Chapter 34: Assessment of orthotic management of gait dysfunction in individuals with traumatic brain injury Flashcards Preview

AAOS Atlas of Orthoses and Assitive Devices > Chapter 34: Assessment of orthotic management of gait dysfunction in individuals with traumatic brain injury > Flashcards

Flashcards in Chapter 34: Assessment of orthotic management of gait dysfunction in individuals with traumatic brain injury Deck (13)
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1
Q

What is kinematics?

A

A description of movements without regard to the forces that generate them.

2
Q

What is kinetics?

A

The forces, moments, and mechanical energies that develop during the course of walking.

3
Q

Head trauma is frequently the result of what?

A

A high-velocity accident with a coup-countercoup effect of the brain shearing against the rough inner surface of the skull.

4
Q

The results upper motor neuron syndrome affect the body how?

A

Hemiparesis: one side of the body
paraparesis: Two limbs:
QuadriparesisThree or more limbs

5
Q

What are some general gait differences seen in patients with TBI?

A

Decreased walking velocity with shorter stride length, shorter stance time, and increased swing tim for the involved limb.
Forefoot first or flat foot at initial contact.
Ankle inversion
Incomplete knee extension
Pelvis drop on the contralateral side.
Inadequate hip, knee and ankle flexion

6
Q

What is the most common deformity seen in a patient with TBI?

A

Equinovarus deformity.

This causes knee hyperextension at midstance.

7
Q

If ankle clonus occurs in a patient with plantaflexion during swing, but is assisted with an AFO, what should be added to the orthosis?

A

A dorsiflexion stop to prevent the stretch response that triggers the clonus.

8
Q

What AFo is good for a patient with Equinovarus deformity with a TBI?

A

Molded plastic AFO with inversion control buildup and/or strap.

9
Q

What orthoses can provide knee stability for a patient with TBI?

A

KAFO with off-set or stance control knee joints
AFO in a few degrees of plantarflexion
Shoe with a a SACH heel.

10
Q

Knee hyperextension in stance phase is commonly produced by what?

A

Spasticity
Plantarflexion contraccture
Lack of motor control
Or compensation for knee extensor weakness.

11
Q

What orthoses can prevent knee hyperextension?

A

AFO with limited plantarflexion

AFO with heel lift (if plantarflexion contracture)

12
Q

What orthosis can be used for hip flexion during stance?

A

Locked external hip joint attached proximally to a pelvic band.

13
Q

What is the main outcome for pelvic retraction?

A

Shortened contralateral step length due to limited hip extension.

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