Measurement & Documentation of Gait Flashcards
What are we directly observing for gait / balance?
how they enter and sit in the clinic, stance, posture, velocity, step length, symmetry, cadence, fluidity of movement, instability / need of assistance
Cut off score for functional reach test?
< 6-7” predictive of falls
Cut off score for TUG test?
> 14sec risk of falls
Average scores for single leg stance test?
EO: >40sec in 50 y/o, >10sec in 80 y/o // EC: 7.9 sec in 50 y/o, 2.1 sec in 80 y/o
Cut off score for Parkinson’s patients for single leg stance test?
10 seconds
What is the 6th vital sign and why?
gait speed bc solid predictor for rehab, cognitive decline, hospitalization, cardiovascular events, body response to physical activity, identifies those at risk
What is a normal stride distance for adults?
1.5m
What is a normal stride time for adults?
~1 second
How many steps in normal stride?
2 steps
Why is gait velocity so important?
cross-walk timing, required walking speed for pedestrian to cross the street is 4ft/second (adult males). Need speed of 1.22 m/second
What are negative aspects of crosswalk timing?
the required 1.22m/gait speed is too fast for children, handicapped pedestrians, and elderly, leading to increase risk of falls or injury when trying to cross the street too quickly
What are the most comment assessments for gait?
Functional Ambulation Classification Scale commonly for CVA // Ranchos Los Amigos commonly for OGA // DGI predicts falls // Gait Speed for falls
What does a score of 0 indicate for the Functional Ambulation Classification Scale?
non-ambulation, absolute walking incapacity even w/ external help
What does a score of 1 indicate for the Functional Ambulation Classification Scale?
non-functional ambulation = dependent walking w/ permanent external help, usually assist of 1 or 2 people and/or only possible during PT sessions
What does a score of 2 indicate for the Functional Ambulation Classification Scale?
household ambulation = walking only indoors on flat horizontal surfaces, within known and controlled areas (speed 0.4m/s)
What does a score of 3 indicate for the Functional Ambulation Classification Scale?
Limited community ambulation = able to walk indoors and outdoors on uneven steps, limited walking distance, need to be able to walk ~1000ft (speed 0.4-0.8 m/s)
What does a score of 4 indicate for the Functional Ambulation Classification Scale?
independent community ambulation = able to walk on all types of irregular surfaces, stairs/steps/ramps/curbs, unrestricted walking distance, may have limp or anomalies (speed 0.8-1.3m/s)
What does a score of 5 indicate for the Functional Ambulation Classification Scale?
Normal ambulation = normal walking in distance/appearance and unlimited distance, no anomalies, walk on toes, heels, and in tandem. (speed 1.3m/s)
What gait speed indicates patient is at risk for recurrent falls?
< 0.55 m/s
What do you avoid when documentating gait observation?
derogatory statements (“pt c/o”), labels, jargon and uncommon abbreviations, non-essential
What do you include when documenting gait observation?
“pt reports”, consciesly written statements, specific behavior you’re seeing, full sentences when in doubt over abbreviations
How do you document functional limitations in gait?
limitation in performance at level of the whole person, functional abilities/status, used to show improvement and justify PT services, standardized measures
How do you document Impairments in gait?
ROM, strength, sensation, spasticity, weakness, foot drop, balance static/dynamic
What DO you document for gait?
distance, kinematics, endurance, functional, speed, AD used, level of assistance required, RPE, surfaces/elevations, open vs closed environment, multitasking
