Reading...
Play button
Play button
Use LEFT and RIGHT arrow keys to navigate between flashcards;
Use UP and DOWN arrow keys to flip the card;
H to show hint;
A reads text to speech;
79 Cards in this Set
- Front
- Back
|
3 functional tasks of gait
|
- weight acceptance
- single limb support - swing limb advancement |
|
|
Define forefoot contact
|
initial contact with the ground made by the forefoot
|
|
|
Define foot-flat contact
|
initial contact with the ground made by entire foot
|
|
|
Define foot slap
|
uncontrolled plantar flexion at the ankle after heel contact
|
|
|
Define abnormal heel off
|
heel not in contact with the ground dring LR or midstance
|
|
|
Define drag
|
contact of the toes, forefood or heel with the ground during swing limb advancement
|
|
|
Define contralateral vaulting
|
rising on the forefoot of the opposite stance limb during limb advacement of the reference leg
|
|
|
List the 10 major things to look for at the ankle/foot for pathological gait
|
- forefood contact
- foot-flat contact - foot slap - excess plantar flexion - excess dorsiflexion - excess inversion/eversion - heel off - No heel off - drage - contralateral vaulting |
|
|
Define no heel off
|
absence of heel rise during terminal stance or preswing
|
|
|
List the 3 major things to look for at the toes for pathological gait
|
- toes up
- inadequate extension - clawed/hammered |
|
|
List the 7 major things to look for at the knee for pathological gait
|
- limited flexion
- excess flexion - wobbles - hyperextends - extension thrust - varus/valgus - excess contralteral flexion |
|
|
List the 7 major things to look for at the hip for pathological gait
|
- limited flexion
- internal rotation - inadequate extension - external rotation - past retract - adduction - abduction |
|
|
List the 9 major things to look for at the pelvis for pathological gait
|
- hikes
- posterior tilt - anterior tilt - lacks forward rotation - lacks backward rotation - excess forward rotation - excess backward rotation - ipsilateral drop - contralateral drop |
|
|
List the 4 major things to look for at the trunk for pathological gait
|
- backward lean
- forward lean - lateral lean - rotates back/forward |
|
|
4 most likely causes of forefoot or foot-flat contact in gait
|
- excess knee flexion in terminal swing
- compensate for weak quads - excess plantar flexion in terminal swing - heel pain |
|
|
Significance (3) of forefoot or foot-flat contact
|
- poor position for heel rocker
- decreases forward momentum of tibia - decreases shock absorption by limiting knee flexion (forefoot) |
|
|
Cause of foot slap
|
weak pre-tibials
|
|
|
Significance (2) of foot slap
|
- decreases forward momentum of the tibia
- decrease shock absorption by limiting knee flexion |
|
|
Cause of excess plantar flexion in weight acceptance
|
- plantar flexion contracture
|
|
|
4 most likely causes of excess plantar flexion in single limb support
|
- plantar flexor hypertonicity
- weak quads - impaired proprioception - ankle pain |
|
|
4 most likely causes of excess plantar flexion in swing limb advancement
|
- weak pretibials
- plantar flexion contracture - plantar felxor hypertonicity - Lack of selective dorsiflexion control in terminal swing |
|
|
Significance of excess plantar flexion in weight acceptance
|
- poor position of heel rocker
- decreases shock absoprtion by limiting knee flexion |
|
|
Significance of excess plantar flexion in single limb support
|
- decreases forward progress of the tibia over the ankle
|
|
|
Significance of excess plantar flexion in swing limb advancement
|
- interferes with foot clearance
- interefere with foot position for initial contact |
|
|
Most likely cause of excess dorsiflexion in weight acceptance
|
- excess hip or kneee flexion
|
|
|
Significance of excess dorsiflexion in weight acceptance
|
- increases demand on hip and knee extensors
- decreases limb stability |
|
|
4 most likely causes of excess dorsflexion in single limb support
|
- weak calf
- excess hip and knee flexion - to lower opposite limb for contact - excess midfoot dorsiflexion secondary to limited ankle mobility |
|
|
Significance of excess dorsiflexion in single limb support
|
- increases the demand on the hip and knee extensors
- intereferes with heel rise and decreases step length of the opposite limb |
|
|
Stage in gait cycle when dorsiflexion weakness most evident
|
Loading response (see foot slap)
|
|
|
General problems seen with dorsiflexor weakness
|
- strike with flat foot
- problems clearing toe - steppage gait or circumduction |
|
|
Stage in gait cycle when plantarflexion weakness most evident
|
Terminal stance
|
|
|
General problems seen with plantarflexion weakness
|
- lack heel rise
- shortened step on contralateral side (loss of toes rocker) - may be unstable if unable to slow down shank |
|
|
Stage in gait cycle when quads weakness most evident
|
- loading response (knee collapses)
|
|
|
General problems seen with quads weakness
|
- collapse during loading response
- keep knee in extension to compensate - shorten steps - strike with metatarsal heads |
|
|
Hip abductor weakness gives you
|
- loss of control af ADDuction
- increased pelvic drop contralaterally - lean over affected side because ground reaction force is medial to the hip |
|
|
Stage in gait cycle when hip extensor weakness most evident
|
loading response
|
|
|
General problems seen with hip extensor weakness
|
- extend knee to compensate
- shorter step - keep trunk back to keep ground reaction force behind hip (results in pelvic rotation) |
|
|
Stage in gait cycle when hip flexion contracture most evident
|
terminal stance
|
|
|
General problems seen with hip flexion contracture
|
- contralateral shortened step
- excess knee flexion - increased lumbar loridosis |
|
|
Stage in gait cycle when knee flexion contracture most evident
|
throughout stance
|
|
|
General problems seen with knee flexion contracture
|
- often no changes seen but increased quad demand
- shorter step - possible toe strike |
|
|
Stage in gait cycle when ankle plantarflexion contracture most evident
|
- mid and terminal stance
|
|
|
General problems seen with ankle plantarflexion contracture
|
- bounce/heel up during mid and terminal stance
- early heel rise - externally rotated, so just roll over inside of foot - increased force to the medial longitudinal arch |
|
|
Classic features of antalgic gait from knee pain
|
- contralateral short step to unload ASAP
- step away from the pain - classic limp |
|
|
Classic features of antalgic gait from arch pain
|
- walk on outside of foot
- sometimes toe-in |
|
|
Prevalance of gait disorders by age in 3 key older groups
|
- 65-74: 15%
- 75-84: 30% - 85+: 50% |
|
|
3 essential requirements of locomotion
|
- progression
- adaptation - postural control |
|
|
2 most general elements of postural control
|
- stability
- orientation |
|
|
List 4 general systems we look for regarding impairments for gait
|
- musculoskeletal
- neuromuscularr - sensory - cognitive |
|
|
Describe reactive stability in gait when trip early in swing
|
- flex swimg limb to clear obstace
- extend stance limb to extend stance |
|
|
Describe reactive stability in gait when trip late in swing phase
|
- extend swing limb to lower leg
- flex opposite leg to clear anticipated obstacle |
|
|
Describe the role of visual sampling as age increases
|
Become more dependent on visual sampling
|
|
|
Normal pattern of turning during gait
|
- proceed from head, trunk, pelvis, feet
- turn in 1-2 steps regardless of distance |
|
|
Major way of increasing stability during turning in gait
|
Increasing number of steps
|
|
|
General features of initiation of gait
|
- move COP back and toward swing leg
- then COP towards stance leg - then COP moves forward to start step |
|
|
Functional distance to be a physiologic walker
|
< 50 feet
|
|
|
Functional distance to do in-house only ambulation
|
75 feet
|
|
|
Functional distance to be a walker around larger home
|
50 meters
|
|
|
Functional distance to for full community ambulation
|
250-300 meters
|
|
|
Speed required for physiologic walking
|
6 meters per min
|
|
|
Speed of in house ambulators
|
14-16 meters/min
|
|
|
Speed of in and around home ambulators
|
24-35 meters/min
|
|
|
Speed of community ambulators
|
48+ meters/min
|
|
|
Speed of normal communityr amublation
|
80 meters/min
|
|
|
Typical speed of hemiplegic gait
|
30 meters/min
|
|
|
Typical speed of Parkinsonian gait
|
34 meters/min
|
|
|
minimum requirements to safely cross the street
|
Must walk 30-80 meters/min for 10-25 meters
|
|
|
From the view of peripheral input, the stance to swing transition in gait is triggered by
|
- hip extension
- unloading of ankle plantarflexors |
|
|
Function of mesencephalic locomotor region
|
- gait initiation and speed of locomotion
- (vetriculspinal tract) |
|
|
Function of pontine locomotor region
|
- postural tone
|
|
|
Functionof subthalamic locomotor region
|
- obstacle avoidance
|
|
|
Role of cerebellum in gait (general)
|
- coordinates movement
- onling error correction - motor learning and adaptation |
|
|
Role of basal ganglia in giat
|
- likely involved in posture through projections to brainstem
- context specific selection of muscle activity |
|
|
Compare O2 costs for paraplegia ambulation vs. WC use
|
- KAFO swing gait: 0.64
- WC: 0.16 (and over twice as fast) |
|
|
3 general elements in the framework for studying pathological gait
|
- impairment framework
- diagnostic framework - combination |
|
|
2 (very general) causes of gait abnormality
|
- pathology
- compensatory strategies |
|
|
3 common neuromusculal impairment groups that influence gait
|
- tone
- coordination - recuitment |
|
|
3 common strategies for clearing the leg
|
- hip hike
- circumduction - lateral lean |
|
|
Control of posture and giat is most affected with to the
|
vermis of the cerebellum
|
