Gait Flashcards
what is gait
mechanism by which the body is transported using co-ordinated movements of the major lower limb joints.
what are the two phases of gait and how much of the gait cycle are they
stance phase - 60%. foot is in contact with the ground and is bearing weight.
swing phase- 40%. the foot in not in contact with the ground.
what does the gait cycle describe
the period of time from initial contact to next initial contact on the same side of the body
what are the five important attributes needed for normal gait
stability in stance - need to be able to transfer weight from one foot to another so stand on one foot.
foot clearance in swing- raising the foot off the ground as we bring it forward
pre-positioning for initial contact-preparing foot for the next stance phase
adequate step length- lower limb needs to be brought forward by a suitable distance during the swing phase before making contact with the ground during the next stance phase.
energy conservation
what is double support and double float
when walking there is a point where both feet are in contact with the ground and that is double support. as the speed of your gait increases the period of double support decreases and there is double float which is a period where both feet aren’t in contact with the ground.
Define running
when the swing phase is longer than the stance phase and there is a period of double float.
what are the steps in the stance phase
initial contact loading response mid-stance (foot flat) terminal stance(heel off) pre-swing (toe off)
what are the steps of-swing phase
initial swing- knee flexes to enable the foot to clear the ground
mid-swing- hip flexes and the pelvis swings forward to enable forward progression. there is dorsiflexion of ankle to neutral position
terminal swing- knee extends, foot is brought close to the ground in preparation for the initial contact
define stride
distance from initial contact with one leg to the next initial contact with the same leg
define step
distance from initial contact with one leg to initial contact with the opposite leg
define cadence
number of steps per min
difference between kinematics and kinetics
kinematics describes the motions themselves and kinetics describes the forces and moments that cause motion
kinetics of the ankle joint during the state phase
tibialis anterior is working eccentrically in initial contact and then relaxes when the foot is flat on the ground
during terminal space phase gastrocnemius and coleus take over to generate power needed for propulsion by powerfully plantar flexing the ankle.
how is energy conserved in normal gait
Minimising the excursion of the centre of gravity of the body
Controlling momentum e.g. by eccentric muscle contraction
Transferring energy passively between body segments by using some of the
elasticity that is inherent in the tendons and ligaments of the
musculoskeletal system
Phasic muscle action: using muscles intermittently e.g. using the example
above, tibialis anterior ‘switches on’ for some phases of the gait cycle (e.g. mid-swing) and ‘switches off’ during others (e.g. mid-stance). If a muscle contracts continuously during the gait cycle, it will fatigue much more rapidly than if it is used intermittently.
what is antalgic gait
patients walk in a manner to reduce pain
limping- shortening stance phase of painful limb
shorten swing phase of normal limb
uneven gait
use walking stick in hand opposite to painful limb so they can lean towards walking stick and shift their centre of gravity away from painful limb
describe hemiplegic gait
due to paralysis of one side of the body
commonly as a result of stroke
patients have spasticity of the affected side of the body so patients have a flexed upper limb and an extended lower limb.
cannot flex hip, knee or ankle so need to lean towards the unaffected side of the body then circumduct the paralysed leg.
describe diplegic gait
spasticity affects both lower limbs
The patient walks with a very narrow-based gait (feet close together), dragging both legs and scraping their toes on the ground. Spasticity in the hip adductors can cause the legs to cross the midline – this is referred to as scissoring (figure 4.40)
Spasticity in the hamstrings means that the knees are slightly flexed and spasticity in the gastrocnemius and soleus results in plantar-flexion of the ankles
describe high-steppage gait
When the foot is raised from the ground in the swing phase, the absence of active dorsiflexion means that the foot, under gravity, assumes a position of plantarflexion. The patient therefore has to flex the hip much more than usual in order to lift their foot high off the ground and stop their toes from dragging along the floor. During ‘initial contact’, the normal eccentric contraction of the tibialis anterior muscle is absent so the foot also tends to slap down onto the ground.
describe parkinsonian gait
flex their neck and trunk forwards to move their centre of gravity in front of their lower limbs
shuffling gait
festinate gait- take accelerating steps
loss of arm swing while walking
describe ataxic gait
An ataxic gait is characterised by clumsy, staggering movements with a broad-base (feet wide apart). Patients often hold their arms outwards to help them to balance. Whilst standing still, the patient’s body may sway back and forth and from side to side – this is called titubation. Patients will not be able to walk heel-to- toe or in a straight li
