Week 9: observational Gait analysis and aging gait

Question 1

What is the 4 step process for an observational task analysis?

Answer 1

1. general observations: timing, space, gait speed, step length
2. Specific deviations: using task related determinants as a guide
3. Hypothesized cause: apply knowledge
4. Testing hypothesis: test strength

Question 2

What is the general sequence of a given activity?

Answer 2

1. initial position
2. initiation
3. execution
4. termination

Question 3

You make the following observation:
inability to stand from sitting in a regular height chair
excessive forward lean in early execution of standing from a tall stool
what is the most likely hypothesis

Answer 3

knee extensor weakness

reason: pt moves the COM closer to the knee to decrease the demand moment at the knee

Question 4

What are the general observation areas to focus when observing a walking pattern

Answer 4

1. symmetry between right and left
2. arm swing opposite of legs
3. head and trunk posture
4. impression of gait speed

Question 5

what is the average gait speed?

Answer 5

1.4 m/s

Question 6

What are the 3 functional tasks of gait?

Answer 6

1. weight acceptance
2. single leg support
3. swing limb advancement

Question 7

What are the 8 phases of gait?

Answer 7

1. initial contact
2. loading response
3. mid-stance
4. terminal stance
5. pre-swing
6. initial swing
7. midswing
8. terminal swing

Question 8

what are the critical events of initial contact?

Answer 8

heel contact

Question 9

what are the critical events for loading response

Answer 9

heel rocker- controlled PF
controlled knee flexion
hip/pelvic stability

Question 10

What are the critical events of mid-stance

Answer 10

1. hip/pelvic stability
2. ankle rocker- controlled tibial advancement

Question 11

what are the critical events of terminal stance

Answer 11

1. forefoot rocker
2. hip extension

Question 12

what are the critical events of preswing

Answer 12

1. rapid ankle pF
2. passive knee flexion

Question 13

what are the critical events of initial swing

Answer 13

1. peak knee flexion

Question 14

what are the critical events for midswing

Answer 14

1. peak hip flexion
2. ankle dorsiflexion to neutral

Question 15

what are the critical events for terminal swing

Answer 15

1. knee extension to neutral

Question 16

what 4 key observations are in weight acceptance?

Answer 16

1. heel first initial contact
2. controlled ankle plantar flexion
3. controlled knee flexion
4. hip/pelvic stability

Question 17

what 4 key observations are in single limb support

Answer 17

1. hip/pelvic stability
2. controlled tibial progression
3. controlled heel rise
4. hip extension

Question 18

what 5 key observations are in swing limb advancement

Answer 18

1. rapid ankle plantar flexion
2. passive knee flexion
3. hip flexion
4. ankle dorsiflexion
5. knee extension

Question 19

how do you determine the greatest external demand moment

Answer 19

GFR is given by the vector and what ever joint has the greatest moment arm then use the arrow to determine if its a flexion or extension demand moment

Question 20

What is a task related determinant

Answer 20

an element or aspect of the task that is critical to successful task performance

Question 21

What are the 4 task related determinants for a sit to stand

Answer 21

1. generate forward trunk momentum
2. position center of mass over feet
3. generate force to raise center of mass
4. arresting momentum of center of mass

Question 22

Which determinant would you expect to be most affected by impaired vestibular control of balance

Answer 22

4. arresting momentum of center of mass

all could be impacted but the 4th is the most affected due to fine tuning of BOS over COM

Question 23

people >65 years of age ___ of 3 experience a fall per year

Answer 23

1.

Question 24

fall is the leading cause of disability and loss of independence for older adults

Answer 24

true

Question 25

Why do falls increase in older age?

Answer 25

nervous sytem, musculoskeletal system, skeletal system, pulmonary, CV, ednocrine

Question 26

What are the two reasons for changes in gait and increased fall risk for older adults? and which is modifiable

Answer 26

1. genetics 2. environment 3. disease environment is modifiable

Question 27

older adults have changes in shape density of bone decrease in bone mass decrease tolerance for stress altered joint motion

Answer 27

true these are all examples of skeletal changes

Question 28

Does active range of motion or passive range of motion decrease more in older adults

Answer 28

active ROM due to the muscle tendon unit fxn is affected

Question 29

Do older adults have lesser or greater demand moments at joints and why?

Answer 29

greater demand moments at joint because of stiff tissues

Question 30

What is sarcopenia?

Answer 30

age associated decline in muscle mass -related to total number of fibers decreasing begins at age 30

Question 31

Does the proximal or distal muscles of the LE lose more power in older adults?

Answer 31

the distal muscles loose more power

Question 32

Do older adults lose more fast with or slow twitch fibers?

Answer 32

lose more fast twitch muscles

Question 33

In older adults there is a ____ co- activation that leads to decreased effective movement production

Answer 33

increased

Question 34

What does a co-activation mean?

Answer 34

relative co-activation of muscles means that both agonist and antagonist contract

Question 35

What percentage of strength decreased after the fifth decade

Answer 35

10-15%

Question 36

Is power more correlated to strength of functional ability in older adults

Answer 36

functional ability

Question 37

Does power or strength decrease earlier and more rapid

Answer 37

power and it affects TUG and gait speed

Question 38

Older adults have sensory changes which result in decreased proprioception, tactile sensitivity, decreased visual threshold decreased hair and nerve cells

Answer 38

yes they have decrease in somatosensory, vision and vestibular

Question 39

Based on the evidence you would expect greater power generation during walking at the ____ joint for a 75-yr old than a 30-yr old person walking at similar walking speeds.

Answer 39

hip hip power generation is compensating for decrease power in ankle for older adults

Question 40

older adults have Increased/decreased gait speed, stride length, SLS time

Answer 40

decreased

Question 41

older adults have increased/decreased step with variability, energy expenditure

Answer 41

increased

Question 42

What is the average freely chosen gait speed in people age 60-80

Answer 42

1.2 m/s

Question 43

Although step length decreases in age what one factors is similar?

Answer 43

step frequency (cadence)

Question 44

What are 3 most common changes in gait kinematics for older adults

Answer 44

1. decrease hip extension motion 2. increase anterior pelvic tilt 3. decreased ankle planar-flexion motion

Question 45

Do older adults or young individuals have higher energy expenditure when walking

Answer 45

older

Question 46

what is the recruitment of muscles greater proximal or distal

Answer 46

greater recruitment of proximal muscles

Question 47

Most of the power generation occurs at the ankle in younger adults what joint takes over in older adults

Answer 47

hip

Question 48

in comparing self selected walking gait of a 30 yr old and a 75 yr old person, you would expect the greatest difference in joint power to occur at the

Answer 48

ankle decrease in power at the ankle in older adults they have to then compensate with the hip