New+Old=complicated

Dengan nama Allah yg Maha Pengasih & Maha Penyayang
Selawat & salam ke atas Rasulullah S.A.W,keluarga & para sahabatnya

Otak tepu = complication from new topic + old topic

Moral of the story = recall always & do revisions,be prepared aspecially for HKL!!!

05/01/10
Cardiorespiratory III
Introduction to intensive care unit (ICU)

*recall CRII
1)Chest physiotherapy,manual physiotherapy technique (postOP.preOP)
-BC,TEE,TEE&progression,resisted breathing exs,ACBT,localize breathing,huffing& coughing with wound support,TME,bed mobility,ambulation,postural awareness,adjuct~~

BLA..BLA..bla

Neuro (new topic for this sem,the most kenchang!!!)
to many assessment form + assignment to do during clinical


06/01/10
Neuro...cont GAIT
Madam Liza = headache Madam Mala = ok but sleepy

NORMAL GAIT + ABNORMAL GAIT

*recall GAIT
1)Gait cycle
-2phase : stance phase & swing phase
-1cycle consist of : 2initial contact for the same foot
-when double stance?? preswing during toe off,heel strike
-when single stance??
-what the thing that we must observe??? : time interval(...) + step length + stride length + width + quality of movement + ....

Scissor gait
Scissor gait is a form of gait abnormality primarily associated with spastic cerebral palsy. It is associated with an upper motor neuron lesion.
This gait pattern is reminiscent of a marionette. Hypertonia in the legs, hips and pelvis means these areas become flexed, to various degrees, giving the appearance of crouching, while tight adductors produce extreme adduction, presented by knees and thighs hitting or crossing in a scissors-like movement, while the opposing muscles, the abductors, become comparatively weak from lack of use. Most common in patients with spastic cerebral palsy, usually diplegic and paraplegic varieties. The individual is forced to walk on tiptoe unless the plantarflexor muscles are released by an orthaepedic surgical procedure.
These features are typical, and usually result in some form and to some degree regardless of the mildness or severity of the spastic CP condition.
-rigidity and excessive adduction of the leg in swing
-plantar flexion of the ankle
-flexion at the knee
-adduction and internal rotation at the hip
-progressive contractures of all spastic muscles
-complicated assisting movements of the upper limbs when walking
When not severe enough to interfere significantly with movement, function, longevity, energy levels or comfort, the scissor gait may be considered to be little more than a different walking "style".

Antalgic gait
Antalgic gait is a form of gait abnormality.
In it, the individual favors certain motions to avoid acute pain. [1]
Conditions associated with an antalgic gait
•Trauma
•Osteoarthritis
•Pelvic girdle pain
•Coxalgia
•tarsal tunnel syndrome

Cerebellar ataxia
Cerebellar ataxia is a form of ataxia originating in the cerebellum.
Romberg's test can be used to distinguish cerebellar ataxia from other forms of ataxia.

Festinating gait
Festinating gait (or Parkinsonian gait) is a form of gait abnormality.
Presentation : The patient moves with short, jerky steps. Term derives from Latin "festino", or "to hurry". The patient has difficulty starting, but also has difficulty stopping after starting. This is due to muscle hypertonicity.
Associated conditions with Parkinson's disease

Pigeon gait
Pigeon gait is a form of gait abnormality.
Presentation : Torsional abnormalities. (Hip dysplasia)

Propulsive gait
Propulsive gait is a form of gait abnormality.
Presentation : Stiff, with head and neck bent.
Conditions associated with a propulsive gait
-Carbon monoxide poisoning
-Parkinson's disease[2]
-Manganese Toxicity

Steppage gait
Steppage gait (High stepping, Neuropathic gait) is a form of gait abnormality. It is associated with a loss of dorsiflexion. It can be caused by damage to the peroneal nerve.
Presentation: Toes point down.
Conditions associated with a steppage gait
-Polio
-Multiple sclerosis
-Guillain-Barré
-Spinal disc herniation
-Peroneal Muscle Atropy
-Peroneal nerve Injury

Stomping gait
Stomping gait (or sensory ataxia gait) is a form of gait abnormality.
Presentation: Uncoordinated walking
Conditions associated with a stomping gait
-Friedreich's ataxia
-Pernicious anemia
-Tabes dorsalis
-Peripheral neuropathy
-Spinal cord disease
-Multiple sclerosis

Spastic gait
Spastic gait is a form of gait abnormality.
Among the treatment options is chemodenervation.[1]
Presentation
Asymmetric foot dragging.
Conditions associated with a spastic gait
-Brain tumor
-Brain abscess
-Sturge-Weber syndrome
-Cerebral palsy
-Cerebrovascular accident
-Multiple sclerosis

Myopathic gait
Myopathic gait (or waddling gait) is a form of gait abnormality.
The "waddling" is due to the weakness of the proximal muscles of the pelvic girdle. The patient uses circumduction to compensate for gluteal weakness.Conditions associated with a myopathic gait
-Pregnancy
-Congenital hip dysplasia
-Muscular dystrophy
-Spinal muscle atrophy

Magnetic gait
Magnetic gait is a form of gait abnormality.
Presentation: Feet seem attached to floor as if by a magnet. In magnetic gait, each step is initiated in a "wresting" motion carrying feet upward and forward. Magnetic gait can be visualized in terms of a powerful magnet being forcefully pulled from a steel plate.
Associated conditions
-Normal pressure hydrocephalus (NPH)

Trendelenburg gait
The Trendelenburg gait is an abnormal gait caused by weakness of the abductor muscles of the lower limb, gluteus medius and gluteus minimus. People with a lesion of superior gluteal nerve have weakness of abducting the thigh at the hip. This type of gait may also be seen in L5 radiculopathy and after poliomyelitis, but is then usually seen in combination with foot drop.
During the stance phase, the weakened abductor muscles allow the pelvis to tilt down on the opposite side. To compensate, the trunk lurches to the weakened side to attempt to maintain a level pelvis throughout the gait cycle. The pelvis sags on the opposite side of the lesioned superior gluteal nerve.

Crouch gait????...not sure,tricep with quad???..better ask madam Liza=P
Crouch gait, a gait pattern characterized by excessive knee flexion in terminal swing and stance, is a frequently observed gait deviation among children with diplegia. No unambiguous definition of crouch gait is present in the literature (Perry, 1992).
Increased knee flexion and ankle hyperdorsiflexion occur during stance phase. They occur in older children and after isolated triceps lengthenings that have been performed without addressing the spastic hamstrings. Hip flexors and hamstrings are tight, and quadriceps and triceps are weak (Gage & Novacheck, 2001).

Physiotherapy intervention
1)gait training
2)strength training
3)stretching
4)eliciting of muscle contraction
5)maximazing skill
bla...bla..bla...

ASSIGNMENT!!!!

Lastly = very stress + tired + lapar + miss my F.A.M.I.L.I.A. + miss pondok hatiku + miss my meow tomei2 + rest?? + sleep?? Zzz + study!!! + sick + .....

DREAM IT & ACHIEVE IT