05-08: Gait Flashcards
1
Q
Phases of Gait (2)
A
- Stance Gait
- Swing Gait
2
Q
Stance Gait
A
- Stability Phase
- 60% of gait cycle
- Foot is in contact with the ground; starts when one heel hits the ground, ends when that foot leaves the ground
3
Q
Swing Gait
A
- 40% of gait cycle
- Starts when toe of one LE leaves the ground, ends when heel of same LE hits the ground
4
Q
Standard terminology - Stance (spot)
A
- Heel strike
- Foot flat
- Midstance
- Heel off
- Toe off
5
Q
Rancho Los Amigos - Stance (mobility)
A
- Initial contact
- Loading response
- Midstance
- Terminal stance
- Pre-swing
6
Q
Foot slap
A
- Impairments
- Happens if dorsiflexors (tibialis anterior) are impaired
7
Q
Standard Terminology - Swing
A
- Acceleration
- Midswing
- Deceleration
8
Q
Rancho Los Amigos - Swing
A
- Initial swing
- Midswing
- Terminal swing
9
Q
Heel Strike (ST)
A
Instant heel touches the ground to the beginning of stance phase
10
Q
Foot Flat (ST)
A
Entire foot makes contact with the ground
11
Q
Midstance (ST)
A
Entire body weight is directly over the stance limb
12
Q
Heel off (ST)
A
Heel of stance limb leaves the ground
13
Q
Toe off (ST)
A
Only toe of the stance limb remains on ground
14
Q
Acceleration (ST)
A
Toe off is complete and the reference limb swings until positioned directly under the body
15
Q
Midswing (ST)
A
Swing limb is directly under the body
16
Q
Deceleration (ST)
A
Swing limb begins to extend and ends just prior to heel strike
17
Q
Initial contact (RLA)
A
- Foot touches the ground
- H = 30˚ Flexion, K = 0˚, A = 0˚, T = 0˚
18
Q
Loading response (RLA)
A
- The period of time between initial contact and the beginning of the swing phase for the other leg
- H = 25˚ Flexion, K = 15˚ Flexion, A = 10˚ Plantar flexion, T = 0˚
19
Q
Midstance (RLA)
A
- The point when other foot is off the floor until the body is directly over the stance limb
- H = 0˚, K = 0˚, A = 5˚ Dorsiflexion, T = 0˚
20
Q
Terminal Stance (RLA)
A
- Begins when stance limb’s heel rises and ends when the other foot touches the ground
- H = 10˚ Extension, K = 0˚, A = 10˚ Dorsiflexion, T = 30˚ MTP Extension
21
Q
Pre-Swing (RLA)
A
- Begins when the other foot touches the ground and ends when the stance foot reaches toe off
- H = 0˚, K = 40˚ Flexion, A = 20˚ Plantar flexion, T = 60˚ MTP Extension
22
Q
Initial Swing (RLA)
A
- Begins when stance leg lifts from the floor and ends when maximal knee flexion during swing
- H = 15˚ Flexion, K = 60˚ Flexion, A = 10˚ Plantar flexion, T = 0˚
23
Q
Midswing (RLA)
A
- Begins when maximal knee flexion during swing and ends when the tibia is perpendicular to the ground
- H = 25˚ Flexion, K = 25˚ Flexion, A = 0˚, T = 0˚
24
Q
Terminal Swing (RLA)
A
- Begins when the tibia is perpendicular to the ground and ends when the foot touches the ground
- H = 35˚ Flexion, K = 0˚, A = 0˚, T = 0˚
25
Tibialis Anterior (Peak activity)
- Just after heel strike
| - Eccentric lowering of the foot into plantarflexion
26
Gastroc-Soleus Group (Peak activity)
- Late stance phase
| - Concentric raising of the heel during toe off
27
Quadriceps Group (Peak activity)
- 1st: Single limb support during stance phase
| - 2nd: Just before toe off to initiate swing phase
28
Hamstring Group (Peak activity)
- Last part of swing phase
| - Deceleration of the unsupported limb
29
ROM Requirements (Gait)
- Hip Flexion: 0-35˚
- Hip Extension: 0-10˚
- Knee Flexion: 0-60˚
- Knee Extension: 0˚
- Ankle dorsiflexion: 0-10˚
- Ankle plantar flexion: 0-20˚
30
Gait Cycle
Sequence of motions that occur from one initial contact of the heel to the next consecutive initial contact of the same heel
31
Base of Support/Width of Walking Base/Step Width
- Distance measured b/t the midpoints of heel contact of the L foot and R foot during consecutive steps in gait
- Distance decreases as cadence increases
- Avg. adult step width = 2-4 inches (5-10 cm)
32
Step Length
- Distance measured b/t R heel strike and L heel strike
- Includes double support, single support, stance and swing of one LE
- Avg. adult step length = 13-16 inches
33
Stride Length
- Distance measured b/t R heel strike and the following R heel strike
- Avg. adult stride length = 26-32 inches
34
Cadence
- Walking speed
- Number of steps a person will walk over a period of time
- Walking slowly = increases time both feet on ground
- Walking quickly = decreases time both feet on ground
- Avg. adult cadence = 110-120 steps per minuteea
35
Walking velocity
- Rate of linear forward motion of the body
- Walking velocity = distance/time
- Recorded in meters per second, feet per second, etc.
36
Single limb phase/support
Only one foot is on the ground and occurs twice during a single gait cycle
37
Double limb phase/support
- Both feet are on the ground at the same time
- Time of double limb support increases as speed of gait increases
- Does not exist during running
- Occurs twice during the gait cycle
38
Degree of toe-out
- Angle formed by each foot's line of progression and a line of intersecting the center of the heel and second toe
- Avg. adult degree of toe-out = 7˚
39
Pelvic rotation
- Rotation of the pelvis opposite to the thorax
- Maintains balance, regulates speed
- Avg. adult = 8˚ (4˚ forward, 4˚ backward), with stance leg
- Counter rotation of thorax helps maintain balance
40
Arm swing during gait
- Help maintain balance
- Opposite UE and LE simultaneously
- Can be altered by Ue injury, trunk rotation problem or LE limitation
41
COG during gait
- Moves vertically and horizontally displaced equally around 2" each
- Pelvic lateral tilt up and down (frontal plane) minimizes displacement of COG
42
Antalgic gait
- "Painful gait"
- Protective gait pattern: Shortened stance time; fast, short step on uninvolved side
- Involved step length is decreased: Avoid WB on involved side b/c of pain
43
Ataxia
- Wide BOS
- Jerky, unsteady movements
- Difficulty walking in straight line; staggering
- Drunken sailor
44
Circumduction
- Circular motion to advance the LE during swing phase
- Compensates for insufficient hip flexion, knee flexion, dorsiflexion
- Limb can be too long
45
Double step
- Alternate steps are of different length or different rate
| - Not a controlled gait pattern
46
Equine (or Equinus) gait
- High steps
| - Caused by excessive gastroc activity or leg length descrepancy (LLD)
47
Festinating gait
- Starts slow, increases and may continue until pt grasps an objective
- Difficulty controlling acceleration and deceleration
- Pt might progress to walking to toes
48
Parkinsonian gait
- Shuffling gait
- Flexed trunk ( --> fwd COG), flexed LEs, decreased UE swing, decreased stride length
- Short rapid steps --> attempt to regain balance and prevent falling
- Impaired initiation of movement
49
Scissor gait
- Legs cross midline when advanced
| - Caused by spastic hip adductors
50
Spastic gait
- Stiff movement
| - Toes catch and drag, LE adducted, hip and knee joints slightly flexed
51
Foot drop
- "Steppage Gait"
- Deep peroneal nerve impairment
- Inability to clear foot during swing b/c DF weakness
- Compensate with excessive hip and knee flexion to advance the LE
Foot slaps on initial contact ---> decrease control
52
Trendelenburg gait
- Usually gluteus medius weakness
| - Excessive lateral trunk flexion and WS over stance LE
53
Vaulting
- Uninvolved stance LE elevates at pelvis and PF to allow the involved LE to swing and advance
- Vault on short side, or side that can't flex
54
Crouch gait
- Limited trunk rotation
| - Lumbar lordosis, anterior pelvic tilt, hip and knee flexion, ankle plantar flexion, exaggerated arm swing
55
Rocking horse gait
- Caused by gluteus maximus weakness
- Hip tends to go into flexion during stance without good stabilization by hip extensors
- Trunk shifts posterior to compensate
- Excessive forward and backward trunk shifting resembles rocking horse
56
Quadriceps weakness gait
- Inability to extend knee during stance
| - Compensates with trunk forward flexion and plantar flexion --> knee hyperextension
57
Hamstring weakness gait
- Both stance and swing affected
- Stance: Knee in genu recurvatum (pushed backward)
- Swing: During deceleration, knee slaps into extension b/c hamstring not strong enough to slow down the forward swing of the LE
58
Foot slap
- Foot slaps on the ground during heel strike
| - Weak dorsiflexors; ankle not able to suppport weight of body at heel strike
59
Waddling gait
- Shoulder behind hips
- Little or no reciprocal pelvis or trunk rotation
- Compensation of excessive lateral WS to advance LE
- Often accompanied by lumbar lordosis and foot drop
- Seen in Muscular dystrophy
