EXAM #2 Flashcards
The act of moving from one
place to the other
Locomotion
The manner of walking
Gait
A smooth, highly coordinated, rhythmical, undulating, reciprocal movement by which the body moves step by step in the required direction at the necessary speed
Walking
The period of time from one event (usually initial contact) of one foot to following occurrence of the same event with the ipsilateral foot
Gait cycle
Described as the period from the initial contact of a particular limb to the point of initial contact of the SAME limb and is equivalent to one gait cycle
stride
Described as the period from initial contact of one limb to the initial contact of the contralateral limb
Step
Normal Gait:
There are _ _ in each stride (or gait cycle)
two steps
Normal gait:
The period of time when the foot is in contact with the ground
stance phase (ST)
Normal gait:
The period of time when the foot is not in contact with the ground
swing phase (SW)
Normal gait:
The period of time when both feet are in contact with the ground
- This occurs twice in the gait cycle, at the beginning and end of the stance phase
Double support (DS)
Normal gait:
The period of time when only one foot is in contact with the ground
- In walking, this is equal to the swing phase of the other limb
single support (SS)
The point in the gait cycle when the foot initially makes contact with the ground
- Represents the beginning of the stance phase
Initial contact (IC)
The point in the gait cycle when the foot leaves the ground
- This represents the end of the stance phase or
beginning of the swing phase
- Also referred to as foot-off
Terminal contact (TC)
Normal gait:
When terminal contact is made with the toe
toe-off (TO)
Normal gait:
The point in time in the stance phase when the full foot is in contact with the ground
Foot flat (FF)
Normal gait:
The point in the stance phase when the heel leaves the ground
Heel off (HO)
Gait:
The distance from a point of contact with the ground of one foot to the following occurrence of the same point of contact with the other foot
- Expressed in meters (m)
Step length
Gait:
Is the period of time taken for one step and is measured from an event of one foot to the following occurrence of the same event with the other foot
- Expressed in seconds (s)
Step period
Gait:
The distance from initial contact of one foot to the following initial contact of the same foot
- Sometimes referred to as cycle length
- Expressed in meters (m
Stride length
Gait:
The period of time from initial contact of one foot to the following initial contact of the same foot
- Expressed in seconds (s)
Stride period or cycle time
Gait:
The rate of change of linear displacement along the direction of progression measured over one or more strides
- Expressed in meters per second (m/s)
Velocity
Gait:
Rate at which a person walks, expressed in steps per minute
Cadence
Gait:
The ratio of the stance period to the swing period
60% stance / 40% swing
Gait:
Controlled by the _ _ _ (postural reflex activity)
central nervous system
Gait:
Major afferent stimuli is provided by:
- Tactile impulses from the sole of the foot
- Proprioceptive impulses (from the lower limb,
trunk, and neck)
In normal walking: Approximately _ steps
are taken per minute
50-60
Phases of gait:
- The “weight-bearing” phase
- Provides the stability of the gait
- Necessary for accurate swing phase to take
place
Stance phase
Includes: 5 Stages of Gait Cycle
- Initial contact
- Loading response
- Mid-stance
- Terminal Stance
- Pre-Swing
Gait - Stance phase:
- First position of “double support”
- The _ _ of the leading stance foot and the toes of the other foot are both on the ground
Initial Contact
Gait - Stance phase:
- Weight transferred onto the outstretched limb
- The first period of double support
Loading Response
Gait - Stance phase:
- Defined as the time the opposite limb leaves the floor until the body weight is aligned over the forefoot
- Body progresses over a single, stable limb
Mid-Stance
Gait - Stance phase:
- The heel is raised as the body moves forward over the stance limb
- The body moves ahead of the limb
Terminal Stance
Gait - Stance phase:
- The second (and final) double support period
- Defined from the time of initial contact of
the contralateral limb to ipsilateral toe-off
- Unloading of the limb occurs as weight is transferred to the contralateral limb
Pre-Swing
Initial contact
Loading response
Mid-stance
Terminal stance
Pre-swing
Gait:
- Defined as the non-weight-bearing phase of
the reference limb
- Begins as soon as the foot of reference limb
leaves the ground (after foot-off), and finishes
just prior to initial contact of the same limb
Swing phase
Gait- Swing phase:
Begins once the foot of the swing limb leaves
the ground until the point at which the swing
limb is directly under the body or at maximum
knee flexion
Initial swing
Gait- Swing phase:
Begins from maximum knee flexion (when the
swing limb is under the body) until the swing
limb passes the stance limb and the tibia is in
a vertical position
Mid-swing
Gait - Swing phase:
From the point at which the tibia is in a
vertical position to the point just prior to
initial contact
- The momentum slows down as the limb
moves into the stance phase again
Terminal swing
Initial swing
Mid-swing
Terminal swing
Normal gait - joint position:
Initial contact
- Ankle
Neutral
- neither dorsiflexed nor plantar flexed
Normal gait - joint position:
Initial contact
- knee
Flexed
- Slight flexion helps absorb the impact of the foot contacting the ground
- Weight of body behind the knee
Normal gait - joint position:
Initial contact
- HIp
Flexed
- Lengthens limb in preparation for contact between heel and ground
- Helps provide for proper placement of foot so that the heel makes contact with the ground
Normal gait - joint position:
Mid-stance
- Ankle
dorsiflexed
Normal gait - joint position:
Mid-stance
- Knee
Extended
- Lengthens limb to help support weight of torso which is now directly over limb
Normal gait - joint position:
Mid-stance
- Hip
neutral
Normal gait - joint position:
Terminal stance
- Ankle
Plantar flexed
- Calf muscles begin to contract strongly bringing the ankle joint into a plantar flexed position
Normal gait - joint position:
Terminal stance
- Knee
Flexed
- Shortens limb to allow clearance from ground
Normal gait - joint position:
Terminal stance
- HIp
Extended
- Torso on the opposite side has moved forward of reference limb
Normal gait - joint position:
Swing phase
- Ankle
neutral
Normal gait - joint position:
Swing phase
- Knee
Flexed/extended
- shorten limb to maintain foot off of the ground
- Extend knee in preparation for initial contact
Normal gait - joint position:
Swing phase
- Hip
Flexed
- Limb catches up to and then passes the torso
Normal gait - Muscle action:
Ankle:
- Tibialis anterior and toe extensors (pre-tibial muscles) maintain foot position in preparation for loading response
Knee:
- Quadriceps contract to prepare for loading response
Hip:
- All hip extensors are active in preparation for their role in stabilizing the thigh during loading response
Initial contact
Normal gait - Muscle action:
Tibialis anterior muscles
swing phase
Normal gait - Muscle action:
Ankle:
- Plantar flexion torque quickly forces the foot to the floor
Knee:
- Eccentric quadriceps activity peaks to meet torque demands and to absorb shock
Hip:
- Extensor muscles fire to counteract flexion torque
- All gluteus muscles fire to stabilize pelvis in frontal plane
Loading response
Normal gait - Muscle action:
Gastrocnemius/soleus complex
stance phase
Normal gait - Muscle action:
Ankle:
- The soleus and gastrocnemius are active to control forward progression of the tibia
Knee:
- Quadriceps activity provides dynamic stability
- Calves act to restrain tibia, allowing femur to advance faster than tibia
Hip:
- Pelvis stabilized in frontal plane by hip abductors
Mid-stance
Normal gait - Muscle action:
Hamstring muscles
swing phase
Normal gait - Muscle action:
Ankle:
- Calf muscle activity peaks to prevent forward tibia collapse and allow the heel to rise
Knee:
- Restraint of the tibia by the calf muscles continue to stabilize the knee
Hip:
- TFL becomes active, possibly to restrain hyperextension of the hip (highly variable)
Terminal stance
Normal gait - Muscle action:
Gluteus medius
Stance phase
Normal gait - Muscle action:
Ankle:
- Residual plantar flexor activity and passive tension contributes to ankle moving into plantarflexion
Knee:
- Motion occurs with only minimal knee flexor activity from the gracilis
Hip:
- Adductor longus activity dynamically contributes to the femur flexing forward
Pre-swing
Normal gait - Muscle action:
Hip flexors
stance phase & swing phase
Normal gait - Muscle action:
Ankle:
- Pretibial muscles are active in preparation for ankle dorsiflexion
Knee:
- Activity peaks for biceps femoris short head, sartorius and gracilis (knee flexion)
- Knee flexion is aided by hip flexion
Hip:
- Iliacus, gracilis, and sartorius peak in activity (hip flexion)
Initial swing
Normal gait - Muscle action:
Quadriceps muscles
Stance phase & swing phase
Normal gait - Muscle action:
Ankle:
- Pretibial muscles are active
Knee:
- Knee extension is created by momentum and gravity
- Hamstrings become active in late mid-swing
Hip:
- Hamstrings initiate activity in late mid-swing
Mid-swing
Normal gait - Muscle action:
Ankle:
- The pretibial muscles are active
Knee:
- Quadriceps are active concentrically to ensure full knee extension
- Hamstring activity peaks in function to decelerate the thigh
Hip:
- Hamstrings peak in activity as they function to decelerate leg
- Gluteus muscles and TFL become active in preparation for role in weight acceptance
Terminal swing
Major Pathological Gait Defects
- Variance from the normal smooth locomotory function of gait can be associated with a deformity in:
- Osseous (developmental, congenital)
- Neurological (sensory, motor)
- Muscular soft tissue (laxity, fibrosis)
- Functional (lack of coordination, neuromuscular)
This is a characteristic gait of a spastic child
with marked bilateral adductor spasm at the
hips and equinus spasm in the ankle
scissoring gait
Also called “Festinating Gait”
- Gait is characterized by increase in cadence,
shortened stride, lack of heel strike and toe
off, as well as diminished arm swinging
Parkinson’s Gait
An interference on coordinating functions of
the cerebella, so the person tends to walk
with a wide base of gait with an unsteady
irregular gait, even if watching feet
Cerebellar gait
Spinal - proprioceptive pathways of the spine or
brainstem are interrupted
- Loss of position and motion sense
- Ambulates with a wide base of gait with foot slap at heel contact
- Often watch feet as they walk
Ataxic Gait
Pathological Gait:
Hip extensor weakness
- The individual will throw the hip backward
with a “lurch” using abdominal and paraspinal
muscle activation just after heel strike on the
affected side
- Also seen in dislocated hip and muscular
dystrophy
Gluteus Maximus Lurch
Pathological Gait:
Gluteus medius weakness
- Drop of the pelvis more than the usual 5°on the unaffected side beginning with initial contact on the affected side and continuing until initial contact on the unaffected side
- Lateral excursion occurs on the affected side
- May compensate by laterally bending trunk to the affected side
Trendelenburg Gait
Pathological Gait:
Most apparent during initial contact through the stance phase of gait
- The affected knee must be locked in
hyperextension at or preceding initial contact by compensatory activity of the gluteus maximus extending the femur and the soleus which extends the tibia
- Repetitive hyperextension of the knee results in stretching of the ligaments and capsule of the
knee and resultant recurvatum of the knee
during the stance phase
Quadriceps weakness
Pathological Gait:
- Results in loss of ankle plantarflexion control
- Foot-off will be delayed and the push-off
phase will be decreased
Gastrocnemius weakness