Gait

Question 1

Name the phases of gait.

Answer 1

heel strike
foot flat
mid stance
heel off
toe off
initial swing/mid swing/terminal swing

Question 2

Double limb support occurs during what phases?

Answer 2

DL support occurs: (sides are for example)

• during R heel strike until R foot flat
• after R foot flat contact through R toe off
• then again during R heel strike to R foot flat

Question 3

What muscles are active during heel strike?

Answer 3

knee extensors to control knee flexion with shock of hitting ground

DFs to control quick lowering of foot

Question 4

What muscle group is active during foot flat to midstance? Why?

Answer 4

PFs are active to eccentrically control anterior translation of tibia

Question 5

T/F: Midstance is a period of single-limb support.

Answer 5

true: all weight is supported by stance limb is the criteria of midstance

Question 6

What muscles are active in midstance?

Answer 6

hip/knee/ankle extensors

hip abductors to stabilize

Question 7

When does peak activity of plantar flexors occur?

Answer 7

after flat foot contact during push off

Question 8

When does the first period of DL support occur?

Answer 8

after initial contact through loading response

Question 9

When does the second period of DL support occur?

Answer 9

preswing (right after toe off)

Question 10

What muscle group causes the forward acceleration of the limb during early swing?

Answer 10

quads

Question 11

T/F: Hamstrings activate in late swing.

Answer 11

true to decelerate the limb to prepare for IC

Question 12

T/F: An increased cadence would also have a increased DL support time.

Answer 12

false, sorter step length actually decreases the duration of period of double support

Question 13

A patient with weak glutes will demonstrate what common gait deviations? What other issues might they have difficulties with that you’ll want to assess?

Answer 13

backwards trunk lean

- difficulty going up stairs or ramps

Question 14

A patient with an antalgic gait due to pain on the R will demonstrate a decreased stance time on what leg? What about step length?

Answer 14

decreased stance time on R

decreased step length on L

Question 15

A patient with weak knee extensors due to stroke may have difficulty with walking, as well as what other functional activities?

Answer 15

walking down stairs
walking down a ramp
- may see forward trunk bending to compensate

Question 16

A patient with calcaneus gait will demonstrate what gait deviations?

Answer 16

excessive forward translation of the tibia, aka increased DF with stance and loading leading to crouched gait likely
- due to weak PFs

Question 17

If a patient demonstrates insufficient forward pelvic rotation, what muscles might be affected?

Answer 17

looking for stiff pelvis, pelvic retraction
- weak abdominal muscles or hip flexor muscles

• see this in stroke

Question 18

A patient with circumduction for swing phase is likely deficient in what muscles?

Answer 18

hip/knee flexors

Question 19

Why might a patient be hip hiking?

Answer 19

weak hip/knee flexors on that side

spastic extensors on that side

Question 20

Why might a patient exhibit a steppage gait?

Answer 20

they can’t DF so they need to flex more in other areas to clear the foot
- think stroke, think diabetic neuropathy of deep peroneal nerve

Question 21

What might abnormal synergistic movement in a patient with stroke look like when they attempt to execute swing phase?

Answer 21

excessive hip/knee flexion with hip abduction

Question 22

Spasticity of the posterior tibilais muscle can result in what foot position?

Answer 22

equinovarus