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Movement Science EXAM 3 > GAIT 2 > Flashcards

GAIT 2 Flashcards

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1
Q

GRF

A

force applied to foot by during stance phase

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1
Q

What causes internal moments/forces?

A

muscles/ligaments/joint capsules
these counteract external forces

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2
Q

external moments (rotation around an axis)

A

created by gravity, inertia, GRF, in relation to joint center

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3
Q

Power generation

A

muscles shortening (concentric contraction)
PUSH

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4
Q

power absorption

A

muscles lengthening (eccentric contraction) CUSH

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5
Q

How does center of pressure change through gait?

A

IC: posterior lateral heel
LR: through lateral midfoot
TS: medially across ball of foot
Pre-swing: 1 and 2nd toes

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6
Q

internal moments in initial contact

A

Hip EXT, Knee FLX, Ankle DF

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7
Q

Internal moments in laoding response

A
  • Hip EXT, Knee EXT, Ankle DF
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8
Q

Internal moments in midstance

A

Hip FLX, Knee FLX, Ankle PF

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9
Q

internal moments in terminal stance

A
  • Hip FLX, Knee FLX, Ankle PF
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10
Q

internal moments in pre-swing

A

Hip FLX, Knee EXT, Ankle PF

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11
Q

What is the goal of gait metabolically?

A

efficiency of gait to use as little energy as possible

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12
Q

oxygen consumption of walking for 20-30 year olds

A

32%

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13
Q

oxygen consumption for walking for 75 year olds or chronically medically ill

A

48%

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14
Q

what increases oxygen consumption?

A

pain

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15
Q

Other aspects of metabolic energy costs of gait

A
  • Sum of potential energy and kinetic energy (translational and rotational)
  • Limbs contribute more total energy than HAT
  • Power generation and absorption – the balance of concentric and eccentric
    forces produce movement of segments and also control speed of moment
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16
Q

fulcrum is at the ___during initial contact to loading response

A

heel is rocker (calcaneal inversion to calcaneal eversion)

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17
Q

fulcrum is at the ___during loading response to terminal stance

A

ankle is rocker

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18
Q

Terminal Stance (heel off) with leg rotating over _____-

A

forefoot is rocker
* Increased MTP extension

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19
Q

fulcrum is the ____ at preswing

A

toe (increased toe extension)

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20
Q

adductor moment of head, arms and trunk is counteracted by hip ______

A

abductors (minimize movement at stance leg) *prevent contralateral hip drop

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21
Q
  • Slight trunk flexion at
A

initial contact
* HAT acceleration is counteracted by hip and back extensors

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22
Q

slight trunk extension during

A

SLS

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23
Q

Pelvic and trunk motion: sagittal plane

A

sinusoidal pattern up and down 4-5 cm with each step

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24
Q

step forward: ____rotation of pelvis

A

anterior rotation with IC
terminal stance/preswing-= posterior rotation

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25
Q

with IC, sinusoidal pattern is (low/high) and then (low/high) at midstance

A

low at IC, high at midstance

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26
Q

SLIDE 13

A
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27
Q

erector spinae are most active during

A

IC (heel strike) and preswing (toe off)

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28
Q

abdominal muscles are most active during

A

active low and variable, related to lateral trunk movement

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29
Q

What is postural righting?

A

dynamic process of re-alignment when changing postures

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30
Q

head stability is the process of

A

maintaining equilibrium orientation of head in space

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31
Q

Head stability controls orientation of

A

sensory receptors (vision, vestibular)
also facilitates gaze stability

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32
Q

head motion in sagittal plane is

A

7-12 degrees

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33
Q

arm swinging helps counterbalance ____ and _____body rotation

A

the swinging leg
decelerate body rotation

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34
Q

shoulder ROM during gait

A

30 deg total (6 deg FLX, 24 deg EXT)

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35
Q

elbow ROM during gait

A

20-45 degrees

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36
Q

SLIDE 19

A
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37
Q

Vertical work is _____ and related to _____during stair gait

A

increased vertical work
related to gravity and step/stair height

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38
Q

torque is greater at knee by _____for ascent and descent

A

3x
knee is more generative during ascent on stairs

39
Q

IC contact on stairs will be more ___- and move ____-

A

anterior and move posterior
vs gait: posterior to anterior

40
Q

most knee flexion is needed during what phase of stair gait

A

foot clearance (90-100 degrees)

41
Q

most hip flexion is needed during ____

A

IC and foot placement (60 degrees)

42
Q

During running, what happens at the knee during impact?

A

greater joint torque generated

43
Q

GRFs at center of pressure during running

A

over 200% of body weight

44
Q

SLIDE 24

A
45
Q

what are some neuro changes with increased age that affects gait?

A

Brain mass decreased 10-20% by age 90
Degeneration of sensory receptors
Nerve conduction velocity - slowed
reaction time
* Visual acuity & depth perception
* Vestibular input
* Hearing loss
medications: understand what kind of meds they are on

46
Q

MSK changes related to gait
muscle atrophy is __% loss per year in healthy adults

A

1%

47
Q

estimated ___% loss of max strength by age ___ without exercise

A

20-40% loss of max strength by age 65

48
Q

Is there a greater loss of type I or type II fibers?

A

type II fast twitch
atrophy of slow twitch type I too with inactivity

49
Q

Do you lose postural extensors or flexors more with age?

A

extensors (let gravity hunch you over)

50
Q

with each decade, there is a decrease in gait velocity by ___%

A

12-16%

51
Q

There is less ____during swing phase for elders

A

less toe clearance
and dcreased dorsiflexion in double limb support

52
Q

community functional benchmark: gait speed greater than

A

4 feet/sec

53
Q

community functional benchmark: gait distance greater than

A

300 m (distance from parking to store or doc office)

54
Q

community functional benchmark: curb height greater than ___ inches

A

8 inches

55
Q

Gait can be a ____ sign to detect preclinical disability

A

vital

56
Q

gait with rolling walker
speed
step length

A

more stance time, less swing time
slower speed 1.5 ft/s
smaller step length 1.1 ft

57
Q

What can cause abnormal gait?

A

deformity (contracture, abnormal joint contours, congenital disorders)
-muscle weakness
-sensory loss
-pain
-impaired motor control

58
Q

Trunk deviations: backward lean due to weak _________

A

hip extensors (WA/SLS): hanging on Ys
hip flexors during swing (SLA)

59
Q

trunk deviations: foward lean
shifts LOG to

A

front of knee and ankle

60
Q

forward lean could also be due to tight ____ or weak_____

A

tight hip flexors, increased plantar flexion
compensate for weak quads

61
Q

other causes for trunk forward leans

A

increased visual cues for decreased proprioception
abdominal pain
ADs

62
Q

counterbalance to lean what way if you have a weak hip abductor

A

lateral lean to the weak side

63
Q

dissociation is

A

separation of trunk and pelvis (pelvis and trunk rotate in opp directions normally, but with abnormal gait, can have trunk moving with pelvis)

64
Q

forward rotation of trunk may be compensation for

A

weak leg to advance limb

65
Q

backward rotation of trunk can be compensation for

A

increased plantarflexion to clear toes

66
Q

With hip hike to clear swinging limb (increased PF, not enough knee flexion making leg longer), pt will use what muscle

A

ipsilateral QL

67
Q

vault pelvic deviation will be on

A

stance leg with addition of plantar flexion

68
Q

anterior pelvic tilt due to

A

weak hip extensors
weak abdominals
tight anterior hip
all lead to tight paraspinals

69
Q

posterior pelvic tilt due to

A

hip flexor weakness
hip extensor weakness
tight hamstrings
shifts LOG posteriorly (backward trunk lean)

70
Q

lack of forward or backward pelvic rotation can be due to

A

back pain
surgical fusion
*will decrease step length

71
Q

excessive forward pelvic rotation is due to

A

need to advance limb (weakness)

72
Q

excessive backward pelvic rotation is due to

A

walk calf (no heel off in terminal stance)
excessive hip flexion (single leg stance)

73
Q

pelvic drop will likely lead to ____ pain during stance

A

back

74
Q

adductor spasticity during single leg advancement will cause

A

ipsilateral drop of pelvis
*contralateral drop during single leg stance

75
Q

what are causes for pelvic drop?

A

weak calf
scoliosis
leg length discrepancy (shorter LE)
weak hip abductors
adductor spasticity

76
Q

what can cause a hip drop
___hip____weakness
____adductor contracture/spasticity
_____abductor contracture

A

ipsilateral hip abduction weakness
ipsilateral adduction contracture
contralateral abductor contracture
*also scoliosis

77
Q

decreased hip extension can be caused by

A

iliopsoas contracture
hip capsule contracture
decreased Knee extension
hip pain

78
Q

early heel rise and/or increased DF may be increasing hip ____

A

hip flexion

79
Q

hip ____ may be compensation for increased knee flexion/ankle dorsiflexion
or compensation for increased plantarflexion in midswing

A
80
Q

hip flexion may be compensation /caused by

A
  • HF contracture or spasticity
  • IT band tightness/TFL
    contracture
  • Hip pain
  • Compensatory for ↑KF and
    ankle ↑DF (SLS)
  • Compensatory for ↑PF in
    MSw
81
Q

what is past retract?

A

Voluntary excessive hip flexion & its
release in TSw to rapidly extend a
flaccid knee by using tibial inertia

82
Q

SLIDE 49

A
83
Q

Compensation for lack of DF may be

A

external rotation of hip (toes point out)

84
Q

IR hip deviation due to:

A
  • Anteversion
  • Contracture/Spasticity of
    IRs
  • Voluntary to increase
    knee stability during
    stance if quads weak
  • Medial HS spasticity
  • ADDuctor spasticity
85
Q

ER hip deviation due to:

A

Retroversion
* ER contracture
* weak IP
* Glut Max spasticity
* Compensation for PF
contracture
* Compensation for
reference limb too long in
swing

86
Q

hip adduction deviation due to:

A

Hypertonicity/contracture
* Ipsi glut med weakness
leading to contralateral drop
* Compensation for weak hip
flexors
* Leg length discrepancy

87
Q

hip abduction deviation due to

A
  • Contracture
  • long contralateral limb
  • Scoliosis w/ pelvic
    obliquity
88
Q

Pt has leg length discrepancy. What deviations might you see to compensate?

A

think

89
Q

decreased knee flexion deviation can be due to

A

Weak or spastic quads Knee pain
Extension contracture
Impaired proprioception
Hip flexor weakness (swing)

90
Q

limited knee flexion in Loading response ____shock absorption

A

decreases normal shock absorption (stiff knee)

91
Q

limited knee flexion in preswing makes ___harder

A

toe off

92
Q

limited knee flexion during in initial swing ____the leg, resulting in _____

A

lengthens leg, toe drag

93
Q

genu recurvatum (hyperextension) can be due to

A

weak quads
weak quads and plantar flexors
quad and/or plantar flexor spasticity
PF contracture

94
Q

genu valgus could be from

A
  • Joint or ligamentous
    instability
  • Bony deformity
  • Pain
  • Ipsi ABDuctor weakness
  • Ipsi trunk lean
95
Q

genu varus could be from

A

Joint or ligamentous
instability
* Bony deformity
* Degenerative joint
changes
* Pain

96
Q

erector spinae most active during

A

loading response

Movement Science EXAM 3 (5 decks)

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