Gait scenario 7

• Reduced push off in terminal stance bilaterally due to prolonged bedrest

  • Main Analysis Findings
  • weakness and/or poor rom in both PFs - 25 degrees PF needed at push off
  • reduced ground reaction force - Newtons 3rd law of motion - equal and opposing forces - as bodies exerts a force onto the ground, the ground will exert an equal and opposing force onto the body - forces are vectors therefore the ground reaction force will have a direction and magnitude
  • The most amount of GRF occurs at the beginning of stance phase and at push off as that is when the knee is dealing with the most force

  
• Reduced push off in terminal stance bilaterally due to prolonged bedrest

  • Further tests/investigations you would like to do
  • plantarflexion rom
  • plantarflexion strength
  • sensory test
  • fear etc
• Reduced push off in terminal stance bilaterally due to prolonged bedrest

  • A suitable outcome measure
  • single leg heel rise (SLHR) - height and weight
  • ankle mechanics - at the end of stance phase, plantarflexion allows for a longer leg length to push off from - prevents vertical displacement
  • 6mwt
• Reduced push off in terminal stance bilaterally due to prolonged bedrest

  • Justification for selection of treatment
  • rope around both ankle - hold bar with one hand, hold rope with one hand and use it to help pull ankle up in plantarflexion
  • plantarflexion strength exercises - calf raises
  • plantarflexion stretch
  • can help increase cadence
• Reduced push off in terminal stance bilaterally due to prolonged bedrest

  • Justification of approaches to facilitated learning:
  • refer to scenario 1
• Reduced push off in terminal stance bilaterally due to prolonged bedrest

  • progression:
  • stop using rope, but hold onto bars to stabilise
  • full gait cycle
  • increase rom/height of plantarflexion
• Reduced push off in terminal stance bilaterally due to prolonged bedrest

  • Main Analysis Findings
  • a lot of GRF at push off as that is when the knee is dealing with the most force = reduced efficiency of gait
  • push off = one of the power phases that determine speed of gait - low push off = slow gait