Week 3 Flashcards
What are common hemiplegic gait abnormalities that lead to asymmetrical gait patterns?
spatial asymmetries
- decreased step and stride length
- variable step width
- decreased height in swing
temporal asymmetries
- decreased single-limb stance time
- increased double-limb stance time
- increased swing time
- decreased cadence
- decreased weight bearing and shift in stance
What gait speed is needed to be independent in ADL’s and less likely to have adverse event?
1 - 1.4 m/s
What gait speed constitutes dependent in ADL’s and is more likely to be hospitalized?
0-0.6 m/s
What is the gait speed cut off for interventions to reduce falls risk?
< 1 m/s
What is a patients gait speed if they are a household ambulator?
0-0.4 m/s
What is the patients gait speed if they are a limited community ambulator?
0.4-0.8 m/s
What is the patients gait speed if they are a community ambulator?
0.8-1.2 m/s
What is normal walking speed?
1.2-1.4 m/s
What is the cutoff gait speed for a patient to be discharged to a SNF vs home?
< 0.1 m/s - SNF
> 0.1 m/s - d/c to home more likely
What are common hemiplegic gait abnormalities seen in the upper extremities?
decreased or absent arm swing - due to hemiplegia
What are common hemiplegic gait abnormalities seen in the trunk?
- decreased rotation - due to asymmetrical arm swing
- ipsilateral lateral trunk lean - glut med weakness (Trendelenburg)
- forward trunk lean - glut max (extensors) weakness
What are common hemiplegic gait abnormalities seen in early stance phase (heel strike to midstance) at the pelvis/hip?
- decreased pelvic rotation
- decreased hip flexion
- increased hip IR
- increased hip adduction - Trendelenburg
What are common hemiplegic gait abnormalities seen in early stance phase (heel strike to midstance) at the knee?
- increased knee flexion (particularly at initial contact)
- peg leg - decreased knee flexion in early-stance followed by knee hyperextension in late-stance
- excessive knee hyperextension throughout stance
What are common hemiplegic gait abnormalities seen in early stance phase (heel strike to midstance) at the foot/ankle?
- decreased tibial progression
- decreased ankle DF
- lack of heel strike
- foot flat and foot slap at initial contact
- foot/ankle instability - inversion, supination
What are common hemiplegic gait abnormalities seen in late stance phase (midstance to terminal stance) at the pelvis/hip?
- decreased pelvic rotation
- decreased hip extension/terminal stance
- hip flexion during forward progression
What are common hemiplegic gait abnormalities seen in late stance phase (midstance to terminal stance) at the knee?
- decreased knee extension
- knee buckling
- delayed movement into knee flexion in preparation for swing phase
What are common hemiplegic gait abnormalities seen in late stance phase (midstance to terminal stance) at the foot/ankle?
- decreased tibial progression - step-to pattern
- decreased heel off at terminal stance
What are common hemiplegic gait abnormalities seen in early swing phase (push off to mid-swing) at the pelvis/hip?
- decreased hip flexion
- hip hiking
- circumduction
- increased compensatory ER
What are common hemiplegic gait abnormalities seen in early swing phase (push off to mid-swing) at the knee?
decreased knee flexion
What are common hemiplegic gait abnormalities seen in early swing phase (push off to mid-swing) at the foot/ankle?
- poor foot clearance
- toe drag
- decreased ankle DF
- increased inversion
What are common hemiplegic gait abnormalities seen in late swing (mid-swing to heel strike) at the pelvis/hip?
- decreased hip flexion
- hip hiking
- circumduction
- increased compensatory ER
What are common hemiplegic gait abnormalities seen in late swing (mid-swing to heel strike) at the knee?
decreased knee extension
What are common hemiplegic gait abnormalities seen in late swing (mid-swing to heel strike) at the foot/ankle?
- poor foot clearance
- toe drag
- decreased ankle DF
- increased inversion
How can spasticity abnormalities impact gait?
- stiff movements
- clonus will cause jerky movements
- UE spasticity patterns exacerbated during gait
- secondary muscle shortening can lead to further abnormalities