Gait

Question 1

What is gait?

Answer 1

The mechanism by which the body is transported using coordinated movements of the major lower limb joints - energy efficient interaction of the musculoskeletal system.

Question 2

Normal gait has 5 attributes (things included to meet normal standards), what are they?

Answer 2

Stability in stance, foot clearing in swing, propositioning for initial contact, adequate step length and energy conservation.

Question 3

What is the gait cycle and which 2 stances is it split into?

Answer 3

The period of time from initial contact to the next initial contact on the same side. 60% stance phase and 40% swing phase, with overlap between the legs of stance as double support (in running, overlap in swing phase).

Question 4

Describe the progression of the stance phase of the gait cycle.

Answer 4

Initial contact (heel strike), loading response, midstance (foot flat), terminal stance (heel off) and pre-swing (toe off).

Question 5

Describe the swing phase of the gait cycle.

Answer 5

Initial, mid then terminal swing.

Question 6

What is a stride?

Answer 6

The distance between initial contact of the right foot and the next initial contact of the right foot.

Question 7

What is a step?

Answer 7

The distance between the initial contact of the right foot and the initial contact of the left foot.

Question 8

In terms of gait, what is cadence?

Answer 8

The number of steps per minutes, rhythm.

Question 9

What’s the difference between kinematics and kinetics?

Answer 9

Kinematics describe motion - joint angles, displacements, velocities and accelerations, whereas kinetics describe things that cause motion - forces and moments.

Question 10

Kinematics of gait:
Sagittal plane - __________ tilt, flexion/extension of the hip, knee and ankle.
__________ plane - adduction/abduction of the hip, knee and ankle (varus/valgus movements).
Transverse - __________ position of the body and limbs.

Answer 10

Pelvic
Coronal
Rotational

Question 11

Muscles produce force to provide stability and propel body segments, what are the 3 types of muscle work and when are they employed?

Answer 11

Concentric (shortening) muscle work for acceleration/power generation,
Eccentric (lengthening) for deceleration/power absorption and
Isometric (same length) for stability.

Question 12

Which 3 components work together to produce the forward progression in gait?

Answer 12

Forward progression is produced partly by the toe ‘push off’ (MTPJ flexion), partly by the plantarflexion of the ankle and partly by the forward swing of the hips accentuated by the swinging movements of the pelvis.

Question 13

What is the role of hip abductors in gait?

Answer 13

When one foot is off the ground, dropping of the pelvis on the unsupported side is prevented by the hip abductors.

Question 14

What is the role of tibialis anterior in gait?

Answer 14

The eccentric contraction of tibialis anterior keeps the heel strike gentle, then the anterior muscles keep the ankle dorsiflexed as the Achilles’ tendon works hard to plantarflex

Question 15

Energy conservation in gait works to:
Minimise the excursion away from the ______ ___ _________, ________ momentum, transfer _______ between body segments and phasic muscle action (working ->__________).

Answer 15

Centre of gravity
Control
Energy
Resting

Question 16

List some general causes of gait abnormalities.

Answer 16

Gait abnormalities are a result of nerve lesions, joint instability, immobility of joints and pain.

Question 17

What is an Antalgic gate?

Answer 17

Stiffness/reduced mobility - walk so as to minimise pain. Painful leg with a short stance phase of the affected leg, lack of a body weight shift to the affected leg, so a short swing phase of the unaffected leg-uneven, walking stick in opposite hand. (Limp)

Question 18

A type of spastic gait is a Hemiplegic gait, explain.

Answer 18

A hemi-brain injury (stroke, cerebral palsy, trauma), flexes upper limb, extended lower limb, short step of unaffected leg and circumduction of the affected leg (for toes to clear the floor).

Question 19

Wha is a diplegic gait?

Answer 19

A result of neuromuscular disorders (e.g. Cerebral Palsy), scissoring, tight muscle groups (Psoas, adductors, HS, calf), ankle plantar flexed, so forefoot bears the initial contact.

Question 20

What is a high stoppage gait/foot drop?

Answer 20

Caused by sciatica, common fibular nerve palsy and neuromuscular disorders, it has the toes hanging down, excessive hip flexion of the affected side and foot slap.

Question 21

What is a Parkinsonian gait?

Answer 21

The result of a neurological disease, with a shuffling short step, forward flexed, no arm swing and festinant (stooped - fall into short steps).

Question 22

What is the Trendelenburg gait?

Answer 22

Weak/paralysed hip abductor muscles (gluteus medius is supposed to keep the hips the same level in stance) - the pelvis drops on the unsupported side. Weakness of the R muscles would mean the L hip drops, when standing on the R leg.