Term
| what are spatiotemporal abnormalities of gait |
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Definition
| gait speed, stance/swing time asymmetries, step length asymmetry |
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Term
| what is the biggest spatiotemporal abnormality? |
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Definition
|
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Term
| what 2 things change to cause decrease in gait speed |
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Definition
| smaller step length or slower cadence |
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Term
| what kind of gait abnormality would you see in someone with painful leg? |
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Definition
| shorter stance time on that leg |
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Term
| stimulation of what in the brain initiates stepping pattern? |
|
Definition
| mesencepahlic locomotor region |
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|
Term
| what is the central pattern generator? |
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Definition
| neuronal network capable of generating a rhythmic pattern of motor activity in the absence of phasic sensory input from peripheral receptors |
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Term
| what does a central pattern generator do? |
|
Definition
| responsible for automaticity of motor behaviors. Generates intra in and inter-limb coordination |
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|
Term
| is most of walking controlled by cortical things? |
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Definition
| no, most is controlled by lower things. So if you have a stroke/tbi, you can still walk |
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|
Term
| what are the 4 common causes of kinematic abnormalities? |
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Definition
| deformity in joint, impared control, muscle weakness, pain |
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|
Term
| what is the problem of deformity that causes kinematic abnormalities? |
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Definition
|
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Term
| what are the 3 causes of deformities |
|
Definition
| contracture, ankylosis, abnormal joint configuratoins |
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|
Term
|
Definition
|
|
Term
| what is the most common deformity? |
|
Definition
|
|
Term
| what happens in contracture |
|
Definition
| structural change within connective tissue (muscle, ligaments, tendons, joint capsule) |
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|
Term
|
Definition
| prolonged inactivity or scar tissue formation from injury |
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|
Term
| what are the 2 types of contracture |
|
Definition
|
|
Term
| which contracture is more common |
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Definition
|
|
Term
| what is elastic contracture |
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Definition
|
|
Term
| what does a plantarflexion contracture do? |
|
Definition
| prevents you from dorsiflexing |
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|
Term
| how is initial contact affected if you have a plantarflexion contracture |
|
Definition
| can't land in neutral. Your toes hit the ground first. |
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Term
| what will happen at initial contact if your contracture is elastic |
|
Definition
| heel will give in and I can go from toes landing first into some dorsiflexion |
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|
Term
| what will I do at initial contact if my plantarflexion contracture is rigid? |
|
Definition
| can't go into any dorsiflexion. Options: knee hyperextension/genu recurvatum to put heel on ground OR heel never touches ground and I just vault over foot like I'm walking on my toes on that side |
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Term
| what are the implications of using genu recurvatum to have heel down because of plantarflexion contracture? |
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Definition
| in order to bring tibia forward, the heel has to come up off the ground. If the heel rises early, I lose my good strong push off at the end, resulting in a shorter step length on the other side |
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|
Term
| how to treat plantarflexion contracture |
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Definition
|
|
Term
| what will a person do to substitute for a lack of tibial advancement in midstance if they have a PF contracture |
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Definition
|
|
Term
| how does an ankle PF contracture affect swing? |
|
Definition
| you can trip over your toes. |
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|
Term
| how do people compensate for ankle PF contracture in swing |
|
Definition
| hip hike, flex knee, hip, abduct hip, sidebend, plantarflex other side |
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|
Term
| what is tight in a knee flexion contracture? |
|
Definition
|
|
Term
| what should you do if someone has a knee flexion contracture |
|
Definition
|
|
Term
| at what phases in gait is knee flexion contracture a problem? |
|
Definition
| initial contact, midstance |
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|
Term
| what has to work as soon as leg hits ground and throughout stance if there is a knee flexion contracture? |
|
Definition
|
|
Term
| what is the problem of knee flexion contracture at midstance |
|
Definition
| harder for other leg to swing through and shortens your step length |
|
|
Term
| how does a knee flexion contracture change leg length |
|
Definition
| functionally shortens leg |
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|
Term
| how does the other leg have to compensate for a knee flexion contracture |
|
Definition
| has to flex more in swing |
|
|
Term
| what is a knee extension contracture |
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Definition
|
|
Term
| how do you compensate for knee extension contracture |
|
Definition
| hip hike, flex hip, abduct hip, dorsiflex ankle more, vault over other foot |
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|
Term
| what do gait compensations do? |
|
Definition
|
|
Term
| what are the postural effects of hip flexion contracture |
|
Definition
| pulls pelvis anteriorly, increases lordosis, increases closing |
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|
Term
| effects of hip flexion contracture on gait |
|
Definition
| limits extension in terminal stance so you can't swing for as long and won't get as strong a push-off. Take shorter steps |
|
|
Term
| what are compensations for hip flexion contracture |
|
Definition
| increased lordosis, increased flexion at knee and ankle |
|
|
Term
| what are the 2 primary causes of muscle weakness |
|
Definition
| disuse atrophy, neurological impairment |
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|
Term
| how is gait effected in muscular weakness |
|
Definition
| reduce walking speed to reduce muscular demand |
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|
Term
| what happens when you reduce walking speed |
|
Definition
| increases metabolic needs |
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|
Term
| how is muscle weakness accommodated |
|
Definition
| use different muscle groups, alter muscle timing (muscle stays on too long or not long enough) |
|
|
Term
| when are dorsiflexors supposed to be working? |
|
Definition
|
|
Term
| what other abnormality does dorsiflexion weakness look like? |
|
Definition
| plantarflexion contracture |
|
|
Term
| how will you know whether something is a PF contracture or a DF weakness? |
|
Definition
|
|
Term
| what are compensations for DF weakness |
|
Definition
| hip hike, flex knee, hip, abduct hip, sidebend, plantarflex other side (same as for PF contracture) |
|
|
Term
| what happens in gait with PF weakness |
|
Definition
| reduced push off results in shorter steps; tibial advancement is unrestricted so they fall forward with ankle rocker in midstance |
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|
Term
| when are weak quads a problem in gait? |
|
Definition
| needed for eccentric control of knee flexion during loading response |
|
|
Term
| what will you do if your quads are weak in gait |
|
Definition
| hyperextend knee to move LOG anterior to knee so knees won't flex and your quads don't have to do any work |
|
|
Term
| what is the term for what happens when you have weak quads |
|
Definition
|
|
Term
| what does all the work of holding you up at the knee if you have weak quads |
|
Definition
|
|
Term
| what other muscles will compensate to extend knee with foot on the ground if your quads are weak |
|
Definition
| soleus, glute max pull on tibia and femur to extend knee if quads can't do it |
|
|
Term
| what will happen if your left hip abductors are weak |
|
Definition
| right hip will drop when you stand on left side |
|
|
Term
| how will someone compensate for weak hip abductors |
|
Definition
| by leaning over the affected side |
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|
Term
| how will someone compensate for weak L glute med? |
|
Definition
| leaning over L side when standing on L side |
|
|
Term
| why does someone compensate for weak hip abductors by leaning over affected side? |
|
Definition
| move COM over affected side to shorten moment arm and require less force from abductors (reduce external hip adduction moment in order to reduce internal hip abduction moment) |
|
|
Term
| when is hip flexor weakness a problem in gait? |
|
Definition
| pre-swing, initial swing when hip flexors are pulling leg off the ground |
|
|
Term
| consequences for other joints if you have weak hip flexors |
|
Definition
| harder to get knee flexion. Have a hard time clearing leg through |
|
|
Term
| compensations for weak hip flexors |
|
Definition
| hip hike, flex knee, abduct hip, sidebend, plantarflex other side |
|
|
Term
| how do proprioceptive impairments affect gait? |
|
Definition
| prevent patient from knowing the position of hip, knee, ankle, foot and contact with floor |
|
|
Term
| how do people compensate for proprioceptive impairments? |
|
Definition
| lock the knee. Strike the floor harder so they can feel it. |
|
|
Term
| what happens if someone has sensory problems mixed with motor problems? |
|
Definition
| they could have a hard time sensing the change and then have a hard time making the change |
|
|
Term
| what 2 sensory inputs are important? |
|
Definition
|
|
Term
| describe limb load sensory inputs |
|
Definition
| increased load is felt as tension in golgi tendon organs. Golgi tendon organs send group 1b signals to CNS telling leg to extend/stand straight in stance. The sense of load in your leg helps hold you pu |
|
|
Term
|
Definition
| activation of group 2 sensors in the hip at extension at the end of stance tells those muscles to flex so that we can get flexion for swing. Triggers flexion |
|
|
Term
|
Definition
| if a muscle gets stretched really fast, it will respond: velocity dependent response to stretch |
|
|
Term
|
Definition
|
|
Term
| how is muscle control altered in clonus/spasticity? |
|
Definition
| by changing limb position and body alignment |
|
|
Term
| why is spasticity a problem in walking |
|
Definition
| muscles are being lengthened all the time |
|
|
Term
| common causes of spasticity |
|
Definition
| cerebral palsy, stroke, MS, TBI, SCI |
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|
Term
| what happens in gait with PF spasticity |
|
Definition
| as you start to load into dorsiflexion, you stretch the plantarflexors. PFs respond by pulling back into hyperextension/genu recurvatum just like PF contracture |
|
|
Term
| how to determine whether someone has PF clonus or PF contracture? |
|
Definition
| do quick stretches to check for clonus. Do passive ROM to check for contracture |
|
|
Term
| what happens during loading response to someone with quadriceps spasticity? |
|
Definition
| knee flexes as it absorbs weight from loading response. This stretch on quads causes them to contract, hyperextending the knee into genu recurvatum. |
|
|
Term
| what happens during swing phase to someone with quads spasticity? |
|
Definition
| knee flexes in swing so that leg can swing through. This stretch on quads causes them to contract so quad extends = problem |
|
|
Term
|
Definition
| hamstring spasticity/contracture |
|
|
Term
| what happens in gait to someone with hamstring spacticity |
|
Definition
| as you extend your leg in stance so that other leg can swing through, the stretch on your hamstrings causes your knee to bend. Gives you flexed knee posture. Looks like knee flexion contracture. |
|
|
Term
| what has to work more if hamstrings are spastic? |
|
Definition
|
|
Term
| what happens in hip adductor spasticity |
|
Definition
| as you swing forwardin gait, adductors contract, pulling leg in. scissor gait |
|
|
Term
|
Definition
| increased tissue (muscle, capsule) tension |
|
|
Term
| what are the 2 barriers to effective walking that are caused by pain? |
|
Definition
| deformity, muscle weakness |
|
|
Term
| how does pain cause deformity? |
|
Definition
| prolonged shortened positions, such as to put joint in open packed position |
|
|
Term
| how does pain cause muscle weakness? |
|
Definition
| muscles around effused joint tend to shut down. Also caused by atrophy |
|
|
Term
| when the knee is effused, what muscle shuts down |
|
Definition
|
|
Term
| when the ankle is effused, what muscles shut down |
|
Definition
| fibularis longus and brevis |
|
|
Term
| what is antalgic gait pattern |
|
Definition
| weight avoidance on affected limb. Caused by pain and/or weakness |
|
|
Term
| characteristics of antalgic gait on affected limb |
|
Definition
| shorter stance time, longer swing time |
|
|
Term
| when would you have a shorter step on your affected limb? |
|
Definition
| if you have a hard time pushing off from that limb |
|
|
Term
| when would you have a shorter step of your unaffected limb |
|
Definition
| if you have pain in affected limb and want a shorter stance of that limb |
|
|
Term
| what should be strengthened to recover locomotion following neurological injury? |
|
Definition
| supraspinal pathways, spinal/afferent pathways = existing pathways associated with locomotion |
|
|
Term
| what interventions to use in recovering locomotion following neurological injury |
|
Definition
|
|
Term
| how do we know that treadmill training works |
|
Definition
|
|
Term
| how do animals/people use treadmills to walk? |
|
Definition
| treadmills provide afferent signals |
|
|
Term
| why does holding cat's teail help |
|
Definition
| unweights the cat so it's easier to walk |
|
|
Term
| what can help with locomotor recovery |
|
Definition
|
|
Term
| what happens if you stop training |
|
Definition
|
|
Term
| what happens if you stop training and then restart |
|
Definition
| you'll pick it up faster the 2nd time than you did the 1st time |
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