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710: Motor Control & Motor Learning > Mobility Rehabilitation > Flashcards

Mobility Rehabilitation Flashcards

1
Q

What type of approach should we take to examination and intervention for mobility disorders?

A

Task-oriented approach

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2
Q

Task-oriented approach to examination and intervention is based on:

a. ICF framework only
b. Systems framework only
c. Both ICF and systems framework
d. None

A

C

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3
Q

Some of the tests and measurements that can be used to document functional abilities related to mobility include what 2 things?

A
  • Level of Mobility Disability

- Functional Mobility Skills

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4
Q

Define level of mobility disability

A

A restriction in participation of mobility related activities in the person’s home and community environment

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5
Q

What is level of mobility disability referred to in the ICF framework?

A

performance

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6
Q

Functional mobility skills are performed in what type of setting?

A

Within a standard setting, such as a clinical environment

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7
Q

What are functional mobility skills referred to in the ICF framework?

A

capacity

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8
Q

In a task-oriented approach, examination of mobility function analyzes performance on what three levels?

A
  • Functional
  • Strategy
  • Impairment
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9
Q

When is a test is classified as a measure of participation (performance)?

A

when it gathers information about the person’s mobility behavior in his or her environment

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10
Q

What are the 2 ways in which participation is measured?

A
  • self-reported

- technology such as pedometers and activity monitors

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11
Q

What are 3 standard measures of functional activity?

A
  • gait velocity
  • 6 or 12 minute walk test
  • technological devices (force plate, EMG) for the clinic
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12
Q

List 5 assessment tools for examining mobility on the functional level

A
  • Dynamic Gait Index
  • Functional Gait Assessment
  • Rivermead Mobility Index
  • Emory Functional Ambulation Profile
  • Physical Performance and Mobility Examination
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13
Q

What are 2 limitations of functional gait measures?

A
  • do not provide insight into underlying impairments because no information is given as to how the performance is achieved
  • they are only indications of the end project (determine level of disability related to mobility)
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14
Q

Why is important to examine mobility on the strategy level?

A

In order to describe the quality of performance (e.g., the ways in which gait patterns deviate from normal)

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15
Q

What is the most commonly used clinical tool to assist the therapists in analyzing a patient’s gait strategies in a systematic way?

A

Observational Gait Analysis (OGA)

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16
Q

List 3 other assessment tools for examining mobility on the strategy level

A
  • Rancho Los Amigos Gait Analysis Form
  • Gait Assessment Rating Scale
  • Rivermead Visual Gait Assessment
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17
Q

What are the limitations to visual gait analysis?

A

There is poor reliability and it is time consuming

18
Q

According to Perry what are the 2 period of gait?

A
  • Stance

- Swing

19
Q

According to Perry what are the 2 tasks of stance?

A
  • weight acceptance

- single limb support

20
Q

According to Perry what are the 2 phases of weight acceptance?

A
  • initial contact

- loading response

21
Q

According to Perry what are the 2 phases of single limb support?

A
  • mid stance

- terminal stance

22
Q

According to Perry what is the single tasks of swing?

A

limb advancement

23
Q

According to Perry what are the 4 phases of limb advancement?

A
  • preswing (also part of stance phase)
  • initial swing
  • mid swing
  • terminal swing
24
Q

Who does “Perry” refer to?

A

Jacqueline Perry

25
Q

People often associate the name Perry with what?

A

analysis of normal and abnormal movement of the trunk, upper extremity, and lower extremity and the restoration of movement through surgery, bracing, electrical stimulation, and exercise

26
Q

What are 4 possible causes of short step length according to Winter’s framework for determining causes of atypical gait?

A
  • Weak push-off prior to swing
  • Weak hip flexors at toe-off and early swing
  • Above-normal knee extensor activity during push-off
  • Excessive deceleration of leg in late swing
27
Q

What are the associated biomechanical and neuromuscular diagnostic evidences behind short step length?

A
  • Below-normal plantar-flexor moment or power generation or EMG during push-off
  • Below-normal hip flexor moment or power or EMG during late push-off and early swing
  • Above-normal quadriceps EMG or knee extensor moment or power absorption in late stance
  • Above-normal hamstring EMG or knee flexor moment or power absorption late in swing
28
Q

Do impairments (strength, ROM, spasticity) predict gait speed?

A

Static examination of factors such as strength, ROM, and spasticity are important; however, they do not always predict gait performance in patients with neurologic lesions

29
Q

What factors play a role between impairments and gait parameters?

A
  • the type and extent of impairment,
  • the functional level of the patient, and
  • the capacity for compensation by other systems
30
Q

What kind of relationship is there between strength training and gait performance?

A

The relationship is nonlinear.

As LE strength increases so do walking speed, up until a point, then it levels off

31
Q

True of False

Oftentimes resolution of impairments alone may not be enough to ensure recovery of functional ambulation skills.

A

True

32
Q

Training at what level is essential?

A

the strategy level

33
Q

What are the 3 facets of intervention on the strategy level?

A
  • progression
  • stability/postural control
  • adaptation
34
Q

What are the 3 important components of treatment plans regarding progression?

A
  • energy generation
  • advancement of the swing leg
  • foot clearance
35
Q

Treatments aimed at postural control include

A
  • improving postural alignment of the head, arms, and trunk (HAT) segments
  • effective generation of an extensor support moment
  • control of mediolateral stability (including placement of the foot at initial con-tact of stance)
  • improving balance in the single- and double-support phases of gait
  • use of assistive devices that broaden the base of support
36
Q

What are 3 ways in which intervention on the strategy level can test adaptation?

A
  • Obstacle courses
  • Forward/Backward/Sideways
  • Anticipation of potential balance threats
37
Q

What must we as PTs do in order to meet the task requirements of progression, stability, and adaptability?

A

Set goals

*Understanding there is no one right strategy to meet these requirements

38
Q

What is necessary in order to achieve maximal locomotor function?

A

combining part with whole-task practice

39
Q

What is an example of whole-task training?

A

Body-weight support on a treadmill (BWST)

40
Q

In conclusion the most important thing in which we want to train in regards to regaining mobility is what?

A

gait speed

710: Motor Control & Motor Learning (14 decks)

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