Gait

Question 1

Gait exam in children with CP

Answer 1

increased co activation of muscle groups disrupting the synergetic neuromuscular control needed for gait

Question 2

Ankle lever arm disfunction

Answer 2

to walking decreases ankle power by 50% (requires half the strength than heal-toe walking)
beneficial compensation for children with CNS dysfunction

Question 3

Joint and Bony abnormalities

Answer 3

Internal/external lever arm become distorted because of bony or positional deformities (ex. femoral antiversion, ER of tibia, equinovalgus, genu recurvatum

Question 4

Jump knee gait

Answer 4

ankle in equinus in late stance
knee and hip hyperflexion in early stance
pelvis normal

Question 5

Equinus gait (toe walking)

Answer 5

True: ankle in equinus during stance
full knee/hip extension
Apparent: ankle normal ROM, knee and hip hyperflex in stance

Question 6

Crouch gait

Answer 6

ankle in excessive dorsiflexion through stance, knee/hip hyperflexed, pelvis normal, ant/post/tilt

Question 7

Stiff-knee gait

Answer 7

reduction in knee flexion during swing, coupled with hip circumduction

Question 8

Green light pediatric interventions

Answer 8

mobility training
treadmill walking
partial BWSTT

Question 9

Yellow light pediatric interventions

Answer 9

AFOs
Fitness training
Estim
Casting
Partial BWSTT
Physical Activity

Question 10

Trendelenburg gait (stance)

Answer 10

GLut med weakness

Question 11

Lateral Trunk bending (stance)

Answer 11

glut med weakness

Question 12

Excessive Knee flexion (stance)

Answer 12

Knee wobbles or buckles- weak quads
Knee remains flexed- knee flexor contracture
compensatory forward trunk bending

Question 13

Foot drop (swing)

Answer 13

weak/delayed contraction of DF

Question 14

Decreased clearance (swing)

Answer 14

weak/delayed hip flexors and plantar flexion push off

Question 15

Dynamic gait interventions

Answer 15

walking with head turns
walking over and around obstacles
walking while carrying objects
walking with attentional challenge

Question 16

Instructive learning

Answer 16

explicit strategic instruction
Ex: pick up foot, land on heal

Question 17

Reinforcement learning

Answer 17

reward based instruction
Ex: you will walk faster

Question 18

Use dependent learning

Answer 18

Repetition based, task specific massed practice
Ex: 10,000 steps on the treadmill

Question 19

Sensorimotor adaption learning

Answer 19

Sensorimotor prediction errors
predicted vs actual movement mismatch

Question 20

BWSTT population

Answer 20

unable to ambulate independently without significant assistance
Patient early (<3 months) in recovery post stroke with significant gait abnormalities/postural instability
nonfunctional ambulators with goal of walking to improve CV function

Question 21

BWSTT Dosing

Answer 21

as little WB as needed
mod-high intensity (70-85% HRmax)
transition to overhead harness without BWS as soon as possible/safe

Question 22

CPG for chronic stroke

Answer 22

Strong evidence shown for mod-high intensity walking training with full body weight
Virtual reality for walking and balance training

Question 23

Orthotics define

Answer 23

any externally applied device to an existing body part that improves function (AFO)
stabilize weak areas of joints
limit/aid motion across joints

Question 24

Neuroprosthetics

Answer 24

a device which helps pr augments the subject sown nervous system
FES

Question 25

NMES vs FES

Answer 25

NMES: produces muscle contraction to generate muscle force FES: attainment of functional movement applied during activity

Question 26

Evidence for FES

Answer 26

positive initial effect on gait speed positive effect on walking function

Question 27

Evidence for AFOs

Answer 27

positive affect on walking function improve foot drop and ankle/knee kinematics