Gait Flashcards
Who was one of the first people to describe the mechanics of gait?
Leonardo da Vinci described the mechanics of the body during standing, walking up and downhill, rising from sitting, jumping, and normal human gait.
When was the first scientific work published by Weber and Weber?
1836
What was the main impetus for the beginning of gait analysis?
In 1872, Edward Muybridge investigated whether all four of a horse’s hooves leave the ground during running. He was hired because of a bet on a horse race. This started gait analysis and cinematography.
What are Dr. E’s three horses names?
Jazz, Mishka, and Keno
Does gait only refer to walking?
No. Gait is any cyclical, repeatable movement pattern of the LE’s.
Why is locomotion not synonymous with gait?
Locomotion just means getting from point A to point B. It could be in a car or flying or whatever.
What is the goal of gait?
Progression of the body
True or False
Generally, gait is the same from individual to individual.
True. Generally, gait is the same, but there will be individualistic differences.
What things can affect gait?
- mood
- gender
- anthropometry
- pathology
- surface
True or False
Kinetics are descriptive.
False
KINEMATICS are descriptive.
Kinetics deals with forces.
There are four kinematic variables of gait. What are they?
- step length
- stride length
- step width
- toe-out angle
True or False
Step length is the same for every individual.
False
Step length has a normal, but it will vary a lot based on leg length.
How is step length measured?
Step length is always measured from the back of one heel to the back of the other heel.
What will change step length?
- speed of gait
- surface
- gender
- mood
What is the normal for stride length?
1.2-1.9 m
True or False
Stride length is equal to one gait cycle.
True!
Stride length is measured from the back of one heel to the back of the same heel. It is the length of one step and is equal to a gait cycle.
The normal for step width is... A. 4 cm B. 10 cm C. 8 cm D. 6 cm
C. 8 cm
You observe a patient walking with their heels close together. What landmarks would you use to measure step width?
Step width is measured from the midpoint of one heel to the midpoint of the other heel.
What characteristics can affect the step width?
It could be affected by wide hips.
A patient walks with a wide step width. What are they increasing?
They are increasing their base of support.
The normal toe-out angle is…
7 degrees
How do you measure toe-out angle?
A straight line is drawn through the midpoint of the heel. Then a line is drawn through the center of the 2nd metatarsal. The angle between these two lines is the toe-out angle.
A patient points their toes out when they walk. Would they be more stable or less stable?
They would be more stable. Their base of support would be increased.
Would someone with anteversion or retroversion have more toe-out?
Someone with retroversion would have more toe-out.
Is stance time occurring when there is one foot on the ground or two?
Both. There are two phases of stance time. A single limb stance and a double limb stance. Stance time is the amount of time you spend with your foot on the ground.
True or False
Stance time decreases as speed decreases.
False.
Stance time decreases as speed increases. Stance time increases with a slower gait.
Do older or younger people tend to spend more time in stance phase?
Older people spend more time in stance because it increases time with both feet on the ground. Their balance isn’t great, so they want the greater base of support.
Which gait decreases stance time on that leg?
A. Ataxic gait
B. Antalgic gait
C. Parkinson’s gait
B. Antalgic gait decreases stance time on the painful leg.
A patient has had a stroke. What modification with gait might you see?
Stance time will be decreased on their bad leg because they don’t trust it.
True or False
Swing time is the amount of time that the leg is in the air.
True!
True or False
As stance time increases, you see a similar increase in swing time.
False.
As stance time goes up, swing time goes down.
Do women or men have an increased cadence?
Women have an increased cadence because our legs are typically shorter, so we walk faster to cover the same distance in the same amount of time. Men tend to have longer legs and therefore, a shorter cadence.
How is cadence measured?
Cadence is measured in steps permanent.
What is a normal cadence for women and men?
W = 117 M = 111 Mean = 113
True or False
Cadence is something you can use to compare your patients to and help them improve.
True!
How is velocity measured?
Velocity = distance/time
Normal community ambulation is... A. 1 mph B. 2 mph C. 3 mph D. 4 mph
C. 3 mph
You can use this to make goals for your patients.
True or False
An increase in cadence always means an increase in velocity.
False
In Parkinson’s festinating gait, the cadence is really fast, but the velocity is not.
Stance phase what percentage of the gait cycle? A. 40% B. 70% C. 50% D. 60%
D. 60%
Why is stance phase a greater percentage of the gait cycle than swing phase?
You have two periods of time when both feet are on the ground and one period of time when one foot is on the ground.
The patient’s heel has just made contact with the ground, should they be in single leg stance or double leg stance?
They should be in double leg stance (22% of gait cycle).
The patient is bringing their opposite foot through the swing, are they in single leg stance or double leg stance?
They are in single leg stance (38% of the gait cycle).
A patient has a normal gait cycle, what percentage of it will they spend in swing phase?
They will spend about 40% of the cycle in swing phase.
A patient comes in and has trouble putting weight through one leg, they have poor body support/stability, and are unable to adapt to surfaces. What phase are they going to have trouble with?
Stance phase. The goals of stance phase are…
- shock absorption
- weight acceptance
- adaptation
- body support/stability
- contribution to body progression
True or False
In stance phase, your body is not progressing forward.
False
Even in stance phase, your body is progressing forward.
What are the goals of the swing phase?
- weight release and transfer
- limb clearance
- transfer of momentum (generate momentum at the hip and transfer it down the leg)
- limb advancement
- contribution to body progression
- preparation for stance
True or False
Walking is a high energy activity.
False
Walking is a very efficient system. The main goals is to conserve energy.
If a patient fatigues easily while walking, what physical property are they probably not using?
Momentum. Momentum helps conserve energy, so if the patient is using too much contraction, they might get fatigued quickly.
Which subdivisions of gait occur during the stance phase?
- initial contact
- loading response
- midstance
- terminal stance
- pre-swing is part of the stance phase
Which subdivisions of gait occur during the swing phase?
- initial swing
- midswing
- terminal swing
You notice that a patient makes initial contact with their posteriomedial heel, is that normal?
No, initial contact should be made with the posteriolateral heel.
Why is it important to land on the lateral aspect of the heel?
Hitting on the lateral aspect of the heel causes the ground reaction forces to push the heel up. This causes pronation. As soon as we hit down, the lateral side is shoved up, and we pronate the foot.
Which one adapts and absorbs shock better?
A. Pronated foot
B. Supinated foot
A. Pronated foot
A pronated foot is a flexible foot. This helps us absorb shock and adapt to surfaces.
At initial contact, the foot pronates. What does this increase?
It increases impulse. Pronating the foot extends the amount of time that the ground reaction force is applied to the lateral heel which dissipates the shock.
Just before initial contact is the foot supinated or pronated?
The foot is supinated just before initial contact. This positions the lateral heel to hit first. A supinated foot is also a functionally longer leg. A pronated foot is a functionally shorter leg.
What is the goal of initial contact?
The goal is to get the foot in the right place to bear weight. It serves to position the limb to start stance with a heel rocker. This is a fulcrum that allows the foot to “roll” into PF.
How many rockers occur during the stance phase?
There are three rockers that occur during stance phase.
True or False
The purpose of the rockers is to stabilize the body as you put weight on the foot.
False
The rockers cause the COM to progress forward even though the leg is not moving.
What is the first rocker? How does it function?
The heel rocker is the first one.
It occurs during initial contact. A ground reaction force on the heel pushes it up and pushes the foot into plantar flexion. The heel rocker is the movement of the ankle from neutral to pronation. It causes the foot to push down into loading response.
True or False
In closed kinetic chain (CKC), pronation and supination involve the whole foot moving.
False
In CKC, all the components of supination and pronation come from the talus and the calcaneus.
Explain subtalar CKC supination.
- Tibial ER
- Talus abduction. The calcaneus cannot move, so the talus moves instead. The calcaneus cannot adduct, so the talus abducts instead.
- Calcaneal inversion
The chain is affected from the bottom up.
A supinated foot increases knee…
A. Varus
B. Valgus
A. Varus