1 - Typical Gait Patterns Flashcards
1
Q
What features are identified in the Sagittal plane? (3)
A
- Stride length
- Cadence
- Speed
2
Q
What features are identified in the Frontal plane? (1)
A
Size of the Base of Support
3
Q
What features are identified in the Transverse plane?
A
Foot Progression Angle
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)
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.
6
Q
Define Cadence
A
The number of steps taken per minute.
7
Q
What is the size of the base of support also called?
A
stride width or interfoot distance
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.
9
Q
In adults, what does stride width vary from?
A
3-9cm
10
Q
Define Foot Progression angle
A
The angle between the line of progression and the alignment of the second ray of the foot.
11
Q
In adults, the foot progression angle is
A
approximately 7 degrees of out-toeing (positive foot progression angle)
12
Q
Why do children have greater variability in foot progression angle?
A
because of differences in tibial torsion and femoral antetorsion.
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.
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
15
Q
What are the four groups of phases of walking?
A
- Weight Acceptance
- Single Limb Support
- Early Swing Limb Advancement
- Late Swing Limb Advancement
16
Q
During phases of weight acceptance, what is primarily happening? (2)
A
- the body’s weight is transferred to the reference limb.
2. shock absorption is important during weight acceptance to ensure efficient energy transfer.
17
Q
Weight acceptance phases include:
A
- Initial Contact
2. Loading Response
18
Q
What is primarily happening during phases of single limb support? (3)
A
- The body passes over a stationary foot.
- During these phases a single limb supports the body.
- The body moves in front of the reference limb.
19
Q
Single Limb Support phases include:
A
- Midstance
2. Terminal Stance
20
Q
During phases of Early Swing Limb Advancement, what is primarily happening?
A
- the reference limb generates momentum through forward propulsion
21
Q
What two steps are required to advance the swing limb?
A
- Initially, this involved pushing off the surface
2. followed by limb clearance strategies (rapid flexing of the reference limb)
22
Q
Early Swing Limb Advancement phases include:
A
- Preswing
2. Initial Swing
23
Q
During phases of Late Swing Limb Advancement, what is primarily happening?
A
the reference limb is decelerated
24
Q
Late Swing Limb Advancement phases include:
A
- Midswing
2. Terminal Swing
25
What are the 8 phases of gait?
1. Initial Contact
2. Loading Response
3. Midstance
4. Terminal Stance
5. Preswing
6. Inital Swing
7. Midswing
8. Terminal Swing
26
What is happening during Initial Contact
Foot contacts the ground
27
What is happening during Loading Response?
Body weight is transferred to the reference limb and shock is absorbed on a flexed limb.
28
What is happening during Midstance?
Body moves over a station foot and balance on one foot is maintained.
29
What is happening during Terminal Stance?
Body progresses past the stationary foot and balance is maintained.
30
What is happening during Preswing?
Generation of momentum for forward propulsion for swing limb advancement.
31
What is happening during Initial Swing?
Clearance of swing limb.
32
What is happening during Midswing?
Deceleration of limb.
33
What is happening during Terminal Swing?
Extended limb for step length and preparation for loading.
34
How many critical events occur at the ankle, knee, and hip?
Ankle: 6
Knee: 4
Hip: 4
35
What 6 critical events occur at the Ankle?
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
36
What 4 Critical Events occur at the Knee?
1. Controlled Knee Flexion
2. Passive knee Flexion to 40 degrees
3. Maximum knee flexion to 60 degrees
4. Knee extension to 0 degrees
37
What 4 Critical Events occur at the Hip?
1. Maintenance of Hip Stability
2. Trailing Limb Posture
3. Hip Flexion to 15 degrees
4. Hip Flexion to 25 degrees
38
What Critical Events happen during Initial Contact?
1. Heel first contact.
39
What Critical Events happen during Loading Response?
1. Controlled ankle plantarflexion
2. Controlled knee flexion
3. Maintenance of hip stability
40
What Critical Events happen during Midstance?
1. Controlled tibial advancement (ankle is moving from plantarflexed to slightly dorsiflexed)
41
What Critical Events happen during Terminal Stance?
1. Controlled ankle dorsiflexion with heel rising
| 2. Trailing limb posture (hip extension)
42
What Critical Events happen during Preswing?
1. Rapid ankle plantarflexion (drives knee forward into..)
| 2. Passive knee flexion to 40 degrees
43
What Critical Events happen during Initial Swing?
1. Maximum knee flexion to 60 degrees
| 2. Hip flexion to 15 degrees
44
What Critical Events happen during Midswing?
1. Dorsiflexion to 0
| 2. Maximum hip flexion to 25 degrees
45
What Critical Events happen during Terminal Swing?
1. Knee extension to 0 degrees
46
At Initial Contact, what are the kinematics of the Ankle?
0 - Neutral
47
At Initial Contact, what Muscle is activated at the Ankle?
Tibialis Anterior
48
At Initial Contact, what are the Kinetics at the Ankle?
GRF is Posterior
49
At Initial Contact, what Critical Event is happening at the ankle?
Heel first contact
50
At Initial Contact, what are the Kinematics at the Knee?
0-5 flexion
51
At Initial Contact, what Muscle is activated at the Knee?
Quadriceps
52
At Initial Contact, what are the Kinetics at the Knee?
GRF is Posterior (plantar moment)
53
At Initial Contact, what are the Kinematics at the Hip?
20 flexion
54
At Initial Contact, what are the Muscles activated at the hip?
Gluteus Maximus, Hamstrings
55
At Initial Contact, what are the Kinetics at the Hip?
GRF is anterior
56
At Initial Contact, what are the Kinematics at the Pelvis?
5 forward rotation
57
At Initial Contact, what are the Muscles activated at the Pelvis?
Gluteus Medius
58
At Initial Contact, what are the Kinematics at the Trunk?
Erect
59
At Initial Contact, what are the Muscles activated at the Trunk?
Trunk Extensors
60
At Loading Response, what are the Kinematics at the Ankle?
5 PF
61
At Loading Response, what are the Muscles activated at the Ankle?
Gastroc-soleus
62
At Loading Response, what are the Kinetics at the Ankle?
GRF is Posterior (plantar moment)
63
At Loading Response, what are the Critical Events at the Ankle?
Controlled Ankle Plantarflexion
64
At Loading Response, what are the Kinematics at the Knee?
15 flexion
65
At Loading Response, what are the Muscles activated at the Knee?
Quadriceps
66
At Loading Response, what are the Kinetics at the Knee?
GRF is Posterior
67
At Loading Response, what are the Kinematics at the Hip
20 flexion
68
At Loading Response, what are the Muscles activated at the Hip?
Gluteus Maximus, Hamstrings
69
At Loading Response, what are the Kinetics at the Hip?
GRF is Anterior
70
At Loading Response, what are the Critical Events at the Hip?
Hip stability
71
At Loading Response, what are the Kinematics at the Pelvis?
5 forward rotation
72
At Loading Response, what are the Muscles Activated at the Pelvis?
Gluteus Medius
73
At Loading Response, what are the Kinematics at the Trunk?
Erect
74
At Loading Response, what are the Muscles Activated at the Trunk?
Trunk Extensors
75
At Midstance, what are the Kinematics at the Ankle?
5 dorsiflexion
76
At Midstance, what are the Muscles Activated at the Ankle?
Gastroc-soleus
77
At Midstance, what are the Kinetics at the Ankle?
GRF through joint
78
At Midstance, what are the Critical Events happening at the Ankle?
Tibial Advancement
79
At Midstance, what are the Kinematics at the Knee?
0-5 Flexion
80
At Midstance, what are the Kinetics at the Knee?
GRF goes through joint
81
At Midstance, what are the Kinematics at the Hip?
0 flexion
82
At Midstance, what are the Kinetics at the Hip?
GRF is through joint
83
At Midstance, what are the Kinematics at the Pelvis?
0 rotation
84
At Midstance, what are the Muscles Activated at the Pelvis?
Gluteus Medius
85
At Midstance, what are the Kinematics at the Trunk?
Erect
86
At Midstance, what are the Muscles Activated at the Trunk?
Extensors and Abdominals
87
At Terminal Stance, what are the Kinematics at the Ankle?
10 dorsiflexion
88
At Terminal Stance, what are the Muscles Activated at the Ankle?
Gastroc-soleus
89
At Terminal Stance, what are the Kinetics at the Ankle?
GRF is anterior (dosi moment)
90
At Terminal Stance, what are the Critical Events at the Ankle?
Controlled Ankle DF (with heel rise)
91
At Terminal Stance, what are the Kinematics at the Knee?
0-5 flexion
92
At Terminal Stance, what are the Kinetics at the Knee?
GRF is anterior
93
At Terminal Stance, what are the Kinematics at the Hip?
20 hyperextension
94
At Terminal Stance, what are the Kinetics at the Hip?
GRF is posterior
95
At Terminal Stance, what are the Critical Events at the Hip?
Trailing Limb Posture
96
At Terminal Stance, what are the Kinematics at the Pelvis?
5 backward rotation, 7 drop, 4 ant tilt
97
At Terminal Stance, what are the Muscles Activated at the Pelvis?
Gluteus Medius
98
At Terminal Stance, what are the Kinematics at the Trunk?
Erect
99
At Terminal Stance, what are the Muscles Activated at the Trunk?
Extensors and Abdominals
100
At Preswing, what are the Kinematics at the Ankle?
15 plantar
101
At Preswing, what are the the Muscles Activated at the Ankle?
Gastroc-soleus
102
At Preswing, what are the Kinetics at the Ankle?
GRF is anterior
103
At Preswing, what are the Critical Events at the ankle?
Raid Ankle Plantarflexion
104
At Preswing, What are the Kinematics at the Knee?
40 flexion
105
At Preswing, what are the Kinetics at the Knee?
GRF is posterior
106
At Preswing, what are the Kinematics at the Hip?
20 hyperextension
107
At Preswing, what are the Muscles Activated?
Rectus femoris, iliopsoas, adductor longus
108
At Preswing, What are the Kinetics at the Hip?
GRF is posterior
109
At Preswing, what are the Kinematics at the Pelvis?
5 backward rotation, 4 ant tilt
110
At Preswing, what are the Kinematics at the Trunk?
Erect
111
At Preswing, what are the Muscles Activated at the Trunk?
Extensors and Abdominals
112
At Initial Swing, what are the Kinematics at the Ankle?
5 plantar
113
At Initial Swing, what are the Muscles Activated at the Ankle?
Tibialis Anterior
114
At Initial Swing, what are the Kinematics at the Knee?
60 flexion
115
At Initial Swing, what are the Muscles Activated at the Knee?
Quads and Hams
116
At Initial Swing, what are the Critical Events at the Knee?
Knee flexion to 60
117
At Initial Swing, what are the Kinematics at the Hip?
15 flexion
118
At Initial Swing, what are the Muscles Activated at the Hip?
Rectus femoris, iliopsoas, adductor longus
119
At Initial Swing, what are the Critical Events at the Hip?
Flexion to 15 degrees
120
At Initial Swing, what are the Kinematics at the Pelvis?
5 backward rotation
121
At Initial Swing, what are the Kinematics at the Trunk?
Erect
122
At Initial Swing, what are the Muscles Activated at the Trunk?
Extensors and Abdominals
123
At Mid Swing, what are the Kinematics at the Ankle?
Neutral
124
At Mid Swing, what are the Muscles Activated at the Ankle?
Tibialis Anterior
125
At Mid Swing, what are the Critical Events at the Ankle?
Dorsiflex to neutral
126
At Mid Swing, what are the Kinematics at the Knee?
25 flexion
127
At Mid Swing, what are the Muscles Activated at the Knee?
Quads and hams
128
At Mid Swing, what are the Kinematics at the Hip?
25 flexion
129
At Mid Swing, what are the Muscles Activated at the Hip?
Hamstring
130
At Mid Swing, what are the Critical Events at the Hip?
Flexion to 25
131
At Mid Swing, what are the Kinematics at the Pelvis?
0 rotation
132
At Mid Swing, what are the Kinematics at the Trunk?
Erect
133
At Mid Swing, what are the Muscles Activated at the Trunk?
Abdominals
134
At Terminal Swing, what are the Kinematics at the Ankle?
Neutral
135
At Terminal Swing, what are the Muscles Activated at the Ankle?
Tibialis Anterior
136
At Terminal Swing, what are the kinematics at the knee?
0-5 flexion
137
At Terminal Swing, what are the Muscles Activated at the Knee?
Quads and Hams
138
At Terminal Swing, what are the Critical Events at the Knee?
Knee Extension
139
At Terminal Swing, what are the Kinematics at the Hip?
20 flexion
140
At Terminal Swing, what are the Muscles Activated at the Hip?
Gluteus Maximus, Hamstrings
141
At Terminal Swing, what are the Kinematics at the Pelvis?
5 forward rotation
142
At Terminal Swing, what are the Muscles Activated at the Pelvis?
Muscle Activation
143
At Terminal Swing, what are the Kinematics at the Trunk?
Erect
144
At Terminal Swing, what are the Muscles Activated at the Trunk?
Trunk Extensors
145
Where does maximum ankle dorsiflexion occur and what degree is it at?
10 degrees and occurs at Terminal Stance
146
Where does maximum ankle plantarflexion occur and what degree is it at?
15 degrees and occurs at Preswing
147
Where does the largest positional change at the ankle occur between and what degrees?
10 degrees dorsiflexion at Terminal Stance to 15 degrees plantarflexion at Preswing.
148
At what two groups of phases is the Tibialis Anterior active primarily and why?
1. During weight acceptance to absorb shock
| 2. Swing limb advancement to clear the limb
149
At what group of phases and phase is the Gastrocsoleus active primarily and why?
1. Single Limb Support phases to stabilize the tibia
| 2. During preswing to promote knee flexion
150
At what two phases does knee flexion primarily occur and why? Degrees?
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
At what group of phases and phase are the hamstrings (biceps femoris) primarily active and why?
1. Weight acceptance to stabilize the hip.
| 2. Terminal swing to decelerate the tibia.
152
At what group of phases and phase are the quadriceps (vastus medialis and vastus lateralis) primarily active and why?
1. Weight acceptance for shock absorption.
| 2. Terminal Swing to extend the limb.
153
The hip moves from __ degrees of hip ___ at weight acceptance to __ degrees of hip ___ at terminal stance.
The hip moves from 20 degrees of hip flexion at weight acceptance to 20 degrees of hip extension at terminal stance.
154
At what phase is hip flexion greatest and what degree?
midswing where 25 degrees of hip flexion is observed
155
At what phases are rectus femoris and adductor longus active primarily and why?
Preswing and Initial swing, they function to support hip flexion and knee flexion.
156
Gluteal muscles are most active what phase?
weight acceptance
157
Gluteus medius is active during phases of
single limb support
158
The erector spina are active at what phases?
loading response and at preswing for the reference limb and contralateral limb
159
When are the abdominals active and when do they increase firing?
active at low level through the gait cycle, but increase during midswing and terminal swing for both the reference limb and contralateral limb.
160
Gait analysis includes observations from a ___ followed by a ___.
Broad Perspsective followed by detailed analysis.
161
Observations from the broad perspective include:
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
Describe what and why you are looking at ability to simultaneously control multiple DOF?
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
Describe why you are looking at symmetry?
Walking requires reciprocal motion, but there should be symmetry between sides in terms of amplitude and speed of motion.
164
What does an individuals BOS include?
The size of the base of support (BOS) should include individual's step length, foot progression angle, and step width.
165
What does the basic criteria for walking include? (5)
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
What do observations from the detailed perspective include? (2)
1. Presence or absence of critical events
| 2. description of kinematics (and probable muscle activation patterns and kinetics)
167
Environmental factors which influence the walking pattern include: (2)
1. Incline of the surface
| 2. Compliance of the surface
168
Walking up an incline requires: (3)
greater
1) ankle dorsiflexion
2) knee flexion
3) hip flexion
169
When individuals walk up a steeper incline, they usually change from a ___ ankle position to a ____ position.
Dorsiflexed to Plantarflexed
170
The individual factor which has the greatest impact on gait is ___ and ___.
Age and Experience
171
What two common gait deviations are found with older adults?
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
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.
less hip extesion
173
Because older adults have difficulty modifying their gait speed, what is typically observed in terms of gait speed?
Both comfortable gait speed and fast gait speed tend to have similar values in older adults.
174
Children with very limited walking experience (younger than 18 months of age) may have ____ at initial contact.
forefoot contact or foot flat contact
175
Usually by 18 months or 6 months of walking experience, children should have ___ at initial contact
a consistent heel first contact
176
Young children also have ____ at weight acceptance.
limited ability to absorb shock
177
Knee flexion and hip flexion at loading response may not be observed until ___ years of age.
4 years of age.
178
Similar to older adults, young children ____
spend less time in single limb stances phases and therefore hip extension at terminal stance may also be limited.
179
Single limb stance times during walking continue to increase until ___ years of age.
6 years of age.
180
By ___ years of age, children have adult like gait patterns.
7 years of age.
181
Why does gait speed continue to be less until adulthood for a child?
Gait speed is dependent on leg length.
182
The most commonly used qualitative measure for gait analysis is
the Rancho Gait Analysis Form
183
Quantitative measures for gait time include: (3)
1. Ten Meter Walk Test
2. 6 Minutes Walk Test
3. Four Square Step Test
184
Quantitative measures for gait score based include: (3)
1. Functional Gait Assessment
2. Dynamic Gait Index
3. Gross Motor Function Measure
185
A Measure designed for adults is
four square step test
186
A measure designed for children is
gross motor function measure
187
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
Midstance
188
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
Hip flexion to 15 degrees at initial swing
189
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
b) Terminal Stance
190
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
d) Stabilize the hip at loading response and decelerate the tibia at terminal swing
191
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) 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
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
d) 4 degrees of anterior pelvic tilt
193
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
c) the shoulder that is ipsilateral to the reference limb is back
194
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
d) 1.32 - 1.37 meters per second
195
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
d) Reduced time in single limb support phases
