Gait Disorders: Evaluation and Management (Neurological Disease and Therapy)

Preface......Page 11
Acknowledgments......Page 15
Contents......Page 17
Contributors......Page 23
I. INTRODUCTION......Page 27
B. Natural History......Page 28
III. THE LANGUAGE OF MOBILITY ASSESSMENT......Page 29
A. Self-Report......Page 30
C. Performance Measures......Page 31
D. Capturing the Range of Mobility......Page 32
E. Interpreting Measures of Mobility......Page 35
IV. AN OVERVIEW OF APPROACHES TO THE CAUSES OF MOBILITY DISABILITY......Page 36
V. TREATMENT OF DYSMOBILITY TO IMPROVE FUNCTION OR PREVENT DISABILITY......Page 37
VI. SUMMARY......Page 39
REFERENCES......Page 40
I. SELF-REPORT MEASURES......Page 45
II. PERFORMANCE-BASED MEASURES......Page 46
A. Gait Speed......Page 47
B. Sets of Multiple Tasks......Page 49
C. Dual Task Walking......Page 53
D. Tests of Volitional Stepping......Page 54
III. SUMMARY......Page 55
REFERENCES......Page 56
I. INTRODUCTION......Page 63
A. Technology......Page 64
B. Terminology......Page 69
III. BIOMECHANICAL CONCEPTS PERTINENT TO GAIT......Page 70
A. Initial Contact......Page 72
E. Pre-swing......Page 74
I. Coronal Plane Motion......Page 75
A. Abnormal Gait Patterns Associated with Upper Motor Neuron Pathologies......Page 76
B. Gait Patterns Associated with LMN and Orthopedic Disorders......Page 78
C. Atypical Gait Patterns Associated with Aging......Page 79
A. Improved Tracking......Page 81
B. Model-Based Analysis......Page 82
VII. SUMMARY......Page 83
REFERENCES......Page 84
II. AGE-RELATED CHANGES IN BIOMECHANICAL CAPACITIES......Page 89
A. Muscle Strength and Power......Page 90
C. Source of Age Differences in Rapid Strength Development......Page 91
D. Myoelectric Latencies......Page 92
E. Reaction Times......Page 93
G. Biomechanical Effects of Age Differences in Latencies and Reaction Times Are Minor......Page 94
I. Proprioception......Page 95
A. Gait Analysis Techniques......Page 96
B. Classical Gait Biomechanics......Page 97
C. Simplified Gait Analysis Approaches......Page 100
E. Energetics of Level Human Gait......Page 101
F. Motor Control of Gait......Page 102
H. Effects of Age......Page 103
I. Turning in a Confined Space......Page 105
J. Divided Attention During Gait......Page 106
A. Importance of Vision......Page 107
B. Stepping Over or Avoiding Obstacles by Turning or Stopping......Page 108
B. Stair Locomotion......Page 109
C. Ramp Locomotion......Page 110
D. Uneven Surface Locomotion......Page 111
A. Recovering from a Trip......Page 112
B. Recovering from a Slip......Page 114
C. Mechanisms Underlying Age and Gender Differences in Performance of Time-Critical Tasks With High Strength Demands......Page 115
VII. AGE AND GENDER DIFFERENCES IN FALLS AND FALL-RELATED INJURY RATES......Page 116
A. The Biomechanics of Hip Fractures......Page 117
B. The Biomechanics of Wrist Fracture......Page 118
REFERENCES......Page 119
I. INTRODUCTION......Page 127
A. Quasi-Static Posture......Page 130
B. Perturbed Quasi-Static Posture......Page 136
C. Perturbed Quasi-Static Posture Requiring Stepping Responses......Page 137
REFERENCES......Page 139
6 Neuropsychological Influences on Gait in the Elderly......Page 143
I. BEHAVIORAL CONTROL SYSTEM......Page 145
C. Behavioral/Affective Dimension......Page 146
D. Executive Control Dimension......Page 147
A. Aging......Page 149
B. Disease......Page 151
A. Setting......Page 152
A. Task Interference......Page 153
B. Instructional Set......Page 154
A. Correlational Model......Page 155
C. Challenge Studies......Page 156
D. Dual Task Paradigm......Page 157
VI. PRACTICAL CLINICAL IMPLICATIONS FOR A BEHAVIORAL CONTROL SYSTEM APPROACH......Page 160
REFERENCES......Page 161
I. MONITORING EVERYWHERE......Page 169
II. PRÊT À PORTER (READY TO WEAR)......Page 170
III. HOME SAFE HOME......Page 172
IV. SHAKING THINGS UP......Page 173
VI. THE INFORMATION WORLD......Page 174
REFERENCES......Page 175
I. EPIDEMIOLOGY......Page 179
II. DIAGNOSES CONTRIBUTING TO GAIT DISORDERS......Page 181
III. APPROACH TO ASSESSMENT......Page 182
A. History and Physical Examination......Page 185
B. Laboratory and Imaging Assessments......Page 186
IV. INTERVENTIONS TO REDUCE GAIT DISORDERS......Page 187
REFERENCES......Page 190
I. INTRODUCTION......Page 195
A. Incidence of Falls......Page 196
C. Fall-Related Morbidity......Page 197
III. CAUSES OF FALLS......Page 198
IV. RISK FACTORS FOR FALLS......Page 199
V. MULTIDIMENSIONAL FALL-RISK ASSESSMENT......Page 203
REFERENCES......Page 207
I. INTRODUCTION......Page 211
A. Multifactorial Interventions......Page 212
B. Single Interventions......Page 213
C. Long-Term Care Setting Interventions......Page 216
D. Hospital Setting Interventions......Page 217
A. Medications......Page 218
C. Orthostatic Hypotension and Hypovolemia......Page 220
E. Disease and Pain Management......Page 221
G. Vitamin D, Calcium, and Vitamin B12......Page 223
J. Behavioral Modification......Page 224
REFERENCES......Page 226
I. INTRODUCTION......Page 233
II. CONSEQUENCES OF FEAR OF FALLING......Page 234
IV. ASSESSMENT OF FEAR OF FALLING......Page 235
V. INTERVENTIONS FOR FEAR OF FALLING......Page 236
VI. COMMUNICATION ABOUT THE PROBLEM......Page 240
REFERENCES......Page 241
I. INTRODUCTION......Page 245
A. Muscular Strength and Power......Page 246
A. Endurance Training......Page 247
C. Multidimensional Training......Page 252
IV. EXERCISE PROGRAMS TO IMPROVE GAIT......Page 254
B. Endurance Training......Page 255
D. Multidimensional Training......Page 260
E. Tai Chi......Page 261
V. AN EXAMPLE OF INTERFACING EXERCISE DESIGN PRINCIPLES TO THE PATIENT: CEREBROVASCULAR ACCIDENT (STROKE)......Page 262
VI. EXERCISE TO REDUCE FALLS......Page 263
VII. ISSUES TO CONSIDER WHEN INTERPRETING THE LITERATURE......Page 265
VIII. SUMMARY......Page 267
REFERENCES......Page 268
13 Clinical Gait Analysis in Neurology......Page 273
I. GAIT ANALYSIS IN PEOPLE WITH CP......Page 274
II. CLASSIFICATIONS OF GAIT PATTERNS USING GAIT ANALYSIS IN CP......Page 277
III. GAIT ANALYSIS IN PD AND HD......Page 280
IV. HUNTINGTON'S DISEASE......Page 283
V. GAIT ANALYSIS IN STROKE......Page 284
REFERENCES......Page 288
I. INTRODUCTION......Page 299
A. Gait Disturbances Typical to the Early Stages of the Disease......Page 300
B. Long-term Prevention Approach......Page 301
C. Symptomatic Medical Treatment......Page 303
A. Gait Disturbances Characteristic to the Advanced Stages of the Disease......Page 304
B. Medical Treatment of Gait Disturbances......Page 305
D. Nonmedical Treatment of Parkinsonian Gait Disturbances......Page 306
REFERENCES......Page 309
I. INTRODUCTION......Page 315
A. Progressive Supranuclear Palsy (PSP)......Page 316
B. Multiple System Atrophy (MSA)......Page 319
C. Huntington's Disease......Page 321
D. Primary Orthostatic Tremor......Page 322
A. Mobility Deficits......Page 323
B. Pharmacotherapy......Page 325
C. Physiotherapy......Page 326
IV. NORMAL PRESSURE HYDROCEPHALUS......Page 327
V. CONCLUSIONS......Page 328
REFERENCES......Page 329
A. Multicausal Nature of Mobility Problems......Page 335
B. Contemporary Systems Approach in Rehabilitation......Page 336
C. Motor Learning in the Framework of the Systems Approach......Page 337
B. Treadmill vs. Overground Walking......Page 338
C. Evidence for Efficacy of Treadmill Training......Page 339
D. Weighing Advantages and Limitations of Treadmill Training......Page 340
A. Rationale......Page 341
B. Adaptation to Unloading......Page 342
C. Evidences Supporting the Use of BWS......Page 345
B. Adaptations to Speed......Page 347
C. Intensity: The Key for Improved Speed and Endurance......Page 351
A. Balance Control During Locomotion......Page 352
B. Sensory Cues in the Control of Balance......Page 353
C. Tactile Sensory Feedback Improves Balance During Walking in Stroke Patients......Page 354
REFERENCES......Page 356
I. CHALLENGE OF WALKING AND IMPORTANCE OF SOMATOSENSORY INFORMATION......Page 365
II. EPIDEMIOLOGY AND CLINICAL IDENTIFICATION OF PERIPHERAL NEUROPATHY......Page 366
III. STATIC BALANCE AND PN......Page 367
IV. EFFECT OF PN ON MOBILITY......Page 368
V. PERIPHERAL NEUROPATHY AND FALL RISK......Page 369
VI. AFFERENT AND EFFERENT IMPAIRMENTS ASSOCIATED WITH PN......Page 370
VIII. CLINICAL EVALUATION OF BALANCE......Page 374
A. Foot Clearance......Page 375
B. Step Variability......Page 376
A. Education......Page 377
D. Strengthening......Page 379
G. Foot Pain......Page 380
REFERENCES......Page 381
I. INTRODUCTION......Page 387
III. PREOPERATIVE......Page 388
IV. INTRAOPERATIVE......Page 390
A. Early Mobilization......Page 391
B. Early Physiatry Evaluation......Page 392
C. Weight Bearing as Appropriate......Page 396
D. Adaptive Equipment......Page 397
E. Disposition......Page 398
REFERENCES......Page 399
I. INTRODUCTION......Page 405
II. PREVALENCE AND CONSEQUENCES OF FOOT PROBLEMS IN OLDER PEOPLE......Page 406
III. EVALUATION OF FOOT AND ANKLE PROBLEMS IN OLDER PEOPLE......Page 407
A. Forefoot......Page 408
C. Rearfoot......Page 412
A. Rheumatoid Arthritis......Page 413
C. Other Systemic Conditions......Page 414
B. Foot Orthoses......Page 415
REFERENCES......Page 417
Index......Page 425
About the Editors......Page 433
About the Book......Page 435
Back cover......Page 436