pathological gait Flashcards
this presentation
walking airds
treartment ideas for gait
how giat migh tbe imparieed
gait anaylsis for patients with neurological conditions
sds
phases of gait
gait analysis - im looking at right leg or rigt ankle then change side
single limb suppot, lumb advacnemt etc
gait speed
6th vital sign, as its so crucial.
falls risk, will tell you discharge evaluation this is based off a patients gait speed.
1.2m/s slowest speed to allow you to cross a road
quick and easy
always get a gait spped.
how do you do gait anlysis
lots of observation
took off clothing to best see te joints and dont have to guess.
be consistent, to from bottom up
videos/recordings dont use your phone use the ficilities, show patients as an external feedbackc loop.
common stance phases
knee hyper - initial contact, mid stance to terminal stance. planer flexion contracter
forefoot initial contact - metertasals hitting floor first not heel - weak dorsiflex and planter flecion contracter
contralateral pelvic drop (trendelenberg), spasticity, need to see weka hop abductors so assess for spasticyty there.
Decreased toe off - terminal stance. lack of great toe extension. 15 degress of great toe extension is normal so if csnt get it. also if plsnter flexors are weak so cant push off. also if no dorsi flexion b=cus as the push off happens foot goes into dorsi before stepping. foot clearance?
comon swing phas deviation
cirmcundauct gair pattenrn
abducted gait pattern
inconsisten
right leg hes not passing the left foot
abducting right leg
not enough foot clearance so weak hamstrings and not using hip flexors. dragging toes
externally roating leg tp compensate the part the are trying to rock over.
step length
neurolofnvsol motor mpar=imrents
laterl trnk flexion
stepedge gaoit
harder to swing leg through so staert leaning trunk back
these are all compensative qualities from these impairemtns
patient example
getting midline where it needs to be before we can start the patient walking, so working on balance,
non motor impairmetns
arms- stiff. either close to body or out to the side or towards air - high gard positure compensating seen in people with cerebellar atxia.
vestibular problems - keep head completely still as feel uncomfortabel turn heading and feels dizzy
gait rehab
task specidic
do i need to adress the stance pase or sing phase - trouble walking home - environmental facrors whaats the ground like - can i simulate this in the clinic.
see them walk. break it down in =to different compents then put back together at end.
exrernal feedaback like walls, mirrors. corners. oaralelle bars to see where there laing
tredmill body weight support
hemiwalkers, framesticks walking aids
fes - seen withv footdrop - electrical stim placed on them to help foot drop.
squeeze, tapping, verbal quese to facilitate muscle contraction
taking degree of freedom out of the equation - so high kneeling to work on ankkle control
encouragement, understanding when their getting tired,,
orthotics
talking with ur orthatist
they can tell you what they can make or what they ave available for you
use it for support through swing or stacne phase
AFO just for teh support of foor drop but there are laods more. this is used to help lift foot up at swing phase
rigid cus there is no joint to planter and dorsi flex at the ankle. used it no ankle stability or lower limb stability, fot supernating whiile standing - rolling outwards
made of carbon fibre, stores energy to help prepel foot up through swing ohase but these are more expensive
