Gait!! Flashcards
what are the 3 functional tasks of gait?
weight acceptance,single limb support, and swing limb advancement
what are the component of weight acceptance
forward progression, stability (preventing collapse), shock absorption
what are the components of single limb stance
forward progression and stability
what are the components of swing limb advancement
foot clearance and limb advancement
define gait cycle.
initial heel contact of one foot to the heel contact of the SAME foot.
Describe the distribution of time spent in stance phase and swing phase. Dual limb and single limb?
Stance (60%)+(Swing (40%)
Single (80) +Double (20%)
Stride length
Distance between 2 successive heel contacts of same foot (2 steps)
Normal=1.48M and 1.32F
Step length
Distance between successive heel contacts of different feet> informs gait symmetry
degree of toe out
angle between the line of progression of the body and a line that goes through the heel and second toe; can accommodate to increase BOS
normal: 5-7
step width
the lateral distance between heel centers of 2 consecutive foot contacts
normal: 3.5 inches
what are the spatial descriptors of gait?
stride length
step length
degree of toe-out
step width
what are the temporal descriptors of gait?
stance time
stride time
step time
cadence
stance time
amount of time in stance phase
stride time
time for a full gait cycle, usually around 1 sec is normal
step time
time for completion of a R or L step -whichever is affected
cadence aka step rate
number of steps/min
normal: 111 steps/minM and 121 steps/minF
gait velocity (m/s or mph)
most relevant test of gait-walking efficiency
normal: 1.37m/s M and 1.32m/s F
What are the 8 common terms of Rancho Los Amigos Terminology?
Stance Phase:
initial contact, loading response, midstance, terminal stance, Pre-swing
Swing phase:
initial swing, mid swing, terminal swing
initial contact (critical event, functional task, muscles involved )
critical event: heel first contact
muscles: hip ext, knee ext, ant tib A
Position (hip,knee,ankle) : 20>5>0
loading response (critical event, functional task, muscles involved )
critical event: hip stability, controlled knee flex, and ankle PF
»shock absorbed, momentum preserved, flat foot
muscles: hip and knee ext, hip add, pretibials
Position (hip,knee,ankle) : 20>15>5
combined, what do IC and LR do functionally:
weight acceptance shock absorption stable base for the body to progress over GRF absorbed Dual limb support
midstance (critical event, functional task, muscles involved )
critical event:controlled body and tibial advancement
muscles: abductors (hip), lessening ext (knee),PF (ankle)
Position (hip,knee,ankle) : 0>5>5
terminal stance (critical event, functional task, muscles involved )
critical events; controlled DF with heel rise as body passes forefoot of stance limb
muscles : only the PF @ ankle
Position (hip,knee,ankle) : 20>5>10
preswing (critical event, functional task, muscles involved )
weight transfer>second pd of dual limb support
critical events: passive knee flex to 40 degrees and ankle PF at 60, MTP ext
muscles: hip adductors, beginning pretib activation at ankle
Position (hip,knee,ankle) : 10>40>15PF
Initial swing
critical events: hip flexion and knee flexion to clear the floor
functional task:limb advancement
muscles: hip and knee flexors, pretibials
mid-swing (critical event, functional task, muscles involved )
thigh advancing, knee extending
critical events: continued hip flexion and foot clearance
muscles: hip and knee flexors, pretibials
Position (hip,knee,ankle) : 25>25>0
terminal swing (critical event, muscles involved )
where the leg reaches to achieve step length
critical event: knee ext
muscles:hip and knee ext, pretibials
Position (hip,knee,ankle) : 20>5>0
What phases make up weight acceptance?
Initial contact
loading response
what phases make up single limb support?
mid stance and terminal stance
What compensations might you observe in someone with decreased great toe ext? What might have caused it?
observed: incomplete forefoot rocker, shortened stance phase
causE: joint hypomobility, plantar fasciitis, pain, bone spur, etc
What compensations might you observe in someone with steppage gait/increased knee flexion? What might have caused it?
observation: increased hip/knee flexion and no DF; prolonged swing
causes: foot drop, nerve disorder, equinus deformity
What compensations might you observe in someone with foot flat contact? What might have caused it?
observation: absent heel rocker> mid/forefoot contact ground first
causes: excessive knee flexion in late swing , weak DF
What compensations might you observe in someone with circumduction? ? What might have caused it?
observation: lateral whipping of the leg due to an elongated swing limb
causes: likely no knee flexion but at least impaired, impaired DF ROM
What compensations might you observe in someone with increased lordosis? What might have caused it?
observation: lack on hip ext in TS> lumbar lordosis for terminal stance phase
causes: hip flexor contracture, hip OA
clinical application: what are the 5 characteristics of muscular dysfunction:
weakness loss of power decreased endurance spasticity contracture
Key roles of the ankle joint:
dorsiflexors: eccentric control of PF at IC
plantarflexors: eccentric control during tibial advancement; concentric @Tst
invertors: eccentrically control pronation until MSt; concentrically supinate for push off
evertors: co-contract to counter stronc inversion during LR/MSt
Key roles of the hip joint:
extensors: initiate hip ext and prep for IC
flexors: advance LE during ISw; conc lift LE for toes clearance
abductors: eccentrically ctrl lowering of contrala pelvis + stability in stance
adductors: conc assist hip flexion after toe off
What compensations might you observe in someone with trendelenburg gait? What might have caused it?
observation: longer swing limb and potentially decreased stance time w/ excessive downward drop of contralat pelvis
causes: mild glute med weakness
What might you observe in someone with compensated trendelenburg gait? What might have caused it?
observation: reduced Gmed demand by trunk lean over stance limb to level pelvis
causes: moderate to severe glute med
What compensations might you observe in someone with foot slap? What might have caused it?
observation: rapid PF after IC (can be audible) bc PF is unchecked by pretibials
causes: Tib ant weakness
What compensations might you observe in someone with knee extension thrust? What might have caused it?
observation: rapis and excessive knee extension during LR
causes: quat spasticity for UMN lesion
