2 GAIT

Question 1

What is typical gait speed in elderly pattern?

Answer 1

• 70m/min (1.4 m/ sec)
• 1.2m stride length
• 115 steps/min

Question 2

What is functional (post stroke) gait speed?

Answer 2

• House ambulation
  
  • 24m/min (.4 m/s)
• Limited community ambulation
  
  • 24 - 48m/min (.4-.8 m/s)
• Full community
  
  • .8m/s

Question 3

what is Gait Velocity and its 2 requirements?

Answer 3

Stride Length x Cadence

• Requirements
  
  • Postural control (sensory and motor integration for single limb stance)
  • Muscle power for swing limb speed (cadence) and excursion distance (stride length)

Question 4

What are two ways to prepare for gait training?

Answer 4

• Aerobic endurance = primes the system
• Mental imagery
  
  • increases cortical excitation (readiness)

Question 5

What are some ways to facilitate movement to enable success?

Answer 5

• Provide assistance
  
  • augmented sensory feedback (vibration/tens)
  • Facilatory techniques (manual handling, FES, orthotics)
• Allows for errors
• Provide extrinsice feedback
• Enable intrinsic feedback

Question 6

What are some speed reccomendations for treadmills?

Answer 6

• Fast: 1.8 - 2.2 mph
• Variable speed
  
  • alter between comfortable and uncofortable
• Post stroke: typically .3mph

Question 7

What are the protocols for BWSTT?

Answer 7

• Non-ambulatory post stroke, can use AD

Question 8

What are changes when increaseing a pt’s gait speed on the treadmill?

Answer 8

• Hip extension angle increased so inc. trailing limb
  
  • If stretched better for hip flexor power increase
  • Better spindle activation
• Hip flexion power
• Plantar Flexion EMG profile

Increased speed = Greater power

Question 9

What was the LEAPS trial?

Answer 9

There is no difference found between HEP or BWSTT for improvement in gait speed

Question 10

What are 4 areas of HEP for Gait training?

Answer 10

• UE/LE strengthing exercise progression
  
  • Gravity eliminated to against grav to resistance
• Sitting Balance (not related to walking)
• Static standing balance progression
  
  • Standing shoulder with, eyes open, eyes closed feet together, etc
• Dynamic Standing balance progression
  
  • catching ball straight on, catching ball towardsNP side, etc

Question 11

What are the stepping options on a treadmil and what do they target?

Answer 11

• Forward walking - whole practice
• Backward - trailing limb posture
• Lateral walking - Glute medius activation
• Unilateral stepping - part practice for swing or stance

Question 12

How does intensity in training affect gait speed?

Answer 12

• Circuit training: improvement in gait speed

Question 13

What in isolation does NOT improve gait?

Answer 13

• Cardiovascular fitness training
• PAssive LE robotics
• Walking overground on level surfaces
• strengthening