gait Flashcards

1
Q

gait (walking, ambulations…)

definition

A
  1. progression of body thru space brought about by repetitive rhythmic alternating movements of the trunk and extremeties
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2
Q

gait cycle
def
3 phases

A
1. period of time btwn two successive similar events on the same* lower extremity
3 phases:
 stance phase
 swing phase
 double support
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3
Q

pre-requs for ambulation (5)

A
  1. balance
  2. strength
  3. ROM (knee, hip, ankle)
  4. motor control/ coordination
  5. sensation (for sensory feedback)
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4
Q

stance phase vs. swing phase

A
  1. stance phase- any part of foot is still in contact with ground
  2. swing phase- extremity is not in contact with ground
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5
Q
stance phase (5)
 and how much time spent
A
  1. starts with heel strike
  2. foot flat- foot coming down on floor
  3. mid-stance- body starts to come over foot
  4. heel rise- body comes in front of body
  5. toe off- toes still in contact but MTPs extended
  6. 60% time
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6
Q
swing phase (3)
 and how much time spent
A
  1. early swing- foot off ground knee and foot come back
  2. mid-swing- toe comes underneath you
  3. late swing- toe progressive forwards in anticipation of next heel strike
  4. 40% time
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7
Q
synonyms for phases of gait
 HS
 FF
 mid st
 HR
 TO
 ESw
 MSw
 LSw
A
  1. HS= initial contact (IC)
  2. FF = loading response
    mid stance = mid stance
  3. HR= terminal stance
  4. TO = pre-swing
  5. ESw = acceleration
  6. Mid and late sw= deceleration
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8
Q

double support
two times it happens (saying it both ways)
what % of time spent in this

A
  1. heel strike and heel rise of other foot orrr initial contact and terminal stance
  2. 20-25% of gait cycle in this stance (in normal rate of ambulation)
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9
Q

what differentiates running from walking?

muscle differences in running

A

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

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10
Q

spatial (linear) parameters of gait (4)

A
  1. stride length
  2. step length
  3. BOS
  4. degree of toe out
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11
Q

stride length

A
  1. linear distance btwn heel strike and next heel strike of same leg
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12
Q

step length
how you measure
how do you name it?

A
  1. linear distance btwn heel strike of one foot and heel strike of other foot
  2. foot thats in front is named for
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13
Q

BOS
how you measure
normal distance
what happens if you walk faster

A
  1. draw line thru center of heels (linearish- make a right angle)
  2. 5-10cm
  3. walking faster narrows base of support
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14
Q

degree of toe out
how you measure
normal measure
what happens if you walk faster

A
  1. line from 2nd MT -> heel and bring line all the way back to center of step (line of progression)
  2. normally there is 7 deg of external torsion = normal toe out
  3. faster walking decreases this angle
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15
Q
time measures of gait
 stride time 
 step time
 cadence
 velocity
A
  1. stride time = cycle time- amt of time that elapses in 1 gait cycle
  2. step time = elapsed time from one heel strike to heel strike of contralateral foot
  3. cadance = # steps/ min (80-120/ min is normal)
  4. velocity = distance travelled/ unit time (3mph, 1.5meters/sec)
    dependent on cadance and stride length
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16
Q

displacement of COG
where it is normal
vertical total excursion
horizontal total excursion

A
  1. normal is S1
  2. vertical total excursion = 2in(1 up and 1 down) - mid stance = highest
  3. horizontal total excursion = 1 inch -> right and 1 inch -> left
17
Q

deviations in vertical or horizontal excursion

A
  1. the more movement = more energy expended

2. increasing horizontal total excursion = a lot of swaying (increasing BOS)

18
Q

horizontal dip of pelvis
normal # and which side its happening on
what happens to other side

A
  1. 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

19
Q

pelvic rotation

trunk rotation

A
  1. when we walk our pelvis rotates about 5 degrees - away from side of heel strike
  2. trunk rotates towards side that does heel strike
20
Q

reciprocal arm swing

A
  1. opposite arm / leg

2. improves efficency

21
Q

time spent in stance vs. swing

A
  1. 60% stance
  2. 40% swing
    when we walk faster less time in stance
22
Q

weakness in pre-tibial muscles (dorsi-flexors)

3 things + 1 gait pattern

A
  1. foot slap in early stance
  2. lack of definitive HS
  3. toe drag in ES => high steppage gait
23
Q

weakness in tricep-spre (gastroc/soleus)

1 thing + 1 gait pattern

A
  1. lack of push off in TO

2. calcaneal gait = wt bearing stays back

24
Q

weakness in quads (2)

A
  1. forward lurching gait/ lean forward with trunk for extension moment
  2. lack of knee flexion in early stance
25
Q

weakness in hamstrings (2)

A
  1. recurvatum (excessive hyperextension) around mid stance when bringing body weight over
  2. terminal impact- lack of eccentric control as you go into terminal swing
26
Q

weakness in hip-flexors

1 things => 1 gait pattern

A
  1. can’t accelerate leg forward during swing

=> hip hiking or circumduction =vaulting

27
Q

weakness in glut med

1 gait pattern

A
  1. trendelenberg gait

- side off floor drops and trunk leans to weak side

28
Q

parkinsons progression (5)

A
  1. lack of heel to toe
  2. lack of pelvic and trunk rotation
  3. lack of arm swing
  4. short step length => more cadence
  5. forward flexed posture (fenestrating gait, trying to catch up with COG)
29
Q

ataxic gait
from
4 signs

A
  1. cerebelluar lesions = lack of coordination
  2. wide BOS
  3. quick step times
  4. poor coordination of hip flexors (overshoot them) => stomping down
  5. lots of time in double support/stance
30
Q

hemipelegic gait (3)

A
  1. decreased stance time on paretic leg
  2. toe drag if dorsiflexors are affected
  3. can lack knee flexion
31
Q

antalgic gait

A

painful gait

1. quick step on hurt limb