Gait Flashcards
Describe the stages of the gait cycle
The typical walk consists of a repeated gait cycle. The cycle itself contains two phases – a stance phase and a swing phase:
Stance phase: Accounts for 60% of the gait cycle. It can be divided into the heel strike, support and toe-off phases.
Swing phase: Accounts for 40% of the cycle. It can be divided into the leg lift and swing phases.
What is the heel-strike stage in the gait cycle? Which muscles are involved?
In the heel-strike stage, the foot hits the ground heel first. There are three muscles/muscle sets involved, each acting at a different joint:
Gluteus maximus – acts on the hip to decelerate the lower limb.
Quadriceps femoris – keeps the leg extended at the knee and hip.
Anterior compartment of the leg – maintains the ankle dorsiflexion, positioning the heel for the strike.
What is the support stage in the gait cycle? Which muscles are involved?
After the heel strike stage, the leading leg hits the ground, and the muscles work to cope with the force passing through the leg. This is known as the support stage.
Quadriceps femoris – keeps the leg extended, accepting the weight of the body.
Foot inverters and everters – contract in a balanced manner to stabilise the foot.
Gluteus minimus, medius and tensor fascia lata – abducts the lower limb. This keeps the pelvis level by counteracting the imbalance created from having most of the body-weight on one leg.
What is the toe-off stage in the gait cycle? Which muscles are involved?
In the toe-off phase, the foot prepares the leave the ground – heel first, toes last.
Hamstring muscles – extends the leg at the hip.
Quadriceps femoris – maintains the extended position of the knee.
Posterior compartment of the leg – plantarflexes the ankle. The prime movers include gastrocnemius, soleus and tibialis posterior.
What is the leg lift stage in the gait cycle? Which muscles are involved?
Once the foot has left the ground, the lower limb is raised in preparation for the swing stage.
Iliopsoas and rectus femoris – flexes the lower limb at the hip, driving the knee forwards.
Hamstring muscles – flexes the lower limb at the knee joint.
Anterior compartment of the leg – dorsiflexes the ankle.
What is the swing stage in the gait cycle? Which muscles are involved?
In the swing phase, the raised leg is propelled forward. This is where the forward motion of the walk occurs.
Iliopsoas and rectus femoris – keep the hip flexed, resisting gravity as it tries to pull the leg down.
Quadriceps femoris – extends the knee, positioning the foot for landing.
Anterior compartment of the leg – maintains ankle dorsiflexion so that the heel is in place for landing.
Describe Trendelenburg Gait
The Trendelenburg sign is where the pelvis drops towards the side of the raised limb. This signifies that the abductor muscles on the standing limb are greatly weakened or paralysed. For example, if the left leg was raised, and pelvic drop was observed on that side, the abductor muscles on the right leg are the cause. This is due to a lesion of the superior gluteal nerve which innervates the abductors.
During walking, a weakness in the abductor muscles gives rise to a characteristic gait. As the pelvis drops on one side, the trunk lurches to the opposite side, in an effort to maintain a steady pelvic level.
During the next step, the trunk is whipped back over the pelvis towards centre. Often the momentum of this is too much for the abdominals, causing the trunk to overcompensate and fall slightly past centre to the opposite side. This highly recognisable lurching walk is called the Trendelenburg gait.
Describe an antalgic gait
An antalgic gait is a gait that results from pain on weight-bearing. It is characterised by a shortened stance phase, and is most commonly seen in patients with chronic musculoskeletal pain. Using stick.
What is a diplegic gait?
- Neuromuscular disorders e.g. cerebral palsy
- Scissoring
- Tight muscle groups (psoas, adductors, calf)
- Ankle plantar flexed
- Forefoot initial contact
What is a high stoppage gate?
- Foot drop (sciatica, neuromuscular disorders etc)
- Toes hang down
- Excessive hip flexion on affected side
- Foot slap
What is the difference in gait between running and walking?
In walking at least one foot always has contact with the ground. In running, a maximum of one foot has contact with the ground at any given time.
