SCI Locomotor Training

incomplete

Greater likelihood of recovery with ____ lesions

6 9

greatest rate of change in the first ____-___ months post SCI

extension flexion PF

Requirements for locomotor training with complete SCI; Full ROM in hip ____, absence of knee ____ and ankle _____ contractures, adequate cardiovascular endurance, high level of motivation

Ankle-foot orthosis (AFO)

Orthotic used for lower lumbar lesions

Knee-Ankle-Foot Orthoses (KAFO)

Individuals with more extensive paralysis or limb deformity may benefit from this orthotic; has ankle/foot control and knee control

solid

most common ankle/foot control for KAFOs; also hinged available

hinge

provides medial/lateral and hyper extension restriction but allows knee flexion in KAFO

Offset Joint

Hinged placed posteriorly to midline of leg, stabilizes the knee in extension during early stance phase; for KAFO

Drop Ring Lock

When a person stands with knee fully extended the ring drops, preventin the uprights from bending; retention button permits the wearer to unlock one upright, then attend to the other one without having the first one drop again (most common)

Craig-Scott KAFOs

May be prescribed with adults for paraplegia, shoe or plastic solid ankle section, BiCAAL ankle joints set in slight dorsiflexion, pawl knee lock with bail release, single thigh bands, enable patient to stand with sufficient backward lean to prevent pitching forward at hip or trunk,

to through

Craig-Scott KAFOs typical gait pattern is usually swing ____ or swing _____ with crutches or walker

HKAFO

addition of a pelvic band and hip joints to the KAFO; prevent abduction, adduction, and hip rotation. If flexion control is required, a drop ring lock can be used in hip joint

THKAFO

Incorporates a lumbosacral orthosis attached to KAFOs; very difficult to don, heavy, cumbersome, seldom worn after patient is discharged from rehab

Reciprocating Gait Orthoses

A THkAFO in which the orthotic hip joints are connected by one or two metal cables or rods; knees are stabilized with knee locks, feet are encased in solid ankle orthoses, one foot is always on the floor so its stable

HIGT

In chronic stage of incomplete SCI, CPG recommendation is ______

Stance control, limb advancement, propulsion, stability and balance

four biomechanical subcomponents of HIGT

4 5

Frequency of HIGT is ___-___ sessions/week

70 80 70 85 15 17

Intensity of HIGT is ___-____ HRR, ____-____% HRmax, ____-____ RPE

1

Time of HIGT; maximize walking in ___ hour session

function efficiency

HIGT has an emphasis on ____ and _____

speed skill overground stair

In a 60 minute session of HIGT, there should be 10 minutes of treadmill ____ dependent, 10 minutes of treadmill _____ dependent, 10 minutes of ____ walking, 10 minutes of ____ training