Michel (Shelly) Denes – Gait & Balance: Quick, Effective & Evidence-Based Therapeutic Solutions

Outline

Quick Tips to Recognize Normal vs. Abnormal Gait Patterns

• Identify where the “breakdowns” occur in normal gait patterns
• What should gait look like? Video examples and demonstrations

Screening Tests & Solutions for Changes in Gait

• Advanced visual assessment techniques
  • Gait speed & cadence changes
  • Double stance time
  • Walking posture
  • Joint motion
  • Muscle strength & muscle tone (Spasticity and Rigidity)
• Video motion analysis and 3D kinematics
• Dynamic surface electromyography
• Dynamic fine wire electromyography

Strategies to Identify the Manifestations & Underlying Causes of Abnormal Gait Patterns

• Pathological gait disorders
• Orthopedic issues
• Musculo-skeletal issues
• Neurological issues
• Pain issues
• Fear of falling

Documentation, Goal Writing, Outcome Expectations and Discharge Planning

• Long- & short-term goal writing tips
• Intensity, frequency and duration of care documentation
• Progress reports: how to get paid & avoid payment denials
• Treatment encounter notes
• Maintenance services: justification tips
• Examples of documentation essentials

CUTTING-EDGE SOLUTIONS FOR GAIT DYSFUNCTIONS IN COMMON CONDITIONS

Parkinson’s Disease

• The “Parkinson’s Shuffle”
• Techniques that minimize “freezing”
• Enriching exercise with simultaneous activities

Multiple Sclerosis

• Techniques to address ataxia issues
• Treatment strategies for relapses or flares
• Benefits of aquatic therapy
• Benefits of Tai Chi and Yoga for gait and balance

Stroke

• Strategies to reteach walking
• Training for family and caregivers
• Functional electrical stimulation (FES)
• Techniques to address Trendelenburg gait
• Exercises to strengthen muscles
• Appropriate assistive devices

Hip & Knee Replacement Rehabilitation

• Techniques to immediately address post-op gait
• Interventions to regain range of motion post-op
• Cautionary considerations: Trendelenburg gait

Leg-Length Discrepancies

• When to correct, and when not
• Testing considerations for muscle imbalance & functional limb-length issues

Indications and Biomechanics for the use of Orthotics

• Weakness at specific joints
• Correction for alignment issues
• Orthotics for LE collapsing even without foot-drop
• Utilizing combined orthotics in unique situations