Gait Flashcards
What is Gait?
The mechanism by which the body is transported using co-ordinated movements of the major lower limb joints
What systems require an energy efficient interaction between them to achieve a normal gait?
Musculoskeletal system
Neurological system
What is the gait cycle?
The period of time from initial contact to next initial contact on the same side of the body
What are the 2 phases of the gait cycle?
Stance phase
Swing phase
What is the stance phase?
Time foot is in contact with the ground and is weight bearing
What is the swing phase?
Time when the foot is not in contact with the ground
What is the approximate percentage of time spent in the stance phase and swing phase in normal gait?
Stance phase = 60%
Swing phase = 40%
What are the 5 important attributes needed for a normal gait?
Stability in stance
Foot clearance in swing
Pre positioning for initial contact
Adequate step length
Energy conservation
What is double support?
Time when both feet are in contact with the floor
What is double float?
Time when both feet are off the floor
At what point does walking become classified as running?
When double float starts
What happens to the period of double float when you run faster?
Double float increases
What are the 5 stages of the stance phase?
Initial contact (heel strike)
Loading response (shock of impact absorbed)
Mid stance (foot flat)
Terminal stance (Heel off)
Pre swing (Toe off)
What are the 3 stages of swing phase?
Initial swing
Mid swing
Terminal swing
What is a stride?
Distance travelled in one gait cycle
Distance from initial contact to initial contact with the same leg
(2 steps)
What is a step?
Half a stride
Distance from initial contact on one leg to initial contact o the other leg
What is cadence?
Number of steps per minute
What is kinematics?
Describing motion
What is kinetics?
Describes the things that cause motion
What is concentric muscle work?
When muscles shorten generating power
What is eccentric muscle work?
When muscles lengthen absorbing power
What is isometric muscle work?
When muscles stay the same length providing stability
What muscles are working in the leg from when intial contact is made (heel strike) to toe off?
Anterior compartment muscles (Tibialis anterior) dorsiflexor is eccentrically contracting so foot doesn’t slap onto floor
Once foot is flat on ground Tibialis anterior relaxes, Gastrocnemius and Soleus generate propulsion power by plant flexing ankle (posterior compartment muscles of leg)
What conserves energy in normal gait?
COG moves relatively little
Momentum controlled by eccentric muscle contractions
Energy transferred between body segments (arms for momentum)
Muscles intermittently used to prevent fatigue
What is an Antalgic gait?
Limp
Walk/gait that reduces pain
How is the gait phases affected in Antalgic gait?
Stance phase of affected leg REDUCED
Swing phase of unaffected leg REDUCED
How is a walking stick helpful for a patient with Antalgic gait?
Walking stick used is hand OPPOSITE painful limb
Patient puts weight on the stick shifting their centre of gravity (COG)
This reduces wait put on painful limb
What is the Trendelenburg gait?
When pelvis drops on the healthy side in the stance phase
Torso swings to affected side to move the COG to help compensate
What causes Trendelenburg gait?
Hip ABductor weakness
What may be the cause of Hip ABductor weakness causing Trendelenburg gait?
Neurological damage of the Superior gluteal nerve (supplies gluteus medius and minimus)
Pain
Surgical trauma
Describe what you would see if a patient had damage to their left superior gluteal nerve?
LEFT Hip ABductor weakness
Pelvis dips to the right
Patient may lean their torso to the left to adjust their COG
What is a hemiplegic gait caused by?
Paralysis of one side of the body
What causes hemiplegic gait?
Hemi-brain injury:
-stroke
-cerebral palsy
-trauma
Describe what happens in a hemiplegic gait:
EXTENDED lower limb
Circumduction of affected leg (brought forward in circular motion from outside to inside)
Upper limb also tends to be flex on the affected side
Patient
What are the 2 phases of gait like in hemiplegic gait?
Short stance phase on affected leg
Short swing phase on healthy leg
What is spasticity?
Continuous contraction
What is Diplegic gait?
When the spasticity affects both limbs
Caused by neurological disorders like cerebral palsy
What can diplegic gait also be called and describe why this happens?
Scissoring gait
Adductors/Hamstrings/Iliopsoas are contracting flexing knees and bringing them together
Ankles also plantar flexed (patient cant put heels on floor)
What causes High Steppage gait?
Unilateral neurological damage
Common fibular palsy causes food drop and foot slap since anterior muscle compartment weak (weak dorsiflexion) cant support the foot loading
What are the tell tale signs of high steppage gait?
Foot drop, Toes hanging down
Foot slap
Excessive hip Flexion on affected side
What causes parkinsonian gait?
Parkinson’s disease (Neurological condition)
What are the characteristic features of a parkinsonian gait?
Lean forward for momentum
Short shuffling steps
Arms flexed
NO ARM SWINGS
What causes ataxic gait?
Cerebella’s disorders:
-Inherited
-Sensory
-Intoxication
Describe an ataxic gait:
Clumsy staggering movements
Legs wide apart
Patient holds arms out to balance
Patients body may sway back and forth side to side
