Upright mobility deficits Flashcards
(29 cards)
factors contributing to functional upright mobility - individual variables
age
prior experience
motor abilities
diagnosis
motivation
primary impairments
secondary impairments
factors contributing to functional upright mobility - mobility tasks
walking
stairs
inclines
curbs
obstacles
single or dual task
factors contributing to functional upright mobility - regulatory features
surface conditions
object characteristics
changes in regulatory conditions between attempts
factors contributing to functional upright mobility - environmental variables
moving or stationary environment
changes in regulatory conditions between attempts
examination of gait/upright mobility
observational gait analysis
digital video recording
outcome measures (10MWT speed 6MWT endurance, FGA, DGI, FIM, HiMAT)
instrumented systems (GAITRite, VICON)
3 essential requirements for successful locomotion
progression
upright/postural control
adapting to the environment
4 biomechanical subcomponents of gait
propulsion
stance control
limb advancement/swing
postural/lateral stability
propulsion
redirect falling COM to kinetic energy; drivers: plantarflexors; greatest* metabolic cost of walking
if PF impaired - might see hip hike, hip flexor compensation, opposite leg boost
stance control
maintenance of upright posture; passive vs active support
limb advancement/swing
progression of non WB limb to accept weight; drivers - hip flexors
postural/lateral stabiltiy
altered foot position to reduce lateral COM movement
stroke - common gait deviations in ankle/foot during stance (4)
foot slap (loading response - weak DF eccentrically, spastic PF)
forefoot/flat foot contact (initial contact, could be weakness or spasticity)
equinus gait (heel does not touch ground, PF contracture, )
no/decreased heel off (decreased propulsion, terminal stance..preswing?,)
stroke common gait deviations in foot/ankle during swing
foot drop/drag (weak DP, spastic PF or contracture, inadequate hip/knee flexion
persistent equinus
stroke common gait deviations in knee during stance (2)
excessive kne flexion (midstance)
- poor propioception, weak quads/knee ext, spastic hs, weak hip ext)
hyperextension (midstance)
- weak quads, spastic quads
stroke common gait deviations in knee during swing (2)
decreased flexion (initial/midswing)
- weak HS, spastic quads, poor hip ext
inadequate knee extension at terminal swing/initial contact
- weak quads, spastic HS
stroke common gait deviations in hip during stance (2)
poor hip position
- weak hip, flexed posture, spastic HS
trendelenburg gait
- weak hip abductors
stroke common gait deviations in hip during swing (4)
decreased hip flexion
- difficulty advancing leg, spastic HS
hip hike
- QL muscle, damage to L3,4 what deviations would u see?)
abnormal substituitions (circumduction, scissoring)
stroke common gait deviations in trunk/pelivs during stance (3)
increased trunk flexion
lateral trunk flexion
pelvic drop (hip ABD)
weakness or spasticity
what is trendelendburg gait
weak hip abductors
opposite side pelvis drops
stroke common gait deviations in trunk/pelvis during swing (2)
decreased (forward pelvic rotation)
- paretic side you will see pelvic retraction
backward trunk lean
- lacking hip flexor strength to swing leg forward
common gait deviations seen in stroke overall
decreased WB over hemiparetic leg
unequal step/stride length; narrows BOS
decreased cadence/abnormal timing
intervention focus for propulsion deficit
reduced speed/symmetry
intervention focus for stance control deficit
buckling, hip/knee collapse
intervention focus for limb advancement/swing deficit
limited paretic step length/speed
