Gait analysis and physiotherapy treatment

Slides:



Advertisements
Similar presentations
Normal Gait.
Advertisements

Human Locomotion Focus on Walking Taylor Murphy HSS 537.
Walking Analysis … the process A gait cycle consists of “the activities that occur from the point of initial contact of one lower extremity to the point.
Stair Gait Lecture Notes.
Gait.
Analysing the Upper & Lower Limb Movement Studies Mvt Studies
Normal human gait: Ankle motion: Ankle is? Talus is the last bone of the vertical weight bearing system, weight is then transferred forwards and backwards.
Biomechanics- Gait.
Common Orthopaedic Conditions Associated with Complex Neurodisability Lindsey Hopkinson and Victoria Healey Heads of Paediatric Physiotherapy Physiocomestoyou.
Gait Analysis Study of human locomotion Walking and running
Analysis of a continuous skill – walking and running (gait)
Ergonomics INSTRUCTOR’S NOTES: This presentation is designed to assist trainers conducting OSHA 10-hour.
Determinants of Gait Determinants of Gait.
1 Gait Analysis – Objectives To learn and understand: –The general descriptive and temporal elements of the normal walking movement –The important features.
Gait Analysis – Objectives
Gait Analysis – Objectives
Gait. RLA - Gait Phases Traditional Phases of Gait Stance Phase (60%)  Heel-strike (contact)  Foot-flat  Mid-stance point  Heel-off  Toe-off.
Normal and Pathological Gait in the Elderly Peggy R. Trueblood, PhD, PT California State University, Fresno.
Preventing Musculoskeletal Injuries at KGH. Kingston General Hospital is committed to providing a safe and healthy work environment for you and your coworkers.
Gait development in children. The prerequisite for Gait development Adequate motor control. C.N.S. maturation. Adequate R.O.M. Muscle strength. Appropriate.
Physical Therapy for Hemiplegia Patients
Gait Analysis PHED 3806.
Assessments.
Mechanical principals of equipment in the gymnasium.
The Gait Cycle:.
4 Evaluation and Assessment. The means by which one seeks information on severity, irritability, nature, and stage of injury Evaluation Subjective elements.
Physiotherapy for Golf Performance Paul Thawley MSc BSc (Hons) MCSP SRP.
Examination of balance PTP 565. Quote of the day The greatest crime is not developing your own potential. When you do what you do best, you are helping.
Co-ordination Exercises. Definition: Coordination refers to using the right muscles at the right time with correct intensity. Coordination or fine motor.
Kamonwan Kathipotjananun Toursim & hospitality. Running is a means for an animal to move on foot. It is defined in sporting terms as a gait in which at.
Discussion Figure 3 shows data from the same subject’s lead leg during planned gait termination. The lead leg arrived first at the quiet stance position.
12014 Live 2 B Healthy® How important is mobility to you and those you serve? Mobility: A Life Goal.
Gait Analysis – Objectives
 Support Events  Foot (Heel) Strike  Foot Flat  Midstance  Heel Off  Foot (Toe) Off  Swing Events  Pre swing  Midswing  Terminal swing.
The Importance of Stretching Before Exercise
Gait.
KINETIC ANALYSIS OF THE LOWER LIMBS DURING FORWARD AND BACKWARD STAIR DESCENT WITH AND WITHOUT A FRONT LOAD Olinda Habib Perez & D. Gordon E. Robertson.
Patient Mobility - Ambulation
Centre of Gravity & Proprioception
Author name here for Edited books chapter Assessing Balance and Designing Balance Programs chapter.
© McGraw-Hill Higher Education. All Rights Reserved Chapter Five.
1 Gait Analysis – Objectives To learn and understand: –The general descriptive and temporal elements of the normal walking movement –The important features.
2) Knee.
Movement disorders and Balance.
Flexibility and Muscles
Physical Fitness Aspects of Wellness.
Lameness a deviation from a normal gait that indicates a structural or functional disorder of the musculoskeletal system.
SPEED AND AGILITY.
Running Gait.
IN THE NAME OF GOD FARAJI.Z.MD.
The Utilization of the Lokomat
Spasticity ; Muscle Hypertonicity
Bare weight Provide a means for locomotion Maintain equilibrium
IC = Initial Contact LR = Loading Response MSt = Mid Stance
DO NOW List any names of muscles that you may know and where they are located in the body. What bones would they attach to? What do you think would be.
Human Gait.
Neurology Examination (cerebellar and gait examination)
Normal Gait.
Chapter 6 – Flexibility and Low-Back Fitness
Improving Muscular Strength and Endurance
Stress Fracture.
Physical Fitness Aspects of Wellness.
Walking Development in Children
Panagiotis Koutakis, BS, Jason M. Johanning, MD, Gleb R
ACTIVE 8 FITNESS Learning outcomes
Elements of Fitness Cardiorespiratory Endurance Muscular Strength
Flexibility Assessment
Temporal-Spatial Gait Characteristics in Youths with Hypermobile Ehlers-Danlos By: Nicole Vigon.
Scoliosis By: Asher and Carson.
EVALUATION OF FUNCTIONAL PHYSICAL HEALTH STATUS AHEAD OF THE HIGH ENDURANCE EXCERCISES ID Liana Plavina¹, Silva Smagare¹, Andris Čakstiņš ¹, Anete.
Presentation transcript:

Gait analysis and physiotherapy treatment Kyungnam college university of Information and Technology Dept. physical therapy Kim Chi Hyok

GAIT Gait is a continual advancing of all anthropometric points the body. -. Active gait phase: advancing the gravity centre. -. Reactive phase: consists of the step and arms swing.

Susanne Klein Vogelbach GAIT cont. Gait is continual escaping from fall, losing and regaining balance. Gait is the highest level of motoric control and automatisation. Susanne Klein Vogelbach

Energy Expenditure Energy expenditure is a basic parameter for assessing the mount of energy used by the individual the activity. It evaluates the mount of energy used while performing physical activity, and the hardness of the physical activity is one of the elements of gait ergonomic analysis. ergonomic analysis: Even if same person, condition given the gait, different elements has between 20 and 15 dermal degree in the gait.

Energy Expenditure Energy expenditure is the mount of energy (express in Kcal or kJ- Average energy expenditure during walking: 1, 7-3, 5Kcal/min or 7, 12-14,65kJ/min), needed for: Performance of the specific external activity by the skeletal muscle, Sustaining the vital processes and correct organism functioning(the cost of keeping the constant body temperature, blood circulation, breathing, etc.)

Energy Expenditure The extent of the gait energy expenditure depends on: Number of muscles involved, (ACTIO – REACTIO) Compensation Intensity and pace of the gait – average of 116 steps/m. Energy used for the essential metabolism depends on the weight and height of the body, age, sex, ambient temperature, diet. ACTIO: active structure(right leg flex. Muscle action) REACTIO: passive structure(left leg fix. Joint, ligament.) Hemiplegia patients gait always ATIO gait. Energy expenditure is higher.

Gait as the highest of motoric control and automatisation Close “co-operation the pyramidal and extra-pyramidal tract determines the appropriate performance of the moves: “If the blacksmith leads the hammer in a way that he uses the pyramidal tract, extra-pyramidal tract provides him with appropriate posture and muscle tone” J. Kreiner Pyramidal tract is responsible for performing the conscious complex moves of the muscle groups. Extra-pyramidal tract is responsible for walking out the automatic moves and regulates the body posture and muscle tone.

GAIT norm Examination of healthy individuals with the help of three-dimensional gait analysis, e.g. VICON. Acquiring objective data concerning the peripheral joint and trunk behaviour during the movement. Analysis of indicator muscle work in the given gait phase.

VICON SYSTEMS ·Vicon MX ·Bonita ·Motus Video ·T-Series ·Bonita Camera ·Tracker ·Blade ·Nexus ·BodyBuilder ·Polygon ·Motus ·MX Giganet ·Remote Video ·Sync Unit ·Life Science ·Animation ·Engineering

Susanne Klein Vogelbach Normal gait - average Average calculated basing on results of thousands of individuals examined with the use of three-dimensional gait analysis. 20% of upper and lower extreme divergencies is rejected, remaining 60% is used to calculate the average for the given population with which patient gait may be compared. Susanne Klein Vogelbach

Normal gait – average. cont. Gait cycle Ranchos Los Amigos(RLA) Prof. Jaquline Perry Gait cycle is described as 100% in the gait analysis and is measured from the moment the heel of the one lower limb is placed on the surface until the heel of the same limb touches the space.

Gait Cycle

Normal gait – average. cont. Gait has 116 steps in one minute. One sec. needs 1.93 steps. Stance phase 60%[1.16 steps.] each step have about 0.3sec. Swing phase 40%[0.77 steps.] each step have about 0.2sec.

Stance phase Comprises 60% of one cycle Initial contact - IC Loading Response - LR Mid-stance - MST Terminal stance - TST

Swing phase Comprises 40% of one cycle Pre-Swing - PSW Initial Swing - ISW Mid-swing - MSW Terminal swing - TSw

Gait Stance phase 60% Swing phase 40% IC ~ 15% LR ~ 15% MSt ~ 15% PSw ~ 10% ISw ~ 10% MSw ~ 10% TStw ~ 10% Foot – Knee – Hip - Trunk Muscle control: - concentric work - excentric - static work - nerve and m. control - endurance - proprioception Motion range: - joint - Muscular

Gait Tests Timed Walking Test General test serves for the gait assessment of patients with various disorders. -. Execution: patient follows the straight line on the chosen distance # Distance: 5m, or 10m, or 20m # Measurement: time and/or compensations number -. Interpretation: results are compared with the previous ones [test, re-test]

Timed Walking Test 대칭적, 완전한 활동 1 정상적 보행, 그러나 운동 혹은 벅찬 활동을 방해하는 피로가 보고 대칭적, 완전한 활동 1 정상적 보행, 그러나 운동 혹은 벅찬 활동을 방해하는 피로가 보고 2 비정상 보행 혹은 일시적 불균형, 10m 를 10초 이내에 보행 가능 3 독립 보행 가능, 10m를 20초 이내에 보행 가능 4 보행 시 편측 만 목발, 지팡이 필요, 10m를 20초 이내에 보행 가능 5 보행 시 양측 목발, 지팡이 필요, 10m를 20초 이내에 보행 가능 6 양측 지지 필요, 10m 보행 시 20초 이상 소요, 때에 따라 휠체어 사용 7 양측지지로 제한적인 몇 걸음 가능, 10m 보행 불가능, 휠체어 사용 8 휠체어에 한정, 독립적 이동 가능 9 휠체어에 한정, 독립적 이동 불가능

Gait Tests cont. Timed “Up and Go” test Test assess the gait balance and fall risk especially among the older patients. -. Execution: patient sits on the stool, ca 45cm, get up, walks 3m, turns back, returns to the stool and sits. [turning back through right and left shoulder] -. Results interpretation: # < 10(14)sec. Norm for the healthy persons under the 65 years # 10(14)~30 sec. High fall risk # > 30 sec. Patient requires help while performing daily activities.

Gait Tests cont. Activity test Foot Ankle Outcome Score[FAOS]. Knee injury and Osteoarthritis Outcome Score[FOOS]. Hip dysfunctions and Osteoarthritis Outcome Score[FOOS]. # Assessments has 5 categories Pain, ADL , Quality of life, Sports & Recreation, Symptoms

Gait Tests cont. FAOS, FOOS, FOOS questionnaires include 5 scales: Pain, other symptoms accompanying the daily life, sport and recreation, and determine how the hip, knee or foot dysfunction influenced the quality of life. Assessed are answers concerning symptoms present in the previous week. Each answer is given points – from 0 to 4. The higher the indicator with the top value of 100, the less symptoms there are, the indicator with the bottom value of 0, the more present are the symptoms.

Gait Tests cont. Edinburgh Visual Gait Score[EVGS] EVGS serves for functional gait assessment of patients recovering from trauma and orthopaedic surgeries in the area of foot, knee or hip as well as neurological disease, strokes, cerebral palsy, neuropathies. EVGS allows for a detailed analysis of the separate body parts: foot, knee, hip, trunk in the specific subphases of The gait with the division into stance and swing phases. Values measured in points are recorded in the system: 2-1-0-1-2. Examined individual may achieve the result from 0 to 34 points. The less points, the more correct gait of the person.

Muscle work with the division into phases

Thanx! Do Your Best Always!