Gait Scenario 2

• Bilateral lack of foot clearance during swing due to weak dorsiflexors after prolonged bed rest – dragging feet rather than using compensation

  • Main Analysis Findings:
  • impairment occurs after toe off, during accel, mid swing and decel
  • weakness within dorsiflexors
  • lack of rom in dorsiflexors - need 5 degrees during swing phase

  
• Bilateral lack of foot clearance during swing due to weak dorsiflexors after prolonged bed rest – dragging feet rather than using compensation

  • Further tests/investigations you would like to do:
  • muscle strength and endurance test of dorsiflexors
  • check proximal control as well - hip flexors (beginning of swing phase)
  • check the individual - fear etc - previous injuries
• Bilateral lack of foot clearance during swing due to weak dorsiflexors after prolonged bed rest – dragging feet rather than using compensation

  • A suitable outcome measure:
  • dorsiflexor strength test
  • dorsiflexor rom
  • functional gait assessment
  • Gait Abnormality Rating Scale
• Bilateral lack of foot clearance during swing due to weak dorsiflexors after prolonged bed rest – dragging feet rather than using compensation

  • Justification for selection of treatment:
  • treatment: need to dorsiflex to a certain height with heel on the ground e.g. place sticker 5cm above the ground and need to reach the sticker when dorsiflexing - can use rope to help
  • strengthen dorsiflexion
• Bilateral lack of foot clearance during swing due to weak dorsiflexors after prolonged bed rest – dragging feet rather than using compensation

  • Progression:
  • increase height of sticker
  • progress to whole gait movement
  • remove safety bars
• Bilateral lack of foot clearance during swing due to weak dorsiflexors after prolonged bed rest – dragging feet rather than using compensation

  • Justification of approaches to facilitated learning:
  • refer to scenario 1
  • cues - slowing down in a car, removing foot of acceleration