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DPT 502 > Gait > Flashcards

Gait Flashcards

1
Q

where does gait fall in the ICF model?

A

body fxn w/in body structures and fxns

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2
Q

where does mobility fall in the ICF model?

A

activity and participation

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3
Q

what is locomotion?

A

moving from one place to another

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4
Q

what is gait?

A

achieving locomotion on foot (walking, running, jogging)

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5
Q

what is ambulation?

A

type of locomotion used

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6
Q

what is involved in walking in daily life?

A

stops

starts

directional changes

negotiating terrains, inclines, stairs, curbs

acceleration, deceleration

adapt to task and environment

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7
Q

what are the 3 requirements for locomotion?

A

1) progression
2) postural control
3) adaptation

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8
Q

what are the goals of normal gait?

A

forward progression

shock absorption

lower quarter mobility

energy conservation

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9
Q

how many phases of gait are there?

A

8

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10
Q

how many phases of stance are there in the gait cycle?

A

5

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11
Q

how many phases of swing are there in the gait cycle?

A

3

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12
Q

what are the 5 stance phases?

A

initial contact

loading

midstance

terminal stance

preswing

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13
Q

what are the 3 swing phases?

A

initial swing

midswing

terminal swing

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14
Q

what is a gait cycle (stride)?

A

IC to IC of the same LE

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15
Q

what % of the 100% gait cycle is the stance phase? swing phase?

A

stance phase-60%

swing phase-40%

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16
Q

when are there 2 periods of double limb support?

A

at the beginning and end of stance phase (22%)

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17
Q

what is the % of IC?

A

0-2%

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18
Q

what is the % of loading response?

A

2-10%

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19
Q

what is the % of midstance?

A

10-30%

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20
Q

what is the % of terminal stance?

A

30-50%

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21
Q

what is the % of preswing?

A

50-60%

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22
Q

what is the % of initial swing?

A

60-73%

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23
Q

what is the % of midswing?

A

73-87%

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24
Q

what is the % of terminal swing?

A

87-100%

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25
Q

what are the fxnal tasks of gait?

A

weight acceptance

single limb support

limb advancement

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26
Q

when does weight acceptance occur?

A

IC and loading response

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27
Q

when does single limb support occur?

A

midstance, terminal stance (early)

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28
Q

when does limb advancement occur?

A

terminal stance, preswing, and all swing phases

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29
Q

when is there max knee flexion in the gait cycle?

A

midswing

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30
Q

what happens in IC?

A

foot makes context with the surface

weight acceptance

prime muscles: concentric tib ant and glut max/med

ankle: 0 deg
knee: 3-5 deg flex
hip: 25-30 deg flex

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31
Q

what happens in loading response?

A

weight acceptance

shock absorption

weight transferring onto the limb

ankle: 15 deg PF
knee: 15 deg flex controlled by quads

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32
Q

what happens in midstance?

A

the body progresses directly over a single limb

single limb support

ankle: 15 deg PF; 15 deg DF
hip: full ext

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33
Q

what happens in terminal stance?

A

progression continues moving the body forward of the limb and weight is transferred to the forefoot

single limb support

propulsion

ankle: 15 deg DF with tibia moving forward towards PF (20 deg pf needed)
hip: 10 deg ext
knee: moving into full ext

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33
Q

what happens at preswing?

A

the limb is unloaded quickly as weight is shifted to the opposite LE

propulsion

getting ready to start leg swinging into next step

ankle: 20 deg PF
knee: 40 deg flex
hip: 10 deg ext

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34
Q

what happens at initial swing?

A

limb shortening for foot clearance

foot comes off the floor and the femur beings to advance forward

ankle: moving into neutral DF out of PF
knee: 40 deg flex
hip: 10 deg ext

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35
Q

what happens in midswing?

A

the knee beings to extend and the foot clears the ground as the femur continues to advance

limb shortening for foot clearance

momentum generated

ankle: neutral
knee: 60 deg flex
hip: 20-30 deg flex

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36
Q

what happens at terminal swing?

A

the knee is fully extended as the LE prepares to contact the ground

coming to the end of swing phase, about to start IC

limb advancement

preparing for IC

decelerating so that you’re not falling forward

ankle: neutral
knee: fully ext
hip: 25-30 deg flex

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37
Q

what can decreased ankle ROM lead to in gait?

A

steppage gait, toe drag, abnormal IC, abnormal push off, lurching gait (trying to get through stance ASAP rocky!)

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38
Q

how much ankle motion is needed for normal gait patterns through all phases when using the least amount of energy?

A

30 deg

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39
Q

what gait deviations can result from PFPS/reduced knee ext due to surgery or injury

A

circumduction gait to avoid knee flexion

upslip do the hip

staying on the heel all of stance and swing

limp

accelerated swing phase???
shortened stance phase???

may cause hip pain

unable to fully ext knee at terminal swing or IC

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40
Q

what are the temporal characteristics of gait?

A

velocity and cadence

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41
Q

what is velocity?

A

distance covered over a unit of time

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42
Q

what is the average walking speed?

A

1.4 m (1.5 yd/sec, 80 m/min, 2.5-3 mph)

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43
Q

what is cadence?

A

of steps per unit of time

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44
Q

what is the range for normal cadence?

A

50-120/130 steps/min

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45
Q

what cadence is considered slow?

A

below 100 steps/min

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46
Q

what cadence is considered fast?

A

above 125 steps/min

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47
Q

what temporal characteristic is important for community ambulation?

A

cadence

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48
Q

what are the spatial characteristics of gait?

A

step length

stride length

step width

angle of progression

jt angular displacements

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49
Q

what is step length? (KNOW THIS)

A

heel of one foot to heel of other foot

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50
Q

what is stride length? (KNOW THIS)

A

IC of one limb to IC of same limb

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51
Q

what is step width?

A

midpoint of one heel to midpoint of other heel and distance bw the 2

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52
Q

what is normal step width?

A

2-4 inches

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53
Q

what is normal angle of progression in gait?

A

7 deg outtoeing

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54
Q

when is the COM the highest?

A

midstance

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55
Q

when is the COM the lowest?

A

at double limb support

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56
Q

how much normal vertical limb displacement is there during gait?

A

2.5 cm (typically 1in in each direction up/down and side to side)

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57
Q

what happens in the sagittal plane at the hip?

A

remains relatively level

3 deg ant/post tilt throughout cycle

increases as speed increases

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58
Q

anterior pelvic tilt accompanies what hip motion?

A

hip extension

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59
Q

posterior pelvic tilt accompanies what hip motion?

A

hip flexion

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60
Q

what sagittal plane motion of the pelvis occurs at IC through midstance?

A

post tilt, ant tilt at the end of midstance (accompanying hip ext)

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61
Q

what sagittal plane motion of the pelvis occurs at preswing?

A

post tilt, then ant tilt, then post tilt in prep for IC

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62
Q

how many degrees of sagittal plane hip motion occurs during gait?

A

40 deg

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63
Q

what happens in the sagittal plane hip after IC to terminal stance?

A

the hip is extending w/hyperextension at terminal stance w/ant pelvic tilt and lumbar hyperextension

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64
Q

what happens in the sagittal plane hip at preswing?

A

the hip moves into flexion then neutral to prepare for lift

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65
Q

what happens in the sagittal plane hip at initial swing to midswing?

A

the hip flexes to 25-30 deg

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66
Q

what happens in the sagittal plane hip at terminal swing?

A

moving into extension to prepare for IC

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67
Q

what happens in the sagittal plane knee at IC?

A

3-5 deg flex after which further flexion occurs

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68
Q

what happens in the sagittal plane knee at the end of loading phase?

A

knee flexed to 15-20 deg

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69
Q

when does the knee move towards ext, reaching full ext in gait?

A

at terminal stance

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70
Q

before ___, the knee begins to flex (35-40 deg) and reaches a max of 60-65 deg during ____

A

preswing, midswing

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71
Q

when is the knee is full ext during gait?

A

terminal swing

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72
Q

when is the knee the most flexed during gait?

A

midswing

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73
Q

what happens in the sagittal plane ankle and foot at IC?

A

neutral

held in OKC by ant tib and ant group EDL and FHL

triceps surae turns on at IC by everting the calcaneous, helping control CKC DF

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74
Q

what happens in the sagittal plane ankle and foot at loading?

A

rapid PF

PF decelerated eccentrically by the ant tib also control of pronation lowering of MLA

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75
Q

what happens in the sagittal plane ankle and foot through midstance?

A

tibia advances over the foot to 10 deg DF

soleus decelerates DF and forward motion of the tibia

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76
Q

at preswing, what muscles are working at the ankle to resupinate the foot and stabilize the navicular during pf?

A

gastrocs and post tib

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77
Q

what muscles work with the ant tib to stabilize the MLA during preswing?

A

the peroneals

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78
Q

what happens in the sagittal plane ankle from terminal stance to swing?

A

the ankle movies from a position of PF to neutral or slight DF

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79
Q

how many degrees of extension does the 1st MTP jt need by the end of preswing?

A

55-60 deg

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80
Q

when does max lateral displacement occur in gait?

A

during unilateral stance when the COM is highest

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81
Q

t/f: max lateral and vertical displacement occur at the same time in the gait cycle

A

true

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82
Q

how many cm of lateral shift should there be during the gait cycle

A

2 cm right and left

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83
Q

how much frontal plane lateral tilt should there be at the pelvis?

A

8 deg on each side

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84
Q

during unilateral stance, does the pelvis drop 8 deg in the stance or swing side?

A

swing side

85
Q

at IC in the frontal plane what is happening at the hip?

A

adducted 10 deg

86
Q

at loading in the frontal plane what is happening at hip?

A

adducted 15 deg

87
Q

at midstance to terminal stance in the frontal plane, what is happening at the hip?

A

hip is in neutral

88
Q

during the swing phase in the frontal plane, what is happening at the hip?

A

abducted 5 deg

89
Q

what is happening at the knee in the frontal plane at loading response?

A

3 deg abduction

90
Q

when does the knee maximally abducted?

A

during swing w/peak knee flex

91
Q

what happens at the subtalar jt at IC in the frontal plane?

A

slight supination

92
Q

what happens at the subtalar jt at loading in the frontal plane?

A

rapid pronation

93
Q

what happens in the frontal plane subtalar jt during midstance?

A

begins to supinate

94
Q

what happens in the frontal plane subtalar jt at preswing?

A

max supinate 8-11 deg

95
Q

how much total frontal plane motion is there at the midtarsal jt?

A

11-15 deg

96
Q

t/f: during midstance, the arch elevates the midtarsal jt’s to supinate

A

true

97
Q

what happens in the transverse plane pelvis during gait?

A

protraction 4 deg
retraction 4 deg
8 deg total motion

98
Q

does ant pelvic rot occur with hip flexion or extension?

A

hip extension

99
Q

does post pelvic rot occur with hip flexion or extension?

A

hip flexion

100
Q

when does max protraction of the pelvis occur in gait?

A

at IC

101
Q

at initial contact is the hip laterally rotated or medially rotated?

A

laterally rotated

102
Q

at initial swing is the hip in lat or med rot?

A

lat rot than med rot by terminal swing

103
Q

how much total hip rotation is there at the hip during gait?

A

8-14 deg

104
Q

immediately after IC, does the hip med or lat rotate?

A

med rotation until extension

105
Q

in mid to terminal stance, is the hip alt or med rotated?

A

lat rotation to neutral

106
Q

by preswing is the hip fully laterally rotated or medially rotated?

A

laterally rotated

107
Q

at IC is the knee lat or med rotated?

A

lat rotated

108
Q

immediately after IC, does the tibia med rot or alt rotate?

A

med rotate

109
Q

at the foot pronates during loading, is the tibia medially or laterally rotating?

A

med rot

110
Q

during midstance to terminal stance is the knee lat or med rotating?

A

lat rot

111
Q

during preswing is the knee in lat or med rot?

A

lat rot

112
Q

when are the GRF the greatest during gait?

A

IC and preswing

113
Q

t/f: AP GRFs are shear forces

A

true

114
Q

which of the 3 GRFs are the smallest?

A

LS shear

115
Q

what is the COP?

A

the location w/in the foot where GRFs are applied

116
Q

where is the COP in preswing?

A

in the forefoot bw the 1st and 2nd metatarsal heads

117
Q

where does the COP start?

A

slightly lat to midpoint of the heel

118
Q

as you put weight into the foot in midstance, where does the COP move?

A

towards the front and middle of the foot

119
Q

as you’re about to toe off, where does the COP move?

A

bw the 1st and 2nd toes

120
Q

what is the fxnal activity at IC?

A

shock absorption (quads and DFs)

121
Q

what muscles are working at IC?

A

quads and Dfers

gastrocs and ant tib co-contract to maintain stability

hamstring decelerate knee

quads co-contract eccentrically with hamstrings

hip in slight flexion stabilized by the glut max and med

122
Q

what muscles are working at LR and midstance?

A

quads and DFers

glutes eccentrically

123
Q

what muscles are working at preswing/initial swing?

A

adductor longus and magnus, illiosoas, rectus fem, sartorius accelerating the swing limb with concentric contractions

124
Q

what muscles are working throughout swing?

A

isometric tib ant to clear the floor

125
Q

what muscles are working at terminal swing/IC?

A

hamstrings, DFers working eccentrically to keep us from falling forward at IC

concentric gastrocs, soleus, and toe flexors

126
Q

at IC, is the foot pronated or supinated?

A

supinated

127
Q

at loading response, is most muscles activity eccentric or concentric?

A

eccentric

128
Q

what muscle works to lower the foot to the ground at loading response?

A

ant tib

129
Q

what muscles are working at loading response?

A

ant tib lowering the foot

eccentric quads with slight hamstring flexion as the knee flexes

glut max stabilizes the trunk and prevents excessive hip flexion

130
Q

what is the primary requirement of midstance?

A

stability

131
Q

when is the COM of the highest?

A

midstance

132
Q

what is the muscles activity at midstance?

A

gastrocs and soleus maintain ankle stability

knee is quite and relies on the gastrocs

glut med, min and TFL stabilize the pelvis in the frontal plane

adductors co-contract to stabilize

133
Q

what is the primary activity at terminal stance and preswing?

A

concentric activity for propulsion

134
Q

what is the primary contributor at terminal stance and preswing as the foot plantarflexes and resupinate?

A

gastrocs

135
Q

what muscle works at terminal stance and preswing to stabilize the navicular during PF onto the toes?

A

tib post

136
Q

what is the primary task of initial swing?

A

acceleration for limb advancement

task and shortening of the limb

137
Q

what is the primary task of terminal swing?

A

deceleration in preparation for IC

138
Q

are more muscles working during swing or stance?

A

stance

139
Q

in the first half of swing, what is the activity of the muscles?

A

the muscles act as accelerators concentrically working

140
Q

what muscles are working concentrically in the first half of swing?

A

illiospoas, rectus fem, and tib ant

141
Q

in the second half of swing, what is the activity of the muscles?

A

the muscles act as decelerators eccentrically working

142
Q

what muscles are working concentrically in the first half of swing?

A

glut max, hamstrings at the hip, quads co-contract with IC to lengthen step in preparation for IC

143
Q

when are the hip flexors most active?

A

in late stance to early swing

144
Q

what is the fxn of the hip flexors?

A

accelerate and advance the limb to clear the limb

145
Q

how do the hip extensors act during terminal swing?

A

eccentrically to decelerate the limb

146
Q

how to the hip extensors act during IC?

A

concentrically to stabilize the trunk and pelvis

147
Q

when is the glut max most active?

A

during the loading phase of the hip and decelerating hip adduction for limb stabilization

148
Q

what is the fxn of the hip abductors?

A

pelvis stabilization in the frontal plane in unilateral stance

149
Q

when is the only time the glut med in inactive?

A

terminal stance

150
Q

when are the 2 peaks in hip adductor activity?

A

early and late stance

151
Q

are the hip adductors more or less active with increased velocity?

A

more active

152
Q

when are the knee extensors most active?

A

terminal swing to 15% of stance eccentrically

153
Q

what is the fxn of knee extensors?

A

shock absorption and preventing knee buckling

154
Q

when is the most quad activity?

A

in preswing from the rectus fem

155
Q

when are the knee flexors active?

A

late mid-swing

co-contract at IC with the quads to stabilize the knee and glut max to extend the hip

156
Q

what are the ankle DFers?

A

tib ant, extensor hallicus, digitorum

157
Q

when are the ankle DFers active?

A

isometrically throughout swing holding the foot in neutral

158
Q

when does PF activity begin?

A

during loading response controlling the tibia over the talus

159
Q

when is there peak activity of the PFers?

A

at terminal stance when you’re about to push off

160
Q

what is the fxn of the peroneals?

A

stabilize the foot arches and assists in rigid lever preswing

facilitate movement of the COM

161
Q

what is the fxn of the intrinsics of the foot?

A

assist supporting the foot in rigid level role, supporting the plantar fascia

162
Q

when are the intrinsics of the foot activated?

A

during the last half of stance phase

163
Q

what is the fxn of UE reciprocal arm swing in gait?

A

stabilizes the body and minimizes the lat motion of the COM

164
Q

t/f: with less arm swing, gait is less energy efficient

A

true

165
Q

t/f: arm swing keeps the gravity low and momentum moving forward

A

true

166
Q

as the arm swings back, what muscles are contracting eccentrically?

A

post/mid delt, lats, teres major

167
Q

are flexors of the arm working in arm swing?

A

no, flexion is from the momentum passively reacting to the stretch pulling back

168
Q

what is the fxn of the trunk during gait?

A

minimize head movement so the eyes have a stable platform

169
Q

t/f: trunk minimizes the movement of the COM

A

true

170
Q

what muscles are working in the trunk to counteract torque?

A

erector spinae, quad lumborum

171
Q

t/f: there is increased abdominal activity with increased velocity

A

true

172
Q

t/f: obliques are active at all speeds

A

true

173
Q

how much sagittal plane trunk motion is there?

A

only about 2-5 degrees

174
Q

what factors of gait reduce the downward displacement of the COM?

A

transverse plane pelvic rotation

sagittal plane ankle motion

175
Q

what factors of gait reduce the upward displacement of COM?

A

stance phase knee flexion

frontal plane pelvic motion

176
Q

what are the phases of running gait?

A

IC, midstance, take off, swing, midswing, terminal swing

177
Q

t/f: there is no double support in running gait

A

true

178
Q

running gait is more of a ____ movement than walking

A

bouncing

179
Q

running gait has ___ swing, and ____ stance

A

longer, shorter

180
Q

t/f: running gait required greater ROM of all jts

A

true

181
Q

what three factors of gait increase in running gait?

A

velocity, cadence, and step length

182
Q

are the GRFs increased in walking or running gait?

A

running gait

183
Q

is more concentric or eccentric activity required for running gait?

A

eccentric

184
Q

is the COM higher or lower in running gait?

A

lower

185
Q

what are the 2 phases of running stance?

A

absorption, propulsion

186
Q

what are the 2 phases of running swing?

A

initial, terminal

187
Q

when is there double float in running gait?

A

at the beginning of initial swing and end of terminal swing when neither limb is in contact with the floor

188
Q

what is the absorption phase of stance in running gait?

A

IC to midstance

lateral heel is in slight supination to quick foot flat

189
Q

what is the propulsion phase of stance in running gait?

A

at midstance the COM moves over the WB foot while opposite swings

the heel leaves the ground and initiates propulsion

once the foot leaves the ground, the first double float phase begins

190
Q

what is the initial swing phase of running swing?

A

1st half of swing is 1st double float

2nd half of swing, contra limb contacts the ground and swing limb accelerates from momentum

191
Q

what is the terminal swing phase of running swing?

A

acceleration to deceleration

2nd double float phase

192
Q

what are the characterisitics of gait with increased speed?

A

lowered COM

longer stride

faster cadence

decreased time in stance

longer time in swing

increased ROM requirements of all jts

faster cadence, more trunk lean

hip can have >80 deg flexion in sprinting

IC on toes in sprinting

193
Q

what is the main force element required to produce forward propulsion in running?

A

POWER

194
Q

when are the hip extensors active in running?

A

late swing and early stance

195
Q

when are the hip flexors active in running?

A

after toe off (preswing)

196
Q

when are the quads, glut med, and PFers active in running?

A

throughout stance

197
Q

what is the role of hip abductors in running?

A

stabilizing the pelvis and some shift

198
Q

from IC to preswing, what muscles are active?

A

gmax, HS, quads, PFers

199
Q

there is an absorption of energy during ____ activity then a release of power ____

A

eccentrically, concentrically

200
Q

what two muscles are always active in running?

A

hip adductors and tib ant

201
Q

when does independent walking usually begin?

A

11-15 months old

202
Q

what are the characteristics of immature gait?

A

arms in “on guard” position

wide BOS

quick cadence

small steps

limited pelvic motion

ER/outtoeing

limited knee flexion

foot flat

203
Q

what are the characteristics of mature walking?

A

stability in stance

sufficient foot clearance in swing

pre-positioning of the foot during swing for IC

adequate step length

efficient energy expenditure

204
Q

when does mature walking usually begin?

A

7 yo

205
Q

what are the gait changes in older adults?

A

decreased vertical movement

decreased arm swing

decreased velocity

increased stance time and double limb support

decreased swing time

206
Q

why may there be compensations in gait?

A

excessive displacemet of COG

higher intensities for prolonged periods of time

207
Q

t/f: in gait compensations more muscles are recruited to help out

A

true

208
Q

what are the neg consequences of gait compensations?

A

fatigue, jt dysfxn, pain, DJD

209
Q

what happens when there are flexion weaknesses during gait?

A

IC occurs at the midfoot if ext is limited

shortened stride length

if the knee doesn’t reach full ext at midstance, the COM remains lower throughout the gait cycle

210
Q

what are the effects of an AD on gait?

A

upper extremities must hold onto the device so there is no arm swing

more energy requirements

greater cognitive demands (walking becomes a more conscious activity)

DPT 502 (9 decks)

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