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Adult Neuro > Gait > Flashcards

Gait Flashcards

1
Q

What is active at initial contact?

A

quads

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2
Q

What do quads do at initial contact?

A

control knee flexion

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3
Q

What do the pretibial muscles do at initial contact?

A

work eccentrically to prevent foot slap

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4
Q

What is active during the loading response?

A

gastrco and soleus from foot flat to midstance

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5
Q

What do gastrco and soleus control during loading response?

A

Eccentrically control forward tibial advancement

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6
Q

What do hip, knee and ankle extensors do during midstance?

A

oppose antigravity forces and stabilize the limb

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7
Q

What do hip extensors do during midstance?

A

control forward motion of the trunk

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8
Q

What do hip abductors do during midstance?

A

stabilize pelvis during unilateral stance

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9
Q

What do plantarflexors do during midstance?

A

propel the body forward

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10
Q

What is at peak activity during terminal stance?

A

plantarflexors (forward propulsion of the body)

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11
Q

What contributes to forward propulsion of the body during preswing?

A

hip and knee extensors (hams and quads): brief burst of activity

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12
Q

What is active during initial swing?

A

quad

hip flexors

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13
Q

What do quads do during initial swing?

A

forward acceleration of the limb

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14
Q

What do hip flexors (iliopsoas) do during initial swing?

A

aid in forward limb propulsion

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15
Q

When are quads silent/ and why?

A

midswing: pendular motion is in effect

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16
Q

How is foot clearance achieved in midswing?

A

contraction of hip and knee flexors and ankle dorsiflexors

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17
Q

What do hamstrings do in terminal swing?

A

decelerate limb in preparation for heel strike

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18
Q

What do quads and ankle dorsiflexors do in late swing?

A

become active to prepare for heel strike

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19
Q

Trunk, Pelvis and Hip Deviations during Stance Phase:

A 
Lateral Trunk Bending
Trendelenburg Gait
Backward Trunk Lean
Forward Trunk Lean
Excessive Hip Flexion
Limited Hip Extension
Limited Hip Flexion
Antalgic Gait
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20
Q

What is lateral trunk bending a result of?

A

gluteus medius weakness

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21
Q

In lateral trunk bending, what side does the bending occur?

A

ipsilateral (same side) of weakness

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22
Q

What other muscles can affect a lateral trunk bend?

A

hip pain

IT band/ soleus tightness

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23
Q

What side does the pelvis drop in a trendelenburg gait?

A

contralateral side of glut med weakness

contralateral pelvis drop

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24
Q

What is a compensatory strategy seen in tredelenburg gait?

A

ipsilateral trunk lean

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25
Q

What is a backward trunk lean a result of?

A

weak gluteus maximus

limited hip flexion

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26
Q

What is difficult for a patient with a backward trunk lean?

A

up stairs and/or ramps

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27
Q

What is a forward trunk lean a result of?

A

weak quads

May also be associated with hip and knee flexion contractures

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28
Q

What does a forward trunk lean do?

A

decreases the flexor moment at the knee

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29
Q

What is excessive hip flexion a result of?

A

weak hip extensors or tight hip and /or knee flexors

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30
Q

What is limited hip extension a result of?

A

tight or spastic hip flexors

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31
Q

What is limited hip flexion a result of?

A

weak hip flexors or tight extensors

32
Q

What is antalgic gait?

A

painful gait

33
Q

What does abbreviated stance time on painful limb result in with antalgic gait?

A

uneven gait pattern(limping)

34
Q

In an antalgic gait, why does the uninvolved limb have a shortened step length?

A

since it must bear weight sooner than normal

35
Q

Knee Stance Phase Deviations:

A

Excessive knee flexion

Hyperextension

36
Q

What is excessive knee flexion a result of?

A

weak quadriceps ( the knee wobbles or buckles) or knee flexor contracture

37
Q

What is difficult for a patient with excessive knee flexion?

A

going down stairs or ramps

38
Q

What is a compensation for weak quads?

A

forward trunk bending

39
Q

What is hyperextension a result of?

A

weak quadriceps, plantarflexion contracture or extensor spasticity ( quadriceps and/or plantarflexors)

40
Q

Foot/Ankle Stance Phase Deviations

A 
Toes first
Foot slap
Foot flat
Excessive dorsiflexion with uncontrolled motion of tibia
Excessive plantarflexion
Varus foot
Claw toes
Inadequate push off
41
Q

What is toes first a result of?

A 
weak dorsiflexors, spastic or tight plantarflexors
shorted LE ( leg length discrepancy), painful heel, or a positive support reflex
42
Q

What is foot slap a result of?

A

weak dorsiflexors or hypotonia

43
Q

How is foot slap compensated?

A

with a steppage gait

44
Q

What is foot flat a result of?

A

weak dorsiflexors, limited range of motion, or immature gait pattern

45
Q

What is Excessive Dorsiflexion with Uncontrolled Forward Motion of the Tibia a result of?

A

weak plantarflexors

46
Q

What is excessive plantarflexion a result of?

A

result of spasticity or contracture of the plantarflexors

Eccentric contraction is poor, as in tibia advancement

47
Q

What is a varus foot?

A

At foot contact, the lateral side of the foot touches first

The foot may remain in varus throughout the stance phase

48
Q

What is varus foot a result of?

A

spastic toe flexors, possibly a plantar grasp reflex

49
Q

What is claw toes a result of?

A

spastic toe flexors, possibly a plantar grasp reflex

50
Q

What is inadequate push off a result of?

A

weak plantarflexors, decreased range of motion or pain in the forefoot

51
Q

Trunk, Pelvis and Hip Swing Phase Deviations

A

Insufficient forward pelvic rotation
Insufficient hip and knee flexion
Circumducted gait
Hip hiking
Excessive hip and knee flexion
Abnormal synergistic activity or spasticity
Decreased amplitude in trunk and pelvis rotation

52
Q

What is insufficient forward pelvic rotation?

A

pelvic retraction

53
Q

What is insufficient forward pelvic rotation a result of?

A

weak abdominal muscles and/or weak hip flexor muscles

54
Q

What is insufficient hip and knee flexion a result of?

A

weak hip and knee flexors or strong extensor spasticity

55
Q

What does insufficient hip and knee flexion result in?

A

inability to lift the LE and move it forward

56
Q

What is circumducted gait?

A

LE swings out to the side (abduction/external rotation followed by adduction/internal rotation)

57
Q

What is circumducted gait a result of?

A

Result of weak hip and knee flexors

58
Q

What muscle is acting in hip hiking?

A

QL action

59
Q

What is hip hiking a compensatory response for?

A

weak hip and knee flexors, or extensor spasticity

60
Q

What is excessive hip and knee flexion?

A

steppage gait

61
Q

What is excessive hip and knee flexion compensatory response to?

A

shortened contralateral lower limb

62
Q

What can excessive hip and knee flexion also be a result of?

A

same side dorsiflexor weakness ( resulting from neuritis of the peroneal nerve in patients with diabetes)

63
Q

Abnormal Synergistic activity or Spasticity:

A

strong flexor synergy pattern
strong extension synergy patter
stroke patient

64
Q

Strong flexor synergy pattern:

A

excessive abduction with hip and knee flexion

65
Q

Strong extension synergy pattern:

A

excessive adduction with hip and knee extension and ankle plantarflexion ( scissoring)

66
Q

Decreased Amplitude in Trunk and Pelvic Rotation

A

Seen in the elderly and characteristic of several known neurological disorders ( patient with CVA or Parkinson’s)

67
Q

Knee Swing Phase Gait Deviations:

A

insufficient knee flexion

excessive knee flexion

68
Q

What is insufficient knee flexion a result of?

A

extensor spasticity, pain, decreased range of motion, or weak hamstrings

69
Q

What is excessive knee flexion a result of?

A

flexor spasticity; flexor withdrawal reflex

70
Q

Foot/Ankle Swing Phase Gait Deviations:

A

foot drop
varus or inverted foot
equinovarus

71
Q

What is foot drop a result of?

A

weak or delayed contraction of the dorsiflexors or spastic plantarflexors

72
Q

What is varus or inverted foot a result of?

A

spastic invertors ( anterior tibialis), weak peroneals, or an abnormal synergistic pattern

73
Q

What is equinovarus a result of?

A

spasticity of the posterior tibialis and/or gastrocnemius/soleus, or structural deformity ( club foot)

74
Q

step length:

A

distance from point of heel strike of one extremity to heel strike of opposite extremity

75
Q

stride length:

A

distance from point of heel strike of one extremity to point of heel strike of same extremity

Adult Neuro (26 decks)

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