MOTOR CONTROL LECTURE 18: GAIT (EXAM III)

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58 Terms

1
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Falls are the ____ leading cause of death in people over 75 years

7th

2
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____% of adults over 75 years ago have had injurious falls acquire a fear of falling

48%

3
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____% begin avoiding situations that require refined balance skills

26%

4
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Decreased balance control is a major factor affecting loss of independent ____

Mobility

5
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____ factors affecting aging:

- changes in gene expression that result in changes in hormonal function, aging & death

Primary

6
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____ factors affecting aging:

- experiential and include nutrition, exercise, stress level, and acquired pathologies

Secondary

7
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_____ ____ is adults observed walking spontaneously in a natural setting

Naturalistic approach

8
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Measures of gait variability are predictive of future ____

Falls

9
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Gait variability measures significantly ____ in older adults who fell

Increase

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____ ____ is the extent individuals performance varies from trial to trial in repeated task

Intraindividual variability

11
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Older adults have ____ levels of muscle responses and different activation sequences among leg muscles than young adults during walking

Higher

12
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___-___% of falls in older adults result from tripping over an object

35-47%

13
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A ____ rate of development of muscle activation contributes to inadequate recovery from trips, leading to falls

Lower

14
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How quickly restorative forces can be generated is critical to recovery of ___

Balance

15
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Older adults are less _____ after slips than young adults

Stable

16
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Older adults slip ____ & _____ and fall more often than younger

Longer & faster

17
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Older adults have difficulty generating efficient reactive postural responses when they ___

Slip

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Slips account for ____-___% of falls and subsequent injuries in older adults

27-32%

19
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___ ___ strategies:

- modify gait in response to environmental challenges to walking

Visually activated

20
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_____ strategies:

- modify gait parameters to minimize destabilizing effects associated with tasks

Predictive

21
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Trips under ____ ____ are a major cause of falls in older adults

Obstacle crossing

22
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Older adults need to begin making modifications to gait patterns ____ to a step requiring obstacle avoidance

Prior

23
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Decreased ____ ____ is a contributor to locomotor changes in older adults

Muscle strength

24
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______ conditions are underlying contributing factors to changes in gait pattern seen in older adults

Pathological

25
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There is reduced _____ associated with peripheral neuropathy

Somatosensation

26
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Peripheral nerve dysfunction is associated with _____ in walking speed

Slowing

27
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Poor ____ is associated with poor walking performance in older adults

Vision

28
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Older adults monitor terrain during walking ____ than younger adults do

More

29
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Age related slowing in walking speed is in part a function of decreased magnitude of ____ repsonse (vestibular)

Saccule

30
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Sensory/motor aspects of performance require more _____ control as individuals age because of frailty, sensory deficits, and problems in sensory integration

Cognitive

31
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____ is critical to maintaining independence

Mobility

32
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Impaired _____ is one of the earliest and most characteristic symptoms of neurologic disorders

Mobility

33
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____/____:

- reduced ability to generate force (primary contributor to disordered gait)

- primary neuromuscular impairment affecting number, type, and discharge frequency of motor neurons

- affects neural and non neural components of force production

- significant reduction in muscle activity in both PF & TA

- weak quads (difficulty controlling knee flexion during loading and midstance)

- hip flexor weakness (affects swing phase of gait)

- hip extensor weakness (forward trunk lean —> threatens stability)

- weak hip ABD (drop of pelvis on side contralateral to weakness —> trendelenburg gait)

- loss of eccentric & concentric contractions

- effect on gait speed

Paresis/weakness

34
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______:

- alters mechanical properties of a muscle producing increased stiffness

- inappropriate activation of a muscle during gait cycle when being rapidly lengthened

- frequent accompaniment of neuro disorders

- quad spasticity (excessive knee extension in stance phase of gait)

- hamstrings spasticity (excessive knee flexion; frequent problem in CP)

- hip ADD spasticity (contralateral drop in pelvis during stance)

Spasticity

35
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_____ spasticity:

- common problem following neuro injury, stroke, CP, TBI

- contributes to pathologic gait patterns in stance and swing phases of gait

PF

36
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Impaired ____ can manifest as:

- coactivation of agonist and antagonist muscles

- abnormal phasing of multi joint movement leading to poor intersegmental coordination

- increased activation of muscles unrelated to spasticity mediated stretch

Coordination

37
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_____ impairments:

- change in alignment

- weakness

- loss of ROM & contractures

MSK

38
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____ balance strategies integrated into gait cycle are necessary to recovery of stability following unexpected perturbation

Reactive

39
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Performance of ____ walking tasks are predictors of adverse health outcomes in geriatric neurologic populations

Complex

40
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____ diminishes the ability to modify gait in response to terrain changes

Stroke

41
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Abnormal somatosensory inputs result in ____ ____

Gait ataxia

42
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Ataxia is worse when ____ cues are reduced or inappropriate

Visual

43
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____ inputs regulate gait on a local (step by step basis) level and global (route finding) level

Visual

44
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____ ____ deficits:

- ipsilateral trunk lean toward stance leg resulting in loss of stabilty

Body image

45
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Impaired ____ ____:

- inappropriate foot placement and difficulty in controlling COM

Body image

46
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____ gait is a gait pattern that results from pain

Antalgic

47
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____ _____ disorders affect the ability to navigate safely though environment, avoiding collisions with obstacles

Spatial relation

48
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Not all patients who have had a ____ will have a gait disorder

Stroke

49
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Posture, balance, and gait require ___ ____

Attentional resources

50
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Attentional demands with postural control in stance and gait are ____ in individuals with impaired balance

Greater

51
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It is important to evaluate walking function under more ______ conditions in people with neuro pathology

Complex

52
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There is a great deal of ____ among patients even with the same diagnosis

Heterogeneity

53
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Management of ____ problems is the key to return to functional independence in patients with neuro pathology

Mobility

54
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Measuring ____ ____ is the single best measure of gait function

Gait velocity

55
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____ evaluation:

- strength

- ROM

- tone

(In passive situations)

Static

56
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____ evaluation:

- examines patient performing functional movements

Dynamic

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______ measures:

- documents level of function and helps predict disability

Functional

58
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____ examination:

- determines resources and constraints affecting gait and other aspects of mobility function

Static