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PHTY302 > Week 9 (a). Gait training after stroke > Flashcards

Week 9 (a). Gait training after stroke Flashcards

1
Q

What are the temporal characteristics of gait?

A

Stance phase - 0-60%

Swing phase - 40%

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2
Q

Characteristics gait - how are they different in older people?

A 
Similar kinematics
Increased stance phase - 66%
Increased double support - 15%
Decreased stride length
Decreased push-off power
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3
Q

What is critical during swing phase at the ankle?

A

Quick change from powerful PF to DF

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4
Q

Concentric activity during stance phase

A

Occurs primarily in double support
Hip ext - beginning of stance
Hip flex - at the end of stance
Ankle PF - end of stance

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5
Q

Eccentric activity during stance phase

A

hip flex
hip abd to control the lateral displacement centre of mass on stance leg
knee ext
ankle PF

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6
Q

Concentric activity swing phase

A

Hip flex. initially

Ankle DF throughout

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7
Q

Is swing phase concentric or eccentric

A

Primarily pendular motion with eccentric muscle activity used to control limb segments

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8
Q

Eccentric activity swing phase

A

Hip ext. mid swing

Knee extensors initially and knee flexors for rest of swing

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9
Q

What are the walking outcomes after stroke?

A

after 12 months, 80 % are walking in some manner

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10
Q

What is the mean walking speed following stroke compared with age matched controls

A
  1. 53 (+/- 0.22)

1. 34 (+/- 0.17)

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11
Q

What is the speed considered necessary for community ambulation

A

> 0.8

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12
Q

What is the walking speed of 0.8 m/s

A

Minimum speed considered necessary for community ambulation

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13
Q

Studies into functional walking capacity in people with stroke

A

Less than half could walk further than home/letterbox

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14
Q

What aspects of gait can be commonly affected by stroke

A

Stance on affected leg
Swing on affected leg
Asymmetrical step length, increased step width

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15
Q

What are common problems in stance after stroke?

A

Shortened

Increased propulsion of intact leg to shorten swing phase

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16
Q

What are common problems in swing after stroke??

A

Decreased propulsion prior to swing phase
Decreased knee flexion and ankle DF in swing
Compensatory circumduction or elevation of pelvis

17
Q

What problem at the hip can cause decreased hip extension in stance

A

Flexor contracture
Weak concentric hip extension
Decreased eccentric hip abd

? Eccentric hip flexor

18
Q

What problem at the knee can cause decreased hip extension in stance

A

Quad weakness

19
Q

What problem at the ankle can cause decreased hip extension in stance

A

decreased DF

decreased eccentric PF

20
Q

Correct way of wording treatment goal for somebody who needs to improve DF

A

need to increase range, strength and speed of concentric dorsiflexion

21
Q

What problem at the hip can cause knee hyperxtension in stance

A

decreased hip extension

22
Q

What problem at the knee can cause knee hyperxtension in stance

A

decreased eccentric hamstrings

Lack of control in inner range

23
Q

What problem at the ankle can cause knee hyperxtension in stance

A

Any cause of decreased DF

24
Q

What problem at the hip can cause increased knee flexion in stance

A

Decreased ext

25
Q

What problem at the knee can cause increased knee flexion in stance

A

Contracture of knee flexors

Decreased concentric quads inner range

26
Q

What problem at the ankle can cause increased knee flexion in stance

A

decreased eccentric PF

27
Q

Reasons for increased lateral pelvic shift

A

Cannot control the shift and go too far (lack eccentric hip Abd.)

28
Q

Reasons for decreased lateral pelvic shift

A

Don’t shift weight enough. - concentric hip Abd

29
Q

Reasons for decreased ankle PF at end of stance (hip)

A

Any cause of not staying on the leg long enough. - Decreased Hip extension, decreased control Hip Abd (don’t want to stay on one leg)

30
Q

Reasons for decreased ankle PF at end of stance (Knee)

A

Any cause not wanting to stay on leg long enough. decreased knee extension

31
Q

Reasons for decreased ankle PF at end of stance (ankle)

A

Loss of dexterity required to switch from eccentric PF to concenctric PF rapidly with large force

32
Q

Reasons for decreased hip flexion in swing

A

Not in the right position for the start of swing.

  • any cause of lack of hip extension.
  • decreased concentric hip flexion
33
Q

Causes decreased knee flexion in swing

A

Knee flexion normally happens after a burst of PF and Hip Ext and is a pendular movement. Address these other joints as causes instead of just giving exercises for hamstrings.

34
Q

Reasons for decreased ankle dorsiflexion in swing

A 
Decreased concentric DF strength
Joint
Spasticity
Muscle length
Lack of dexterity in switch between DF and PF

PHTY302 (9 decks)

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