ADLs Flashcards
What is the first period of the gait cycle with double limb support?
Heel strike/initial contact
Lasts until end of heel off/terminal stance phase
What is the first period of single limb support during the gait cycle?
Midstance
What muscles are activated during Heel strike?
Quadriceps (Knee extension) - shock absorption
Ankle DF - control lowering of the foot from heel strike to foot flat
What muscles are activated during foot flat phase?
Triceps surae - eccentrically control tibial advancement
What muscles are activated during midstance?
Hip extensors - control FWD motion of the trunk
Hip Abductors - stabilize pelvis suring single limb support
Knee Extensors (quads)
Triceps Surae - control FWD tibial advancement
Ankle DF
Achilles tendon elongates and stores energy
What muscles are activated during heel off?
Ankle PF - Generates propulsion of the body and swing limb
The energy stored in the Achilles tendon releases
In what phase is the peak activity of the ankle PF mm?
heel off
What muscles are activated during the toe-off phase?
Hip extensors (Hamstrings)
Knee Extensors (Quads)
FWD propulsion
What muscles are activated during acceleration gait phase?
swing phase
Hip Flexors
Knee extensors (Quads)
The quadriceps become silent during what phase of the swing phase? Why?
a. Midswing
b. Pendular motion is in effect
What phase of the gait cycle has the most knee flexion?
Midswing
What muscles are activated during midswing?
Hip and knee flexors
Ankle DF (elevate the toe for clearance)
What muscles are active during terminal swing/Deceleration?
Early phase - Hip extensors (Hamstrings)
Late swing phase - Quads and ankle DF for preparation of heel strike
How much does the pelvis rotate during the gait cycle?
8 degrees in total
4 degrees for each limb
How much lateral pelvic tilt is there during gait cycle?
5 degrees
Controlled by hip ABD - swinging limb drops during loading response
To what degree is the pelvis naturally anteriorly tilted?
10-15 degrees
hip Flexors pull FWD until end of terminal stance
The pelvis moves side-side by ___ cm, towards the stance limb, in loading response.
4 cm
What is the avg cadence?
110 steps/min
What is the avg step width range?
1-5 inches
Steps width increases as a person grows
What is the avg. walking speed?
1.3 m/s
3 mi/hr
What is the avg metabolic cost of walking while on a even surface?
5.5 kcal/min
What is/are the possible cause(s) of the following Gait deviation?
Lateral Trunk bending during stance phase
- Weak gluteus medius
- Hip pain
What is/are the possible cause(s) of the following Gait deviation?
Backward trunk lean during stance phase
Weak gluteus maximus
Will also see difficulty with stairs and/or ramps
What is/are the possible cause(s) of the following Gait deviation?
FWD trunk lean during stance phase
- Weak quads
- hip/knee contractures
What is/are the possible cause(s) of the following Gait deviation?
Excessive hip FLX during stance phase
- weak hip EXT
- tight knee FLX
What is/are the possible cause(s) of the following Gait deviation?
Limited hip EXT during stance phase
Tight hip flexors
What is/are the possible cause(s) of the following Gait deviation?
Limited hip FLX during stance phase
- Weak hip flexors
- tight extensors
What is/are the possible cause(s) of the following Gait deviation?
Antalgic gait (painful gait)
UNINVOLVED limb as a shorter step length as WB occurs sooner than normal
asymmetrical gait pattern
What is/are the possible cause(s) of the following Gait deviation?
Excessive knee FLX during stance phase
- weaks quadriceps
- knee FLX contracture
Can observe difficulty going down ramps and/or steps
What can be a compensation for weak quads?
FWD trunk bending
What is/are the possible cause(s) of the following Gait deviation?
Knee hyperextension during stance phase
- weak quads
- PF contracture
- extensor spasticity
What is/are the possible cause(s) of the following Gait deviation?
Forefoot initial contact
- weak DF
- tight/spastic PF
- LLD- shortened limb
What is/are the possible cause(s) of the following Gait deviation?
Foot slap
- weak DF
- hypotonia
What is/are the possible cause(s) of the following Gait deviation?
Foot flat
- weak DF
- decreased ROM
- neonatal/immature gait pattern
What is/are the possible cause(s) of the following Gait deviation?
calcaneal gait
Loading predominately on heel with excessive DF and uncontrolled FWD motion of the tibia
Weak PF
What is/are the possible cause(s) of the following Gait deviation?
Equinus gait
Heel does not touch the ground
spasticity/contracture of PF mm
What is/are the possible cause(s) of the following Gait deviation?
Supination
Varus calcaneus with excessive loading on lateral foot
- spastic inverters
- weak everters
- pes varus
- genu varum
What is/are the possible cause(s) of the following Gait deviation?
Hyperpronation
Valgus calcaneus and excessive medial contact of foot during stance
- weak invertors
- spasticity
- pes valgus
What is/are the possible cause(s) of the following Gait deviation?
Clawed toes
- spastic toe flexors
- hyperactive plantar grasp reflex
What is/are the possible cause(s) of the following Gait deviation?
Inadequate push-off
- weak PF
- decreased ROM into PF
- forefoot pain
What is/are the possible cause(s) of the following Gait deviation?
insufficient FWD pelvic motion during swing phase
- weak abdominal muscles
- weak flexor muscles
What is/are the possible cause(s) of the following Gait deviation?
Insufficient hip and knee FLX during swing phase
- weak hip and knee flexors
- inability to lift the leg and move it FWD
What is/are the possible cause(s) of the following Gait deviation?
Circumduction
weak hip and knee flexors
What is/are the possible cause(s) of the following Gait deviation?
hip hiking
QL action
- Weak hip and knee flexors
- extensor spasticity
What is/are the possible cause(s) of the following Gait deviation?
Excessive hip and knee FLX during swing phase (Steppage gait)
compensation for shortening the leg
weak DF
What is/are the possible cause(s) of the following Gait deviation?
insufficient knee FLX during swing phase
- extensor tightness
- pain
- decreased ROM
- weak hamstrings
What is/are the possible cause(s) of the following Gait deviation?
Excessive knee FLX during swing phase
- flexor spasticity
- flexor withdrawal reflex
What is/are the possible cause(s) of the following Gait deviation?
Foot drop
- weak or delayed DF
- spastic PF
What is/are the possible cause(s) of the following Gait deviation?
Varus or inverted foot during swing phase
- spastic inverters
- weak evertors
What is/are the possible cause(s) of the following Gait deviation?
equinovarus during swing phase
- spastic posterior tibialis and/or triceps surae
- developmental abnormality
Describe two point gait pattern
Cane or crutches
AD and opposite LE are moved together
Describe delayed two-point gait pattern with a cane
- cane advancement
- involved LE advanced
- uninvolved LE advanced
Describe three-point gait pattern
Crutches
- Both crutches and involved LE are advanced together
- uninvolved limb advancement
When is a delayed three-point gait pattern indicated?
When the patient requires increased stability and slower movements
Describe a delayed three-point gait pattern
- both crutches are advanced
- involved LE advancement
- uninvolved LE advancement
Describe the Three Point Pressure Principle use for orthotics
Single force is placed at the deformity/angulation; two additional counterforces are applied in opposing direction
What are metatarsal pads used for?
Moves pressure from the metatarsal heads to the shafts –> allows for more push-off in weak or inflexible feet
Located posterior to metatarsal heads
What is a cushion heel used for?
Used of relieve strain on plantar fascia –> Absorbs forces at heel contact
What is a longitudinal arch support used for?
Decompression of the subtalar joint and corrects pes planus/flat foot
What is a UBCL (university of California Biomechanics Lab) Insert used for?
Plastic molded insert to correct flexible pes planus
What is a scaphoid pad used for?
supports longitudinal arch