- distance b/w 2 successive events on opposite limbs

- horizontal distance b/w 2 points on opposite limbs - 7-10cm is normal

- number of steps/minute Men = 108 steps/min Women = 118 steps/min

Gait Flashcards by LJ Estes

What is a full gait cycle?

from initial contact of one foot to initial contact of that same foot

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What is the stance phase and what percentage of gait does it take up?

initial contact to pre-swing
60%
entire period in which the foot is on the ground

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What is the swing phase and what percentage of gait does it take up?

from toe off to just before heel strike
40%
time foot is in the air

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What is stride length?

distance b/w IC to IC on same limb

Men = 1.51m
Women = 1.32m

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How do you calculate stride length?

velocity divided by .5 x cadence

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What is step length?

distance b/w 2 successive events on opposite limbs

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What is toe clearance?

minimal distance from hallux to floor during swing phase
normal is 1.28-1.9cm

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What is step width?

horizontal distance b/w 2 points on opposite limbs
7-10cm is normal

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What is foot progression angle?

angle b/w longitudinal axis of foot & line of gait progression
5-7 degrees is normal
toe angle or toe out

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What is gait speed/velocity?

6th vital sign
distance traveled over a specific time period
Men = 1.37m/sec
Women = 1.30m/sec

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What is cadence?

number of steps/minute
Men = 108 steps/min
Women = 118 steps/min

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At what speed does walking usually turn into running?

4.8 to 5.0 mph
running has NO double limb support

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Describe CoM displacement in the sagittal and frontal planes during the gait cycle

Sagittal:
- 1-2 inches
- highest in mid-stance
- lowest LR & PreSw

Frontal:
- about 3cm
- most during mid-stance

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How could you decrease CoM excursion?

pelvic rotation
pelvic list/obliquity
stance phase knee flexion, foot & knee mechanics
hip adduction in stance phase

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How does the LoG differ from GRF during gait?

LoG:
- is always a plumb-line into the ground

GRF:
- equal and opposite to the foot force
- direction changes

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How are vertical, A-P, and M-L GRF different in gait?

Vertical:
- most & perpendicular to the ground

A-P:
- parallel to ground, shear force
- Prevent slipping via: decrease distance b/w foot location & CoM and decrease speed

M-L:
- small shear force
- prevent slipping via: decreasing step width

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Where is the CoP on the foot through the stance phase?

IC = just lateral to mid-heel
MS= lateral midfoot
TS & PreSw = medial forefoot

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If toe drag occurs in Initial swing what does this normally mean?

lack of knee flexion

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If toe drag occurs in mid-swing what does this normally mean?

lack of ankle DF

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Explain how the medial longitudinal arch of the foot behaves during the gait cycle

raised initially & as it moves through LR & stance phase it lowers to absorb shock & create elasticity for push off

When are the Post tib and fibularis muscles active during the gait cycle?

Post Tib:
- IC (ECC)
- LR (ECC)
- MStan (early=ECC; late = Conc)
- TS (Conc)

FIbularis:
- TS (Conc)

What is the difference between Primary, Secondary, and Compensatory gait deviations?

Primary:
- directly caused by an impairment (weakness, deformity, impaired motor control, pain)

Secondary:
- From abnormal posture at adjacent joint

Compensatory:
- accommodation for an impairment, rather than being a direct result of an impairment

How is the gait of a young child?

Age 3:
- uneven step length
- IC w/ flat foot
- Knee hyperextended throughout stance
- LR & MS pronation
- Wide BoS
- UE’s high-low guard positions
- lack of pelvic rotation
- decreased stride length with increased cadence

How is the gait of an older adult?

> Age 60:
- decreased velocity
- decreased stride/step length
- decreased anticipatory abilities
- decreases SLS & increased DLS
- wide BoS
- may need AD
- loss of independence

Why would you see flat foot at the foot and ankle in IC?

- weak DF's - impaired motor control

Why would you see foot slap at the foot and ankle in LR?

- weak DF's

Why would you see early heel off or vaulting at the foot and ankle in Mid stance?

Early heel off: - skeletal deformity - PF contracture - limited DF Vaulting: - length of stance limb too short - can't DF swing limb - knee flexion restriction

Why would you see inadequate MTP extension at the foot and ankle in PreSw?

- pain at MTP joint - effusion of joint

Why would you see toe drag at the foot and ankle in initial swing?

- knee flexion limited

Why would you see excessive pronation at the foot and ankle in Terminal stance?

- skeletal deformity - weak INV's

Why would you see drop foot at the foot and ankle in mid swing?

- weak DF's - deep fibular nerve lesion

Why would you see extensor thrust at the knee in IC?

- weakness/spasticity of quads - upper motor nerve lesion

Why would you see genu recurvatum or crouch gait at the knee in mid stance?

Genu Rec: - knee extension weakness - contracture of PF's - loose posterior structures of knee Crouch gait: - knee flex contracture

Why would you see inadequate knee flexion at the knee in initial swing?

- knee extension contracture

Why would you see excessive knee flexion at the knee in mid swing?

- impaired motor control - inadequate DF

Why would you see varus/valgus thrust at the knee in LR?

Thrust into either position via: - skeletal deformity - ligament instability

Why would you see inadequate knee extension at the knee in terminal swing?

- knee flexion contracture - joint effusion

Why would you see glute max gait at the hip in LR?

- glute max is weak which leads to leaning backwards to lock hips into extension

Why would you see antalgic gait at the hip in mid stance?

*avoids pain* - decreased stance on limb - painful to apply pressure to limb

Why would you see scissoring gait at the hip in mid stance?

- thighs touch (usually cerebral palsy)

Why would you see a trendelenburg sign at the hip in mid stance?

- weak abductors on contralateral side (glute med)

Why would you see excessive backward rotation at the hip in terminal swing?

- hip flexion contracture

Why would you see steppage gait at the hip in mid swing?

*hip flexes excessively* - inadequate knee flexion - inadequate ankle DF

Why would you see circumduction at the hip in mid swing?

*leg swings laterally* - poor knee flexion/ankle DF - lengthened swing limb or shortened stance limb

What are some dysfunctions seen in IC?

weak DF's -> abbreviated heel contact, flat foot contact & forefoot contact shortened limb (compensatory) -> forefoot contact PF contracture -> inadequate DF Knee pain -> inadequate knee ext

What are some dysfunctions seen in LR?

Inadequate knee flexion due to: - weak quads (P) - skeletal deformity (P) - abnormal PF activity (S) Foot slap: - weak DF's (P) Inadequate PF: - abbreviated/absent heel rocker (S)

What are some dysfunctions seen in stance?

Inadequate DF: - ankle pain/effusion (P) - PF contracture (P) Excessive eversion: - weak invertors (P) - genu valgus (S) - hindfoot valgus w/ uncompensated forefoot valgus (P) Inadequate knee ext: - knee pain/effusion (P) - excessive DF posture (S)

What are some dysfunctions seen in terminal stance/push-off?

Inadequate DF: - weak DFs (P) - ankle pain/effusion (P) No heel off: - weak PF's (P) - forefoot pain (P) - inadequate toe ext (S) - excessive ankle DF (S) Inadequate MTP Ext: - skeletal deformity (P) - avoid forefoot pain (S)

What are some dysfunctions seen in Swing phase?

Inadequate DF (mid swing): - weak DF's (P) - PF contracture (P) Excessive Inversion (mid swing): - flaccid paralysis of pretibials (P) Toe drag (initial & mid swing): - initial = inadequate knee flexion (S) - mid = inadequate DF strength (P) or inadequate hip flex (S) Inadequate knee flexion (initial): - tibiofemoral pain (P) - inadequate hip flex (S) - inadequate knee flexion in pre swing (S)