Gait Flashcards
Define gait
Mechanism which the body is transported using co-ordinated movements of upper and lower limbs
Phases of gait cycle
Stance phase (60%) Swing phase (40%)
Gait cycle definiton
period from initial contact to next initial contact on the same side
5 important attributes for normal gair
Stability in stance Foot clearance (swing) Pre-positioning for initial contact Adequate step length Energy conservation
What is it called when both feet are in contact with the ground?
Double support phase
What defines running?
When there is no double support
Instead, double float when both feet are off the ground
What happens in sprinting?
Length of stance and swing phases swap
swing 60%, stance 40%
Stance subdivision
ILMTP
Initial contact (normal heel strike) Loading (absorb impact) Midstance (foot flat) Terminal stance (plantarflexed ankle) Pre swing (metatarsophalangeal joint flex to push off)
Swing subdivision
Initial swing (knee flexes to clear ground) Mid swing (hip flexes and pelvis swings forward, dorsiflexion of ankle) Terminal swing (knee extends)
How is tilting of pelvis towards unsupported side prevented?
Gluteus medius and minimus (hip abductors)
Stride
Distance from initial contact to the next initial contact with same leg
Step
Distance from initial contact with one leg to initial contact with the other
Cadence
Number of steps per minute
Kinematics
Motions (joint angles, displacements)
Kinetics
Forces and movements that cause motion
Concentric
Muscles shorten (acceleration and power generation)
Eccentric
Muscles lengthen (deceleration and shock absorption)
Isometric
Stability
Muscles used in initial contact
Tibialis anterior (dorsiflexed)
Muscles used in terminal stance (plantarflexion)
Gastrocnemius and soleus
How is energy conserved during gait cycle?
Maintaining centre of gravity
Momentum (eccentric muscles)
Transfer energy
Phasic muscle action (on then off action)
Antalgic gait
Reduce pain
Limp
shorten stance phase in affected limb = shorten swing phase in unaffected limb
Antalgic gait eased by
Walking stick in hand opposite to pain
Lean towards stick and reduce load through painful side
Trendelenburg gait
Superior gluteal nerve affected
Gluteus minimus and medius fail - usually prevent pelvis dropping
Actions trendelenburg gait
Pelvis drops on unaffected side (rises on affected)
Pelvis swings towards affected side = waddle
Hemiplagic gait cause
paralysis of one side of body
stroke, cerebral palsy
Hemiplagic gait action
Spasms on affected side - constant contraction of upper leg flexor muscles and lower leg extensor muscles = stiff
CIRCUMDUCTION (swing) affected leg round
Diplegic gait
Spascity affects both limbs
Hip adductors spasms cause scissoring
High steppage gait
Foot drop - Weakness of dorsiflexion
Have to flex hip more to lift foot off ground
Causes foot drop
Common peroneal nerve problems
Sciatica
Neuromuscular disease
Muscle not working in foot drop
Tibialis anterior (no eccentric action when placing foot down dor initial contact so SLAPS down)
Flick associated with deep peroneal nerve damage (supplies anterior leg)
Eversion flick
no high steppage
Parkinsonian gait
Difficult to initiate movement Flex neck and trunk forwards = forward COG Shuffling Festinant = accelerate Loss of arm swing
Ataxic gait causes
Proprioceptive (loss of sense of position of joints) Cerebellar disease Vestibular damage (damage to balance organs in ear)
Cerebellar disorders causes
Inherited
Acquired (stroke)
Alcohol intoxication
Ataxic gait character
Clumsy staggering broad based arms outwards swaying cant do heel to toe
DRUNK