1 / 19

Walking

Walking. Wael Alasaq PT. Ph.D. Kuwait University PT Dep. 1.1-1.5 m/s community functional speed. Only 7% of discharged pts are able to walk 500 m continuously @ a safe speed (Rd X). Walking requires. Ability stand up against gravity Move COG Maintain COG within BOS.

filia
Télécharger la présentation

Walking

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript

  1. Walking Wael Alasaq PT. Ph.D. Kuwait University PT Dep.

  2. 1.1-1.5 m/s community functional speed. • Only 7% of discharged pts are able to walk 500 m continuously @ a safe speed (Rd X)

  3. Walking requires • Ability stand up against gravity • Move COG • Maintain COG within BOS

  4. Walking dysfunction is very common in pt with stroke. • Mainly due: - Muscle weakness & paralysis - Poor motor control - Soft tissue contractures - Adaptation (as he/she tries to walk despite the problems present)

  5. Requirement for successful walking • Stability (support by the LL) & dynamic balance • Progression requirement (propulsion of the body in the desired/intended direction) • Basic locomotor rhythm • Adaptation requirement ( to changing environment)

  6. Gait cycle • Two phases stance & swing • Stance apprx 60% of the gait cycle • Wt acceptance • Med stance • Push off • Swing apprx 40% of gait cycle • Early swing • Late swing

  7. Gait cycle cont In some texts the phases are divided to more subphases. Stance to five: • Initial contact • Loading response • Mid-stance • Terminal stance • Pre-swing

  8. Gait cycle cont Swing phase subdivided to 3: • Initial swing • Mid-swing • Terminal swing

  9. Gait cycle cont. • @ end of each phase & beginning of the other there are periods of double support (80% of the cycle)

  10. Spatiotemporal Variables of gait • Cadence • Stride length • Step length • Velocity • # of steps per min • The distance covered from one heel strike to the following heel strike, by the same foot. • Distance from on foot strike to the foot strike of the other foot. • The average horizontal speed of the body measured over one or more strides

  11. Muscle activity The main role is to provide the mechanical power for • Keeping the body in the upright position, ie support against gravity, • Moving body segments, mainly around three major joints What are they?

  12. Age related changes • Slower walking speed • Stride length decrease • Increase in duration of double support • Decrease in vision • Decrease in cardiovascular capacity • Muscle strength • Joint flexibility • Bone mass

  13. Are these changes due to age or other factors?

  14. Variability in gait following stroke • Mainly due: - Muscle weakness & paralysis - Poor motor control - Soft tissue contractures - Adaptation (as he/she tries to walk despite the problems present)

  15. Variability in gait following stroke Cont. In stroke pt , Research have found • Decrease in hip extension @ end of stance • Decrease in hip flexion in mid swing • Decrease in knee flexion @ toe-off & mid- swing • Decreased dorsiflexion @ foot contact, & during stance associated with hyperextended knee. • Decreased ankle plantarflextion @ toe-off • Increased knee flexion @ foot contact.

  16. Please refer to your book for understanding the difference between the Typical & atypical kinematics of the gait. • Tip: Make a table of comparison for ease reference.

  17. Guidelines for training Aims of intervention is optimization of walking performance by: • Preventing adaptive changes in LL soft tissues. • Eliciting voluntary contraction in key mm grp in LL. • Increase muscle strength & coordination

  18. optimization of walking performance cont. 4. Increase walking velocity & endurance. 5. Maximize skill, ie increasing flexibility. 6. Increasing cardiovascular fitness.

  19. Practice in groups Using your book start from p 100

More Related