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PCM > Gait > Flashcards

Gait Flashcards

1
Q

Average Stride Length

A

28-32 inches

Stride = same foot to same foot

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2
Q

Average Cadence

A

90-120 steps/minute

Women higher by 6-9 steps/minute

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3
Q

Average Speed

A

3 mph

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4
Q

Gait Cycle

A

From heel strike to next heel strike of same foot

Phases:
Stance - when foot is in contact with ground
Swing - when foot is not in contact with ground

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5
Q

Gait Cycle Phases

A

Heel-strike to foot-flat (contact)
Foot-flat to heel-off (mid-stance)
Heel-off to toe-off (propulsion)
Toe-off to heel-strike (swing)

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6
Q

Contact Phase

A

Lateral calcareous strikes ground
At point of impact, tibia internally rotates
Calcareous everts and talus drops and addicts to unlock midtarsal joints - provides maximum shock absorption
Foot lowered eccentrically to ground by extensor digitorum longus and tibialis anterior muscles

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7
Q

Mid-stance Phase

A

Flat-food to heel-off
Rearfoot fully pronates
Metatarsals hit ground to bring foot flat on ground
Body’s center of gravity passes from behind to over foot
Subtalas joint resupinates (calcareous everts and talus abducts)
Locks midtarsal joints
Transforms foot from shock absorber to a rigid lever
Posterior tibialis m. = important restraint to overpronation; active foot supinator
As body passes over mid-foot it places ankle in maximal dorsiflexion, putting a maximal preload on the gastrocnemius-soleus complex

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8
Q

Propulsion Phase

A

Heel-lift to toe-off
As heel rises body continues forward over metatarsals and begins to pull heel off ground
Extension of metatarsalphalangeal (MTP) joint - especially 1st MTP => windlass effect of plantar fascia that elevates the arch and further assists in supination of foot
Foot = rigid lever and used to propel body forward by maximal contraction of gastrocnemius-soleus and hamstrings
Toe-off: line of progression passes between 1st and 2nd metatarsals that are in maximal extension
Phase concludes with body weight moving over great toe at toe-off

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9
Q

Swing Phase

A

Last phase
Foot dorsiflexes to keep toes from hitting ground
Supinates to position foot for lateral calcareous to make contact at heel strike
Cycle repeats

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10
Q

Stance

A

From heel strike (initial contact) to toe off (pre swing)
60% of gait cycle
When foot is on ground and weight bearing
Most problems occur during stance phase

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11
Q

Swing

A

From toe off to heel strike
40% of gait cycle
Foot moves forward and is not weight bearing

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12
Q

Function of the 8 Phases of Gait

A
  1. Initial contact
    * establish contact with leading foot, begin STANCE
  2. Loading response
    * shock absorption
    * begin weight bearing
    * continue progression of forward movement
  3. Mid stance
    * limb & trunk stability
    * progression over stationary foot
  4. Terminal stance
    * progression past stationary foot
    * prepare for swing
  5. Pre swing
    * weight release from stationary foot
    Position limb for swing
  6. Initial swing
    * prepare for foot clearance
    Advance food from trailing position
  7. Mid swing
    * foot clearance
    * limb advancement
  8. Terminal swing
    * prepare for stance
    * complete limb advancement
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13
Q

Requirements of Gait

A 
Stability in stance
Foot clearance in swing
Pre-position for initial contact
Adequate step length
Energy conservation
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14
Q

Stability in Stance

A

Single limb support for a total of 80% of gait cycle (40% for each foot)
Stable foot, ankle, knee, hip, torso

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15
Q

Foot Clearance in Swing

A

Requires coordination of entire limb

  • ankle dorsiflexion
  • knee flexion
  • hip flexion
  • retain stability in stance
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16
Q

Pre-position for Initial Contact

A

Foot-ankle-knee-hip all in correct alignment
Ready to place foot in desired location
Ready to absorb weight transfer

17
Q

Adequate Step Length

A

Too short: expend energy, minimal progress

Too long: lose balance, strain ligaments and muscles

18
Q

Conservation of Energy

A

Center of gravity moves more than 2 inches up and down during gait cycle
Accomplished through pelvic list (in early stance, as weight is transferred to foot, hip on non-weight bearing side DROPS about 2 inches)
Considered energy efficient (otherwise would have to raise, expend more energy to lift entire leg mass)

19
Q

Innominate (Pelvic) Rotation

A

As foot moves forward for heel strike, innominate rotate forward (anteriorly) in a sagittal plane
“Lengthens” femur (some compensation for pelvic list)
Rotation about 4 degrees, reverse in stance phase

20
Q

Lateral Displacement of Pelvis

A

2 legged walk, feet hit about 2-4 inches apart
Only 1 foot on ground 80% of time (total booth feet in cycle)
Center of mass has to compensate
Pelvis shifts laterally about 2 inches
Facilitates abduction of hit during stance

21
Q

Antalgic Gait

A

Adopted limp to avoid pain on weight-bearing structures
Characterized by a very short stance phase on affected side

Common Causes:
Trauma
Osteoarthritis
Pelvic girdle pain
Coxalgia
Tarsal tunnel syndrome
22
Q

Arthrogenic Gait

A

Due to stiffness in affected joints (usually hip or knee) from deformity/decreased joint space
Plantar flexion of foot opposite to affected side to increase clearance
Affected leg is circumducted (passive circular motion)
Step is usually shorter
Not always painful

Common Causes:
Osteoarthritis of hip or knee joints
Post orthopedic surgeries of hip or knee

23
Q

Ataxic Gait

A 
Unsteady, uncoordinated walk
Needs broad base of support: wide base and feet thrown out
Loss of sensation or control
May lurch or stagger
Patient often watches feet when walking
Common Causes
Vestibular
Cerebellum abscess/hemorrhage
Friedreich's ataxia
Pontine-cerebellar atrophy
Chronic mercury poisoning
Posterior fossa tumor
Wernicke's syndrome (chronic alcohol abuse)
Drugs
24
Q

Parkinsonian (Festinating) Gait

A

Characterized by small shuffling steps
Hypokinesia (general slowness of movement)
In extreme cases - akinesia (total loss of movement)
Reduced stride length and walking speed while cadence rate is increased

Exhibited by some patients with Parkinson’s Disease (PD)

25
Q

Steppage (Foot Drop, High Stepping, Neuropathic) Gait

A

Full foot drop
Hip raised very high to clear toe
Usually a quiet gait

Common Causes:
Peroneal (common fibular) nerve injury as a result of:
* lumbar disc herniation (most common)
* poliomyelitis
* multiple sclerosis
* Guilain-Barre syndrome
* Parkinson's disease
26
Q

Hemiplegic Gait

A

Leg is stiff, without flexion at knee and ankle, and with each step is rotated away from the body, then towards it, forming a semicircle

27
Q

Average Step Length

A

14-16 inches

PCM (26 decks)

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