Week 3 Flashcards
What is observational gait analysis?
A process by which clinicians gather data regarding a patient’s functional abilities and limitations with gait by watching them walk
What is the point of Observational Gait Analysis?
- Understand abilities and impairments - Assist diagnosis - Evaluate effectiveness of treatment - Inform intervention
How does the Ranchos Los
Amigos (RLA) form work?
- Identify a reference limb
- Shade each deviation in the body region in which they are present
What is recommended for data
acquisition in the RLA system?
- Gross Review to sense the flow of action
- Specific Analysis: should follow an anatomic sequence in order to sort the multiple events happening at the joints
What is the sequence of specific analysis?
- Floor contact
- Ankle/foot
- Knee
- Hip
- Pelvis
- Trunk
How is data interpretation
handled in the RLA system?
- Total limb function is identified by summing the gait deviations that occur at each phase of gait
- The findings per phase are then related to the basic cause of the functional deterrence as deduced from the physical exam findings of weakness, contracture, spasticity, sensory loss and pain
What are the advantages of the RLA system?
• Little to no instrumentation
• Inexpensive
• General description of gait
variables
What are the disadvantages of the RLA system?
- Unknown reliability
* Unknown validity
ow reliable are we with
Observational Gait Analysis?
- Inter- rater reliability range from slight to high
- Intra- rater reliability range from moderate to high
What are the things thought to contribute to the reliability of observational gait analysis?
- Difficulties involved in observing and making accurate judgements about motions occurring simultaneously at numerous body segments
- Inadequate training and observational gait analysis methods
What is the effect of the use of video software to
improve reliability?
- Inc inter-rater reliability
* Dec efficiency
What are the top 10 ways to improve observational gait analysis?
- Learn normal gait
- Communicate expectations
- Unobstructed view
- Select plane of observation
- Select joint of focus
- Follow joint through gait cycle
- Systematically repeat at all joints
- Compare right and left
- Use binary scoring
- Corroborate with physical exam
What are the issues of Injury/disease and Loss of
Function?
• Grief reaction - Why me? • Identity loss - Am I defined by my abilities? • Fear and anxiety - Can I still work? • Loss of confidence - Can I still do that?
Why the need for foot/ankle
intervention?
• Compressive forces of the ankle - 1/2 body weight during standing - 5 times body weight during walking - 13 times body weight during running
What can the therapist influence/role in a patient that needs an orthotic?
- Joint mal-alignment
- Limb-length discrepancy
- Decreased flexibility
- Muscle imbalance
- Muscle weakness
- Poor neuromuscular skills
- Kinetic chain dysfunction
What are the Indications for an Orthosis Rx?
Demonstrated need for: • Support and alignment • Prevention or correction of deformity • Substitution or enhancement of function • Decrease pain
What are the goals for an Orthotic Treatment Program?
• Restore function • Prevent further injury and progression • Protection of involved joints • Kinesthetic reminder of previous injury • Return to prior activity levels; work, exercise, leisure
What are the characteristics of Orthotic Treatment Programs: Prefabricated Devices?
- Short term need
- Temporary use
- Simple function
- Diagnostic
What are the characteristics of Orthotic Treatment Programs: Custom Molded Devices?
- Chronic and progressive prognosis
- Long-term use
- Maximal control
- Control needed at multiple joints
What are the Nomenclatures of LE Orthoses?
• FO - Foot Orthosis • AFO – Ankle Foot Orthosis • KAFO – Knee Ankle Foot Orthosis • KO – Knee Orthosis • HKAFO – Hip Knee Ankle Foot Orthosis
