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Flashcards in Ambulation Assessment and Training Deck (31)
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1
Q

what are some gait recovery predictors

A
initial ASIA classification
classification and age
Lower Extremity Motor Score
Quad Strength ( >3/5 indicates likelihood of ambulation)
sparing of pin prick sensation
2
Q

what ranges of motion do we want in the lower extremity joints for gait

A

ankle- need at least neutral but would like 10 degrees or more of DF
knee- full extension and flexion

hip- neutral or at least 10 degrees extension

3
Q

what are some things we look at when evaluating gait potential

A

LEVEL OF INJURY- must have fair trunk strength. those with function in muscles crossing the hip do better
UPRIGHT TOLERANCE- tolerate upright with good hemodynamic response for 20 min before being cleared for locomotor training
ENDURACE- physical and mental
UE STRENGTH
PROM
BALANCE- trunk strength of at least a 3+
SPASTICITY- more difficult to ambulate and unsafe

4
Q

At what level of injury is community ambulation a goal

A

L4 and below

5
Q

at what levels of injury is household ambulation a goal

A

L1, L2 and L3

6
Q

at what levels of injury is exercise ambulation a goal

A

above T2, T2-T6, T7-T10, T11-T12

7
Q

What might you expect at T2 level of injury

A

partial UE function
tilt table, standing frames
goals: standing,exercise

8
Q

what might you expect at T2-T6 level of injury

A

complete UE function
standing frame, RGO
goal:standing, exercise

9
Q

what would you expect for T7-T12 level of injury

A
partial to complete trunk function
standing and exercise ambulation
RGO, KAFO
bracing is usually recommended
wheelchair is primary mode of locomotion
10
Q

what would you expect for L1 level of injury

A
complete trunk function
some hip flexion
RGO, KAFO
exercise and household ambulation
bracing is recommended
w/c is primary mode of locomotion
11
Q

what would you expect for someone with L2 level of injury

A
stronger hip flexors
KAFO
exercise and household ambulation
bracing is recommended
wheelchair is primary mode
12
Q

what would you expect for someone with L3 level of injury

A
quad strength-knee control
combo of KAFO/AFO or just bilateral AFO
household or community ambulation
bracing recommended
wheelchair is primary mode
13
Q

what would you expect for someone with L4 and below level of injury

A
full quads
partial hamstring
AFO or SMO
bracing recommended
usually community ambulator
14
Q

hip flexor strength requirement

A

2/5 is sufficient to advance the leg even with a KAFO

anything less than that would require trunk/pelvis stability or compensation to advance forward

15
Q

quad strength requirement

A

score of 0,1or 2 requires a locked KAFO or stance control
score of 3 may unlock KAFO
score of 4 or 5 no bracing at knee; only AFO

16
Q

hamstring strength requirements

A

3,4,5 will stabilize the knee in stance

strength of 0,1,2 may present with genu recurvatum, increased WB on UE, and uneven stance

17
Q

dorsiflexion strength requirements

A

need an AFO if strength of 0,1,2 or 3

4,5 orthotic depends on PF strength and proprioception

18
Q

what is the importance of strong plantarflexors

A

provides eccentric tibial control in stance
weight shifting
step length on contralateral side

19
Q

what is the primary goal of locomotor training

A

provide sensory cues to retrain neural patterns that will result in effective locomotion

20
Q

with what population is locomotor training evidence found the best in

A

best evidence is with incomplete SCI

21
Q

How long must someone be able to tolerate standing with a good hemodynamic response as well to be allowed to locomotor train

A

for 20 minutes

22
Q

what are contraindications for locomotor training

A
unstable fractures
osteoporosis
open wounds
contact precautions
contractures
23
Q

what is the andago

A

a manually assisted treadmill training system that offers dynamic body weight support

24
Q

what body weight gait training device can be used over a treadmill or the ground

A

the Lite Gait; it allows for some manual facilitation but may need more than one person to control the device

25
Q

what is the lokomat

A

a driven robotic gait orthosis that guides the patients legs on a treadmill

26
Q

progression of sit to stand

A

bilateral UE on parallel bar–>one on bar one on w/c–>bilateral UE on w/c

27
Q

what is the guarding technique when someone is practicing trunk balance in standing

A

facilitate from behind or the side with one hand on their shoulder
tell them to hang on their Y ligaments for less muscle activation

28
Q

what is it called when you hang on your Y ligaments for passive stability

A

parastance position

29
Q

which gait pattern as the feet going past the hands

A

swing through

30
Q

which gait pattern has the feet progressing forward to the hands

A

swing to

31
Q

what is the sequence of a four point gait pattern

A

right crutch-left leg-left crutch-right leg

head follows the direction of the leading leg