Gait and balance: Difference between revisions

Newer edit →

Revision as of 02:43, 18 May 2007

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

@@ Line 1: / Line 1: @@
+==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
 {{OSCE2}}
 [[Category:Medicine]][[Category:OSCE]]

wikademia>Koppertone

Revision as of 02:43, 18 May 2007

Balance

Stance

Gait

Pathological Gaits