Walking

Question 1

What are the 3 stages of the fitts and posner model of motor learning

Answer 1

Cognitive -> associative -> automatic

Question 2

What are the 3 stages of the systems model of motor learning

what does each stage change?

Answer 2

Novice-> advanced -> expert

Allows more degrees of freedom

Question 3

What are the most important principles of neuroplasticity

Answer 3

1. Intensity matters

Specificity matters

repetition matters

salience matters

Question 4

What amount of steps in gait training was shown to induce neuroplasticity

Answer 4

2000-6000

Question 5

What kind of practice is better for learning, Massed or distributed

Answer 5

distributed

Question 6

what kind of practice is better for learning, blocked vs random

Answer 6

random

Question 7

how do we measure intensity for patients

Answer 7

Use cardiovascular parameters unless they have cardiac conditions or are on betablockers, then you use RPE

Question 8

how do we calculate max HR for pts

Answer 8

208-0.7age

Question 9

What RPEs are best for gait training

Answer 9

14 or higher out of 20

Question 10

An orthostatic drop of ________ is contraindicated in gait training

Answer 10

20mmhg

Question 11

Systolic pressure of ________ or diastolic of ________ is contraindicated for gait training

Answer 11

200mmhg 110mmhg

note: also unstable angina and orthostatic drop of 20mmhg

Question 12

Which of these training modes did best for gait training:

Low volume, high intensity

Limited progressive treadmill (gradual 20% increase)

or PNF

Answer 12

Low volume, high intensity

Question 13

T or F: gait training improves performance on non-gait outcome measures

Answer 13

T

but non-gait training does not improve performance on gait outcome measures

Question 14

Should, May, or Should not: use moderate to high intensity walking training of 60-80% HRR or 70-85% of HRmax

Answer 14

Should

Question 15

Should, May, or Should not: Virtual reality walking training

Answer 15

should

Question 16

Should, May, or Should not: virtual reality balance training

Answer 16

May

Question 17

Should, May, or Should not: recumbent stepping, cycling, strength training

Answer 17

may

Question 18

Should, May, or Should not: robot assisted gait training

Answer 18

Should not

Question 19

Should, May, or Should not: Body weight supported treadmill

Answer 19

should not

however, dr. szott says we may do it if we keep intensity high and don’t unload the patient too much

Question 20

Should, May, or Should not: use sitting or standing balance training to improve gait

Answer 20

should not

Question 21

What are the 4 biomechanical sub components of gait

Answer 21

Stance control

limb advancement

propulsion

postural stability

Question 22

T or F: too much feedback can be detrimental to motor learning

Answer 22

T

Question 23

Should, May, or Should not: Use AFO for QOL, Improving gait speed, improving dynamic balance

Answer 23

should

Question 24

Should, May, or Should not: Use AFO to control tone or spasticity

Answer 24

Should not

Question 25

Should, May, or Should not: Use AFO for strength/muscle activation

Answer 25

may provide with decreased stiffness (for partial assistance) Should provide an AFO if it's a chronic loss of strength

Question 26

Should, May, or Should not: Use an AFO for gait kinematics

Answer 26

May

Question 27

T or F: AFOs are effective for improving plantar flexion spasticity in gait

Answer 27

False

Question 28

FES should be used for what?

Answer 28

Mainly foot drop, Improves: QOL Muscle Activation dynamic balance gait speed walking endurance mobility

Question 29

FES may be used for what

Answer 29

Gait kinematics, dorsiflexion in IC, LR, Swing

Question 30

Why might a FES(functional electrical stimulation) not be helpful

Answer 30

Because patients with foot drop often also have problems in stance phase too that this does not address