late stance (pre-swing)?

A

excessive pelvic retraction and lack of terminal hip ext

lack of knee flexion and ankle PF

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53
Q

what are the causes of excessive pelvic retraction and lack of terminal hip extension in late stance?

A

no stretch of the hip flexors

no “driver” for the LE flexor arm of SPG/CPG to initiate swing phase

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54
Q

what are the causes of lack of knee flexion and ankle DF in late stance?

A

weakness of calf muscles (GS)

inadequate PROPULSION

even though we have tone of the calf muscles, there is a lack of activation

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55
Q

t/f: even though we have tone of the calf muscles, there is a lack of activation of the muscles in late stance that limit knee flexion and ankle PF

A

true

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56
Q

in early and mid swing phase, the dominant muscle activity in the LE is…

A

extensor tone

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57
Q

when the extensor tone is dominant in the LE in early and mid swing phase, what muscles are weak?

A

hip flexor activity is weak

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58
Q

what are the typical kinematic deviations in early and mid swing phase?

A

limited hip flexion

limited knee flexion

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59
Q

when hip flexion is limited during early and mid swing, what do we often see pts doing?

A

hip hiking or circumducting

OR

advancing the limb with hip adductors (limb ER and outward toe angle)

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60
Q

when the adductors are used to advance the limb in early and mid swing, what is the position of the limb?

A

ER and outward toe angle

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61
Q

what are the causes of limited hip flexion in early and mid swing phase?

A

decreased activation of flexor muscles, often with hypertonicity of extensor muscles/extensor synergy dominance

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62
Q

what causes limited knee flexion in early and mid swing?

A

decreased activation of HS often with hypertonicity of rectus fem

reciprocal inhibition of the HS w/lots of quad activation

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63
Q

the ____ needs to be facilitated out of synergy early on

A

HS

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64
Q

what can we do to decrease reciprocal inhibition to the HS?

A

calm the rectus fem and facilitate active HS

get into hooklying for low stress HS activation

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65
Q

what are the typical kinematic deviations in late swing?

A

limited knee extension and ankle DF for IC

decreased loading response

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66
Q

what are the causes of limited knee ext and ankle DF for IC at late swing?

A

contracted/hypertonic calf muscles

decreased DF activity

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67
Q

what are the causes of decreased loading response at late swing?

A

inadequate heel strike and no jt loading “driver” to activate the LE extensor arm of the SPG/CPG

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68
Q

what is the secondary impairment of spatiotemporal adaptations?

A

decreased ROM

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69
Q

what are the composite impairments of spatiotemporal adaptations?

A

increased “learned non-use”

clinical hypertonicity

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70
Q

what are the spatiotemporal gait adaptations?

A

decreased walking speed

short and/or uneven step and stride length

increased stride width

increased double limb support phase

dependence on support through the hands

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71
Q

how do we measure gait velocity?

A

the a forward 10m WT (2m ramp up, 6m walk, 2m deceleration)

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72
Q

why do we do the 10mWT with max speed too?

A

bc we want to see what happens when pts change speed for things like going to the bathroom, getting the phone, or getting the door

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73
Q

what is the range for normal walking speeds?

A

1.2-1/4 m/s

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74
Q

what is an important gait velocity threshold for community ambulation and independence in ADLs?

A

0.8 m/s

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75
Q

what is the MCID for gait velocity?

A

0.1 m/s

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76
Q

t/f: a change in gait velocity of 0.1 m/s is significant for mortality

A

true

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77
Q

people who fell had significantly slower ____ times

A

3mBWT

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78
Q

3mBWT times slower than ____ indicated a pt is very likely to fall

A

4.5s

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79
Q

3mBWT times faster than ____ indicated a pt is unlikely to fall

A

3s

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80
Q

what is the procedure for the 3mBWT?

A

align heels w/start tape

walk backwards as quickly and safely as possible without looking back

instructed to stop (timing stops) when they reach the 3m tape mark (no ramp up or deceleration)

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81
Q

documentation of gait should always include what things?

A

level of assistance, gait velocity, and distance

gait fxnal classifications based upon the velocity

description of gait patterns limitations (OGA)

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82
Q

distances of >____ft will jeopardize qualification (insurance coverage) for PT

A

100

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83
Q

to avoid distances over 100 ft, what should we do?

A

keep distances low to increase velocity, control and decrease level of assistance

improve safety and independence w/in reduced distances when you’re setting goals

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84
Q

what is the cutoff gait velocity for household walker?

A

0.4 m/s

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85
Q

what is the cutoff gait velocity for limited community ambulation?

A

0.8 m/s

86
Q

what is the cutoff gait velocity for community ambulation?

A

bw 1.2-1.4 m/s

87
Q

who is a physiological walker?

A

some who walks for exercise only either at home or in parallel bars during PT

no level of independence

88
Q

what population are frequently physiological walkers?

A

severe TBI

89
Q

who is a limited household walker?

A

someone who relies on walking to some extent for home activities

requires assistance for some walking activities, uses a WC or is unable to perform others

90
Q

who is an unlimited household walker?

A

someone able to use walking for all household activities w/o any reliance on a WC

encounters difficulty w/stairs and uneven terrain

may not be able to enter or leave the house independently

91
Q

who is a most-limited community walker?

A

someone who can enter and leave the home independently

can ascend and descend a curb independently

can manage stairs to some degree

independent in at least one moderate community activity (ie appointment, restaurant) and needs assistance or is unable in no more than one other low-challenge (ie church, neighborhood, visiting a friend)

92
Q

a most limited community walker is independent in at least one _____ _____ activity and needs assistance or is unable in no more than one other ___ ___ activity

A

moderate community, low-challenge

93
Q

who is a least-limited community walker?

A

someone who demonstrates independence in stair management

independent in all moderate community activities w/o assistance or use of a WC

independence in either local stores or uncrowded shopping centers

independence in at least 2 other moderate community activities

94
Q

when going through the Ranchos Los Amgios Gait Analysis form, what is the procedure to go through?

A

decide your reference limb

decide on your sequence

determine your major problem(s)

characterize major deviations by each phase

examine for minor deviations

generate an assessment

assessment drives the intervention plan

95
Q

what is the basis for HIGT?

A

high intensity, variable stepping protocol w/an emphasis on overall fxn and efficiency

96
Q

what vitals are HIGT based on?

A

HRmax or HRR

97
Q

t/f: HIGT is based on phases of gait

A

false, it is based on biomechanical subcomponents of gait

98
Q

what are the 4 biomechanical subcomponents of gait?

A

propulsion

limb swing

postural/lateral stability

stance control

99
Q

what is propulsion?

A

forward progression of COM

100
Q

propulsion can be correlated to ___ ___

A

gait speed

101
Q

propulsion accounts for what % of metabolic cost of walking?

A

50-75%

102
Q

what is limb swing?

A

advancing the trailing limb past the stance limb

103
Q

limb swing accounts for what % of metabolic cost of walking?

A

5-10%

104
Q

what is stance control?

A

maintenance of postural stability and accepting weight

can I advance the limb forward without the limb collapsing under me?

105
Q

stance control accounts for what % of metabolic cost of walking?

A

25%

106
Q

what is postural/lateral stability?

A

maintenance of lateral move of COM (balance upright)

can I maintain upright? can I keep the COM in the midline?

107
Q

postural/lateral stability accounts for what % of metabolic cost of walking?

A

5-10%

108
Q

what role does neuroplasticity play in locomotor training?

A

we are trying to change the brain to change gait

109
Q

will challenging limb swing or challenge propulsion have a greater effect?

A

challenging propulsion will have more of an effect bc it accounts for a larger % of metabolic cost of walking

110
Q

what are some “pre-requisites” to gait?

A

appropriate WB status

postural alignment

ROM

muscle performance

motor fxn

balance

static and dynamic control

111
Q

when is locomotor training initiated?

A

once the pt has achieved adequate mobility and stability w the ability to initiate and control the pelvis and LE in the appropriate sequence for swing and stance

112
Q

t/f: the training principles for gait are impairment based

A

true

113
Q

what are the training principles for gait?

A

impairment based

task oriented to the specific task of walking

goal-directed and meaningful (salient)

progressed to maximally challenge the pt’s capabilities

repetition

114
Q

gait training is ____ oriented

A

task

115
Q

t/f: gait training is progressed to maximally challenge the pt’s capabilities

A

true

116
Q
A
117
Q

what are the various methods for locomotor training?

A

body weight support

treadmill systems

robotic assistance

dance

virtual reality

exergaming

strengthening

circuit training

mental imagery

118
Q

what are the principles to promote motor learning and neuroplasticity?

A

practice

feedback

focus of attention

119
Q

what is the principle of practice in motor learning?

A

the amount and repetitions

120
Q

what are the various types of practice in motor learning?

A

variable, constant, blocked, and random

121
Q

what is the principle of feedback in motor learning?

A

intrinsic feedback through own body systems

extrinsic feedback through the therapist usually to change the intrinsic feedback

122
Q

intrinsic feedback is through what?

A

own body systems

123
Q

extrinsic feedback is through what?

A

usually the therapist to change the intrinsic feedback

124
Q

what is the 2 types of focus of attention in motor learning?

A

external and internal

125
Q

what is external focus of attention?

A

attention to result

“pretend like you’re walking in a cave”

126
Q

what is internal focus of attention?

A

focus on how the body is performing

“want you to realize that every time you step on the R leg your knee is snapping back, don’t let it”

127
Q

what is locomotor training with body weight support and treadmill?

A

suspending a pt over a treadmill w/weight unloading

128
Q

what are the two ways we can use body weight support?

A

can remove partial body weight or just prevent falls

129
Q

what can we use to allow those w/LE and trunk weakness to take more steps w/o need for excessive UE support or compensation?

A

body weight support and treadmill

130
Q

t/f: body weight support high volumes allows reciprocal locomotor patterns in absence of supraspinal input

A

true

131
Q

what is a key benefit of body weight support and treadmill walking?

A

it allows for high reps

132
Q

what is the prime focus of locomotor training with body weight support and treadmill?

A

normalizing kinematics

133
Q

key components of locomotor training with body weight support are to promote ___ ____ w/ or w/o manual facilitation into flexion/extension and minimization of compensation

A

normalized kinematics

134
Q

what can PTs do to further facilitate normalized kinematics with locomotor training with body weight support?

A

be on either side of the treadmill and manually facilitate flexion/extension for the entire session

135
Q

what are additional locomotor training strategies?

A

treadmill w/o body weight support or fall prevention

virtual reality and exergaming

augmentation of muscles force production

balance and dynamic postural controls during overground walking

circuit training

motor imagery

robotics

136
Q

what are the benefits of treadmill walking w/o body weight support or fall prevention?

A

CPG activation

pacemaker assistance

variability in speed and incline

137
Q

what is the downside of treadmill walking w/o body weight support or fall prevention?

A

lack of variability in compliance of surfaces

138
Q

what are the benefits of virtual reality and exergaming?

A

it is salient, variable, and engaging

139
Q

what are the benefits of augmentation of muscle force production?

A

it is task specific to locomotor training w/external resistance

140
Q

how can we augment muscles force production?

A

with body weight or limb segment weight

part to whole tasks practice (hip flexion with ankle weights for step ups)

141
Q

what is the purpose of balance and dynamic postural control during overground walking?

A

to maintain stance (stability) and dynamic postural control (controlled mobility)

142
Q

how can we do balance and dynamic postural controls during overground walking?

A

LOS training

anticipatory and reactive postural control

COM control w/a reduction in BOS

transitions to and from single limb stance

143
Q

t/f: there is ample evidence in the transfer of static balance activities to dynamic control of gait

A

false, there is limited evidence of the transfer of static balance activities to dynamic control of gait

144
Q

t/f: overground walking must be trained w/incorporation of dynamic postural controls

A

true

145
Q

how can we incorporate dynamic postural control into overground walking?

A

walking on compliant surfaces

head movt with gait

visual disturbances with gait

change in speed

146
Q

what pts would we want to use balance and dynamic postural controls during overground walking?

A

pts that report difficulty walking on compliant surfaces

147
Q

what is circuit training?

A

using a variety of tasks oriented stations

148
Q

what are the benefits of circuit training?

A

it produces a lot of variability and randomization FOR THOSE IN THE LATER STAGE OF MOTOR LEARNING

149
Q

circuit training should be used in what populations?

A

those in the later stages of motor learning

150
Q

t/f: we should customize and strategically build stations based on what we want to improve

A

true

151
Q

how long should we do motor imagery for?

A

10-20 minutes

152
Q

what is motor imagery used for?

A

to augment and supplement strategies w/mental imagery

153
Q

what is motor imagery?

A

visualizing the performance of a movt or the sensory experience of a movt

154
Q

what is the difference bw visual imagery and kinesthetic imagery?

A

visual imagery is visualizing the performance of a movt

kinesthetic imagery is imagining the sensory experience of a movt

155
Q

mental imagery is good for successful gait training in what population?

A

pts with ataxia

156
Q

what are robotics designed for?

A

to improve gait fxn

157
Q

t/f: some robotics need special certification for use

A

true

158
Q

t/f: robotics may reduce motor output to match only what the pt needs

A

true

159
Q

how does robotic work?

A

the motor input will kick in where the pt is lacking

160
Q

what are the potential downsides of robotics?

A

the pt may become reliant on it

can become very passive

neuroplastic principle of intensity suffers

161
Q

is robotics designed for high or low reps

A

high

162
Q

what neuroplastic principle may suffer with the use of robotics?

A

intensity

163
Q

robotics may be helpful for what pts?

A

pts with VERY low levels of mobility w/no other options for ambulation (ie SCI or physiological walkers)

164
Q

according to the HIGT 2020 CPG, what conditions is HIGT effective for?

A

chronic (6 months) stroke, iSCI (incomplete SCI), and TBI

165
Q

HIGT desires to improve what?

A

gait EFFICIENCY (walking speed and endurance)

166
Q

t/f: HIGT is good to make gait look “pretty”

A

false

167
Q

t/f: HIGT principles are directly related to neuroplastic principles

A

true

168
Q

HIGHT treatment interventions are …

A

valued by the pt

specific to the task being (re)learned

provided at high dosage

challenging

169
Q

t/f: treatments in HIGT are likely to be associated w/beneficial neuroplastic changes and improvements in fxn

A

true

170
Q

what is the rationale for HIGT?

A

make the pt look worse initially w/the ultimate goal of it normalizing later

171
Q

what are the principles of neuroplasticity in HIGT?

A

intensity

variability and error

specificity

repetition

172
Q

intensity in HIGT is based on what values?

A

HRmax or HRR

173
Q

how do we use the principle of variability and error in HIGT?

A

introducing error augmentation

174
Q

how do we increase dosage in HIGT?

A

increased the volume of steps

175
Q

what has previous research told us about prescription for walking in PT?

A

steps taken in PT are generally under dosed

176
Q

to apply specificity and repetition in HIGT, what do we need to do?

A

prioritize stepping practice w/a high # of reps

177
Q

what is a more reliable measure of intensity in HIGT when a pt is on beta blockers or the pt is lower level?

A

RPE

178
Q

what are some ways to progress intensity in HIGT?

A

increased speed, incline, duration, or mass (add weights)

179
Q

what is the frequency of HIGT (FITT)?

A

4 days/week

180
Q

what is the intensity of HIGT (FITT)?

A

70-80% HFmax

Borg 14-18 (zone 4)

181
Q

what is the time of HIGHT (FITT)?

A

as much time in zone 4 >30 minutes

182
Q

what is the type in HIGT (FITT)?

A

variable stepping practice (forward walking, backward walking, side stepping, obstacles, etc)

183
Q

what measure for intensity doesn’t account for autonomic dysregulation, deconditioning, or medication use (beta blockers)?

A

HRmax

184
Q

what are the intensity targets for HIGT?

A

70-85% HRmax

70-80% HRR

14-18 Borg RPE (6-20 scale) or 6-8 Borg RPE (1-10 scale)

185
Q

how does error augmentation help with gait?

A

it allows the NS to adapt to work harder

186
Q

t/f: variability improves performance and improved retention

A

true

187
Q

what are the benefits of error augmentation?

A

kinematic variability

environmental variability

external forces

188
Q

pt must have what ability to introduce error augmentation in gait training?

A

ability to learn

189
Q

what considerations would make error augmentation a bad option for gait training?

A

sensory or memory deficits

cerebellar lesions

190
Q

how can we provide assistance to stance control?

A

body weight support

191
Q

how can we provide error augmentation for stance control?

A

weighted vest

192
Q

how can we provide assistance for propulsion?

A

pulling the pt forward

193
Q

how can we provide error augmentation for propulsion?

A

pulling the pt backward

194
Q

if a pt has ___ consecutive errors, it is too challenging

A

5

195
Q

t/f: error augmentation may induce short term clinical hypertonicity until efficiency is improved

A

true

196
Q

what concerns need to be addressed prior to error augmentation?

A

ortho and medical concerns

197
Q

as a pt leans more towards the left on the error and assistance curve, should we increase assistance or increase error?

A

increase assistance

198
Q

as a pt leans more towards the right on the error and assistance curve, should we increase assistance or increase error?

A

increase error

199
Q

as the degree of acquisition of a skill increases, what should we do?

A

introduce more error augmentation

200
Q

how can we progress the propulsion phase?

A

elastic or belt resistance to forward progression (resisted walking/posterior forces)

add mass to body/legs

increase speeds

uphill/incline or stairs

201
Q

how can we regress the propulsion phase?

A

anterior directed stabilizing straps at the pelvis

decreased speeds

202
Q

how can we progress the stance control phase?

A

adding weight to the trunk (weighted vest)

stair negotiation

203
Q

how can we regress the stance control phase?

A

reduce body weight with body weight support

handheld assist

204
Q

how can we progress the postural/lateral stability phase?

A

practice on unstable or narrow surfaces (balance beam)

obstacle avoidance

dual physical tasks

uneven surfaces

stair climbing

multidirectional walking (backward, side stepping)

205
Q

how can we regress the postural/lateral stability phase?

A

anteriorlateral straps to decrease pelvic translation

handheld assist

ADs

206
Q

how can we progress the limb swing phase?

A

add leg weight

apply elastic resistance

step over obstacles

207
Q

how can we regress the limb swing phase?

A

manual assistance

elastic assistance

body weight support

208
Q

if pt is doing really well in one phase of gait but struggling in another, what can we do?

A

add assistance where the y are struggling and add error augmentation where they are doing well

209
Q

if a pt makes 3-5 consecutive errors, shift ___ on the error assistance curve

A

L

210
Q

if a pt shows limited/no errors, shift ___ on the error assistance curve

A

R

211
Q

t/f: there is a leapfrog effect from gait training to transfers

A

true

DPT 620: Neuro (13 decks)

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