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Gait analysis and stroke rehab


dreinke

975 views

I know that this is stepping on PT responsibilities but I think that all PTs and OTs should have to produce something like this for their patients. Take this with a grain of salt, I do not intend this as medical advice, but education for yourself so you can be a better patient.

 

When I first got out of the hospital, still in a wheelchair I would sit staring at people walking to see what they were doing right that I couldn't do. My PTs did not have any videos of human gait that would have helped me understand where I was going wrong, all I got was do it this way with no breakdown into smaller pieces. I finally fired that PT and went to one that could at least see what was going wrong. here are some videos I found on the internet if you want to try and look at them and improve on your own.

 

Also read a complete textbook on human gait, way over my head but at least it gave me a few muscle groups to strengthen at the gym. I still waddle but the leg swing out is significantly reduced.

 

Gait Analysis: Normal and Pathological Function

by Jacquelin Perry, Bill Schoneberger

 

Besides a human walking there is a model you can slow down, speed up and turn

 

http://www.frontiernet.net/~Imaging/gait_model.html

 

http://library.med.utah.edu/neurologice ... ormal.html Movies from the NeuroLogic Exam and PediNeuroLogic Exam websites are used by permission of Paul D. ****, M.D., University of Nebraska Medical Center and Suzanne S. Stensaas, Ph.D., University of Utah School of Medicine. Additional materials were drawn from resources provided by Alejandro Stern, Stern Foundation, Buenos Aires, Argentina; Kathleen Digre, M.D., University of Utah; and Daniel Jacobson, M.D., Marshfield Clinic, Wisconsin. The movies are licensed under a Creative Commons Attribution-NonCommerical-ShareAlike 2.5 License.

 

Biomechanics of gait walking

http://www.utoledo.edu/hshs/kinesiology/pdfs/Biomech_of_Walking_and_Running.ppt#257,2,Biomechanics of Gait Walking

 

http://www.cse.ohio-state.edu/research/ ... index.html

 

A comparison of normal and stiff-legged gaits.This one even includes some stair walking

 

 

Contains the skeleton walking

 

http://www.youtube.com/watch?v=8s0FY4D_ ... re=related

 

Biomechanics of the foot http://www.footkneepain.com.au/

 

Primal Pictures human anatomy demo

 

sitting to standing, toe flexing, head turning

 

http://www.youtube.com/watch?v=1Ohpyc2K ... re=related

 

Some free demos available here

 

http://www.anatomy.tv/

 

animated gait in slow motion

 

http://www.nsf.gov/news/mmg/media/media/gait_final1.swf

 

movement analysis here go to site map/gallery

 

http://www.musculographics.com/index.html

 

demo video looks good I wish all therapy depts. could have this in order to break down exactly what stroke survivors are doing wrong so the indivdual pieces could be corrected.

 

http://kine.is/modules.php?op=modload&n ... load&cid=2

 

This gives the various phases of gait

 

http://moon.ouhsc.edu/dthompso/gait/intro.htm

 

A lot of this is very pertinent to me because my pre-motor cortex is dead, which means planning of complicated movements is not being automatically done so I have to manually think about and fire the individual muscles. Of course this is my own self diagnosis, which the patient should never do.

 

http://www.lowerextremityreview.com/news/in-the-moment-stroke

 

Now if we could get the 3d movements and stroke rehab mapped to standard walking then we might get to where a damage diagnosis could be correlated with the therapy prescriptions.

http://oc1dean.blogspot.com/2011/01/3d-movements-and-stroke-rehab.html

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Dean: when I read this blog, I got up, poured myself a glass of wine, which I should not do. I am dealing with some house structural problems here with the snow, ice and yet another storm due tonight and a blizzard due Tuesday. But again, you hit that spot and I said, for my guy, I will need a bit of relaxation.

 

Bruce's affected hip is rotated out. His affected foot is turned on its side, inward. The long leg brace held the thigh in proper position, but he can no longer wear that due to the spasticity. The AFO holds the foot in proper position, but the issue is with the hip-femur=largest bone in the body, holds the most weight and is messed up. Personally I think it goes even further to the severe arthritis just diagnosed in his lower spine.

 

Bruce's gait is odd to say the least, but his balance is good and he accomodates the improper position as best he can. Like you, he has found what works for him. Drove all his PTs crazy, but if and when he decides on the Baclofen pump, and then he will have to learn to walk all over again, this is what we have.

 

Personally, honey, at this point I don't think he will ever walk more than a few feet again. Mentally has just given up. But that is not the issue here.

 

I, like you, reviewed many videos of proper body weight distribution, muscle to bone interaction and weight distribution. We are talking about the major body weight maintenance in the body.

 

I will certainly take a look at your suggested sites with much interest. Thanks, Debbie

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Dean: You sure did a lot of research on gait. I had a bi-lateral brain-stem stroke which I lived thru but my gain is off, mainly left side affected. The videos helped me a lot. I think I need to pay more attention to heal-toe movement and exercise by walking slower to get it "right". My neuro said my brain isn't communicating with my left leg muscles to pull the leg up but I'm still working on trying to prove him wrong. Thanks for posting. Leah

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Dean,

You got it right!!!

Thank you for sharing all of your research.

I will be perusing all of the sights.

I agree with you. This is what PT's should do.

 

I find all of your posts very helpful.

Ruth

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