Gait Flashcards by Morgan Mowers

What is a gait cycle?

Heel strike to ipsilateral heel strike

I.e.- left gait cycle = time left heel hits ground to the time the left heel hits the ground again

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What is a step?

Heel strike to contralateral heel strike

So right step = right heel strike to the left heel strike

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What is stride length?

Distance between ipsilateral foot contacts

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What is step length?

Distance between contralateral foot contacts

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What is step width?

Distance between heel centers of contralateral feet (BoS)

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What is foot angle?

Angle formed between long axis of foot and line of progression– angle between where foot is pointed and the center line

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What is cadence

Steps per minute

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What is stride time

Time to complete gait cycle

I.e. Left foot IC to next left foot IC

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What is step time

Time for completing a step (left foot IC to right foot IC)

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What is single limb support time

Amount of time only one foot on ground

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How is walking speed calculated

Distance/time

Spatial-temporal descriptor

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Initial swing/Terminal swing

Which is speeding up or slowing down?

Initial = acceleration
Terminal = deceleration

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Goals of muscles in gait

Keep CoG at minimum
Decrease vertical/lateral CoG excursion
Decrease energy expenditure

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Least stabile position in gait

30-50 percent– single leg stance, highest and most lateral CoG

(Unsure of exact percentages but the single leg stance times– so like 30 and again at 80)

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What side does lateral pelvic tilt occur at?

Side of unsupported (swing) leg– keeps CoG from rising too high

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Relative adduction of stance hip is controlled by

Abductors of stance leg

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Purpose of knee flexion at midstane

Prevents further rise in CoG

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Forward rotation happens on _____ side

Swing

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Backward rotation occurs on _____ side

Stance

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Total pelvic rotation during gait

8 degrees

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Purpose of pelvic rotation in gate

Lengthens legs to prevent excessive CoG excursion

If your hips didn’t rotate, your legs wouldn’t really advance you

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Kinetic energy lowest at _____, greatest at _______

Lowest = midstance
Greatest = double limb

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Potential energy highest at ______, lowest at ______

Highest at midstance
Lowest at double limb

Highest when CoG is highest, lowest when CoG is lowest

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Tilt ______ with speed

Increases

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Hip at initial contact

30 degrees of flexion-- moves into extension as trunk moves over foot

Peak hip extension

Terminal stance

Knee at IC

5 degrees of flexion

Knee during loading response

20 degrees of loading

When does knee move towards extension

Terminal stance

Peak knee flexion?

Pre to mid swing

At initial contact-- ankle is

Neutral to slight PF

DF in midstance

10 degrees

Plantarflexion mainly occurs

During push-off and into initial swing

In swing, ankle....

Neutral DF!!!!!

Pelvic drop during loading

Contralateral

Hip during loading

Adducts

Ankle-- initial contact, stance, rest of stance/swing

Inversion IC, Eversion stance, Inversion rest of stance/swing Supination-pronation-supination

Foot transforms from what to what in each gait cycle?

From flexible/shock absorber | To a rigid elver

Eversion in stance...

Adds flexibility to midfoot

Late stance STJ

Arch rises, STJ supinate to add rigidity and prepare foot to support large loads

Pelvis rotation IC -- stance -- swing

Contralateral posterior, contralateral anterior, ipsilateral anterior -hip internally/externally rotates in response to this rotation

Shoulder girdle rotates ______ direction of pelvis

Opposite

Restriction in trunk motion

Increases energy expenditure

Max shoulder extension

Heel contact

Max flexion of shoulder

Double limb support | Shoulder moves in opposite direction of hips/trunk

Vertical GRF in walking gait

Double hump-- IC and push off

A/P GRF in walking gait

Posterior in IC, then anterior in push off

Sagittarius plane internal moments at IC

Hip extensor moment Knee flexor moment Dorsiflexor moment

Sagittal plane internal moment at foot flat

Hip extensor Knee extensor DF

Sagittal plane internal moment at midstance

Hip flexor Knee flexor PF

Sagittal plane internal moment in heel off

Hip flexor Knee flexor Dorsiflexor Toe flexor

Sagittal plane internal moment in toe off

Hip flexor Knee extensor Plantarflexor Toe flexor

Summary of joints at initial contact

Flexed hip, minimally flexed knee, neutral / pf ankle

External moments at initial contact

Hip flexed/adducted, knee extended, ankle plantarflexed

Muscle activity at initial contact

Hip extensors | Pre-tibials to control DF (ant tib , ext digitorum, ext hallucis)

Critical event at loading response

- shock absorption by quads/hip extensors | - restrained ankle PF

Muscle activity at loading response

- Pretib muscle slow foot drop rate (eccentric) - Quads limit knee flexion (most action here--eccentric) - Gluts/adductor magnus prevent further flexion - Hip abductors control pelvic drop/hip adduction

Phase of greatest muscle activity and why?

Loading response-- most amount of eccentric contraction by multiple muscle groups.

Critical events in midstance

- forward progression - knee extension increases stability - pelvic stabilization maintains upright trunk

External moments in midstance

Ankle Df Knee flexion Hip flexion Hip adduction

Muscle activity in midstance

Eccentric gastroc/soleus Eccentric glutes and adductor Quads-knee stability

Critical events in terminal stance

- body wt advances beyond area of support | - free forward fall of body

External moments in terminal stance

Dorsiflexion Knee flexion Hip extension to hyperextension

Muscle activity in terminal stance

Strong gastroc/soleus (soleus advances tibia!!)

Critical event in pre-swing

Knee flexion

Moments at pre-swing

ankle df Hip extension Knee extension

Muscle activity in pre-swing

Gastroc slowly decreases activity

Critical events in initial swing

Knee flexion | Hip flexion

Muscle activity in initial swing

Iliacus, sartorial/gracious for hip flexion | Pre-tibial- begin lifting the foot

Critical events in mid-swing

Ankle dorsiflexes to clear floor (it's in neutral though!) | Hip flexion for limb advancement

Muscle activity in mid-swing

Minimal pre-tib and hip flexion | Hamstrings begin firing at the end

Critical events in terminal swing

Hip decelaration Knee deceleration Knee extension Ankle DF

Muscle activity in terminal swing

HS restrain hip flexion, control tibial momentum End: quads fire to complete knee extension Pre-tibials ensure control of dorsiflexion

Weakness examples in abnormal gait

Disuse atrophy | Neuro impairment

Sensory loss issue in gait

Proprioception

Impaired motor control examples

Spasticity Timing Sequencing

Pain in abnormal gait will cause

Tissue limits Swelling Arthritis

Consequences of excessive PF in stance

Limits progression Shortened stride length Reduced gait velocity

Consequences of excessive plantarflexion in swing

Obstructs limb advancement (toe drag)

Consequence of inadequate knee flexion in loading response

Reduces shock absorption

Consequences of inadequate knee flexion in pre-swing

Difficult toe-off | Greater hip flexion required

Consequences of inadequate knee flexion in initial swing

Toe drag

Consequence of inadequate knee flexion in mid swing

Limited hip flexion will also occur

Inadequate hip extension in midstance

Forward trunk lean Lumbar spine lordosis Flexed knees

Consequences of inadequate hip extension in terminal stance?

Possible anterior pelvic tilt Shortened step length Possibly increased knee flexion