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The critical element in the Get Up & Go Test is:
A. Agility
B. Balance
C. Flexibility
D. Path
E. Time
Agility
Balance
Flexibility
Path
Time
Timed Get Up and Go Test (TGUAGT): The TGUAGT is one of the most commonly used tests of gait and balance. The TGUAGT begins by observing the patient rising from the chair to stand. The patient walks at their usual pace 3 meters, turns around, walks back to the chair and sits down. Time of <20 seconds = independent for transfers and mobility; while time of >30 seconds suggests increased risk for falls and dependence.
An 80 year old patient is seen for a routine exam. An annual gait evaluation with a Timed Get Up and Go Test is performed. Her time is < 20 seconds. The most likely prediction from this result is increased:
A. Dependency
B. Transferability
C. Risk likelihood neurological dependency
D. Falls risk
Dependency
Transferability
Risk likelihood neurological dependency
Falls risk
GUAGT time <20 seconds = independent for transfers and mobility; while times of >30 seconds suggest increased risk for falls and dependence.
A comprehensive gait assessment includes (check all that apply - 1 point each)
A. Babinski
B. Endurance
C. Finger to Nose Test
D. Romberg
E. Standing Balance
Babinski
Endurance
Finger to Nose Test
Romberg
Standing Balance
A comprehensive and qualitative gait assessment includes: o Preliminary evaluation: To assess gait, begin with a general neurologic test looking at cranial (including visual fields and acuity), cerebellar (heel to shin, Rhomberg), and peripheral nervous systems, paying additional attention to foot sensation, proprioception (great toe position sense, 10g monofilament, vibratory), and function. Look for musculoskeletal abnormalities and deformities, particularly of the foot and lower extremities and the spine. o Endurance: Observe the patient for signs of fatigue or for comorbid problems that compromise walking. o Standing and balance: Observe how the patient rises (need to use arms to push off, or balance problems rising) and stands (with or without support). Ask the patient to stand with eyes closed, and to turn 360 degrees. o Walking: Observe how the patient begins to walk (i.e. hesitancy or multiple attempts), the step height for feet, foot clearance (looking for foot drop), step symmetry between right and left sides, and the speed of the gait. Look for signs of path deviation and need to use adaptive equipment to maintain a straight path. Look at the posture and trunk for evidence of swaying, flexion, arm swing, and stability. Assess tandem and heel walking gaits.
Comprehensive gait assessment DOESN'T include:
A. Endurance
B. Allen Test
C. Romberg
D. Standing balance
Allen Test
1. A comprehensive and qualitative gait assessment includes: o Preliminary evaluation: To assess gait, begin with a general neurologic test looking at cranial (including visual fields and acuity), cerebellar (heel to shin, Rhomberg), and peripheral nervous systems, paying additional attention to foot sensation, proprioception (great toe position sense, 10g monofilament, vibratory), and function. Look for musculoskeletal abnormalities and deformities, particularly of the foot and lower extremities and the spine. o Standing and balance: Observe how the patient rises (need to use arms to push off, or balance problems rising) and stands (with or without support). Ask the patient to stand with eyes closed, and to turn 360 degrees. o Walking: Observe how the patient begins to walk (i.e. hesitancy or multiple attempts), the step height for feet, foot clearance (looking for foot drop), step symmetry between right and left sides, and the speed of the gait. Look for signs of path deviation and need to use adaptive equipment to maintain a straight path. Look at the posture and trunk for evidence of swaying, flexion, arm swing, and stability. Assess tandem and heel walking gaits. o Endurance: Observe the patient for signs of fatigue or for comorbid problems that compromise walking.