Self-Assessment: Muscle US: Quantitative Assessment & Patterns of Muscle Involvement | Gait Analysis & Orthotics for NMDs-Gait Analysis & Orthotics for NMDs: Dr. Tan Presentation

Gait Analysis & Orthotics for NMDs: Dr. Tan Presentation

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The document is a presentation by Dr. Faye Chiou Tan, focusing on the approach to gait issues in adult-onset neuromuscular (NM) disorders for a 2024 session. It covers several key areas: normal gait, gait in NM disorders, and the influence of gait aids and orthotics.<br /><br />The presentation begins by describing normal human gait as a process of controlled falling, which requires the maintenance of balance while moving the body forward. A crucial aspect of gait efficiency is minimizing the movement of the center of gravity (COG), as any excess movement can result in unnecessary energy expenditure. This is particularly challenging for individuals with NM disorders due to their limited energy reserves.<br /><br />Dr. Tan outlines the six determinants of gait proposed by Saunders et al. in 1953, which include pelvic rotation, pelvic obliquity, lateral displacement of the pelvis, knee flexion, knee extension, and ankle/foot mechanisms. These factors help in energy conservation by reducing COG movement.<br /><br />Understanding the gait cycle involves differentiating between the stance and swing phases, focusing on muscle activity. Eccentric muscle contractions occur mostly during the stance phase to decelerate and stabilize the limb, while concentric contractions dominate the swing phase, providing acceleration.<br /><br />Gait patterns in NM disorders differ based on muscle weakness—proximal or distal. Patients with proximal muscle weakness, such as in myopathies, may exhibit a waddling gait or use compensatory mechanisms like hip leaning, while those with distal weakness, such as in neuropathies, may experience foot slap or resort to laborious gait strategies like steppage gait.<br /><br />The discussion extends to more complex NM disorders, combining both proximal and distal weaknesses, their impacts on gait, and the associated fall risks. The session emphasizes awareness of these patterns and possible management strategies to improve mobility and safety in individuals with NM diseases.

Keywords

gait issues

neuromuscular disorders

normal gait

gait aids

orthotics

proximal muscle weakness

distal muscle weakness

gait cycle

energy conservation

fall risks