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Examination of Gait
Question | Answer |
---|---|
Purposes of Gait: | 1.) Assist with understanding of gait characteristics of a particular disorder. 2.) Assist with movement diagnosis |
Obtaining an accurate description of gait patterns and variables. | Assist w/ understanding of gait characteristics of a particular disorder |
ID and describing typical gait deviations | Assist w/ understanding of gait characteristics of a particular disorder |
Determining fxn ambulation capabilities in relation to pt's need | Assist w/ understanding of gait characteristics of a particular disorder |
Classifying the severity of a disability | Assist w/ understanding of gait characteristics of a particular disorder |
Predicts the pts future status | Assist w/ understanding of gait characteristics of a particular disorder |
ID and describing gait deviation and difference b/w the pt's gait and normal gait | Assist with movement dx |
Analyzing devieation and ID mechanisms responsible for them | Assist with movement dx |
Determining balance, endurance, energy expenditure, safety and determining their impact on gait | Assist with movement dx |
Who are disturbances in gait most common with? | Elderly |
what % is of gait problems effect ppl over the age of 60 | 15% |
What % of gait problems effect pple over the age of 80 | 25% |
What % of nursing home pple are affected by gait disturbances | 50% |
People with gait disturbances are more at risk for what? | Falls |
4 common reason for gait disturbances: | 1. Pain 2. immobile joint 3. Muscle Weakness 4. Abnormal neurological control |
If the disturbance is symmetrical what does it suggest? | faulty neurological control (except in hemiplegia) |
If disturbance is asymmetrical what does it suggest? | Pain-Fixed Joint- Muscle Weakness (except hemiplegia) |
Onset of problem is Acute: | may be s/s of vascular disease |
More chronic conditions can be cause from | alcoholism or certain other drugs |
difficulty starting and stopping walking | Parkinsons |
Associated with vertigo or light-headness- | Pain, numbness or tingling in limbs |
Problem worse at night due to darkness | Sensory impairment (diabetes) decreased visual input |
When examining a person gait what view do you look at | front, back, side |
What are the 7 things you should pay attention to in a exam. | 1. Get up from chair 2. initiates walking 3. walking at different speeds 4. turns in both directions 5. walks of toe, heel, straight line, EO, EC 6. Stand with EO/EC 7. Copes with postural challenges |
non-specific characteristics of Gait | widened base in standing, short step while walking, greater proportion of gait cycle spent in double-limb support |
unique characteristics of Gait | cerebellar ataxia; Arthritis of the hip (trendelenburg); Parkinson's disease; |
What are the 3 basic area you can divide gait problems into? | 1. joint and skeletal abnormalities 2. motor abnormalities 3. Impaired balance (cblr and ssy ataxia) |
If you can place the problem into one of the three division what can you proceed to | looking deeper into that area |
Antalgic Gait: | gait disturbance due to pain |
If pt has a limp what is it caused from | discomfort in WB (hyperesthesia or oA) |
Hyperesthesia | to much sensation |
By age 75 what % of population has OA changes in large joints? | 85% |
If there is pain during gait what happens to the stance phase of the affected leg? | gets shorter (place gingerly on the floor and immediately lifted) |
Gait disturbances from immobile jts consist of? | Loss of mobility from arthritis; Plantar flexion conjecture due to long time in cast; |
Apraxic gait involves what lobe | Frontal |
characterized by hesitation in starting and in short , shuffling step that rarely leave the floor (magnetic walk) | Apraxic Gait |
Difficulty maintaining upright posture due to forward flexion upper trunk, arms, and knees. | Apraxic Gait |
Lack reflexes against sudden perturbations | Apraxic Gait |
Typically maintains arm swing | Apraxic Gait (how you rule out Parkinson's) |
Gait is not due to mm weakness, paralysis or other motor/ssy impairments | Apraxic Gait |
may or may not have memory or other cognitive impairments | Apraxic Gait |
this person will not be able to catch himself when falling but a malinger could | Apraxic Gait |
characterized by no objective s/s of neurological deficit and all kinds of arm and leg movement that follow no physiological pattern | malingering gait |
Selection of interventions are : | tx of impairments to improve gait determines need for Ads, orthoses, prostheses etc.. |
When you evaluate the treatment of effectiveness you should: | determine how interventions will affect gait-and- how safe is the patient now as opposed to before he had the intervention |
the level of consistency of either a measuring instrument or a method of analysis | reliability |
Sensitivity | true positive |
Specificity | true negative |
the degree that a measurement refelcts what it suppose to measure | validity |