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Clinical Gait > Exam 1 > Flashcards

Exam 1 Flashcards

1
Q

Gait

A

any method of locomotion characterized by periods of loading and unloading of the limbs

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2
Q

Characteristics of Gait

A
  1. Goal Oriented
  2. Efficient
  3. Involves Multiple Systems
  4. Integral to Daily Life
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3
Q

Stride

A

period from one heel strike to the next strike of the SAME foot

  • ~144 cm for adult males
    ex) R stride = R heel contact to next R heel contact
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4
Q

Step

A

period from one heel strike to the next heel strike of the OPPOSITE foot

  • named by the leading foot
  • ~72 cm for adult males
    ex) R step = L heel contact to R heel contact
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5
Q

Stance

A

period when reference foot is on the ground

- FIRST 60% of the gait cycle

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6
Q

Swing

A

period when reference foot is in the air

- LAST 40% of the gait cycle

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7
Q

Double Limb Support

A

2 periods when BOTH feet are on the ground

  • 1) Loading Response (0-10%)
  • 2) Pre-swing (50-60%)
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8
Q

Single Limb Support

A

period when only 1 foot is on the ground

  • 1 period for each foot - 2 periods/cycle
  • 1) Reference Limb (10-50%)
  • 2) Opposite Limb (60-100%)
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9
Q

Step Width

A

medial-lateral distance between heels

- Normal: 8-10cm

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10
Q

Fick Angle

A
  • angle of foot relative to the line of progression

- Normal: 7 degrees (toes OUT)

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11
Q

Cadence

A

steps/min

  • Males: 110 steps/min
  • Females: 116 steps/min
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12
Q

Walking Speed

A

good predictor of FUNCTION

  • 1.37 m/s (3 mph) = FUNCTIONAL
  • *generally increase step length BEFORE increasing cadence to increase speed
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13
Q

Functional Tasks

A

1) Weight Acceptance (0-10%)
2) Single Limb Support (10-50%)
3) Limb Advancement (50-100%)

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14
Q

Weight Acceptance

A

a) shock absorption
b) initial limb stability
c) preservation of forward progression

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15
Q

Single Limb Support

A

a) body weight support

b) preservation of forward progression

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16
Q

Limb Advancement

A

a) limb elevation
b) limb FORWARD advancement
c) preparation for stance

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17
Q

Initial Contact

A

% of Cycle: 0%
Key Event: heel contact
Functional Task: weight acceptance

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18
Q

Loading Response

A

% of Cycle: 0-10%
Key Events: SAME heel contact –> OPPOSITE toe-off
Functional Task: weight acceptance

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19
Q

Mid-Stance

A

% of Cycle: 10-30%
Key Events: OPPOSITE toe-off –> SAME heel rise
Functional Task: single limb support

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20
Q

Terminal Stance

A

% of Cycle: 30-50%
Key Events: SAME heel rise –> OPPOSITE initial contact
Functional Task: single limb support (last)

21
Q

Pre-Swing

A

% of Cycle: 50-60%
Key Events: OPPOSITE initial contact –> SAME toe-off
Functional Task: limb advancement

22
Q

Initial Swing

A

% of Cycle: 60-73%
Key Events: SAME toe-off –> feet adjacent
Functional Task: limb advancement

23
Q

Mid-Swing

A

% of Cycle: 73-87%
Key Events: feet adjacent –> tibia vertical
Functional Task: limb advancement

24
Q

Terminal Swing

A

% of Cycle: 87-100%
Key Events: tibia vertical –> SAME heel contact
Functional Task: limb advancement

25
Q

Generators of Forward Progression

A

1) Initial Step - preparation&raquo_space; weight shift&raquo_space; progresssion
2) Foot Rockers - heel, ankle, forefoot, & toe
3) Propulsive Forces - CONCENTRIC mm activity to maintain forward progression (minimal b/c gait is efficient)

26
Q

Shock Absorption

A

ECCENTRIC mm activity as a part of weight acceptance

  • a) Ankle
  • b) knee
  • c) hip
27
Q

Vertical CoM Displacement

A
  • 2 sine waves/cycle
    Low: midpoint of double limb support (5% - LR & 55% - PSw)
    High: midpoint of single limb support (30% - MSt & 80% MSw)
    Normal: 5 cm
28
Q

Horizontal CoM Displacement

A
  • 1 sine wave/cycle
    MAX: midpoint of stance (30% - ipsilateral & 80% - contralateral)
    Normal: 4 cm
    **reduced by pelvic obliquity; physiologic valgus; momentum/inertia
29
Q

Minimize Vertical RISE of CoM

A

1) Pelvic Obliquity - ADDuction of WBing hip

2) Knee flexion during LR/MSt

30
Q

Minimize Vertical DROP of CoM

A

1) Pelvic Frontal Rotation - forward/backward motion
2) Ankle Sagittal Plane Rotation - DF/PF
* *functionally LENGTHEN the limb

31
Q

Selective Muscle Control

A

activation of particular muscles at specific times for specific purposes
- requires intact proprioception & kinesthesia

32
Q

GRF Components

A
  1. ) Vertical - perpendicular to ground/supporting surface (120% BW)
  2. ) A-P - parallel to supporting surface (20% BW)
    a) POSTERIOR at IC
    b) ANTERIOR at toe-off
  3. ) Medial-Lateral - parallel to supporting surface (5% BW)
    - direction depends on location of CoM to foot
33
Q

Center of Pressure

A

point of application of GRF

  • midpoint of heel (lateral) at IC
  • lateral midfoot region at MSt
  • medial forefoot&raquo_space; great toe from TSt&raquo_space; TO
34
Q

Inverse Dynamic Equations

  • Linear: FORCES summed about the CoM
  • Angular: MOMENTS summed about the CoM
  • Joint reaction force & joint moment are only UNKNOWNS in the equation
  • calculated from the ground up
A

Inverse Dynamic Equations

  • Linear: FORCES summed about the CoM
  • Angular: MOMENTS summed about the CoM
  • Joint reaction force & joint moment are only UNKNOWNS in the equation
  • calculated from the ground up
35
Q

Assumptions of JRFs

A

1) No Friction
2) Degrees of Freedom vary
3) Rigid Body Segments - masses concentrated at their CoM
4) No Co-Contraction of agonist/antagonists

36
Q

Effect of Movement Speed

INCR speed –» INCR body segment acceleration –» INCR JRFs/GRFs –» INCR joint moments

A

Effect of Movement Speed

INCR speed –» INCR body segment acceleration –» INCR JRFs/GRFs –» INCR joint moments

37
Q

Moment

A

external joint moments as a function of time

38
Q

Initial Contact - Ankle Sagittal Plane

A

ROM: neutral
Torque Demand: external PF
Muscle Activity: pretibial mm (tibialis anterior & EDL)
Functional Significance: foot position for LR

39
Q

Loading Response - Ankle Sagittal Plane

A

ROM: neutral&raquo_space; 5 deg PF
Torque Demand: external PF
Muscle Activity: pretibial mm (eccentrically)
Functional Significance: heel rocker

40
Q

Midstance - Ankle Sagittal Plane

A

ROM: 5 deg PF&raquo_space; 5 deg DF
Torque Demand: external DF
Muscle Activity: gastroc & soleus (eccentric)
Functional Significance: ankle rocker

41
Q

Terminal Stance - Ankle Sagittal Plane

A

ROM: 5 deg DF&raquo_space; 10 deg DF; MTP extend 30 deg
Torque Demand: external DF (MAX)
Muscle Activity: gastroc & soleus (MAX - eccentric)
Functional Significance: forefoot rocker

42
Q

Pre-Swing - Ankle Sagittal Plane

A

ROM: 10 deg DF&raquo_space; 15 deg PF; MTP extend 60 deg
Torque Demand: external DF DECR&raquo_space; no GRF
Muscle Activity: gastrocsoleus decreases rapidly - elastic recoil of PF thrusts tibia forward
Functional Significance: toe rocker

43
Q

Initial Swing - Ankle Sagittal Plane

A

ROM: 15 deg PF&raquo_space; 5 deg PF
Torque Demand: external PF (gravity)
Muscle Activity: pretibial mm (concentric - against gravity into DF)
Functional Significance: foot clearance contributes to single limb advancement

44
Q

Mid Swing - Ankle Sagittal Plane

A

ROM: 5 deg PF&raquo_space; neutral
Torque Demand: LOW level external PF (gravity)
Muscle Activity: pretibial mm (against gravity)
Functional Significance: foot clearance contributing to limb advancement

45
Q

Terminal Swing - Ankle Sagittal Plane

A

ROM: neutral
Torque Demand: LOW external PF
Muscle Activity: pretibial mm (isometric)
Functional Significance: neutral foot position assures heel contact at IC

46
Q

LR through MSt - Ankle Frontal Plane

A

ROM: 2 deg inversion&raquo_space; 2-3 deg eversion
Torque Demand: external eversion
Muscle Activity: inverters - tib anterior & posterior (eccentric)
Functional Significance: subtalar PRONATION assists w/ push-off

47
Q

TSt through PSw - Ankle Frontal Plane

A

ROM: 2-3 deg eversion&raquo_space; 4-6 deg inversion
Torque Demand: eversion DECR&raquo_space; inversion INCR
Muscle Activity: posterior tib (concentric); soleus & peroneals (eccentric) - rigid foot for push-off
Functional Significance: SUPINATION provides rigid lever for push-off

48
Q

ISw through TSw - Ankle Frontal Plane

A

ROM: 4-6 deg inversion&raquo_space; slight eversion
Torque Demand: negligible
Muscle Activity: pretibial & ankle inverters (eccentric) - controlling slight eversion
Functional Significance: prepare foot for initial contact

Clinical Gait (1 decks)

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