Gait and Mobility Lab Flashcards
What are the outcome measures used to assess gait and mobility?
General: Descriptive, any abnormalities in gait of functional mobility tasks. Level of independence or effort.
Scales: Functional Gait Assessment and many other measures.
Measurable gait outcomes: (Time or distance). Gait speed over 10 or 5 m, self-paced or rapid paced. Norms exist.
Timed Up and Go (TUG): Measure of general mobility (in seconds). Can be w/ a dual task. MiniBESTest w/ a cognitive task.
Time walking tasks: 6MWT-walking endurance. There are norms for comparison.
Stairs: Descriptive. Independence, pattern used, difficulty effort, time, # of stairs.
Computerized gait assessments: Sensors that detect pressure and provide output on gait parameters.
Wireless monitors and sensors: Apps and other systems that can calculate gait parameters.
Gait Lab: 3-D motion analysis, of Joint Kinetics and Kinematics and EMG.
What are some important features to look for when doing an observational gait analysis?
Go head to toe or vice versa
General: Speed, stance, clearance of LE in swing, step length, use of support, symmetry. Consider different phases of gait (initial contact, toe-off)
Alignment or Orientation: Posture, head over shoulders, shoulder over hips, limb positions, trunk alignment, HAT, BOS.
Pattern: Look at each leg separately to see if there are any deviations in specific gait phases (such as range, muscle work, timing, weight acceptance for each LE, LE advancement)
Stability: Muscular control and coordination of trunk and limbs. General balance control. Trunk stability over based.
“Functional” Gait: Normal functional gait implies the ability to adapt to different conditions. Can they go forward, backward, sideways, change of surface, incline, indoors or outdoors, turn.
Stairs: Performance, assistance, effort, technique (alternating or non-alternating).
How is gait speed assessed?
What is the shorter test valid for?
10MWT: measured in m/s. Must have 2 m before and 2m after for acceleration and deceleration, total of 14m area. Provide encouragement in a standardized manner b/c it can increase walking speed.
5MWT: Stroke population gait speed
Describe the protocol for a 10MWT:
- Make sure client is wearing comfortable clothes and appropriate footwear.
- Client should use normal ambulatory devices.
- Set up 10m area w/ 2 m acceleration and deceleration zones.
- Give client a practice run. Then two successive tests. Take the average of 2 trials.
- Take client to the acceleration line. Give them a target past the 10m mark to walk towards.
“I am going to time your walking speed. On the word ‘go’ walk at a comfortable pace in a straight line to the target.” - Be consistent w/ the timer. I.e. use heel strike to heel strike of one foot to start/stop timer.
- Record gait speed in m/s. Record if assistive device was required.
- Can do self-paced or fast.
- What is the TUG for?
- What equipment is needed for the TUG?
- What is a normal range for the TUG?
- General screening tool for functional mobility. Originally for 65+ now for 18+.
- Cognitive TUG-Task #14 of the MiniBESTest. If > 10% time needed compared to normal TUG or new imbalances, then dual task incurred a cost. - Standard armchair, wristwatch w/ seconds, taped line on floor, 3 m from chair.
- Normal time for healthy elderly is 10-12 sec.
What is the procedure for the TUG?
- Place chair in location w/ enough space, not against a wall.
- Measure 3 m from forward legs of arm chair and mark distance w/ coloured tape. Make sure pt can see tape.
- Pt wears regular footwear and can use walking aid.
- No physical assistance should be given or cueing. - Start position: Pt has back against chair, arms on the arrest, walking aide nearby, feet on the floor.
- “On the word go, stand up and walk at a comfortable and safe pace to the line on the floor, turn, return to the chair and sit down. Demonstrate.
- Stop timing when pt bum touches chair.
- You can do a trial run before official timing.
- What is the 6MWT?
2. What equipment needs to be set up for this test?
- Submaximal functional test of walking endurance. Distance walked in 6 min. Used for pt w/ decreased endurance due to disease or reconditioning.
- 20 m should be marked off w/ markers every 1m. Stopwatch, pulse oximeter and BP machine as needed. BORG exertion scale.
What is the protocol for the 6MWT?
- Pre and post walk record client’s baseline HR, O2 stats, resp rate, Bp and level of dyspnea or level of execration.
- Walk as quickly as you can for 6 min to cover as much ground as possible. You may rest if you need to, but continue walking ASAP. The patient determines the pace. Therapists walks slightly behind so they do not influence the pace.
- Encouragement must be standardized as it can influence walking speed (You are doing well, keep up the good work, at regular intervals).
- Pulse and O2 stats can be recorded at regular intervals if necessary. Record the total distance walked as well as the # of rest periods and duration of rest periods.
- Record time to regain baseline O2 sats, pulse and BP after the walk.
* There is a significant learning effect over the first 3 trials. SO ideally do 2 practice trials are done before the test trial.
What is the BORG scale and modified BORG?
BORG: 6-20 (20 being very very hard)
Modified BORG: 0-10 (10 being maximal)
