gait Flashcards
gait (walking, ambulations…)
definition
- progression of body thru space brought about by repetitive rhythmic alternating movements of the trunk and extremeties
gait cycle
def
3 phases
1. period of time btwn two successive similar events on the same* lower extremity 3 phases: stance phase swing phase double support
pre-requs for ambulation (5)
- balance
- strength
- ROM (knee, hip, ankle)
- motor control/ coordination
- sensation (for sensory feedback)
stance phase vs. swing phase
- stance phase- any part of foot is still in contact with ground
- swing phase- extremity is not in contact with ground
stance phase (5) and how much time spent
- starts with heel strike
- foot flat- foot coming down on floor
- mid-stance- body starts to come over foot
- heel rise- body comes in front of body
- toe off- toes still in contact but MTPs extended
- 60% time
swing phase (3) and how much time spent
- early swing- foot off ground knee and foot come back
- mid-swing- toe comes underneath you
- late swing- toe progressive forwards in anticipation of next heel strike
- 40% time
synonyms for phases of gait HS FF mid st HR TO ESw MSw LSw
- HS= initial contact (IC)
- FF = loading response
mid stance = mid stance - HR= terminal stance
- TO = pre-swing
- ESw = acceleration
- Mid and late sw= deceleration
double support
two times it happens (saying it both ways)
what % of time spent in this
- heel strike and heel rise of other foot orrr initial contact and terminal stance
- 20-25% of gait cycle in this stance (in normal rate of ambulation)
what differentiates running from walking?
muscle differences in running
in running there are times neither leg is in contact with the ground
muscles:
glut max and hamstrings in early stance
quads in early stance -> late swing
iliopsosas -> late stance throughout swing
PF- earlier in stance (for more push off)
DF- isometric and concentric in early stance
spatial (linear) parameters of gait (4)
- stride length
- step length
- BOS
- degree of toe out
stride length
- linear distance btwn heel strike and next heel strike of same leg
step length
how you measure
how do you name it?
- linear distance btwn heel strike of one foot and heel strike of other foot
- foot thats in front is named for
BOS
how you measure
normal distance
what happens if you walk faster
- draw line thru center of heels (linearish- make a right angle)
- 5-10cm
- walking faster narrows base of support
degree of toe out
how you measure
normal measure
what happens if you walk faster
- line from 2nd MT -> heel and bring line all the way back to center of step (line of progression)
- normally there is 7 deg of external torsion = normal toe out
- faster walking decreases this angle
time measures of gait stride time step time cadence velocity
- stride time = cycle time- amt of time that elapses in 1 gait cycle
- step time = elapsed time from one heel strike to heel strike of contralateral foot
- cadance = # steps/ min (80-120/ min is normal)
- velocity = distance travelled/ unit time (3mph, 1.5meters/sec)
dependent on cadance and stride length
displacement of COG
where it is normal
vertical total excursion
horizontal total excursion
- normal is S1
- vertical total excursion = 2in(1 up and 1 down) - mid stance = highest
- horizontal total excursion = 1 inch -> right and 1 inch -> left
deviations in vertical or horizontal excursion
- the more movement = more energy expended
2. increasing horizontal total excursion = a lot of swaying (increasing BOS)
horizontal dip of pelvis
normal # and which side its happening on
what happens to other side
- 5deg dip of pelvis on side you are swinging forward
2. side you are standing on = side you are in stance on…. glut med contracts to stabilize
pelvic rotation
trunk rotation
- when we walk our pelvis rotates about 5 degrees - away from side of heel strike
- trunk rotates towards side that does heel strike
reciprocal arm swing
- opposite arm / leg
2. improves efficency
time spent in stance vs. swing
- 60% stance
- 40% swing
when we walk faster less time in stance
weakness in pre-tibial muscles (dorsi-flexors)
3 things + 1 gait pattern
- foot slap in early stance
- lack of definitive HS
- toe drag in ES => high steppage gait
weakness in tricep-spre (gastroc/soleus)
1 thing + 1 gait pattern
- lack of push off in TO
2. calcaneal gait = wt bearing stays back
weakness in quads (2)
- forward lurching gait/ lean forward with trunk for extension moment
- lack of knee flexion in early stance
weakness in hamstrings (2)
- recurvatum (excessive hyperextension) around mid stance when bringing body weight over
- terminal impact- lack of eccentric control as you go into terminal swing
weakness in hip-flexors
1 things => 1 gait pattern
- can’t accelerate leg forward during swing
=> hip hiking or circumduction =vaulting
weakness in glut med
1 gait pattern
- trendelenberg gait
- side off floor drops and trunk leans to weak side
parkinsons progression (5)
- lack of heel to toe
- lack of pelvic and trunk rotation
- lack of arm swing
- short step length => more cadence
- forward flexed posture (fenestrating gait, trying to catch up with COG)
ataxic gait
from
4 signs
- cerebelluar lesions = lack of coordination
- wide BOS
- quick step times
- poor coordination of hip flexors (overshoot them) => stomping down
- lots of time in double support/stance
hemipelegic gait (3)
- decreased stance time on paretic leg
- toe drag if dorsiflexors are affected
- can lack knee flexion
antalgic gait
painful gait
1. quick step on hurt limb
