Gait: Flashcards

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1
Q

What are the phases of gait

A

stance phase
swing phase

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2
Q

Tasks doing gait

A
  • weight acceptance
  • single leg support
  • limb advancement
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3
Q

Periods gait

A
  • load response: initial contact to opposite toe off
  • mid stance: Opposite toe off to heel raise
  • terminal stance: heel raise to opposite initial contact
  • Pre swing: opposite initial contact to toe off
  • initial swing: toe off and feet adjacent
  • mid swing: feet adjacent to tibia vertical
  • terminal swing: tibia vertical to next initial contact
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4
Q

Lower extremity kinematics in the sagittal plane: pelvis

A
  • initial contact: loading response the pelvis is posteriorly rotated (less than 5º)
  • loading response to midstaalnace: pelvis is neutral
  • midstance to terminal stance: pelvis is anterior rotated (less than 5º)
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5
Q

Lower extremity kinematics in the sagittal plane: hip

A
  • 30º hip flexion = initial contact
  • 10º hip extension = mid stance to pre swing
  • terminal stance –> terminal swing hip flexes
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6
Q

Lower extremity kinematics in the sagittal plane: knee

A
  • initial contact = knee flexed (shock absorber)
  • going into loading response flex the knee 20º
  • going into mid stance knee extends (5º knee flexion)
  • pre swing knee flexes
  • midswing terminal knee starts to extension
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7
Q

Lower extremity kinematics in the sagittal plane: ankle

A
  • Initial contact: ankle is neutral
  • loading response: PF 10º
  • midstance: 10 DF from 10 º PF?
  • preswing: starts to PF during pre swing
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8
Q

Lower extremity kinematics in the frontal plane: pelvis

A
  • up and down
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9
Q

Lower extremity kinematics in the frontal plane: hip

A
  • initial contact to Loading response = adduction of the initial contract leg and abduction of the leg that is leaving stance phase
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10
Q

Lower extremity kinematics in the frontal plane: knee

A
  • has to do with natural alignment
  • in stance some are more valgus and then that might be exaggerated in the swing phase
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11
Q

Lower extremity kinematics in the frontal plane: ankle (subtler joint)

A
  • Initial contact: inverted position (land on posterior lateral calcareous
  • in response to ground reaction force the calcareous shifts to eversion
  • midstance towards pressing calcareous everts a little bit
  • midstance goes from everted to inverted to get more stability so during pressing there is a edge to live to push off
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12
Q

Lower extremity kinematics in the horizontal plane: Hip

A
  • Right = reference limb
  • initial contact ER of the right and IR of the left (terminal stance)
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13
Q

When during gate is COM highest during Gait

A
  • single leg stance increase Potential energy and COM is the highest
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14
Q

when is COM lowest during gait

A
  • double leg stance = increased kinetic energy
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15
Q

GRF during initial contact (in the sagittal plane)

A
  • ankle: falls behind the joint = plantarflexion moment
  • knee: passes anterior to the joint = external knee extension moment
  • hip falls anterior to the joint = external flexion flexion moment
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16
Q

GRF during loading response (after initial contact) (sagittal plane)

A
  • ankle: external plantarflexion moment
  • knee: external flexion moment (shifts behind the joint)
  • Hip: external flexion moment
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17
Q

GFR through midstance (sagittal plane)

A
  • ankle: dorsfilexion moment
  • knee: external extension moment
  • hip: hip extension moment
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18
Q

GFR pre-swing (sagittal plane)

A
  • ankle: dorsiflexion moment
  • knee: extension moment
    -hip: extension
19
Q

GRF initial swing (sagittal plane)

A
  • ankle: dorsiflexion moment
  • knee: flexion moment (helps to flex the knee to bring closer to axis)
  • hip: external extension moment
20
Q

Review charts in notes

A
21
Q

determinants of gait

A

help maintain COM
- pelvic rotation
- pelvic tilt
- stance phase knee flexion
- ankle mechanism
- foot mechanism
- lateral displacement

22
Q

Pelvic rotation as a determinant of gait

A
  • minimizes flexion and extension of the hip
  • minimizes vertical displacement
23
Q

pelvic tilt as a determinant of gait

A

minimizes upward vertical displacement by slightly dropping
- keeps COM from going to high

24
Q

Stance phase knee flexion as a determinant of gait

A
  • in midstance the knee is slightly flexed to keep it from rising too high
  • slight knee flexion at mid stance minimizes upward vertical displacement
25
Q

ankle mechanism as a determinant of gait

A
  • Calcaneus makes the leg longer due to extended more posterior
  • minimizes vertical depression
26
Q

Foot mechanism as a determinant of gait

A
  • forefoot lengthens from pressing to initial swing by moving from DF to PF minimizes vertical depression
27
Q

Lateral displacement

A
  • many have valgus knees to narrow the BOS and minimize lateral displacement
  • increase BOS and you increase lateral displacement
28
Q

Running gait cycle

A
  • initial contact
  • loading response
  • mid stance
  • pre swing
  • float phase
  • early swing
  • late swing
  • float
29
Q

running stance phase % and swinging %

A
  • stance = 40%
  • swing = 60%
30
Q

What are the running sagittal plane kinematics
- pelvis
- hip
- knee
- ankle

A
  • pelvis: initial contact = posterior tilt
  • hip: IC= 35º of flexion into 5º of extension (harder to control the hip flexion moment)
  • knee: IC= 50º flexion into 20º of flexion into 100º flexion
  • 30º DF into 15º PF and then back into DF
31
Q

Running gait kinematics in the frontal plane
- subtalar

A

-subtalar:
heel strike: inversion into eversion and then back to inversion for push off

32
Q

GRF during running

A
  • braking impulse: ground sticking in a posterior direction
  • propulsion: pushing off the ground pushes you forward
  • medial strike of foot and lateral string of the ground
33
Q

Gait at ambulation onset (around 1 years old)

A
  • high guard= arms up for stability
  • no reciprocal arm swing
  • hips externally rotated for stabilization
  • toe strike
  • PF thru stance
  • short step length
  • increased cadence
  • increased lateral displacement
34
Q

Toddle gait patterns

A
  • wide BOS
  • decreased single leg support time
  • shorter step length
  • slower velocity
  • higher cadence
35
Q

elderly gait patterns

A
  • decrease free walking speeding g
  • shorter step length
  • shorter stride
  • longer duration double-support periods
36
Q

Gait: CVA

A
  • decreased step length
  • decrease stance time on involved leg
  • decrease trunk rotation/retracted pelvis (hold involved side in a flexed hip position)
  • drop foot: no DF to clear/trouble in the swing phase
  • spastic: unequal leg - slightly inverted and PF with knee extended and therefore has to hip hike/circumduct hip
  • flaccid: no muscle control
37
Q

Gait: parkinsons

A
  • muscle rigidity/stiff joints
  • increase cadence
  • shortened stride
  • lack of heel/toe off – shuffle feet
  • diminished arm swing
  • fenestrated gait: trouble initiating gait but then will speed up
  • often deconditioned and then have a high cost of energy while walking
38
Q

gait: ataxic

A
  • trouble with the cerebellum
  • decreased ability tot control balance
  • increased BOS
  • large side to side deviation
  • higher cost of energy while walking
  • often have an anterior/posterior jerk
  • typical with TBI, cerebral palsy
39
Q

Gait: gluteus medius weakness

A
  • lateral trunk bending/glute med lurch
  • lean toward weak side (does not have to produce as much torque)
  • decrease muscle requirements
40
Q

Gait: glute max weakness

A
  • controls hip flexion in loading response
  • posterior trunk lean two reduce the hip flexion moment
  • glute max gait
41
Q

gait: quad weakness

A
  • in the sagittal plane counters knee flexion moment
  • forward trunk lean = bring LOG anterior to knee or create external knee extension force
  • increase hip extensor/soleus activity
42
Q

Gait: glute max/quad weakness

A
  • external support of UE on thigh
  • counter trunk flexion moment while assisting knee extension
43
Q

Gait: weak PF

A
  • increase knee flexion and DF during stance
  • less than normal step length on unaffected side
  • calcaneal gait pattern
  • knee buckles with diminished push off
44
Q

Gait: weak DF

A
  • 3/5 MMT – foot slap= strong enough to clear flood but do not have strength to control
  • <3-/5 MMT - foot drop= can’t lift against gravity = longer leg and have to increase hip and knee flexion + toe strike = stoppage
  • can also see them circumduct or vault = uninvolved PF to clear involved leg