Gait Flashcards
Define gait
Mechanism by which the body is transported using coordinated movements of the major lower limb joints
What are the 5 attributes of a normal gait
Stability in Stance
Foot clearance in Swing
Pre-positioning for initial contact
Adequate step length
Energy conservation
What is a gait cycle
Describes the period of time from initial contact to next initial contact on the SAME side of the body
What is proportion of stance, swing phase in a gait cycle
Stand phase: 60%, foot contact with the ground
Swing Phase: 40%, for is not in contact with the ground
What is the the double support phase
Both legs in contact with the floor
What is the double float phase
Both legs in the air
How is gait cycle for running different from walking
Swing phase is longer than stance phase
Describe the steps for the gait cycle
Initial contact (heel strike
Loading response
Mid-stance (foot flat)
Terminal stance (heel off)
Pre-swing (toe off)
Describe the steps for the swing phase of the gait cycle
Initial swing (for push off)
Mid-swing
Terminal swing
Define stride
Distance from
IC (initial contact) Right ➡️ IC Right
Define step
Distance from IC Right ➡️ IC Left
Define cadence
Number of steps per minute
What does kinematic describe in gait
Motion
-joint angles
-displacements
-velocities
-accelerations
What does kinetics describe in gait
Things that cause motion
-forces
-moments
List the different types of muscle contraction and when it is used
Concentric contraction (shortens muscle)
-acceleration, power generation
Eccentric contraction (lengthens muscle) -deceleration, shock absorption
Isometric contraction (same length)
-stability
Describe the steps in the kinetics of the ankle joint during the stance phase
- Tibialis anterior works eccentrically
- Tibialis anterior relaxes
- Gastrocnemius and soleus plantarflexes ankle
By what mechanisms is energy observed during normal gait
-Minimising excursion of the centre of gravity of the body
-Controlling momentum (e.g. eccentric muscle contraction)
-Transferring energy passively between body segments (using tendons, ligaments)
-Phasic muscle action (using muscles intermittently such as in Tibialis anterior)
What are the seven different types of common gait abnormalities
Antalgic gait
Trendelenburg gait
Hemiplegic gait
Diplegic gait
High-steppage gait
Parkisonian gait
Ataxic gait
Describe the features of antalgic gait
Cause: Patients walk in a manner that reduced pain (OA of hip)
Appearance:
-walk with a limp
-uneven gait
-affected limb; shortening stance phase
-unaffected limb; eventually shorten the wing phase
Describe the features of Trendelenburg gait
Causes: Superior gluteal nerve lesion
-muscle pain, inhibition of function
-trauma
-biomechanical hip instability
Appearance:
Unaffected side; pelvis drops in stance phase, swinging torso over towards the affected side
Gait: waddling
What are the two types of Trendelenburg gait
Uncompensated Trendelenburg gait (unaffected side of pelvis drops)
Compensated Trendelenburg gait
(swinging torso over towards the affected side)
Describe the features of Hemiplegic gait
Cause: Paralysis of one side of the body
-stroke, cerebral palsy, trauma to CNS
Condition:
-spasticity of the affected side
Appearance:
-Flexed upper limb, extended lower limb
-Short stand phase
Unaffected side; leans towards this side
Affected side; circumduct leg of this side
Where is the spasticity the most severe in Hemiplegic gait
Flexor muscles of upper limb
Extensor muscles of lower limb
(Dominant muscle groups)
Describe the features of Diplegic gait
Causes: cerebral palsy
Condition: spasticity affects both lower limbs
Appearance:
-Dragging both legs on the ground
-Legs cross midline (SCISSORING)
Describe the features of High-steppage gait
Condition:
Weakness of ankle dorsiflexion
Causes:
-common perineal nerve palsy
-sciatica
-neuromuscular disease
Appearance:
-flex hip much more than usual
-during initial contact, normal eccentric contraction of the Tibialis anterior muscle i absent
-compensate lack of dorsiflexion by an EVERSION FLICK
Describe the features of Parkisonian gait
Cause:
Reduction in dopamine (vital for regulating body movement) as a result of degeneration of subtantia nigra
Appearance:
-difficult to initiate movement
-flex neck and trunk forwards
-absence of arm swing
-short steps (SHUFFLING gait)
-accelerating steps (FESTINANT gait)
Describe the features of Ataxic gait
Causes:
-proprioceptive (loss of awareness of the position of joints)
-cerebellar disease
-vestibular (damage to organs of balance)
Appearance:
-clumsy, staggering movements, broad-base
-sway back and forth, side to side (TITUBATION)
What are the causes of cerebellar dysfunction
Inherited
Acquired (e.g.stroke)
Alcohol intoxication
