Chapter 14

Question 1

What do limitations in gait result in?

Answer 1

restricted participation in the mobility domain

Question 2

What does mobility disability cause?

Answer 2

reduced performance on functional activities

overall ADLs

Question 3

Effect of motor system impairments:

Answer 3

paresis
spasticity
cocontraction
non-neural component

Question 4

What can paresis/weakness result in?

Answer 4

inability to generate adequate FORCES to move the body forward

Question 5

What does weakness affect the ability to walk independently depend on?

Answer 5

which muscles are affected.
how weak are the affected muscles.
What’s the capacity of other muscles to compensate

Question 6

Plantor flexion gait abnormalities:

Answer 6

Strong hyperextension in stance; lack of knee flexion in swing;
Low plantar flexor power/work

Question 7

Plantor flexion gait abnormalities compensation:

Answer 7

Partially compensated by hip flexors during pull-off

Question 8

Quad gait abnormalities:

Answer 8

trouble in stabilizing the knee during MSt

Question 9

Quad gait abnormalities compensation:

Answer 9

Hyperextension in MSt

Question 10

Hip flexor gait abnormalities:

Answer 10

Inadequate hip flexion during swing phase;
Additionally, inadequate hip flexion causes a lack of knee flexion in swing phase; as a result, the toe clearance is reduced or lost

Question 11

Hip flexor gait abnormalities compensation:

Answer 11

abdominals in conjunction with posterior tip of pelvis
circumduction
contralateral vaulting
leaning trunk laterally toward opposite limb

Question 12

Hip extensor gait abnormalities:

Answer 12

Inadequate control of HAT segment;

Forward trunk lean that threatens stability

Question 13

Hip extensor gait abnormalities compensations:

Answer 13

Backward lean in stance used to compensate by controlling CoM

Question 14

Hip abductor gait abnormalities:

Answer 14

Drop of the pelvis on the less impaired side, i.e., Trendelenburg gait

Question 15

Hip abductor gait abnormalities compensation:

Answer 15

A lateral shift of CoM over the stance leg along with lateral lean of the trunk toward the stance leg

Question 16

How does spasticity contribute to gait disorder?

Answer 16

inappropriate activation when muscle is lengthened during the gait cycle
alterations in mechanical properties of the muscle causing changes in intrinsic stiffness

Question 17

What is an abnormal strategy?

Answer 17

loss of fractionation of movement (corticospinal lesions)

Question 18

Examples of disordered pattern of muscle activation and recruitment?

Answer 18

Reduced recruitment

Overactivity (unrelated to spasticity)

Question 19

Examples of dyscoordination:

Answer 19

abnormal synergies
disordered pattern of muscle activation
cocontraction

Question 20

Musculosketal impairments Non-neural contributing factors to dyscoordination):

Answer 20

Decreased ROM
Weakness
Contracture
Changes in alignment

Question 21

How many degrees of DF are required for normal progression during gait?

Answer 21

5 degrees

Question 22

How many degrees of PF contracture results in low heel contact and early flat foot during loading?

Answer 22

15 degrees

Question 23

How about in children with spastic CP to produce a forefoot contact at foot strike

Answer 23

30 degrees

Question 24

What do sensory inputs serve as?

Answer 24

a trigger for initiation of swing

are necessary for adapting locomotion to changing environmental conditions.

Question 25

Effect of sensory impairments include:

Answer 25

Somatosensory deficits Visual deficits Vestibular deficits

Question 26

What does somatosensory deficits result in?

Answer 26

gait ataxia

Question 27

What can loss of proprioception cause?

Answer 27

reduced modulation of muscle activity throughout the gait cycl

Question 28

Visual deficits:

Answer 28

Critical to anticipatory control of balance during gait Critical for obstacle avoidance Loss of visual inputs affect both stability and adaptability requirements of gait.

Question 29

What do vestibular deficits depend on?

Answer 29

the age at the time of the loss of vestibular function

Question 30

Impairment in perceptual system:

Answer 30

Body Image and Scheme Disorder Spatial Pain Cognitive

Question 31

Body Image and Scheme Disorder:

Answer 31

Decreased stability Inappropriate foot placement Difficulty controlling the center of mass relative to a changing base of support

Question 32

Spatial relation disorder:

Answer 32

Reduced ability to navigate safely through the environment | “Topographic disorientation”

Question 33

What is antalgic gait pattern characterized by?

Answer 33

decreased velocity, shortened stance, stiffer limbs, decreased push-off

Question 34

Compensatory strategies used in presence of pain:

Answer 34

Reduced weight bearing on painful side Avoidance of impact loading Reduced joint excursion Decreased joint compressive forces