Gait

Question 1

What gait phases are double limb?

Answer 1

IC

LR

PSw

Question 2

What gait phases are single limb?

Answer 2

MSt

Tst

ISw

MSw

TSw

Question 3

How much hip extension is required for gait?

How much hip flexion?

Answer 3

20 ext

30 flx

Question 4

How much knee flex/ext is required for normal gait

Answer 4

0-60

Question 5

How much plantar and dorisflexion is required for gait?

Answer 5

10 DF

20 PF

Question 6

Moment definition

Answer 6

rotation around an axis

external vs internal

Question 7

Power generation is accomplished with muscles ______

Power absorption is accomplished with muscles ______

Answer 7

shortening, concentric

Lengthening, eccentric

Question 8

During gait, the center of pressure starts ___________ on the heel, and moves _______ onto the ball of the foot

Answer 8

Posterio-lateral

anterio-medial

Question 9

The center of pressure is over the ______ during pre-swing

Answer 9

First and second toes

Question 10

What are the internal moments at the hip, knee, and ankle during initial contact?

Answer 10

Hip Ext, Knee Flexion, Ankle DF

Question 11

What are the interal moments at the hip, knee, and ankle during loading response?

Answer 11

Hip Ext, Knee EXT, Ankle DF

Question 12

What are the interal moments at the hip, knee, and ankle during midstance?

Answer 12

Hip FLX, Knee FLX, Ankle PF

Question 13

What are the interal moments at the hip, knee, and ankle during terminal stance?

Answer 13

Hip FLX, Knee FLX, Ankle PF

Question 14

What are the interal moments at the hip, knee, and ankle during preswing?

Answer 14

Hip FLX, Knee EXT, Ankle PF

Question 15

What are the 3 external forces in gait

Answer 15

Intertia

Gravity

Ground Reaction Force

Question 16

The goal of gait training is to

Answer 16

teach patient to use as little energy as possible

32% oxygen consumption in healthy 20-30y/o

48% oxygen consumption in 75y/o or person with medical condition

Question 17

T or F, limbs contribute more to total energy during walking than head and trunk

Answer 17

True

Question 18

At the initial contact -> loading response phase, where is the fulcrum/rocker?

Answer 18

Fulrum/rocker at the heel

The calcaneous moves from inversion to eversion

Question 19

During loading response to terminal stance, what structure is the fulcrum/rocker?

Answer 19

ankle fulcrum

Question 20

During terminal stance, where is the rocker/fulcrum?

Answer 20

leg rotates over forefoot

Question 21

During pre-swing, what is the rocker/fulcrum?

Answer 21

Leg rotates over toes

Question 22

How does the rocker/fulcrum of the foot move throughout gait?

Answer 22

Heel -> ankle -> forefoot -> toes

Question 23

Trunk stays erect during free speed walking

slight trunk ________ at initial contact

slight trunk __________ during single leg stance

Answer 23

flexion

extension

Question 24

During gait, the adductor moment of the head+arm+trunk is counteracted by __________

Answer 24

abductors

Question 25

What kind of movement occurs in the sagittal plane during gait?

Answer 25

sinusoidal pattern up and down 4-5cm with eachstep

Question 26

Where is the low point of the sinusoidal pattern

Answer 26

low at initial contact high at mid-stance

Question 27

What kind of motion occurs in the frontal plane during gait

Answer 27

pelvic side to side motion of 4-5cm and a 5 degree pelvic drop with trunk lean 5cm

Question 28

what kind of motion occurs in the transverse plane during gait

Answer 28

pelvic rotation 4-8 degrees with opposite trunk rotation

Question 29

During gait Frontal plane motion: Saggital plane motion: Transverse plane motion:

Answer 29

Saggital: Sinusoidal pattern Frontal: Pelvic side to side Motion Transverse: Pelvic rotation w/ trunk rotation

Question 30

During what part of gait is the erector spinae most active? NOTE: I think this will be a test Q because of how much Dr. Dice mentioned it.

Answer 30

LOADING RESPONSE

Question 31

How much shoulder and elbow flx is normal during gait?

Answer 31

Shoulder ROM: 30 degrees total ( 6 flx 24 ext) elbow rom: 20-45

Question 32

UE muscle activity and movement is ____________

Answer 32

primarily driven by gravity and highly variable

Question 33

During stair gait, greater _______ activation is necessary torque at the knee is _____ greater for ascent vs descent

Answer 33

quad x3

Question 34

How is intial contact on stairs different than on ground?

Answer 34

Anterior to posterior foot level ground: Posterior to anterior foot

Question 35

What stage of stair gait is most knee flexion needed?

Answer 35

foot clearance

Question 36

what stage of stair gait is most hip flexion needed?

Answer 36

foot placement

Question 37

What are the 5 stages of stair gait

Answer 37

weight acceptance pull up foward continuance foot clearance foot placement

Question 38

What are the 3 stages of running gait?

Answer 38

Stance Float Swing

Question 39

During running gait, most torque generated is at the ______ during impact

Answer 39

Knee note: Ground reaction force at center of pressure is over 200% of BW

Question 40

What are the primary muscle groups used for running

Answer 40

Hip extensors Quadriceps Gastroc/Soleus

Question 41

During running you need increased ________________ in lower extremity

Answer 41

joint ROM

Question 42

Neuro changes seen by age 90: Brain Mass, Muscle atrophy

Answer 42

decreased brain mass 10-20%, 1% muscle loss per year in healthy adults estimated 20-40% loss of maximal strength by age 65 atrophy of slow twitch fibers w/ inactivity overall diminished functional reserve

Question 43

Gait speed declines _____________ per decade

Answer 43

12-16% Decreased strike/step length More time w/ doublelimb support 30% instead of 18% deceased dorsiflexion

Question 44

Older patients gait will have a wider ____________ _____ toe clearance during swing phase _____ trunk flexion during gait and difficulty with obstacle avoidance

Answer 44

Base of support Less Foward

Question 45

Abnormal elderly gait includes ______ in gait measures Gait Variability ________ to change gait speed/direction postural sway that requires ________ inability to ________ while walking

Answer 45

Asymmetry Inability External Support Multitask

Question 46

Community functional benchmarks: Gait speed: ____ Distance ______ curb height ______

Answer 46

4ft/sec >300m Curb height >8in

Question 47

Gait using a rolling walker might lead to slower speed: ________ smaller step length and ________ stance time/ ______ swing time

Answer 47

1.5 f/s (instead of 4 ft per second) Increased stance time/ Decreased swing time Note: Pattern becomes more apparent the longer an individual uses a RW

Question 48

Foward lean during gait might be due to: ____ hip flexors a compensation for _______ quads (Increased plantarflexion) or ______ visual cues for __________ propriocepton Or assistive devices

Answer 48

Tight hip flexors Compensate for weak quads Increased visual cues for decreased proprioception Note: Shifts LOG in front of Knee and Ankle

Question 49

Backward lean in gait might be due to Weak _______during weight acceptance and Single Limb Support or weak ___________ during single leg advancement

Answer 49

Hip Extensors (Leaning back takes the hip extensors out of the movement when supporting weight) Hip flexors ( Leaning back assists the weak hip flexors to swing the leg foward)

Question 50

Lateral lean of the trunk during gait might be due to weak hip ____________ or hip pain during weight acceptance or single limb support or a __________ stance limb Or a use of an assistive device

Answer 50

Abductors Short Stance Limb

Question 51

Gait deviations: Trunk rotations One example of a deviation is that trunk moves w/ pelvis due to decreased disassociation Use of assistive device Rotation of the trunk backwards during gait can compensate for ______ plantarflexion Rotation of the trunk foward during gait can help to _____________

Answer 51

Compensate for increased plantarflexion Rotation Foward to advance limb

Question 52

Pelvic deviations during gait: A hike can be used to ________ the swinging limb using _____ quadratus lumborum

Answer 52

Clear swinging limb using ipsilateral quadratus lumborum

Question 53

Pelvic deviation: Vault is simular to hike with an addition of _______

Answer 53

Plantarflexion

Question 54

Anterior Pelvic Tilt might be due to _______ hip extensors ______ Abdominals and _____ hip flexors

Answer 54

Weak hip extensors Weak Abdominals Tight Hip Flexors

Question 55

Posterior Pelvic tilt during gait might be due to _____ hip flexors ______ hip extensors _____ hamstrings shifts the Line of gravity ___________

Answer 55

Hip Flexor weakness hip extensor weakness tight HS Shifts LOG posteriorly

Question 56

Pelvic deviations: if you're lacking rotation foward or backward it can be due to ____________

Answer 56

Back Pain Decreased step length potential surgical fusion

Question 57

Excessive foward pelvic rotation can be due to ____________ Excessive backward pelvic rotation can be due to ___________--

Answer 57

Compensation to help advance limb Weak Calf, No heel Off (During terminal Stance) Or Excessive hip flexion (During single limb support)

Question 58

Pelvic drop during gait is likley to lead to ________ and can be due to weak ___________

Answer 58

Back pain during stance Weak calf (Ipisilateral during single limb support) Or scoliosis

Question 59

Hip drop due to a shorter LE will appear as _______ during single leg advancement and ______________ during single limb support

Answer 59

Ipsilateral to single limb advancement Contralateral to single limb support (trendelenberg)

Question 60

Weak hip abductors lead to a __________ hip drop during single limb support Adductor spasticity will lead to an ____________ drop in single limb advancement Adductor spasticity will lead to a ___________ drop in single limb support

Answer 60

Contralateral Ipsilateral Contralateral

Question 61

Past retract gait voluntary excessive hip flexion and it's release in order to __________

Answer 61

rapidly extend a flaccid knee using inertia

Question 62

Decreased hip flexion during gait might be due to Hip flexor _______ hamstring _____________- hip pain compensation for Hip Extensor weakness or a result of foot drag

Answer 62

Hip Flexor Weakness Hamstring spasticity

Question 63

During initial swing decreased ________ reduces step length

Answer 63

Hip Flexion Limited hip flexion may also limit knee flexion during swing

Question 64

Decreased hip flexion due to gait is most impactful during ________, clearance of the LE needed

Answer 64

Most impactful durng Midswing

Question 65

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