Gait Disorders: Evaluation and Management

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ISBN: 9780824723934 | 0824723937
Cover: Hardcover
Copyright: 7/15/2005

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With chapters by many of the foremost international authorities on aging, neurology, and mobility research, this reference provides an up-to-date review of approaches to gait disorders and falls. A focus is placed on recent assessment and intervention practices for common gait disorders, especially those seen in older adults, including sections on neuro-psychological influences, fear of falling and exercise, and strategies for specific disease groups, such as neurological disorders.

Preface

iii

Acknowledgments

vii

Contributors

Section I. Gait Disorders and Mobility in Older Adults: Fundamental Concepts

1. Gait, Mobility, and Function: A Review and Proposed Classification Scheme

(18)

Stephanie Studenski

I. Introduction

(1)

II. Epidemiology

(1)

III. The Language of Mobility Assessment

(7)

IV. An Overview of Approaches to the Causes of Mobility Disability

(1)

V. Treatment of Dysmobility to Improve Function or Prevent Disability

(2)

VI. Summary

(1)

References

(5)

2. Clinical Evaluation of Gait Disorders: No-Tech and Low-Tech

(18)

Neil B. Alexander

I. Self-Report Measures

(1)

II. Performance-Based Measures

(9)

III. Summary

(1)

References

(7)

3. Laboratory-Based Evaluation of Gait Disorders: High-Tech

(26)

Patrick O. Riley and D. Casey Kerrigan

I. Introduction

(1)

II. Gait Analysis Laboratory Methods

(6)

III. Biomechanical Concepts Pertinent to Gait

(2)

IV. Normal Kinematic and Kinetic Parameters

(4)

V. Clinical Application of Laboratory Gait Analysis

(5)

VI. Gait Analysis-Current Developments

(2)

VII. Summary

(1)

References

(5)

4. Age-Associated Changes in the Biomechanics of Gait and Gait-Related Falls in Older Adults

(38)

James A. Ashton-Miller

I. Prevalence of Gait Problems Among Older Adults

(1)

II. Age-Related Changes in Biomechanical Capacities

(7)

III. Gait on Level Surfaces

(11)

IV. Obstacle Avoidance During Level Gait

(2)

V. Gait on Surfaces that Are not Level

(3)

VI. Trips and Slips

(4)

VII. Age and Gender Differences in Falls and Fall-Related Injury Rates

(1)

VIII. Fall-Related-Injury Biomechanics

(2)

IX. Conclusions

(1)

References

(8)

5. Neuromuscular and Biomechanical Elements of Postural Equilibrium

101

(16)

Karen L. Reed-Troy and Mark D. Grabiner

I. Introduction

101

(12)

References

113

(4)

6. Neuropsychological Influences on Gait in the Elderly

117

(26)

Bruno Giordani and Carol C. Persad

I. Behavioral Control System

119

(4)

II. Individual Modulating Factors

123

(3)

III. Environmental Modulating Factors

126

(1)

IV. Task-Specific Modulating Factors

127

(2)

V. Methodological Approaches for Clarifying Behavioral Control System Factors in Walking

129

(5)

VI. Practical Clinical Implications for a Behavioral Control System Approach

134

(1)

References

135

(8)

7. Gait Assessments and Interventions: A Glimpse into the Future

143

(10)

Jennifer Healey and Jeffrey M. Hausdorff

I. Monitoring Everywhere

143

(1)

II. Prêt à Porter (Ready to Wear)

144

(2)

III. Home Safe Home

146

(1)

IV. Shaking Things Up

147

(1)

V. Look Who's Walking

148

(1)

VI. The Information World

148

(1)

References

149

(4)

Section II. Gait Disorders and Falls: Assessments and Interventions

8. Common Gait Disturbances: A Clinical Overview

153

(16)

Neil B. Alexander and Alton Goldberg

I. Epidemiology

153

(2)

II. Diagnoses Contributing to Gait Disorders

155

(1)

III. Approach to Assessment

156

(5)

IV. Interventions to Reduce Gait Disorders

161

(3)

V. Conclusions

164

(1)

References

164

(5)

9. Fall Risk Assessment: Step-by-Step

169

(16)

Laurence Z. Rubenstein and Karen R. Josephson

I. Introduction

169

(1)

II. Epidemiology

170

(2)

III. Causes of Falls

172

(1)

IV. Risk Factors for Falls

173

(4)

V. Multidimensional Fall-Risk Assessment

177

(4)

References

181

(4)

10. Best Clinical Practice Models to Reduce Falls

185

(22)

Robert J. Przybelski and Jane Mahoney

I. Introduction

185

(1)

II. Overview of Evidence Base for Falls Interventions

186

(6)

III. Specific Components of a Multifactorial Intervention

192

(8)

IV. Conclusion

200

(1)

References

200

(7)

11. Fear of Falling

207

(12)

Sharon L. Tennstedt

I. Introduction

207

(1)

II. Consequences of Fear of Falling

208

(1)

III. Factors Associated with Fear of Falling

209

(1)

IV. Assessment of Fear of Falling

209

(1)

V. Interventions for Fear of Falling

210

(4)

VI. Communication About the Problem

214

(1)

References

215

(4)

12. Therapeutic Exercise to Improve Balance and Gait and Prevent Falls

219

(28)

Tanya A. Miszko and Steven L. Wolf

I. Introduction

219

(1)

II. Factors Associated with Abnormal Balance and Gait

220

(1)

III. Exercise Programs to Improve Balance

221

(7)

IV. Exercise Programs to Improve Gait

228

(8)

V. An Example of Interfacing Exercise Design Principles to the Patient: Cerebrovascular Accident (Stroke)

236

(1)

VI. Exercise to Reduce Falls

237

(2)

VII. Issues to Consider When Interpreting the Literature

239

(2)

VIII. Summary

241

(1)

References

242

(5)

Section III. Gait Disorders in Specific Disease Groups: Assessment and Intervention

13. Clinical Gait Analysis in Neurology

247

(26)

Meg Morris, Belinda Bilney, Karen Dodd, Sonia Denisenko, Richard Baker, Fiona Dobson, and Jennifer McGinley

I. Gait Analysis in People with CP

248

(3)

II. Classifications of Gait Patterns Using Gait Analysis in CP

251

(3)

III. Gait Analysis in PD and HD

254

(3)

IV. Huntington's Disease

257

(1)

V. Gait Analysis in Stroke

258

(4)

VI. Summary and Conclusions

262

(1)

References

262

(11)

14. Treatment of Parkinsonian Gait Disturbances

273

(16)

Nir Giladi and Yacov Balash

I. Introduction

273

(1)

II. Treatment of Gait Disturbances in the Early Stages of Parkinsonism

274

(4)

III. Treatment of Gait Disturbances in the Advanced Stages of Parkinsonism

278

(5)

IV. Conclusions

283

(1)

References

283

(6)

15. Treatment of Axial Mobility Deficits in Movement Disorders

289

(20)

Bastiaan R. Bloem, Elf K. Orhan, and Frank-Erik De Leeuw

I. Introduction

289

(1)

II. Extrapyramidal Syndromes

290

(7)

III. Cerebrovascular Disorders

297

(4)

IV. Normal Pressure Hydrocephalus

301

(1)

V. Conclusions

302

(1)

References

303

(6)

16. Systems Approach to Gait Rehabilitation Following Stroke

309

(30)

Anouk Lamontagne and Joyce Fung

I. Introduction and Background

309

(3)

II. Treadmill Training

312

(3)

III. Weight Supported Locomotor Training

315

(6)

IV. Speed-Intensive Walking

321

(5)

V. Sensory Cues and Balance Adjustment During Locomotion

326

(4)

VI. Concluding remarks

330

(1)

References

330

(9)

17. Optimizing Gait in Peripheral Neuropathy

339

(22)

James K. Richardson

I. Challenge of Walking and Importance of Somatosensory Information

339

(1)

II. Epidemiology and Clinical Identification of Peripheral Neuropathy

340

(1)

III. Static Balance and PN

341

(1)

IV. Effect of PN on Mobility

342

(1)

V. Peripheral Neuropathy and Fall Risk

343

(1)

VI. Afferent and Efferent Impairments Associated with PN

344

(4)

VII. Which Patients with PN Are More Likely to Fall?

348

(1)

VIII. Clinical Evaluation of Balance

348

(1)

IX. Evaluation of Gait

349

(2)

X. General Recommendation and Interventions

351

(4)

XI. Summary

355

(1)

References

355

(6)

18. Posthip Fracture and Hip Replacements

361

(18)

Jeremy A. Idjadi, Kenneth Koval, and Joseph D. Zuckerman

I. Introduction

361

(1)

II. Goals

362

(1)

III. Preoperative

362

(2)

IV. Intraoperative

364

(1)

V. Postoperative

365

(8)

VI. Summary

373

(1)

References

373

(6)

19. Optimizing Gait in Older People with Foot and Ankle Disorders

379

(20)

Hylton B. Menz and Stephen R. Lord

I. Introduction

379

(1)

II. Prevalence and Consequences of Foot Problems in Older People

380

(1)

III. Evaluation of Foot and Ankle Problems in Older People

381

(1)

IV. Common Musculoskeletal Foot and Ankle Problems that Can Affect Balance and Gait

382

(5)

V. Foot Problems Associated with Systemic Disease

387

(2)

VI. The Role of Footwear and Foot Orthoses

389

(2)

VII. Conclusions

391

(1)

References

391

(8)

Index

399

(8)

About the Editors

407

(2)

About the Book

409

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