Walking

Question 1

what are the essential components of walking?

Answer 1

• feet shoulders/hips width apart
• equal weight distribution on both LL
• ankle dorsiflexion
• pelvic neutral position
• extension of hips throughout
• lateral weight shift
• flexion of knee on heel strike –> extension –> flexion
• flexion of knee during swing
• lateral pelvic tilt
• rotation of pelvis forward
• extnension of knee and dorsiflexion

Question 2

List down some of the possible compensatory behaviour.

Answer 2

• wide base of support
• externally rotated hips
• slow gait velocity
• short step length
• trunk inclined forward
• hips hiking
• foot drop

Question 3

What is the gait speed requirement for patient to be community ambulant?

Answer 3

0.8m/s

Question 4

Briefly describe the complete gait cycle.

Answer 4

Stance (60%): 
- Heel strike 
- Loading response 
- Mid stance 
- Terminal stance 
Swing (40%):
- Pre-swing 
- initial swing
- mid swing
- later swing

Question 5

What do you observe during gait analysis?

Answer 5

• number of assist required
• amount of assist and mobility aid required
• general observation on step length, duration of swing and stance phases
• specific aspects of walking (essential component)

Question 6

Assessments used for assesing walking ability?

Answer 6

• 10 Metre Walk Test (10MWT)
• Timed up and Go (TUG)
• Modified Barthel Index (MBI) – look at the ability
• Mobility Scale for Acute Stroke (MSAS) – look at ability, can or cannot

Question 7

National Stroke Foundation (NSF) recommend what kind of treatment/intervention for post-stroke patient to improve walking ability?

Answer 7

• tailored repetitive practice of walking (or components of walking)
• part task or whole task
• tilt table can be used for part task training

Question 8

What are some of the considerations before putting patient for Bodyweight supported exercise (BWS) ?

Answer 8

• mm strength at least 2-3 in LL

- patient must be able to engage in semi-supervised practice (motivated, no/mild deficit in cognition)

Question 9

What are some of the benefits of Virtual Reality?

Answer 9

• good for semi-supervised practice
• provides feedback (both performance and results)
• motivation, fun
• good alternative for patients with decent muscle strength (grade 4)

Question 10

Who will benefit from the use of Robotics?

Answer 10

• patients with muscle strength grade 0-2, acute-subacute and unable to walk.
• patients who can engage in semi-supervised practice.
• help to regain independence in functional activities.