Gait Flashcards
1
Q
stance phase
A
encompasses the entire period during which the foot is on the ground
2
Q
swing phase
A
encompances the entire time the foot is in the air for limb advancement
3
Q
order of stance phase (5)
A
1) initial contact
2) loading response
3) midstance
4) terminal stance
5) preswing
4
Q
order of swing phase (3)
A
1) initial swing
2) mid swing
3) terminal swing
5
Q
what percent of gait is the stance phase?
A
60%
6
Q
initial contact
A
step and the heel touches the ground
stance phase
7
Q
what percent range is initial contact?
A
0-2%
8
Q
loading response
A
point of initial contact to when the opposite leg is lifted off the ground
double support at this point
9
Q
what percent range is loading response?
A
0-10%
10
Q
midstance
A
contralateral extremity is lifted and the body is slightly leaning forward over the support limb
11
Q
what percent range is mid stance?
A
10-30%
12
Q
terminal stance
A
(from the end of mid stance) when the body is over the support limb TO the point of initial contact over the contralateral foot
swinging motion after mid stance* once the opposite leg heel hits the ground terminal stance is over! its basically the point of transition from mid stance to preswing
13
Q
what percent range is terminal stance?
A
30-50%
14
Q
Preswing
A
initial contact of the contralateral leg
the leg that we’ve been talking about lifts off at the toe (the toe pops up at the end of terminal)
DOUBLE SUPPORT!
15
Q
what percent range is pre-swing
A
50-60%
at this point stance phase is over –> go onto swing phase
16
Q
what percent of gait cycle does the swing phase total???
A
40%
17
Q
Initial swing
A
lift off of toe to a point of maximum knee flexion
this is the whole amount of time that the toe comes off the ground til the knee is totally bent
18
Q
what percent range is initial swing??
A
60-73%
19
Q
mid swing
A
point of maximum knee flexion to when the tibia is vertical (perpendicular with ground)
20
Q
what percent range is mid swing
A
73-87%
21
Q
terminal swing
A
point when the tibia is vertical (perpendicular with the ground) to the point of initial contact with the floor
22
Q
what is the percent range for terminal swing??
A
87-100%
23
Q
temporal parameter
A
measure gait in terms of time
24
Q
spatial parameter
A
measure gait in terms of distance
25
average step length males
2.4 ft
26
average step length for females
2.1 ft
27
average step length overall
2.3 ft
28
step defined as
the distance from the same point on opposite feet (usually from the point of initial contact)
ex: right step length- measure back of left foot then lift the right foot, step forward. measure the location where the right foot hit the ground
29
average stride length females
4.2 ft
30
average stride length males
4.8 ft
31
average stride length overall
4.6 ft
32
stride defined as
the distance of the same point of contact on someones foot.
so left foot stride-- measure back of left foot. step forward with right foot--- then step forward with left foot-- measure back of the left foot
CANNOT just double a step to get a stride as the right & left steps are not always equal
33
average base of support measurement
2 to 4 inches, distance between heels
34
angle of toe out (line of progression & foot)
normal = 7 degrees
35
cadence
steps/time
36
average cadence
113 steps/min
37
walking velocity average males
276 ft/min
38
walking velocity average females
250 ft/min
39
walking velocity average overall
262 ft/min
40
stride duration
time to complete a stride
41
step duration
time to complete a step
42
stance time
duration of stance phase
43
double support time
20% of the stance phase (amount of time that both feet are on the floor)
44
single support time
40% of stance phase
Entire swing phase
(amount of time 1 foot is on the floor)
45
what are the double support subtypes???
loading response
| Preswing
46
what percentages of gait cycle is the hip in flexion?
0 - 30%
&
60-100%
47
what percentages of gait cycle is hip in extension??
35-60%
48
what percentages of gait cycle is the knee in flexion
0 - 100%
| at the very end like 95ish it looks like there could be some extension
49
knee is most flexed at what percentage of the gait cycle??
70-80%
50
Knee flexion is lowest at what percentage of gait cycle??
30-50%
and
95-100%
51
What percentages of the gait cycle is the ankle in dorsiflexion?
20-55%ish
52
at what percentages of the gait cycle is the ankle in plantar flexion?
0-15%
| and 60-85%
53
At what percentage of the gait cycle is the ankle mostly at neutral
85-100% (if had to choose tho this is plantarflexion)
54
What causes gait???
forces influence kinetics
this includes:
- gravity
- muscular contraction
- inertia (tendency of an object to resist change in motion)
- ground reaction forces (for every action theres an equal and opposite reaction - newton's 3rd law)
55
Walking is a series of:
controlled falls
56
when you hit 150 steps/min you are ______.
This is considered ________.
running!
totally single support
57
body force vectors-- COG/body weight falls towards the ground & create an
equal and opposite force from the ground
if it didn't you would fall through the floor
58
passenger unit
body subdivision consisting of: head, neck, arms, trunk
this is carried rather than contributing directly to walking
59
locomotor unit
lower extremity & pelvis - directly impacts walking
60
locomotor unit consists of how many joints??
11 jts= lumbrosacral (2), hip, knee, ankle, subtallar, MTP
61
functions of the locomotor unit
- propulsion (body uses gravity to move)
- stance stability (controlled falling from one stance limb to the other)
- shock absorption
- energy conservation (normal BOS allows for minimal energy use)
62
basic objective of the locomotor unit
is to move the passenger unit forward along the line of progression
63
forward momentum is maintained during stance by:
the rockers (fulcrums) at the heel, ankle, metatarsal heads
64
heel rocker
initial contact to loading response
(heel down to flat foot)
pretibial muscles prevent foot drop and promote tibial movement (these muscles keep the foot in dorsiflexion)
65
ankle rocker
loading response to terminal stance
| flat foot to lift heel off ground
66
forefoot rocker (metatarsal head rocker)
terminal stance to preswing
| heel off ground to toe off ground
67
efficiency of gait - what is important - why
the goal of a good gait cycle is minimize work/energy used.. When the COG is good then gait is most efficient
rockers are important for efficiency of gait cycle** ex: no heel rocker- foot just goes down flat & the entire body needs to work to shift foot for less motion
68
average distance of vertical displacement of COG
2 inches
69
vertical displacement of COG has a smooth
sinusoidal curve
70
the vertical displacement of COG is highest during
midswing
| maximum knee flexion to the vertical tibia
71
the vertical displacement of COG is lowest during
double support
72
horizontal displacement of the COG shifts towards the
weight bearing side (right to left etc)
73
horizontal displacement of COG has a smooth
sinusoidal curve
74
average horizontal displacement of the COG (distance)
2 inches
75
gait is determined by adjustments made by the body to
help minimize the movement of the COG
76
COG is kept normal by what sort of drop in the frontal plane??
total degrees
lateral pelvic drop
4 deg on each side for an average total of 8 to 10 deg
weight bearing, leg hip drops contralateral leg-hip lift
77
COG is kept normal by what sort of rotation in the transverse plane??
total degrees??
pelvic rotation
6 to 10 deg
as you move forward, the hip rotates with forward leg motion
78
what knee motion keeps gait normal??
Knee flexion during mid stance (if you can't bend your knee than your foot will hit the floor/drag on the floor)
79
how does the lower extremity cause a smooth raising/lowering of the COG???
the coordination between knee, ankle, and foot allows for fluid movement
deviation in one of these joints may affect COG and throw off gait
80
excessive plantar flexion may be caused by (3)
- weakness of pretibial muscles (ant tibialis, peroneals)
- plantarflexion contracture (shortening, imbalance --> ankle cannot get to 0 degrees)
- soleus/gastroc spasticity
81
excessive ankle plantar flexion impact on initial contact and loading response
- low heel contact/forefoot contact --> this leads to a reduction or total loss of the heel rocker
-- foot slap (no heel contact just causes smack of the whole foot on ground)
82
excessive ankle plantar flexion impact on midstance
- premature heel rise (vigorous walker) -- walks on toes
| - knee hyperextension (outstretch leg to get foot flat on the floor) -- common with CVA, SCI, CP, TBI
83
excessive ankle plantar flexion impact on swing (gait)
toe drag ---> leads to compensations like......
- hip hiking
- circumduction
- lateral trunk leaning
- contralateral vaulting
84
excessive ankle dorsiflexion caused by: (2)
- triceps surae weakness (calf muscles- gastroc, soleus, plantaris)
- ankle locked at neutral due to fusion or orthosis (brace)
85
Inadequate knee flexion/excessive knee extension is caused by (4)
- quadriceps weakness --> impacts stance (snaps knee to extension to compensate for weak quads to prevent collapse)
- pain--> impacts stance & swing
- quadriceps spasticity --> impacts stance & swing
- excessive ankle plantar flexion --> impacts stance
86
Inadequate knee flexion/excessive knee extension effect on loading response
When quads are really weak - there is no knee flexion to allow for stability
87
knee deviations effect on swing -
| no knee flexion/too much knee extension
- toe dragged along ground
- decreased ability to move limb forward
(also occurs b/c lack of hip flexion)
88
Excessive Knee flexion
Inadequate knee extension
is caused by:
inappropriate hamstring activity--> swing & stance (SPASTICITY)
knee flexion contracture --> impacts swing & stance
89
Inadequate hip extension & excessive hip flexion caused by: (5)
- hip flexion contracture
- anterior iliotibialband contracture
- hip flexor spasticity
- pain (intra-articular pressures least at 3--40 deg of flexion)
- arthrodesis: fusion of bone - surgery as last resort or just happens spontaneously
90
inadequate hip flexion is caused by (2)
- hip flexor weakness
| - joint arthrodesis (rare)
91
inadequate hip flexion effect on gait (swing)
failure to reach 15 deg hip flexion reduces limb movement forwards
92
compensation for hip flexor insufficiency
- posterior pelvic tilt with abdominals (use abs to swing LE forward)
- circumduction which is done by the following motions:
- hip hiking w quadratus lumborum
- forward pelvic rotation
- hip abduction
- contralateral vaulting
- excessive/rapid knee flexion
- contralateral lean
93
excessive adduction of the hip effects stance phase of gait:
coxa vera (inward pointing hips) results in knee valgus (knees going in to touch each other)
94
excessive adduction of the hip effects swing phase of gait:
scissor gait
95
causes of excessive hip adduction (4)
- ipsilateral abductor weakness
- ipsilateral adduction contracture or spasticity (tightnesss)
- substitution of abductors as hip flexors
- contralateral hip abduction contracture (tight lateral musculature will lead to scissor gait)
96
excessive abduction effect on gait stance:
wider BOS requires more energy
97
excessive hip abduction caused by (4)
- ipsilateral hip abduction contracture
- ipsilateral short leg (i.e. ambulated or if leg is severely a diff length)
- ipsilateral voluntary abduction during circumduction
- scoliosis with pelvic obliquity
98
excessive external rotation is caused by (3)
- glut max overactivity
- excessive plantarflexion
- retroverted acetabulum/femoral head
99
excessive internal rotation is caused by (5)
- adductor overactivity
- anterior abductor overactivity (TFL/glut medius)
- medial hamstring overactivity
- quad weakness
- anteverted acetabulum/femoral head
