CVA Intervention Part 3

Question 1

What percentage of gait is stance and swing?

Answer 1

60% is stance
40% is swing

Question 2

Critical Components of Gait

Answer 2

Adequate flexion at the hip and knee, and dorsiflexion at the ankle during swing phase
Adequate extension at the hip/knee, passive dorsiflexion at the ankle and forward momentum of tibial translation during stance phase

Question 3

Key points of control (where PT places their support) during gait

Answer 3

There is NO one single arrangement for support that always helps. It depends on goals for the patient and tour environment

Question 4

Guarding form the side position

Answer 4

Prevents Sagittal plane deviations
- knee buckling/hyperextension
- excessive trunk flexion or extension
- uncontrolled movement of the hemiparetic shoulder

Question 5

Guarding from the back

Answer 5

Position helps supply light body weight support allowing the patient to ambulate with a more reciprocal pattern
Helps prevent falls by pulling a patient close to you

Question 6

Pre gait activity

Answer 6

Assesses weight acceptance onto stance hemiparetic leg
PT is guarding on the side and patient has their arm on the wall for support

Question 7

Impairment mitigation ideas for stance phase training

Answer 7

Sit to stand
Tap-ups
Standing therex
Stagger stance dynamic balance activities
Single leg stance activities (high level)

Question 8

Augmented intervention techniques for swing phase practice and training

Answer 8

Practice:
Slide!
- Paper shoe/ sock over shoe
- Sheet assist
- Tactile cues/ manual assist
Dorsiflexion wrap with ACE band
Thera and wrap (ankle, knee and hip)

Training:
Heel slides (mat or standing)
Tap ups (resisted)
Supine heel drop floor to mat

Question 9

Whole task practice for gait

Answer 9

Without AD:
Treadmill training
Overground

With AD:
Device for compensation
Bilateral device
Device with narrow BOS