Measurement & Documentation of Gait

Question 1

What are we directly observing for gait / balance?

Answer 1

how they enter and sit in the clinic, stance, posture, velocity, step length, symmetry, cadence, fluidity of movement, instability / need of assistance

Question 2

Cut off score for functional reach test?

Answer 2

< 6-7” predictive of falls

Question 3

Cut off score for TUG test?

Answer 3

> 14sec risk of falls

Question 4

Average scores for single leg stance test?

Answer 4

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

Question 5

Cut off score for Parkinson’s patients for single leg stance test?

Answer 5

10 seconds

Question 6

What is the 6th vital sign and why?

Answer 6

gait speed bc solid predictor for rehab, cognitive decline, hospitalization, cardiovascular events, body response to physical activity, identifies those at risk

Question 7

What is a normal stride distance for adults?

Answer 7

1.5m

Question 8

What is a normal stride time for adults?

Answer 8

~1 second

Question 9

How many steps in normal stride?

Answer 9

2 steps

Question 10

Why is gait velocity so important?

Answer 10

cross-walk timing, required walking speed for pedestrian to cross the street is 4ft/second (adult males). Need speed of 1.22 m/second

Question 11

What are negative aspects of crosswalk timing?

Answer 11

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

Question 12

What are the most comment assessments for gait?

Answer 12

Functional Ambulation Classification Scale commonly for CVA // Ranchos Los Amigos commonly for OGA // DGI predicts falls // Gait Speed for falls

Question 13

What does a score of 0 indicate for the Functional Ambulation Classification Scale?

Answer 13

non-ambulation, absolute walking incapacity even w/ external help

Question 14

What does a score of 1 indicate for the Functional Ambulation Classification Scale?

Answer 14

non-functional ambulation = dependent walking w/ permanent external help, usually assist of 1 or 2 people and/or only possible during PT sessions

Question 15

What does a score of 2 indicate for the Functional Ambulation Classification Scale?

Answer 15

household ambulation = walking only indoors on flat horizontal surfaces, within known and controlled areas (speed 0.4m/s)

Question 16

What does a score of 3 indicate for the Functional Ambulation Classification Scale?

Answer 16

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)

Question 17

What does a score of 4 indicate for the Functional Ambulation Classification Scale?

Answer 17

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)

Question 18

What does a score of 5 indicate for the Functional Ambulation Classification Scale?

Answer 18

Normal ambulation = normal walking in distance/appearance and unlimited distance, no anomalies, walk on toes, heels, and in tandem. (speed 1.3m/s)

Question 19

What gait speed indicates patient is at risk for recurrent falls?

Answer 19

< 0.55 m/s

Question 20

What do you avoid when documentating gait observation?

Answer 20

derogatory statements (“pt c/o”), labels, jargon and uncommon abbreviations, non-essential

Question 21

What do you include when documenting gait observation?

Answer 21

“pt reports”, consciesly written statements, specific behavior you’re seeing, full sentences when in doubt over abbreviations

Question 22

How do you document functional limitations in gait?

Answer 22

limitation in performance at level of the whole person, functional abilities/status, used to show improvement and justify PT services, standardized measures

Question 23

How do you document Impairments in gait?

Answer 23

ROM, strength, sensation, spasticity, weakness, foot drop, balance static/dynamic

Question 24

What DO you document for gait?

Answer 24

distance, kinematics, endurance, functional, speed, AD used, level of assistance required, RPE, surfaces/elevations, open vs closed environment, multitasking