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Term 3 > Neuromuscular Unit 8 Gait > Flashcards

Neuromuscular Unit 8 Gait Flashcards

1
Q

What are the requirements of Normal Gait?

A
  • Progression
  • Stability (Posture)
  • Adaptation
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2
Q

When assessing gait, what should you put in the Objective/FIM Statement?

A
  • Distance
  • Terrain
  • Assistive Device
  • Level of Assistance

“Pt amb 100’ on even tile with RW with minimal assistance”

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3
Q

When assessing gait, what should you put in the Observational Analysis?

A
  • Temporal Factors
  • RLA Analysis
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4
Q

When assessing gait, what should you put in the Outcome Measures?

A
  • Speed
    –10 meter walk test
  • Function:
    –Functional Gait Assessment
    –Dynamic Gait Index (DGI)
  • Endurance:
    –2 min or 6 min walk test
  • Gait/Balance:
    –Tinetti
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5
Q

With Distance and Temporal Factors, what is Step Length?

A

When Initial Contact of one foot to Initial Contact of opposite foot

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6
Q

With Distance and Temporal Factors, what is Stride Length?

A

When Initial Contract of one foot to the following Initial Contact of same foot

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7
Q

With Distance and Temporal Factors, what is step width?

A

Horizontal distance between heels of each foot

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8
Q

With Distance and Temporal Factors, what is Cadence? What is the normal?

A

The number of steps per unit time
(Normal: 112.5 steps/min)

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9
Q

With Distance and Temporal Factors, what is Velocity?
What is the normal?

A

The average horizontal speed of body
(Normal: 1.46 m/s)

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10
Q

In the Gait Cycle, when is the leg mostly extended and longer?

A

In Stance Phase

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11
Q

In the Gait Cycle, when is the leg mostly flexed and shorter?

A

In Swing Phase

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12
Q

What is the greatest change in degrees at the hip?

A

Pre-swing going to Initial-swing (25°)

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13
Q

What is the greatest amount of change in Knee Flexion in gait?

A

From Terminal Stance to Preswing

Going from 0° to 40° of flexion

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14
Q

What are the Requirements for Loading Response?

A

This is a combination of Eccentric motion into knee flexion, PF to allow for foot flat to occur and appropriate shock absorption

  • Hip: 20° of flexion {Ecc Hip Ext}
  • Knee 15 ° of flexion: This is a 15° change into flexion from initial contact (0° flx) {Ecc quads}
  • Ankle 5° PF: This is a 5° change into PF (0°) (Ecc DF)
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15
Q

What are the requirements for Mid Stance?

A

Most static Phase in Gait
This is the coordination of the Extensors (Trunk extensors, glutes, and quads) and a co-contraction of eccentric ankle plantarflexors

  • Pelvis, Hip, Knee: 0°
  • Ankle: 5° DF: This is a 10° change from 5° PF to DF {Ecc PF}
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16
Q

What are the requirements for Terminal Stance?

A

Forward/Medial weight shift, with increase hip extension and ankle DF;
still requires co-contraction of hip/knee extensors;
Eccentric control of PF to slow tibia into DF

  • Hip: 20° of extension (20° change from 0°)
  • Knee: 0°
  • Ankle: 10 degrees of DF (5° change from 5° DF to 10°)

It important to have the 20° of Extension in hip

17
Q

What are the requirements for Pre-Swing?

A

Depression of the ilium;
Knee Release;
Metatarsal WB with 15° PF;
ASIS should be pointed forward and should not be deviated in the frontal plane

  • Hip: 10° of extension (10° change into flexion; from 20° of extension)
  • Knee: 40° of flexion (40° change from 0°)
  • Ankle: 15° of PF (25° change into PF; from 10° of DF)
18
Q

What are the requirements for Initial Swing - Mid Swing?

A
  • Co-contraction of hip/knee flexors
  • Created by extension moment in the hip prior (facilitation of GTO)
  • DF is initiated at initial swing and progressed into mid-swing for foot clearance
  • In Initial swing the hip is flexed at 15° and has a 10° change going into Mid-swing (25° of Flexion)
  • In initial swing the knee is flexed at 60° and has a 35° change going into Mid-swing (25° of flexion)

Eccentric Hamstring is in charge with Initial swing to Mid Swing, the body is essentially applying the brakes

19
Q

What are the requirements for Terminal Swing - Initial Contact?

A
  • Coordinated hip flexion, Terminal knee extension and ongoing ankle DF that was activated at Initial-Mid swing
  • The only difference between terminal swing and initial contact from a movement standpoint is that there is a point of contact with initial contact

From Terminal Swing to Initial contact the degrees are the same:
Hip: 20° of flexion
Knee: 0° of flexion
Ankle: 0°

20
Q

What are Gait Abnormalities with Mid to Terminal Stance?

A
  • Increased Hip Flexion (Forward Trunk)
  • Increased Hip Extension (Backward Trunk)
  • Increased Knee Flexion (Knee Buckle)
  • Increased Knee Extension (Knee Hyperextension/Genu Recurvatum)
21
Q

What are causes of Gait Abnormalities with Pre swing throughout swing phases?

A
  • Lack of Hip Flexion
  • Lack of Knee Flexion
  • Lack of Dorsiflexion

Lack of knee flexion and DF are due to weakness of the Flexors and hypertonicity of the Extensors

22
Q

With Gait Abnormalities with Pre swing throughout swing phases, what are common compensations? Why are these compensations happening?

A
  • Circumduction (weak hip FLX and increase in ADD)
  • Vaulting (Excessive PF)
  • Foot Drag/Foot Drop (No DF)
  • Steppage Gait Good Hip Flexion (Lack of DF)
23
Q

What is a common gait abnormality in Initial Contact?

A

Lack of heel strike, due to lack of DF

24
Q

What is a common gait abnormality in Loading Response?

A

Foot slap, due to Excessive PF

25
Q

With Gait, what are 3 Abnormal Motor Impairments?

A
  • Abnormal Tone
  • Weakness/Paresis
  • Abnormal Synergies
26
Q

In Gait if a person has Abnormal Tone what would the result and compensation be if they have PF Spasticity?

A
  • In Initial Contact they have lack of heel strike/forefoot contact
  • In Initial Swing to Terminal Swing they will have lack of DF throughout

Compensation:
- They will have Trunk/Knee/Hip Flexion (Shortened Stance Time
- They may have Circumduction, Hip Hike, Steppage Gait

27
Q

In Gait if a person has Abnormal Tone what would the result and compensation be if they have Quadriceps Spasticity?

A
  • In Mid/Terminal Stance they have Excessive knee extension
  • In Pre- to Mid-Swing they have lack of knee flexion
    (they would no longer have longer leg)

Compensation:
- They may have shortened Stance Time/Forward Trunk Flexion
- They may have Circumduction/Hip Hike/Contralateral Vaulting
(Because flexors are most likely weak)

28
Q

In Gait if a person has Abnormal Tone what would the result and compensation be if they have Hamstring Spasticity?

A
  • In Terminal Swing they have lack of knee extension
  • In Mid and Terminal Stance they have excess knee flexion

Compensation
- They may have Forward Lean/Crouched Posture
- Shortened Stance time/Forward trunk flexion

29
Q

In Gait if a person has Abnormal Tone what would the result and compensation be if they have Adductor Spasticity?

A
  • Pre to Mid Swing they have increased hip ER and lack of hip flexion

Compensation
- They may have Circumduction / Scissoring Gait

30
Q

In Gait if a person has Abnormal Tone what would the result and compensation be if they have Hip Flexor Stiffness?

A
  • In Mid to Terminal Stance they have increased hip flexion

Compensation
- They may have shortened stance time with deceased contralateral step length

31
Q

In Gait if a person has Weakness/Paresis what would the result and compensation be if they have PF weakness?

A
  • In Mid and Terminal Stance they’ll have a knee buckle
  • In Pre-Swing they have lack of PF

Compensation
- Backward Trunk lean
- Hip ER or Hip flexion

32
Q

In Gait if a person has Weakness/Paresis what would the result and compensation be if they have DF weakness?

A
  • In Initial Swing through Initial Contact they would have lack of DF (Foot drag)
  • In Loading Response they would have lack of eccentrics leading to a foot slap

Compensation
- They’ll have Ipsilateral Hip Hike, Circumduction/Steppage; Contralateral Vaulting
- Forward Trunk

33
Q

In Gait if a person has Weakness/Paresis what would the result and compensation be if they have Quadriceps weakness?

A
  • In Mid and Terminal Stance they would have a knee buckle or Hyperextension

Compensation
- They’ll have a forward trunk lean; shortened step length

34
Q

In Gait if a person has Weakness/Paresis what would the result and compensation be if they have Hip Flexor weakness?

A
  • In Pre to Initial Swing they would have lack of hip flexion

Compensation
- They’ll have forward lean; Circumduction with Adductor Longus

35
Q

In Gait if a person has Weakness/Paresis what would the result and compensation be if they have Hip Extensor weakness?

A
  • In Mid-Stance they would have increased hip flexion

Compensation
- They’ll have a backward lean; shortened step length

36
Q

In Gait if a person has Weakness/Paresis what would the result and compensation be if they have Hip Abductor weakness?

A
  • In Mid-Stance they would have contralateral Pelvic Drop

Compensation
- They’ll have a T-Gait Pattern

Term 3 (44 decks)

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