Gait Flashcards
Muscle activity initial contact
- Dorsiflexors isometrically hold ankle in DF during heel strike and prepare to lower foot to ground
- Quads contract to place knee in extension
- Hamstrings help stabilize knee and prevent hyperextension
- Hip extensors and abductors contract to stabilize the trunk and pelvis over the leg.
Muscle activity loading reponse
Beginning:
- Dorsiflexors eccentrically control lowering of the foot towards the ground
- Quads eccentrically control knee flexion during weight acceptance
Whole phase:
- Hip extensors contract concentrically for hip extension
End of phase:
- Plantar flexors eccentrically control DF as tibia moves over foot
- Post tib eccentrically controls pronation
- Quads start to concentrically contract to draw femur forward over tibia
Muscle activity midstance
- Plantar flexors eccentrically control DF as body moves over stance limb
- Minimal knee muscle activity
- Quads continue concentric contraction for closed chain knee extension
- Hip abductors stabilize pelvis and prevent contralateral hip drop (trendelenburg)
- Iliopsoas starts to eccentrically control hip extension
Muscle activity terminal stance
- Plantar flexors work concentrically to help foot propel body forward
- Minimal knee muscle activity
- Hip abductors continue to stabilize pelvis
- Iliopsoas continues to slow rate of hip extension
Muscle activity pre-swing
- Plantar flexor activity peaks with toe-off
- Hamstrings begin to produce knee flexion
- Hip flexors begin to concentrically flex the hip
Muscle activity Initial swing
- Dorsiflexors contract concentrically to clear foot from ground
- Hamstrings assist with foot clearance by flexing knee
- Hip flexors continue to concentrically contract to flex hip and advance limb forward
Muscle activity midswing
- Dorsiflexors continue to concentrically contract to maintain DF
- Momentum advances limb with little knee or hip activity
Muscle activity terminal swing
- Dorsiflexors continue to concentrically contract to maintain DF
- Ankle invertors concentrically supinate the foot to prepare for initial contact
- Quads concentrically extend knee for initial contact
- Hamstrings eccentrically decelerate limb and control knee extension
- Hip extensors eccentrically slow rate of hip flexion and prepare limb for initial contact
Antalgic gait
- Protective gait pattern with decreased stance time on involved side to avoid WB d/t pain.
- Rapid, shorter swing phase on involved side
Ataxic gait
- Staggering, unsteadiness, wide BOS, exaggerated movements
- Often seen with cerebellar things
Circumduction
- Using circular motion to advance leg during swing phase
- Compensate for insufficient hip/knee flexion or DF
- Often seen with stroke
Double step gait
Alternate steps are of a different length or at a different rate
Equinous gait
- High steps, walking on toes
- Gastroc hyperactivity or contracture
Festinating gait
- Rapid, small, shuffling baby-steps
- On toes, falling forward
- Forward flexion of trunk and knees
- Parkinson’s
Scissoring gait
- Legs (knees) cross midline with advancement
- Adductor spasticity
Steppage gait
- Lift feet high off ground
- Excessive knee/hip flexion
- Compensating for dorsiflexor weakness
- Foot slap at initial contact
Tabetic gait
High stepping ataxic gait pattern where feet slap ground.
Trendelenburg gait
- Glute med weakness on stance leg
- Hip drop on contralateral swing side
- Lateral trunk flexion towards stance side
Vaulting gait
Swing leg advances by comepsating with excessive plantar flexion on stance leg
What causes foot slap?
- Weak DF
- DF paralysis
What causes toe down instead of heel strike?
- PF spasticity
- PF contracture
- Weak dorsiflexors
- Dorsiflexor paralysis
- Leg length discrepancy
- Hindfoot pain
What causes clawing of toes?
- Toe flexor spasticity
- Positive support reflex
What causes heel lift during midstance?
- Insufficient dorsiflexor ROM
- Plantar flexor spasticity
What causes no toe off?
- Forefoot/toe pain
- Weak plantar flexors
- Weak toe flexors
- Insufficient plantar flexion ROM
What causes exaggerated knee flexion at contact?
- Weak quads
- Quadriceps paralysis
- Hamstring spasticity
- Insufficient knee extension ROM
What causes knee hyperextension in stance?
- Compensation for weak quads
- Plantar flexor contracture
What causes exaggerated knee flexion at terminal stance?
- Knee flexion contracture
- Hip flexion contracture
What causes insufficient knee flexion with swing?
- Knee effusion
- Quad extension spasticity
- PF spasticity
- Insufficient knee flexion ROM
What causes excessive knee flexion with swing?
- Flexor withdrawal reflex
- Lower extremity flexor synergy
What causes insufficient hip flexion at initial contact?
- Weak hip flexors
- Hip flexor paralysis
- Hip extensor spasticity
- Insufficient hip flexor ROM
What causes insufficient hip extension at stance?
- Insufficient hip extension ROM
- Hip flexion contracture
- Lower extremity flexor synergy
What causes circumduction during swing?
- Compensation for weak hip flexors
- Compensation for weak dorsiflexors
- Compensation for weak hamstrings
What causes hip hiking during swing?
- Compensation for weak dorsiflexors
- Compensation for weak knee flexors
- Compensation for extensor synergy pattern
What causes exaggerated hip flexion during swing?
- Lower extremity flexor synergy
- Compensation for insufficient ankle dorsiflexion
