11- Abnormal Mobility

Question 1

What can loss of proprioception cause??

Answer 1

reduced modulation of muscle activity throughout the gait cycle

Question 1

What are the factors correlated with participation in community ambulation?

Answer 1

• balance - gait velocity - strength (in hemiparetic limb)

Question 2

Functional consequences of vestibular deficits depend heavily on ________ at the time of vestibular loss.

Answer 2

age

Question 2

What does spatial relations disorder cause?

Answer 2

• reduced ability to navigate safely through the environment

Question 3

What can paresis/weakness result in?

Answer 3

Inability to generate adequate forces to move the body forward due to deficient recruitment of motor units, and secondary changes in muscle fibers. It can cause altered number, type, and discharge frequency

Question 4

What is defective muscle activation?

Answer 4

paretic component

Question 5

What is critical for obstacle avoidance?

Answer 5

visual input

Question 6

_______ is a major risk factor for falls.

Answer 6

Dementia

Question 7

How does spasticity contribute to gait disorder?

Answer 7

1. through inappropriate activation when muscle is lengthening during gait cycle 2. alterations in mechanical properties of the muscle causing changes in intrinsic stiffness

Question 8

Limitations in gait have been identified as one of the most debilitating consequences of neurologic pathology including:

Answer 8

CVA, PD, MS

Question 8

What is spasticity?

Answer 8

abnormal velocity-dependent recruitment of muscle during lenthening

Question 9

What does body image and scheme disorder cause?

Answer 9

• decreased stability - inappropriate foot placement - difficulty controlling the center of mass relative to a changing base of support

Question 11

Where does mobility fit into the ICF framework?

Answer 11

Activity Limitations and Participation Restrictions

Question 13

What is the relationship between strength and gait velocity when it comes to the effects of paresis?

Answer 13

Non-linear relationship with a threshold of strength for walking to occur, and a ceiling at which increase in strength does no influence gait speed

Question 15

What are the main muscle groups involved with gait?

Answer 15

Plantarflexors, quadriceps, hip flexors, extensions, and abductors

Question 16

What are abnormal synergies?

Answer 16

loss of fractionation of movement (corticospinal lesions)

Question 17

Spasticity affects many patient populations, including:

Answer 17

CVA, CP, MS, TBI

Question 18

Sensory inputs serve as what?

Answer 18

1. a trigger for initiation of swing 2. are nessesary for adapting locomotion to changing environmental stimuli

Question 19

What is critical to anticipatory control of balance during gait?

Answer 19

visual input

Question 20

What is paresis?

Answer 20

Loss of adequate force generation in muscles

Question 21

What are some non-neural musculoskeletal impairments?

Answer 21

-decreased ROM -weakness -contracture -changes in alignment -changes in passive properties (impede ability to generate power at diff speeds)

Question 22

What problems do adults with vestibular problems have?

Answer 22

gait ataxia and difficulty stabilizing the head in space

Question 23

What is the nonneural component?

Answer 23

changes in mechanical properties of muscle-tendon system (eg., intertia, elasticity, and viscosity)

Question 24

How much does weakness affect the ability to walk independently? It depends on…

Answer 24

• which muscles are affected - how weak the affected muscles are - the capacity of other muscles to compensate

Question 24

What happens to the knee in patients with stroke, as seen on a kinematic recording?

Answer 24

Excessive hyperextension of knee during stance and lack of knee flexion in swing phase

Question 25

What is dyscoordination?

Answer 25

inappropriate activation unrelated to stretch cocontraction of agonist and antagonist muscles Inadequate scaling of muscle activity

Question 26

What are the different ways to classify gait disorders?

Answer 26

- Neurologic diagnosis - Pathophysiologic mechanisms

Question 26

What are some compensatory strategies used in the presence of pain?

Answer 26

-reduced weight bearing on painful side - avoidance of impact loading - reduced joint excursion - decreased joint compressive forces

Question 27

What does loss of visual input cause?

Answer 27

affects both stability and adaptability requirements of gait

Question 29

Whats sort of deficit results in gait ataxia, and becomes more affected with or without inaccurate visual inputs?

Answer 29

Somatosensory deficits

Question 30

What sorts of issues go with impairment in the perceptual system?

Answer 30

- pain

Question 32

What is the effect on the soleus in patients with MS

Answer 32

They have little modulation of soleus stretch reflex response throughout gait cycle

Question 33

What is cocontraction?

Answer 33

loss of selectivity in motor output

Question 34

The normal control of gait requires the integration of both ________ inputs and _______ inputs.

Answer 34

peripheral sensory inputs descending supraspinal inputs

Question 35

Disorders of gait are one of the _________ and most _____________ of a wide variety of neurologic conditions.

Answer 35

Earliest Characteristic Symptoms

Question 36

What type of gait pattern does pain cause?

Answer 36

antalgic gait pattern (resulting from pain characterized by decreased velocity, shortened stance, stiffer limbs, decreased foreceful foot contact on push off)

Question 37

What is changes in mechanical properties of the muscle tendon systems?

Answer 37

nonneural component

Question 38

EMG recordings show ______ in patients with stroke?

Answer 38

a lack of phasic activation of the calf muscle and low activities of TA

Question 39

What does spastic plantar flexors cause?

Answer 39

they affect forward foot clearance during swing, subsequent toe-drag

Question 40

What is loss of selectivity in motor output?

Answer 40

cocontraction component

Question 41

What is abnormal velocity-dependent EMG recruitment during muscle lengthening

Answer 41

spastic component