Week 9 - Abnormal Gait Patterns and Ataxia Flashcards
What are the three primary subcategories of ataxia?
Sensory, cerebellar, and vestibular ataxia.
What is the main cause of sensory ataxia?
Loss of proprioception due to dysfunction of the dorsal columns of the spinal cord or related brain structures
What test is most significant in differentiating sensory ataxia from other types?
Romberg’s test
Which ataxia type is associated with vertigo, nausea, vomiting, and nystagmus?
Vestibular ataxia.
What are the key symptoms of cerebellar ataxia?
- Dysmetria
- tremor
- dysdiadochokinesia
- hypotonia
- weakness
- nystagmus.
Which part of the cerebellum is responsible for balance and eye movement control?
Vestibulo-cerebellum (flocculus and nodulus).
What characterizes frontal ataxia?
- Difficulties in standing erect
- hyperextension posture
- gait with scissor-crossed legs.
What is mixed ataxia?
A combination of symptoms from two or more types of ataxia.
What are the primary goals of physical therapy for ataxia?
- Improve balance
- postural stabilization
- upper extremity function
- independent gait.
What are the key principles in ataxia rehabilitation training?
Progress from simple to complex, practice with eyes open and closed, and use compensation methods when needed.
Which tests are commonly used to assess balance in ataxia patients?
- Berg Balance Scale
- Functional Reach Test
- Time Up and Go Test
- Dynamic Gait Index.
What are some approaches to improving proprioception in ataxia patients?
- Proprioceptive Neuromuscular Facilitation (PNF)
- resistive exercises
- balance board training
- suit therapy.
What is the main aim of vestibular exercises in ataxia rehabilitation?
To reduce dizziness and enhance balance by stimulating vestibulo-ocular and vestibulo-spinal reflexes.
What sports activities are beneficial for ataxia patients?
Horse riding, swimming, billiards, golf, and darts.
What are the four gait patterns that can appear due to spasticity?
- Hyperextension
- Scissoring
- Circumduction
- Slap-foot (vaulting, high steppage)
What are potential treatment approaches for spasticity-related gait patterns?
- Use of AFOs
- foot sliders
- muscle stimulation
- neuro K-taping
- core stability exercises
- strengthening hip abductors/flexors
- gait retraining.
How can a scissoring gait pattern be corrected?
Wide plank with visual cues to minimize scissoring.
What intervention helps correct a wide ataxic gait pattern?
Using a walker within two green lines for visual guidance
How can tandem walking help patients with severe ataxia?
Assists them in walking along a straight line to improve balance.
What exercises help vaulting with foot drop/slap?
Bending over a counter while working on hip flexion and ankle dorsiflexion, stepping over objects.
How do Nordic poles assist with gait training?
They improve gait rhythm and promote better coordination
What is the purpose of ‘choo-choo train’ walking?
Retrains the brain for coordinated trunk rotation, arm swing, and normal gait patterns with Nordic poles.
What is dysdiadochokinesia?
The impaired ability to perform rapid, alternating movements.
What is adiadochokinesia?
The complete inability to perform rapid, alternating movements.
What two exercises can be used to assess dysdiadochokinesia?
Toe tapping and sliding the heel up to the knee and back down
What coordination exercises can be used for a patient with ethanol-induced hemiataxia?
Two exercises in sitting and two in standing to improve right lower extremity coordination
What is the purpose of hand-in-hand walking for patients with left-sided neglect?
Helps them become aware of their neglected side
How can patients with left-sided neglect practice spatial awareness?
Spotting objects on the left side in the hallway and avoiding obstacles placed strategically.
What is the first and second step in training a patient with Pusher Syndrome before walking?
Teach weight-shifting onto the UNAFFECTED side by leaning toward a wall.
Have the patient lean towards the UNAFFECTED side and lift the AFFECTED leg for 5 seconds.
How is assisted walking performed for a patient with Pusher Syndrome?
PTA supports the AFFECTED side while giving verbal and tactile cues to shift weight toward the UNAFFECTED side
What is circumduction gait?
A gait pattern where one leg moves straight forward while the other swings out to the side in an arc.
What are common causes of circumduction gait?
- Weakness in hip flexors or knee flexors
- leg length discrepancy
- reduced knee mobility.
What is hip hike and vaulting gait?
Hip hike: Lifting the hip to clear the foot.
Vaulting: Pushing off with the stance leg to help the other leg clear the ground.
What are the main causes of hip hike and vaulting gait?
- Weak hip/knee flexors
- leg length discrepancy
- reduced dorsiflexion
What is toe catch gait?
A gait pattern where the toes drag and catch the ground due to weak dorsiflexors
What are treatment options for toe catch gait?
- Therabands for hip flexion
- strengthening exercises
- bracing
- adaptive shoes
- taping the toe for sliding
- AFOs
What is steppage gait?
A high stepping gait with a slapping sound due to weak dorsiflexors, causing the foot to drop
What are common causes of steppage gait?
- Weak foot and ankle dorsiflexors
- sensory loss
- neurological conditions such as peripheral neuropathy
What is an initial contact with flat foot and stiff knee gait pattern?
A gait where the foot lands flat on the ground, and the knee remains locked without flexing
What are the main issues in a stiff knee gait?
Lack of knee flexion, poor shock absorption, and difficulty with propulsion.
What is knee hyperextension gait?
A gait pattern where the knee snaps backward due to weak hamstrings.
How can knee hyperextension be managed?
- Encouraging knee flexion when walking
- using straps around the knees during exercises
- practising sit-to-stand partway
- strengthening hamstrings and quadriceps together
What is a crochet gait pattern?
- Seen mostly cerebral palsy (CP)
- where the knees remain flexed
- hips abducted
- the patient appears to be in a squatting position
What is scissoring gait?
- legs cross over midline while walking
- often due to tight hip adductors or weak glute muscles.
What are treatment options for scissoring gait?
- Stretching tight hip adductors
- strengthening glutes and hip abductors
- gait training.
