Gait Flashcards
5 phases of gait cycle
Initial Contact Loading response Midstance Terminal stance Preswing
Normal step length is between
25-30 INCHES; WALKING SPEED 1.5 M/S
glut max most active which phase of gait cycle
The gluteus maximus is inactive in all phases of the gait cycle except the initial contact phase. The gluteus maximus is eccentrically contracting during initial contact
rocker knife used in
hemiplegia
weak quads
genu recurvatum
Excessive varus moment
foot is too far medially, socket is too abducted
excessive valgus moment at the knee
foot is set too far laterally, socket is too adducted
excessive knee flexion
not enough friction in nee unit, too much dorisflexion in the foot, weak quads, socket too far anterior, foot too far posterior, knee flexion contracture
excessive knee extension
too much friction in the knee, too much plantar flexion in the foot, weak quads (recurvatum), socket placed too far posteriorly, foot placed too far anteriorly
opponens orthosis
immobilizes the thumb (often ligamentous injury) can help with arthritic conditions
Swing through gait
two crutches on ground and legs are swung forward beyond point of crutch palcement
phantom pain tx
TCA
amputation at tarsometatarsal junction
lisfranc amputation
talus and calcaneus remain amputation
chopart
Chronic right hip OA
With hip osteoarthritis, an antalgic gait and abductor lurch (swaying of the trunk over the side of the affected hip) may be noted. A trunk lean toward the painful hip brings the center of mass over the joint and decreases the mechanical stress across the joint. Circumduction is seen in a long limb, abductor muscle contracture, and stiff knee.
when do calf muscles undergo eccentric contraction
The calf muscles are inactive in initial contact and loading response phase. They undergo eccentric contraction in midstance phase, and concentric contraction in terminal stance phase. Midstance phase is the period from lift off of the contralateral extremity from the ground to the point where the ankles of both extremities are aligned in the frontal plane.
valgus deformity at the ankle what kind of flare do you use
Medial heel flares resist valgus motion at the ankle, whereas lateral heel flares resist varus motion.
The ischial containment socket is the most commonly prescribed socket for transfemoral amputees. Its narrow medial-lateral dimension helps to maintain femoral ADDUCTION, resulting in a more efficient stance phase of gait. Unlike the quadrilateral socket, where WEIGHT BEARING primarily occurs on the medial ischium and ischial ramus; the femoral end generally sits about ¼-½ inch above the distal end of the socket. The quadrilateral socket provides a relief in each corner for the hamstring tendon, gluteus maximus, rectus femoris, and the adductor longus.
medial lateral dimension is narrower than the AP ;
Many polycentric knees are designed so that the center of rotation moves anteriorly very rapidly during the first few degrees of knee flexion, quickly passing in front of the floor reaction line and facilitating the swing phase. Because the polycentric knee can be flexed under weight bearing during the terminal stance, when properly dynamically aligned it can offer both excellent stance stability and ease of swing-phase flexion. All polycentric knees shorten mechanically to a slight degree during flexion, adding additional toe clearance during midswing.
greater knee stability, symmetric gait, equal knee length when sitting
linear distance between successive points of contact of SAME foot; measured from heel strike to heel strike of same foot
stride length
Linear distance in the plane of progression between corresponding successive contact points of opposite feet; heel strike one foot to heel strike of the other foot, normally 15-20 inches
step length
number of steps per unit time
cadence
I LIKE MY TEA PRESWEETENED for stance phase divisions
intial contact, loading response , midstance, terminal stancd, preswing
swing phase devisions “in my teapot:
initial swing, mid swing, terminal swing
opposing muscles are sutured to each other and to the periosteum at the end of the cut bone with minimal tension
myoplasty
muscles and fasciae are suturred directly to bone through drill holes
myodesis
amputation of tarso metatarsal junction
lis franc
removed all tarsals and metatarsals, only talus and calcaneus bones remain
chopart
vertical calcaneal amputation
pirogoff
horizontal calcaneal amputation…..
boyd
University of cali biomechanics lab (UCBL) orthosis
custom molded orthosis to control flexible calcaneal deformities (rearfoot valgus/varus) and mid tarsal issues forefoot abduction/adduction.
rocker bar
relieve metatarsal pain, strip placed across the sole just posterior to the metatarsal heads….can be uses plantar fasciitis, neuropathic ulcer………relieves metatarsal heads….metatarsal bar is similar but shorter
reciprocal gait orthosis
used for upper lumbar paralysis in which active hip flexion is preserved
scott craig orthosis
bilateral kafo for standing and ambulation in paraplegics with neuro level l1 or lower, can do unsupported standing by resting on Y ligament iliofemoral ligament…paras can ambulate with scott craig orthosis and crutches or walker using a swing to or swing through gait pattern
Taylor and knight taylor brace
taylor- flex/ex control TLSO, 2 posterior paraspinal bars attached to inferior pelvic band
Knight taylor brace- like above plus lateral bands and a thoracic band to restrict lateral bending….stable T or lumbar Fractures
Flexion control TLSO
jewett hyperextension brace…………..
cruciform anterior spinal hyperextension tlso
similar to jewett (jewett more like a circle in front, cash is a cross)
