Gait

Question 1

Characteristics of Gait

Answer 1

• Assessment of gait is important due to its importance in normal function and because it can reveal functional limitations in general
• Main Tasks
  ~ Forward progression/ Get from A to B
  ~ Balance the body from one side to
  the other
  ~ Support and maintain upright body
• 2 Main Phases
  ~ Stance
  > Loading and unloading of the
  lower extremity.
  ~ Swing
  > Positioning of limb for loading
  and unloading.
  ~ Both contain sub-phases

Question 2

Stance Phase

Answer 2

• Heel Strike/Initial Contact
  ~ Normal stance phase begins with
  heel strike.
• Loading Response
  ~ Loading of foot, ankle, knee, and
  hip occur.
• Mid-Stance
  ~ Divider between loading and
  unloading.
  ~ Loading ends and unloading begins
• Terminal Stance
  ~ Body moves ahead of weight
  bearing limb.
  ~ End of unloading.
• Pre-Swing
  ~ Weight bearing limb is fully
  unloaded and weight is transferred
  to contralateral limb.

Question 3

Swing Phase

Answer 3

• Toe-Off/Initial Swing
  ~ Thigh advances as foot comes off of
  surface.
• Mid-Swing
  ~ Thigh and foot advance past the
  stance limb.
• Terminal Swing
  ~ Limb prepares for heel strike.

Question 4

What Happens to the pelvis and trunk during gait?

Answer 4

• In the transverse plane, the pelvis rotates forward/protracts during the swing phase through the loading response
• The pelvis rotates backwards during loading response and mid-stance
• Trunk movements are contrary to pelvis movements

Question 5

Antalgic Gait (“Limp”)

Answer 5

• Decreased stance phase due to pain/injury on that side

Question 6

Hip Hike/Hip Circumduction

Answer 6

• Can be caused by many things
  ~ Lack of knee flexion
  ~ Lack of ankle dorsiflexion

Question 7

Foot Drop

Answer 7

• Most likely due to weakness of ankle dorsiflexors
  ~ Compensates by flexing hip and
  knee in order to get foot up
• Anterior compartment syndrome will cause this gait

Question 8

Vaulting

Answer 8

• Usually a compensation of the uninvolved side
  ~ Compensation helps clear uninvolved
  side with ROM deficits
  > Pt. will make themselves longer
  on the good side in order to
  clear the bad side
• May also be a control issue

Question 9

Early Heel Off

Answer 9

• Usually seen in those with posterior lower leg hypomobility
• “Bouncing”
• “Toe walkers”

Question 10

Observational Gait Assessment

Answer 10

• LR = Loading Response: Weight transferred to advancing limb, double limb support.
• MSt = Midstance: Body positioned over single limb.
• TSt = Terminal Stance: Body moves ahead of weight bearing limb.
• PSw = Pre-Swing: Weight bearing limb is unloaded and weight transferred to contralateral limb.
• ISw (toe-off) = Initial Swing: Thigh advances as foot comes off of walking surface.
• MSw = Mid-Swing: Thigh and foot advance past the stance limb.
• TSw = Terminal Swing: Knee extends, limb prepares for initial contact (IC/Heel Strike)