Gait Deficits Flashcards

1
Q

what is a major problem among persons of all ages with neurological pathologies such as CVA, TBI, MS, cerebellar disease, developmental delay, down syndrome, spina bifida, CP

A

falls

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2
Q

associated with impaired balance, loss of postural control mechanisms (impaired hip, stepping, and ankle strategies)

A

falls

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3
Q

pathologies can affect what aspects of gait

A
  • sensory
  • motor
  • perceptual
  • cognitive
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4
Q

what can result from sensory impairments on gait

A
  • may result in gross ataxia
  • may result in difficulty initiating certain phases of gait and inability to adapt to environmental demands (feedforward/feedback)
  • may alter sensory weighting for postural control (vision, somatosensory, vestibular deficits; lack of success in certain environments)
  • may alter body schema/spatial relations
  • pain or perception of pain may alter gait quality
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5
Q

how can cognitive and perceptual deficits effect gait

A
  • reduced cognitive reserve = reduce motor ability
  • impair dual task ability
  • impair safety awareness
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6
Q

dementia (cognitive deficits) may impair what

A

dual task ability and perception

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7
Q

CVA/TBI (cognitive deficits) may impair what

A

safety awareness (inability to assess safe walking conditions, lack of self-awareness into deficits)

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8
Q

what is correlated to falls

A

gait speed

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9
Q

the slower the gait speed =

A

the higher the risk of falls

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10
Q

what is the normal adult gait speed

A

1.3 m/s

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11
Q

pts with neurological injuries tend to ambulate slower due to

A

sensory or motor and/or cognitive or perceptual deficits

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12
Q

what other factors can predict community function besides gait speed

A

balance, self-efficacy, depression and fatigue (assessed via FGA, FES, depression scales)

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13
Q

what gait speed is needed to be a community ambulator

A

0.8 m/s

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14
Q

what time is used to determine how long it will take a pedestrian to cross a street when determine traffic signals

A

1.2 m/s

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15
Q

gait characteristics of cerebellar lesion

A
  • wide BOS
  • staggering/drunk
  • path deviation
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16
Q

gait characteristics of PD (basal ganglia lesion)

A
  • slow speed
  • short, shuffling steps (festination)
  • en bloc turning
  • freezing episodes
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17
Q

uncoordinated gait

A

ataxia

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18
Q

common gait deviations in individuals with neurologic disorders at the foot and ankle

A
  • toe contact with floor during swing (toe drag)
  • inadequate DF with swing
  • IC with forefoot
  • M-L instability in midstance
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19
Q

common gait deviations in individuals with neurologic disorders at knee

A
  • inadequate knee flexion in swing
  • hyperextension of knee in stance to compensate for quad weakness or lack of motor control/stability of knee
  • excessive knee flexion during stance
20
Q

common gait deviations in individuals with neurologic disorders at hip

A
  • ER
  • hiking during swing to clear foot
  • circumduction
  • inadequate hip flexion in early swing
  • inadquate extension in stance
  • drop of unaffected side of pelvis during affected stance phase (glut med weak)
21
Q

common gait deviations in individuals with neurologic disorders at pelvis

A
  • pelvic retraction on hemiplegic side
22
Q

common gait deviations in individuals with neurologic disorders at trunk

A
  • forward flexion of trunk to compensate for weak knee extensors during stance
  • lateral flexion of trunk to compensate for weak hip abductors during stance
23
Q

ROM of hip needed for gait

A
  • 25 def flexion (IC, LR, MSw, TSw)
  • 15deg ext (TSt)
  • some rotation and abd/add
24
Q

ROM of knee needed for gait

A
  • full ext 0deg
  • 60deg knee flexion (initial swing)
25
Q

ROM of ankle needed for gait

A
  • 15 deg PF (pre-swing)
  • 10deg DF (terminal stance)
    -5 deg DF required to clear toes during swing phase
26
Q

ROM of foot needed for gait

A
  • 50deg ext of great toe (pre swing)
27
Q

IC made with forefoot

A

forefoot contact

28
Q

IC made with forefoot AND hindfoot

A

flatfoot contact

29
Q

rapid PF after initial contact (heel strike); audible sound; cannot control tibialis anterior

A

foot slap

30
Q

excessive inversion of calcaneous or forefoot in any phase

A

excessive inversion/pes cavus

31
Q

excessive eversion of calcaneous or forefoot in any phase

A

excessive eversion/pes planus

32
Q

inadequate 1st MTP extension in preswing

A

inadequate MTP extension

33
Q

clawed toes with or without hammer toes

A

excessive IP flexion

34
Q

foot contact with ground during swing phase

A

toe drag

35
Q

excessive ankle PF of stance limb to help advance swing limb

A

contralateral vault

36
Q

inadequate extension of hip in stance phase

A

inadequate extension/crouched gait

37
Q

less than normal hip flexion for any phase

A

inadequate flexion

38
Q

more than normal hip flexion in swing phase

A

excessive flexion/steppage gait

39
Q

position of femur with excessive rotation

A

medial/lateral rotation of hip

40
Q

abduction of femur beyond neutral

A

abduction

41
Q

adduction of femur beyond neutral

A

adduction/scissoring gait

42
Q

thigh abduction and flexion followed by adduction during swing phase

A

circumduction

43
Q

> 5 deg drop of iliac crest of swing limb during stance on the reference leg

A

contralateral drop/trendelenberg

44
Q

elevation of iliac crest of reference limb above neutral during swing phase

A

pelvis hike

45
Q

> 5deg backward rotation during terminal stance and may continue t/o phases

A

excessive backward rotation of pelvis/retracted pelvis

46
Q

> 5deg forward rotation during mid and terminal swing

A

excessive forward rotation/protracted pelvis

47
Q

any excessive tilt at pelvis

A

excessive anterior/posterior pelvic tilt (APT/PPT)