Gait Flashcards
when does the gait cycle begin and finish
begins with the first ground contact of one foot and ends when the same foot makes ground contact again
what is gait
a method of human locomotion. a learned feature. autonomic and conscious control- central pattern generators. involves use of both legs alternately for support and propulsion. varies according to age, gender, body geometry and pathology
tasks of gait cycle- weight acceptance
tasks of gait cycle- transfer of weight onto limb that has completed swing and has unable alignment. shock absorption and forward progression
tasks of gait cycle- single limb support
one limb must support the entire body weight and provide truncal stability
tasks of gait cycle- limb advancement
require foot clearance as limb swings through to its destination in front of body
stages of gait cycle
stance phase- 60% if cycle. considered leg has a period in contact with ground. swing phase- 40%- average speed period when foot is not in contact with the ground (early, middle and late swing)
gait cycle opposite legs
as we get initial contact on one leg, terminal stance to pre swing on other leg, mid stance of other leg, terminal stance is initial contact on opposite side
stages of gait cycle
stance- initial contact, loading response, mid stance, terminal stance, pre-swing
swing- initial swing, mid swing and terminal swing
initial contact
first period of double stance- quads and hamstrings working to adopt a support role. heel strike= hip flexed- extension initiated, knee extended, ankle dorsiflexed, eccentric lowering of foot to floor
loading response
foot flat. hip extension- concentric action- abductors stabilize pelvis and trunk, knee flex- a cushion effect- eccentric quadriceps, ankle PF- eccentric of dorsiflexors- eversion- transfer weight to lateral border of foot. double support ends. body weight transferred onto leg-leg in pre swing.
mid-stance
first part of single limb support- COM passes from behind to infront of stance foot, hip extension- momentum- abductors of stance limb control pelvis (stop it lowering), knee restores to slight flex, ankle DF by momentum- controlled eccentrically PF. begins with lifting foot and continuous until body weight is over support foot: leg goes over foot- legs in mid swing
terminal stance
body is propelled forwards and ends stance phase. hip extension increased by gravity 0° at heel rise. abductor power decreases at onset of double support. heel rise- passive. heel rise and continues until heel hits ground: body weight moves forward beyond foot and leg in trailing position
pre swing
second double support interval, ground contact of opposite leg results in- increased ankle PF, increased knee flexion, decreased hip extension. body weight transfer to opposite limb. begins with initial contact of foot and end with toe off
initial swing
hip flexion- initial concentric action to propel limb forward, assisted by gravity and momentum. knee flexion- hamstrings concentric contraction from pre swing. ankle- concentric dorsiflexion to clear toes from ground. begins with foot is lifted and ends when foot is opposite the stance leg.
mid swing
hip and knee flexion continues to keep toes from floor. knee flexion may reduce by gravity (eccentric of hamstrings)- medial rotate for heel strike. ankle PF- to neutral by eccentric action of DF. from end of initial swing to point when tibia is vertical, leg gis in late mid-stance
terminal swing
deceleration- final stage of swing. hip flexion- momentum continues, eccentric controls slows. knee- from flexion to extension by momentum- controlled by eccentric hamstrings. ankle DF for heel strike
upper body movements
flexion and extension of hip- causes lumbar spine rotation. to keep head facing forward- thoracic and cervical rotation to opposite side. reciprocal movement of upper and lower limbs right- shoulder flexion- left hip flexion. flexion and extension of elbow mimic shoulder movement but slight delay
gait measurements
qualitative gait assessment- BOS, step length, stride length, toe in/out, weight transference, speed, cadence
kinematics- MA - angles of joints and muscle activity, kinetics- force platform analyses
changes in older peoples gait
reduction in overall velocity and stride length. reduction in agility- uneven surfaces or crowds or darkness. decreased arm swing, pelvic rotation. a flat foot approach to heel strike and toe off. due to- decreased muscle bulk/ strength, decreased flexibility and joint range, loss of vision and hearing
abnormal gait pattern- ataxic and analgesic and apraxia
ataxic- unsteady, uncoordinated walk with wide BOS, the feet thrown outward. antalgic- a short stance phase on painful side- avoids pain on weight-bearing structures
apraxia- unable to carry out familiar, purposeful movements in the absence of paralysis or other motor or sensory impairments. he process is forgotten
abnormal gait pattern- trendelenburg gait and hemiplegic
trendelenburg- caused by weakness of the abductor muscles of the lower limb, gluteus medius and minimus which results in the pelvis dropping to the opposite side.
hemiplegic- weakness down one side following a CVA
