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DPT707: Kine 2 > 1 - Typical Gait Patterns > Flashcards

1 - Typical Gait Patterns Flashcards

1
Q

What features are identified in the Sagittal plane? (3)

A
  1. Stride length
  2. Cadence
  3. Speed
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2
Q

What features are identified in the Frontal plane? (1)

A

Size of the Base of Support

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3
Q

What features are identified in the Transverse plane?

A

Foot Progression Angle

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4
Q

Define a Stride.

A

One cycle of walking is a stride (the time and distance between the heel contact of one foot and that of the same foot)

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5
Q

Each cycles of walking is composed of how many steps?

A

Two (the time and distance between the heel contact of one foot and that of the opposite foot.

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6
Q

Define Cadence

A

The number of steps taken per minute.

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7
Q

What is the size of the base of support also called?

A

stride width or interfoot distance

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8
Q

Define Stride Width

A

the distance between the middle of the right foot and middle of the left foot in phases of double limb support.

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9
Q

In adults, what does stride width vary from?

A

3-9cm

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10
Q

Define Foot Progression angle

A

The angle between the line of progression and the alignment of the second ray of the foot.

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11
Q

In adults, the foot progression angle is

A

approximately 7 degrees of out-toeing (positive foot progression angle)

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12
Q

Why do children have greater variability in foot progression angle?

A

because of differences in tibial torsion and femoral antetorsion.

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13
Q

Usually prepubescent children have (LESS/MORE) out-toeing than post-pubescent children.

A

Usually prepubescent children have LESS out-toeing than post-pubescent children.

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14
Q

Children around 4 years of age have _ degrees of out-toeing while children around 16 years of age have _ degrees of out-toeing.

A

2 and 7

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15
Q

What are the four groups of phases of walking?

A
  1. Weight Acceptance
  2. Single Limb Support
  3. Early Swing Limb Advancement
  4. Late Swing Limb Advancement
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16
Q

During phases of weight acceptance, what is primarily happening? (2)

A
  1. the body’s weight is transferred to the reference limb.

2. shock absorption is important during weight acceptance to ensure efficient energy transfer.

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17
Q

Weight acceptance phases include:

A
  1. Initial Contact

2. Loading Response

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18
Q

What is primarily happening during phases of single limb support? (3)

A
  1. The body passes over a stationary foot.
  2. During these phases a single limb supports the body.
  3. The body moves in front of the reference limb.
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19
Q

Single Limb Support phases include:

A
  1. Midstance

2. Terminal Stance

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20
Q

During phases of Early Swing Limb Advancement, what is primarily happening?

A
  1. the reference limb generates momentum through forward propulsion
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21
Q

What two steps are required to advance the swing limb?

A
  1. Initially, this involved pushing off the surface

2. followed by limb clearance strategies (rapid flexing of the reference limb)

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22
Q

Early Swing Limb Advancement phases include:

A
  1. Preswing

2. Initial Swing

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23
Q

During phases of Late Swing Limb Advancement, what is primarily happening?

A

the reference limb is decelerated

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24
Q

Late Swing Limb Advancement phases include:

A
  1. Midswing

2. Terminal Swing

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25
Q

What are the 8 phases of gait?

A
  1. Initial Contact
  2. Loading Response
  3. Midstance
  4. Terminal Stance
  5. Preswing
  6. Inital Swing
  7. Midswing
  8. Terminal Swing
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26
Q

What is happening during Initial Contact

A

Foot contacts the ground

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27
Q

What is happening during Loading Response?

A

Body weight is transferred to the reference limb and shock is absorbed on a flexed limb.

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28
Q

What is happening during Midstance?

A

Body moves over a station foot and balance on one foot is maintained.

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29
Q

What is happening during Terminal Stance?

A

Body progresses past the stationary foot and balance is maintained.

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30
Q

What is happening during Preswing?

A

Generation of momentum for forward propulsion for swing limb advancement.

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31
Q

What is happening during Initial Swing?

A

Clearance of swing limb.

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32
Q

What is happening during Midswing?

A

Deceleration of limb.

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33
Q

What is happening during Terminal Swing?

A

Extended limb for step length and preparation for loading.

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34
Q

How many critical events occur at the ankle, knee, and hip?

A

Ankle: 6
Knee: 4
Hip: 4

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35
Q

What 6 critical events occur at the Ankle?

A
  1. Heel first contact.
  2. Controlled Ankle Plantarflexion
  3. Controlled Tibial Advancement
  4. Controlled Ankle Dorsiflexion with heel rising
  5. Rapid Ankle Plantarflexion
  6. Dorsiflexion to Neutral
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36
Q

What 4 Critical Events occur at the Knee?

A
  1. Controlled Knee Flexion
  2. Passive knee Flexion to 40 degrees
  3. Maximum knee flexion to 60 degrees
  4. Knee extension to 0 degrees
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37
Q

What 4 Critical Events occur at the Hip?

A
  1. Maintenance of Hip Stability
  2. Trailing Limb Posture
  3. Hip Flexion to 15 degrees
  4. Hip Flexion to 25 degrees
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38
Q

What Critical Events happen during Initial Contact?

A
  1. Heel first contact.
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39
Q

What Critical Events happen during Loading Response?

A
  1. Controlled ankle plantarflexion
  2. Controlled knee flexion
  3. Maintenance of hip stability
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40
Q

What Critical Events happen during Midstance?

A
  1. Controlled tibial advancement (ankle is moving from plantarflexed to slightly dorsiflexed)
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41
Q

What Critical Events happen during Terminal Stance?

A
  1. Controlled ankle dorsiflexion with heel rising

2. Trailing limb posture (hip extension)

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42
Q

What Critical Events happen during Preswing?

A
  1. Rapid ankle plantarflexion (drives knee forward into..)

2. Passive knee flexion to 40 degrees

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43
Q

What Critical Events happen during Initial Swing?

A
  1. Maximum knee flexion to 60 degrees

2. Hip flexion to 15 degrees

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44
Q

What Critical Events happen during Midswing?

A
  1. Dorsiflexion to 0

2. Maximum hip flexion to 25 degrees

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45
Q

What Critical Events happen during Terminal Swing?

A
  1. Knee extension to 0 degrees
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46
Q

At Initial Contact, what are the kinematics of the Ankle?

A

0 - Neutral

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47
Q

At Initial Contact, what Muscle is activated at the Ankle?

A

Tibialis Anterior

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48
Q

At Initial Contact, what are the Kinetics at the Ankle?

A

GRF is Posterior

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49
Q

At Initial Contact, what Critical Event is happening at the ankle?

A

Heel first contact

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50
Q

At Initial Contact, what are the Kinematics at the Knee?

A

0-5 flexion

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51
Q

At Initial Contact, what Muscle is activated at the Knee?

A

Quadriceps

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52
Q

At Initial Contact, what are the Kinetics at the Knee?

A

GRF is Posterior (plantar moment)

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53
Q

At Initial Contact, what are the Kinematics at the Hip?

A

20 flexion

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54
Q

At Initial Contact, what are the Muscles activated at the hip?

A

Gluteus Maximus, Hamstrings

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55
Q

At Initial Contact, what are the Kinetics at the Hip?

A

GRF is anterior

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56
Q

At Initial Contact, what are the Kinematics at the Pelvis?

A

5 forward rotation

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57
Q

At Initial Contact, what are the Muscles activated at the Pelvis?

A

Gluteus Medius

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58
Q

At Initial Contact, what are the Kinematics at the Trunk?

A

Erect

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59
Q

At Initial Contact, what are the Muscles activated at the Trunk?

A

Trunk Extensors

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60
Q

At Loading Response, what are the Kinematics at the Ankle?

A

5 PF

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61
Q

At Loading Response, what are the Muscles activated at the Ankle?

A

Gastroc-soleus

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62
Q

At Loading Response, what are the Kinetics at the Ankle?

A

GRF is Posterior (plantar moment)

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63
Q

At Loading Response, what are the Critical Events at the Ankle?

A

Controlled Ankle Plantarflexion

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64
Q

At Loading Response, what are the Kinematics at the Knee?

A

15 flexion

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65
Q

At Loading Response, what are the Muscles activated at the Knee?

A

Quadriceps

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66
Q

At Loading Response, what are the Kinetics at the Knee?

A

GRF is Posterior

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67
Q

At Loading Response, what are the Kinematics at the Hip

A

20 flexion

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68
Q

At Loading Response, what are the Muscles activated at the Hip?

A

Gluteus Maximus, Hamstrings

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69
Q

At Loading Response, what are the Kinetics at the Hip?

A

GRF is Anterior

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70
Q

At Loading Response, what are the Critical Events at the Hip?

A

Hip stability

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71
Q

At Loading Response, what are the Kinematics at the Pelvis?

A

5 forward rotation

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72
Q

At Loading Response, what are the Muscles Activated at the Pelvis?

A

Gluteus Medius

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73
Q

At Loading Response, what are the Kinematics at the Trunk?

A

Erect

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74
Q

At Loading Response, what are the Muscles Activated at the Trunk?

A

Trunk Extensors

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75
Q

At Midstance, what are the Kinematics at the Ankle?

A

5 dorsiflexion

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76
Q

At Midstance, what are the Muscles Activated at the Ankle?

A

Gastroc-soleus

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77
Q

At Midstance, what are the Kinetics at the Ankle?

A

GRF through joint

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78
Q

At Midstance, what are the Critical Events happening at the Ankle?

A

Tibial Advancement

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79
Q

At Midstance, what are the Kinematics at the Knee?

A

0-5 Flexion

80
Q

At Midstance, what are the Kinetics at the Knee?

A

GRF goes through joint

81
Q

At Midstance, what are the Kinematics at the Hip?

82
Q

At Midstance, what are the Kinetics at the Hip?

A

GRF is through joint

83
Q

At Midstance, what are the Kinematics at the Pelvis?

A

0 rotation

84
Q

At Midstance, what are the Muscles Activated at the Pelvis?

A

Gluteus Medius

85
Q

At Midstance, what are the Kinematics at the Trunk?

86
Q

At Midstance, what are the Muscles Activated at the Trunk?

A

Extensors and Abdominals

87
Q

At Terminal Stance, what are the Kinematics at the Ankle?

A

10 dorsiflexion

88
Q

At Terminal Stance, what are the Muscles Activated at the Ankle?

A

Gastroc-soleus

89
Q

At Terminal Stance, what are the Kinetics at the Ankle?

A

GRF is anterior (dosi moment)

90
Q

At Terminal Stance, what are the Critical Events at the Ankle?

A

Controlled Ankle DF (with heel rise)

91
Q

At Terminal Stance, what are the Kinematics at the Knee?

A

0-5 flexion

92
Q

At Terminal Stance, what are the Kinetics at the Knee?

A

GRF is anterior

93
Q

At Terminal Stance, what are the Kinematics at the Hip?

A

20 hyperextension

94
Q

At Terminal Stance, what are the Kinetics at the Hip?

A

GRF is posterior

95
Q

At Terminal Stance, what are the Critical Events at the Hip?

A

Trailing Limb Posture

96
Q

At Terminal Stance, what are the Kinematics at the Pelvis?

A

5 backward rotation, 7 drop, 4 ant tilt

97
Q

At Terminal Stance, what are the Muscles Activated at the Pelvis?

A

Gluteus Medius

98
Q

At Terminal Stance, what are the Kinematics at the Trunk?

99
Q

At Terminal Stance, what are the Muscles Activated at the Trunk?

A

Extensors and Abdominals

100
Q

At Preswing, what are the Kinematics at the Ankle?

A

15 plantar

101
Q

At Preswing, what are the the Muscles Activated at the Ankle?

A

Gastroc-soleus

102
Q

At Preswing, what are the Kinetics at the Ankle?

A

GRF is anterior

103
Q

At Preswing, what are the Critical Events at the ankle?

A

Raid Ankle Plantarflexion

104
Q

At Preswing, What are the Kinematics at the Knee?

A

40 flexion

105
Q

At Preswing, what are the Kinetics at the Knee?

A

GRF is posterior

106
Q

At Preswing, what are the Kinematics at the Hip?

A

20 hyperextension

107
Q

At Preswing, what are the Muscles Activated?

A

Rectus femoris, iliopsoas, adductor longus

108
Q

At Preswing, What are the Kinetics at the Hip?

A

GRF is posterior

109
Q

At Preswing, what are the Kinematics at the Pelvis?

A

5 backward rotation, 4 ant tilt

110
Q

At Preswing, what are the Kinematics at the Trunk?

111
Q

At Preswing, what are the Muscles Activated at the Trunk?

A

Extensors and Abdominals

112
Q

At Initial Swing, what are the Kinematics at the Ankle?

113
Q

At Initial Swing, what are the Muscles Activated at the Ankle?

A

Tibialis Anterior

114
Q

At Initial Swing, what are the Kinematics at the Knee?

A

60 flexion

115
Q

At Initial Swing, what are the Muscles Activated at the Knee?

A

Quads and Hams

116
Q

At Initial Swing, what are the Critical Events at the Knee?

A

Knee flexion to 60

117
Q

At Initial Swing, what are the Kinematics at the Hip?

A

15 flexion

118
Q

At Initial Swing, what are the Muscles Activated at the Hip?

A

Rectus femoris, iliopsoas, adductor longus

119
Q

At Initial Swing, what are the Critical Events at the Hip?

A

Flexion to 15 degrees

120
Q

At Initial Swing, what are the Kinematics at the Pelvis?

A

5 backward rotation

121
Q

At Initial Swing, what are the Kinematics at the Trunk?

122
Q

At Initial Swing, what are the Muscles Activated at the Trunk?

A

Extensors and Abdominals

123
Q

At Mid Swing, what are the Kinematics at the Ankle?

124
Q

At Mid Swing, what are the Muscles Activated at the Ankle?

A

Tibialis Anterior

125
Q

At Mid Swing, what are the Critical Events at the Ankle?

A

Dorsiflex to neutral

126
Q

At Mid Swing, what are the Kinematics at the Knee?

A

25 flexion

127
Q

At Mid Swing, what are the Muscles Activated at the Knee?

A

Quads and hams

128
Q

At Mid Swing, what are the Kinematics at the Hip?

A

25 flexion

129
Q

At Mid Swing, what are the Muscles Activated at the Hip?

130
Q

At Mid Swing, what are the Critical Events at the Hip?

A

Flexion to 25

131
Q

At Mid Swing, what are the Kinematics at the Pelvis?

A

0 rotation

132
Q

At Mid Swing, what are the Kinematics at the Trunk?

133
Q

At Mid Swing, what are the Muscles Activated at the Trunk?

A

Abdominals

134
Q

At Terminal Swing, what are the Kinematics at the Ankle?

135
Q

At Terminal Swing, what are the Muscles Activated at the Ankle?

A

Tibialis Anterior

136
Q

At Terminal Swing, what are the kinematics at the knee?

A

0-5 flexion

137
Q

At Terminal Swing, what are the Muscles Activated at the Knee?

A

Quads and Hams

138
Q

At Terminal Swing, what are the Critical Events at the Knee?

A

Knee Extension

139
Q

At Terminal Swing, what are the Kinematics at the Hip?

A

20 flexion

140
Q

At Terminal Swing, what are the Muscles Activated at the Hip?

A

Gluteus Maximus, Hamstrings

141
Q

At Terminal Swing, what are the Kinematics at the Pelvis?

A

5 forward rotation

142
Q

At Terminal Swing, what are the Muscles Activated at the Pelvis?

A

Muscle Activation

143
Q

At Terminal Swing, what are the Kinematics at the Trunk?

144
Q

At Terminal Swing, what are the Muscles Activated at the Trunk?

A

Trunk Extensors

145
Q

Where does maximum ankle dorsiflexion occur and what degree is it at?

A

10 degrees and occurs at Terminal Stance

146
Q

Where does maximum ankle plantarflexion occur and what degree is it at?

A

15 degrees and occurs at Preswing

147
Q

Where does the largest positional change at the ankle occur between and what degrees?

A

10 degrees dorsiflexion at Terminal Stance to 15 degrees plantarflexion at Preswing.

148
Q

At what two groups of phases is the Tibialis Anterior active primarily and why?

A
  1. During weight acceptance to absorb shock

2. Swing limb advancement to clear the limb

149
Q

At what group of phases and phase is the Gastrocsoleus active primarily and why?

A
  1. Single Limb Support phases to stabilize the tibia

2. During preswing to promote knee flexion

150
Q

At what two phases does knee flexion primarily occur and why? Degrees?

A
  1. 15 degrees of knee flexion at loading response supports shock absorption
  2. 60 degrees of knee flexion at initial swing supports limb clearance.
151
Q

At what group of phases and phase are the hamstrings (biceps femoris) primarily active and why?

A
  1. Weight acceptance to stabilize the hip.

2. Terminal swing to decelerate the tibia.

152
Q

At what group of phases and phase are the quadriceps (vastus medialis and vastus lateralis) primarily active and why?

A
  1. Weight acceptance for shock absorption.

2. Terminal Swing to extend the limb.

153
Q

The hip moves from __ degrees of hip ___ at weight acceptance to __ degrees of hip ___ at terminal stance.

A

The hip moves from 20 degrees of hip flexion at weight acceptance to 20 degrees of hip extension at terminal stance.

154
Q

At what phase is hip flexion greatest and what degree?

A

midswing where 25 degrees of hip flexion is observed

155
Q

At what phases are rectus femoris and adductor longus active primarily and why?

A

Preswing and Initial swing, they function to support hip flexion and knee flexion.

156
Q

Gluteal muscles are most active what phase?

A

weight acceptance

157
Q

Gluteus medius is active during phases of

A

single limb support

158
Q

The erector spina are active at what phases?

A

loading response and at preswing for the reference limb and contralateral limb

159
Q

When are the abdominals active and when do they increase firing?

A

active at low level through the gait cycle, but increase during midswing and terminal swing for both the reference limb and contralateral limb.

160
Q

Gait analysis includes observations from a ___ followed by a ___.

A

Broad Perspsective followed by detailed analysis.

161
Q

Observations from the broad perspective include:

A
  1. Smoothness of motion
  2. Symmetry or asymmetry of motion
  3. Pace
  4. Size of BOS
  5. Ability to perform basic criteria for walking
162
Q

Describe what and why you are looking at ability to simultaneously control multiple DOF?

A

Typically walking patterns are very fluid. Individuals without disabilites and children with 6 years of experience walk using very smooth movements, suggesting the ability to simultaneously control multiple degrees of freedom?

163
Q

Describe why you are looking at symmetry?

A

Walking requires reciprocal motion, but there should be symmetry between sides in terms of amplitude and speed of motion.

164
Q

What does an individuals BOS include?

A

The size of the base of support (BOS) should include individual’s step length, foot progression angle, and step width.

165
Q

What does the basic criteria for walking include? (5)

A
  1. Ability to absorb shock during weight acceptance
  2. Support the body on a single limb.
  3. Generate forward propulsion
  4. Clear the swing limb
  5. Decelerate the swing limb.
166
Q

What do observations from the detailed perspective include? (2)

A
  1. Presence or absence of critical events

2. description of kinematics (and probable muscle activation patterns and kinetics)

167
Q

Environmental factors which influence the walking pattern include: (2)

A
  1. Incline of the surface

2. Compliance of the surface

168
Q

Walking up an incline requires: (3)

A

greater

1) ankle dorsiflexion
2) knee flexion
3) hip flexion

169
Q

When individuals walk up a steeper incline, they usually change from a ___ ankle position to a ____ position.

A

Dorsiflexed to Plantarflexed

170
Q

The individual factor which has the greatest impact on gait is ___ and ___.

A

Age and Experience

171
Q

What two common gait deviations are found with older adults?

A
  1. Older adults may reduce the time spent in single limb stance phases and increase the time in phases of double limb support.
  2. Have difficulty modifying their gait speed.
172
Q

Because older adults reduced the time spent in single limb stance phases, this suggests there is limited time in terminal stance, and therefore ___ is the frequent observation.

A

less hip extesion

173
Q

Because older adults have difficulty modifying their gait speed, what is typically observed in terms of gait speed?

A

Both comfortable gait speed and fast gait speed tend to have similar values in older adults.

174
Q

Children with very limited walking experience (younger than 18 months of age) may have ____ at initial contact.

A

forefoot contact or foot flat contact

175
Q

Usually by 18 months or 6 months of walking experience, children should have ___ at initial contact

A

a consistent heel first contact

176
Q

Young children also have ____ at weight acceptance.

A

limited ability to absorb shock

177
Q

Knee flexion and hip flexion at loading response may not be observed until ___ years of age.

A

4 years of age.

178
Q

Similar to older adults, young children ____

A

spend less time in single limb stances phases and therefore hip extension at terminal stance may also be limited.

179
Q

Single limb stance times during walking continue to increase until ___ years of age.

A

6 years of age.

180
Q

By ___ years of age, children have adult like gait patterns.

A

7 years of age.

181
Q

Why does gait speed continue to be less until adulthood for a child?

A

Gait speed is dependent on leg length.

182
Q

The most commonly used qualitative measure for gait analysis is

A

the Rancho Gait Analysis Form

183
Q

Quantitative measures for gait time include: (3)

A
  1. Ten Meter Walk Test
  2. 6 Minutes Walk Test
  3. Four Square Step Test
184
Q

Quantitative measures for gait score based include: (3)

A
  1. Functional Gait Assessment
  2. Dynamic Gait Index
  3. Gross Motor Function Measure
185
Q

A Measure designed for adults is

A

four square step test

186
Q

A measure designed for children is

A

gross motor function measure

187
Q

Which of the following phases of walking represents a phase of single limb support, where the body is moving over a stationary foot?

a) Terminal Swing
b) Preswing
c) Loading Response
d) Midstance

188
Q

Which of the following gait kinematics represents a critical event in walking?

a) Pelvic drop in single limb stance phases
b) Hip flexion to 15 degrees at initial swing
c) Knee extension to 0-5 degrees of flexion at midstance
d) Ankle dorsiflexion to 5 degrees of plantarflexion at initial swing

A

Hip flexion to 15 degrees at initial swing

189
Q

Which of the following phases represents the phase during walking in which the gastroc-soleus is MOST active?

a) Midswing
b) Terminal Stance
c) Loading Response
d) Initial Swing

A

b) Terminal Stance

190
Q

Which of the following knee kinematics are related to hamstring muscle activity during walking? During walking, the hamstrings…

a) Extend the hip at terminal stance and decelerate the tibia at terminal swing
b) Extend the hip at terminal stance and flex the knee and preswing
c) Stabilize the hip at loading response and flex the knee at preswing.
d) Stabilize the hip at loading response and decelerate the tibia at terminal swing

A

d) Stabilize the hip at loading response and decelerate the tibia at terminal swing

191
Q

Which of the following statements regarding kinetics explains the muscle activity of the hip during terminal stance phase?

a) The ground reaction force is behind the hip, creating an extensor moment, such that the individual relies on passive structures such as the hip joint and ligaments at terminal stance.
b) The ground reaction force is in front of the hip, creating a flexor moment, such that the individual relies on passive structures such as the hip joint and ligaments at terminal stance.
c) The ground reaction force is in front of the hip, creating an extensor moment, such that the individual must rely on activation of the gluteus maximus for hip extension.
d) The ground reaction force is behind the hip, creating a flexor moment, such that the individual must rely on activation of the gluteus maximus for hip hip extension.

A

a) The ground reaction force is behind the hip, creating an extensor moment, such that the individual relies on passive structures such as the hip joint and ligaments at terminal stance.

192
Q

Which of the following motions descries the kinematics of the pelvis during terminal stance phase?

a) 0 degrees of pelvic rotation
b) 5 degrees of forward pelvic rotation
c) 0 degrees of pelvic tilt
d) 4 degrees of anterior pelvic tilt

A

d) 4 degrees of anterior pelvic tilt

193
Q

Which of the following kinematics describes the position of the trunk at loading response?

a) the shoulder that ipsilateral to the reference limb is rotated forward
b) the trunk follows pelvic rotation motion
c) the shoulder that is ipsilateral to the reference limb is back
d) the shoulder that is ipsilateral to the reference limb is not rotated

A

c) the shoulder that is ipsilateral to the reference limb is back

194
Q

Which of the following values of speed would be considered typical for self selected walking speed in an adult between 20 and 69 years of age?

a) 1.91 - 2.12 meters per second
b) 0.56 - 0.75 meters per second
c) 0.95 - 1.20 meters per second
d) 1.32 - 1.37 meters per second

A

d) 1.32 - 1.37 meters per second

195
Q

Which of the following differences in walking are observed both in older adults and young children?

a) Variability in heel first contact at initial contact
b) Excessive hip and knee flexion in stance phase
c) Reduced shock absorption in weight acceptance
d) Reduced time in single limb support phases

A

d) Reduced time in single limb support phases

DPT707: Kine 2 (3 decks)

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