Gait - Pharmacology - lab vaules

Full range of motion required for optimal gait in the HIP, Knee and Ankle

Hip — 20 extension and 25 flexion

Knee — 0- 60 flexion

Ankle — 10 DF - 15 PF

initial contact ( heel strike)

The heel touches the ground; begin the stance phase

hip flexed 20dg

Knee flexed 5 ° ( shock absorption)

Ankle neutral

loading response ( foot flat)

entire foot is in contact with the ground

Hip flexed 20

Knee flexed 15

Ankle plantarflexed 5

Mid Stance

The entire body weight is over the stance limb

Hip neutral

Knee flexed 5

Ankle dorsiflexed 5

terminal stance (heel off)

Heel of stance limb lifts off the floor

Hip 20 extension

Knee 5 flexion

Ankle 10 dorsiflexion

preswing ( toe off)

Only the toe of the stance limb remains on the floor

Hip 10 extension

Knee 40 flexion

Ankle 15 plantarflexion

initial swing (Acceleration)

toe is off the ground and swings until positioned directly under the body

Hip flexed 15

Knee flexed 60

Ankle 5 plantar flexion

mid swing

swing limb is under body

HIP flexed 25

Knee flexed 25

Ankle neutral

Terminal swing ( Deceleration)

swing limb begins to extend, ending just prior to heel strike

Hip flexed 20

Knee flexed 5

Ankle neutral

cadence

number of steps an individual will walk over a period of time ( 110- 120 per minute)

gait cycle

motion that occurs between initial contact on one foot and initial contact on the same foot

step length

distance between right heel strike and left heel strike ( 28 inches)

Stride length

distance between right heel strike and right heel strike (56 inches)

Ataxic gait

staggering and unsteadiness, wide base of support, exaggerated movements

Antalgic gait

Protective gait pattern where stance time on the painful leg is avoided or decreased ( joint/bone and muscle/ tendon pain). Has a shorter swing phase

Cerebellar gait

staggering gait seen in cerebellar disease

Circumduction gait

Circular motion used to advance the leg during the swing phase

Insufficient hip and knee flexion or dorsiflexion to clear foot of ground during swing phase.

Double step

Alternate steps are different lengths or at a different rate

Equine

High steps usually involve excessive activity of the gastrocnemius

Festinating

Walking on toes as if pushed

Hemiplegic

Abducts the paralyzed limb, swings it around,

Parkinsonian

Increased forward flexion of the trunk and knees. Gait is shuffling with quick, small steps

Scissor

legs cross midline during advancement

Spastic

Gait with stiff movements, toes catch and drag, legs held together, hip and knee joints slightly flexed

Steppage

High knees with foot slap at initial contact. Caused by weak dorsiflexors

Tabetic

high-stepping ataxic pattern with foot slapping

Trendelenburg

Lateral trunk flexion and weight shifting over stance leg (right Trendelenburg = left glute med weakness)

Vaulting

Swing leg advances by excessive plantar flexion of the stance leg. Compensatory gait pattern due to lack of knee flexion or leg length discrepancy.

Disease-modifying antirheumatic drugs

Example: Rheumatrex, Arava

Slow or halt progression of rheumatic disease

HIGH incidence of TOXICITY

Glucocorticoid (cortico-steroids)

Examples: Dermacort, Cordrol

It mimics the hormone cortisol. Used to suppress the immune system and reduce inflammation. Used to treat Rheumatoid arthritis, lupus, and multiple sclerosis; asthma flares, COPD, and allergic rhinitis.

The therapist must wear a mask during sessions due to a weakened immune system and look for signs of cortisol toxicity, such as a buffalo hump and moon face

Nonopioid

Example: Tylenol, Aspirin

Used to relieve pain, fight inflammation, and reduce fever

Opioid ( narcotics)

Example: OxyContin, Demerol

Used to treat severe pain. Medication stimulates opioid receptors to limit pain impulses from reaching destination

What is Albuterol used for?

Albuterol is a bronchodilator and works by rapidly relaxing and opening the airways in your lungs.

TREATS ASTHMA think inhaler

normal oxygen saturation rate

95% to 98%

If O2 falls below 90%, discontinue exercise

People who suffer from COPD might have a normal resting SPO2 of 88% - 92%

Normal heart rate for adults

60 to 100 beats per minute

Less than 60bpm = bradycardia

More than 100bpm = tachycardia

amitriptyline

Example: (Elavil)

is a tricyclic antidepressant. While originally approved for depression, it is now more commonly prescribed "off-label" in lower doses to treat chronic nerve pain, prevent migraines, and improve sleep.

Side effects: Sedation (exam)

Dry mouth, drowsiness, constipation, dizziness, and weight gain.