Gait and balance: Difference between revisions
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wikademia>Wikademia m moved Gait and Balance to Gait and balance |
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**arise from chair in single movement without using arms | **arise from chair in single movement without using arms | ||
**sit down in a smooth motion without falling | **sit down in a smooth motion without falling | ||
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==Stance== | ==Stance== | ||
*patient to place feet together without any support | *patient to place feet together without any support | ||
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==Other OSCE modules== | ==Other OSCE modules== | ||
{{OSCE2}} | {{OSCE2}} | ||
[[Category: | [[Category: Clinical Skills]][[Category:OSCE]] | ||
Latest revision as of 05:16, 23 April 2009
Balance
- patient to sit in a chair with back straight against the back of the chair
- keep arms folded while standing
- note:
- sit without leaning or sliding
- arise from chair in single movement without using arms
- sit down in a smooth motion without falling
Stance
- patient to place feet together without any support
- note:
- stand for > 30sec
- stand without loss of balance with eyes closed (Romberg’s Test)
- turn head to both sides and look up without losing balance
- maintain balance when nudged gently (nudge 3 times on the sternum)
- stand on one leg
- reach up to get an object and down to get an object without loss of balance
Gait
- patient to walk across room, turn and walk back as quickly as possible
- note:
- INITIATE gait immediately (if no, dopamine deficiency/ substantia nigra lesion)
- maintain normal step HEIGHT, clearing the floor with their feet (maximum of 5 cm)
- > 5 cm → high stepping
- maintain a step LENGTH between stance toe and swinging heel that is length of foot
- step symmetry and CONTINUITY (raises heel of one foot as other foot touches down)
- maintain a straight path and normal truncal STABILITY (no swaying back, knee flexion or arm abduction)
- observed from behind: normal walk stance with feet almost touching
- STOP without difficulty
- TURN without discontinuity of steps
Pathological Gaits
- Parkinsonian → shuffling gait, lack of arm swinging, difficulty initiating/stopping.
- foot drop → compensate with high-stepping.
- spastic hemiparesis → leg is extended, foot is plantarflexed
- sensory ataxia → wide, unsteady gait that is worse with eyes closed.
- cerebellar ataxia → unsteady, wide based gait, difficulty with turns, veers towards side of lesion
- antalgic → painful, short contralateral step
Other OSCE modules
Acute Confusion - Acute Coronary Syndrome Orders - Anemia - Arterial Blood Gasses - Asthma - Blood Pressure - Chest pain - Chest XRay - CHF - Coma - COPD - Cranial Nerves - Diabetic History - Diabetic Foot - Dysphagia - EKGs - Gallbladder and Liver - Liver Disease - Gait and Balance - Headache - Hematemesis - Hypertension - Jugular Venous Pulses - Knee Exam - Lymph Nodes - Community Acquired Pneumonia - Parkinson Disease - Peripheral Arterial Insufficiency - Pneumonia Examination - Precordial Exam - STD's - Spleen - Swollen Leg Exam - Thyroid Exam - Upper vs Lower Motor Neuron Lesions - Urinary Incontinence