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PCM Midterm > Gait > Flashcards

Gait Flashcards

1
Q

Average step length and stride length

A

Step: 14-16 inches

Stride: 28-32 inches

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2
Q

General factors that may change gait

A

Age
Pain
Disease
Fatigue

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3
Q

Avg cadence?

How is this different in women vs. men?

A

Avg cadence = 90-120 steps/min

Women higher by 6-9 steps/min

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4
Q

Avg gait speed

A

3 mph

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5
Q

Gait cycle

A

From heel strike to next heel strike of SAME foot

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6
Q

What are the 2 main phases of gait

A

Stance - period when foot is in contact with ground

Swing - period when foot is not in contact with ground

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7
Q

4 sub-phases of gait

A

[stance] = contact –> midstance –> propulsion

[swing] = swing

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8
Q

Define contact

A

Lateral calcaneus strikes ground and at point of impact, tibia internally rotates, causing calcaneus to evert and talus to drop and adduct to unlock midtarsal joints and provide max shock absorption

Foot is lowered eccentrically to ground by extensor digitorum longus and tibialis anterior

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9
Q

Define mid-stance

A

Cycle progresses from flat foot to heel off, as rearfoot fully pronates, metatarsals hit ground to bring foot flat on ground, body’s center of gravity passes from behind to over foot

During this phase, subtalar joint resupinates (calcaneus everts and talus abducts) and locks midtarsal joints, transforming foot from shock absorber to rigid lever

Posterior tibialis is an important restraint to overpronation and is an active foot supinator. As body passes over midfoot, it places ankle in max dorsiflexion, putting maximal preload on the gastroc/soleus complex

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10
Q

Define propulsion

A

Heel lift progresses to toe off

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11
Q

Define swing

A

Last phase of gait - foot dorsiflexes to keep toes from hitting ground and supinates to position foot for lateral calcaneus to make contact aat heel strike

Cycle then repeats

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12
Q

How much of the gait cycle is spent in stance phase?

A

60%

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13
Q

During which phase of gait do most problems occur?

A

Stance phase

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14
Q

Stance phase consists of initial contact, loading response, midstance, terminal stance, and pre-swing. Which of these comprises the majority of stance phase?

A

Pre-swing 50-60% of stance phase

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15
Q

Which part of stance phase is heel strike?

A

Initial contact

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16
Q

Which part of stance phase is foot flat?

A

Loading response

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17
Q

Which part of stance phase is heel off?

A

Terminal stance

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18
Q

Which part of stance phase is toe off?

A

Pre-swing

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19
Q

Swing phase makes up 40% of total gait cycle. What are the components of swing phase?

A

Initial swing
Midswing
Terminal swing

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20
Q

When the right leg is in initial contact(heel strike), the left side is ___________

A

Terminal stance (heel off)

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21
Q

When the right leg is in loading response (foot flat), the left side is ___________

A

Pre-swing (toe off)

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22
Q

When the right leg is in midstance, the left side is ___________

A

Midswing

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23
Q

When the right leg is in terminal stance (heel off), the left side is ___________

A

Initial contact (heel strike)

24
Q

When the right leg is in pre swing (toe off), the left side is ___________

A

Loading response (foot flat)

25
Q

Function of initial contact phase of gait

A

Establish contact with leading foot, begin stance

26
Q

Function of loading response (phase 2 of gait)

A

Shock absorption
Begin weight bearing
Continue progression

27
Q

Function of phase 3 of gait: midstance

A

Limb and trunk stability

Progression over stationary foot

28
Q

Function of phase 4 of gait: terminal stance

A

Progression past stationary foot

Prepare for swing

29
Q

Function of phase 5 of gait cycle: preswing

A

Weight release from stationary foot

Position limb for swing

30
Q

Function of phase 8 of gait cycle: initial swing

A

Prepare foot for clearance

Advance foot from trailing position

31
Q

Function of phase 7 of gait cycle: midswing

A

Foot clearance

Limb advancement

32
Q

Function of phase 8of gait cycle: terminal swing

A

Prepare for stance

Complete limb advancement

33
Q

8 phases of gait

A
  1. Initial contact
  2. Loading response
  3. Midstance
  4. Terminal stance
  5. Pre-swing
  6. Initial swing
  7. Midswing
  8. Terminal swing
34
Q

5 requirements of gait

A

Stability in swing

Foot clearance in swing

Preposition for initial contact

Adequate step length

Energy conservation

35
Q

Foot clearance in swing requires what motions of the LE?

A

Ankle dorsiflexion

Knee flexion

Hip flexion

36
Q

Adequate step length is a requirement for gait. What happens if steps are too short vs. too long?

A

Too short: expends energy, minimal progress

Too long: lose balance, strain ligaments and muscles

37
Q

How is energy conserved through pelvic List?

A

In early stance, as weight is being transferred to foot, hip on nonweight bearing side DROPS about 2” (to make up for center of gravity moving about 2” up and down during gait cycle)

38
Q

How is energy conserved in the gait cycle as the foot moves forward for heel strike?

A

Innominate (pelvic) rotation - innominate will rotate forward in a sagittal plane

Effect is to lengthen femur (some compensation for pelvic list)

Rotation is about 4 degrees, and reverses in stance phase

39
Q

How does your center of mass compensate to facilitate abduction of the hip during stance phase?

A

Pelvis shifts laterally about 2”

40
Q

Pathologic gait described as painful

A

Antalgic

41
Q

Pathologic gait described as stiff

A

Arthrogenic

42
Q

Pathologic gait described as unsteady

A

Ataxic

43
Q

Pathologic gait described as semicircle

A

Hemiplegic

44
Q

Pathologic gait described as shuffling

A

Parkinsonian

45
Q

Pathologic gait described as foot drop

A

Steppage

46
Q

_____gait = swing enhanced on affected side, stance phase shortened on affected side, adopted limp to avoid pain on weight bearing structures

A

Antalgic

47
Q

Causes of antalgic gait

A 
Trauma
Osteoarthritis
Pelvic girdle pain
Coxalgia
Tarsal tunnel syndrome
48
Q

______ gait = due to stiffness in joints; plantar flexion of contralateral foot during stance phase to increase clearance (circumduction)

A

Arthrogenic

49
Q

Causes of arthrogenic gait

A

Osteoarthritis of hip/knee joints

Post orthopedic surgeries of hip/knee

50
Q

____ gait may lurch or stagger, patient watches feet while walking, needs broad base of support

A

Ataxic

51
Q

Causes of ataxic gait

A 
Vestibular
Cerebellar abscess/hemorrhage
Friedrichs ataxia
Pontine-cerebellar atrophy
Chronic mercury poisoning
Posterior fossa tumor
Wernicke's syndrome (alcohol abuse)
Drugs
52
Q

_____ gait may be caused by cerebrovascular event. leg is stiff without flexion at knee or hip. Leg rotates away then back towards - semicircle

A

Hemiplegic

53
Q

Causes of hemiplegic gait

A

Stroke

Spinal cord injury

54
Q

T/F: parkinsonian gait is found in all patients with parkinsons

A

False, only some

[may also be caused by first generation antipsychotics]

55
Q

Hypokinesia vs. akinesia

What pathologic gait are these associated with?

A

Hypokinesia = generally slow movement

Akinesia = total loss of movement

Parkinsonian (festinating) gait

PCM Midterm (7 decks)

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