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Examination of Gait

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
Created by: klkoester