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Musculoskeletal > Gait > Flashcards

Gait Flashcards

1
Q

Stance phase: standard terminology

A

1) heel strike
2) foot flat
3) midstance
4) heel off
5) toe off
60% of gait cycle

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2
Q

Stance phase: Rancho Los Amigos

A

1) initial contact
2) loading response
3) midstance
4) terminal stance
5) preswing
60% of gait cycle

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3
Q

Swing phase: standard terminology

A

6) acceleration
7) midswing
8) deceleration
40% of gait cycle

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4
Q

Swing phase: Rancho Los Amigos

A

6) initial swing
7) midswing
8) terminal swing

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5
Q

Heel strike

A

the instant that the heel touches the ground to begin stance phase

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6
Q

Foot flat

A

the point in which the entire foot makes contact with the ground and should occur directly after heel strike

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7
Q

Midstance

A

the point during the stance phase when the entire body weight is directly over the stance limb

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8
Q

Heel off

A

the point in which the heel of the stance limb leaves the ground

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9
Q

Toe off

A

the point in which only the toe of the stance limb remains on the ground

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10
Q

Acceleration

A

begins when toe off is complete and the reference limb swings until positioned directly under the body

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11
Q

Midswing

A

the point when the swing limb is directly under the body

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12
Q

Deceleration

A

begins directly after midswing, as the swing limb begins to extend, and ends just prior to heel strike

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13
Q

Initial contact

A

the beginning of the stance phase that occurs when the foot touches the ground

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14
Q

Loading response

A

corresponds to the amount of time between initial contact and the beginning of the swing phase for the other leg

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15
Q

Midstance

A

corresponds to the point in stance phase when the other foot is off the floor until the body is directly over the stance limb

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16
Q

Terminal stance

A

begins when the heel of the stance limb rises and ends when the other foot touches the ground

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17
Q

Pre-swing

A

begins when the other foot touches the ground and ends when the stance foot reaches toe off

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18
Q

Initial swing

A

begins when the stance foot lifts from the floor and ends with maximal knee flexion during swing

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19
Q

Midswing

A

begins with maximal knee flexion during swing and ends when the tibia is perpendicular with the ground

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20
Q

Terminal swing

A

begins when the tibia is perpendicular to the floor and ends when the foot touches the ground

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21
Q

Hip flexion: necessary ROM

A

0-30°

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22
Q

Hip extension- necessary ROM

A

0-10°

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23
Q

Knee flexion- necessary ROM

A

0-60°

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24
Q

Knee extension- necessary ROM

A

0°

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25
Q

Ankle DF- necessary ROM

A

0-10°

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26
Q

Ankle PF- necessary ROM

A

0-20°

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27
Q

Initial contact- muscle activity

A
  • Ankle DF place the ankle in DF during heel strike
  • Quads activate to place the knee in extension
  • HS activate to stabilize the knee and prevent its’ hyperextension
  • Hip extensors and abductors contract to stabilize the trunk and pelvis over the leg
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28
Q

Loading response- muscle activity

A
  • the ankle DF activate eccentrically
  • quadriceps activate eccentrically to control knee flexion as the stance limb accepts the weight of the body
  • in the latter portion of the phase the PF contract eccentrically to control DF as the tibia moves over the foot
  • the tib post eccentrically controls pronation of the foot
  • the quads contraction becomes concentric to draw the femur forward over the tibia
  • throughout the phase the hip extensors remain active concentrically to produce hip extension
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29
Q

Midstance- muscle activity

A
  • PF continue to act eccentrically to control DF as the body moves over the stance limb
  • activity of the knee musculature is minimal during this phase though the quads act concentrically to continue producing CKC knee extension
  • hip abductor muscles stabilize the pelvis and prevent contralateral hip drop
  • iliopsoas also begins to contract eccentrically to control hip extension
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30
Q

Terminal stance- muscle activity

A
  • PF begin to work concentrically to aid the foot in its propulsion of the body forward
  • knee muscle activity remains limited
  • the hip abductors continue to stabilize the pelvis
  • iliopsoas continues to slow the rate of hip extension
31
Q

Pre-swing- muscle activity

A
  • PF at their peak activity
  • HS begin to produce knee flexion, though the momentum of the body also aids this motion
  • iliopsoas begins to work concentrically to produce hip flexion, along with the other hip flexors
32
Q

Initial swing- muscle activity

A
  • ankle DF contract concentrically to clear the foot
  • the HS assist with foot clearance
  • hip flexors continue to move the limb forward
33
Q

Midswing- muscle activity

A
  • ankle DF continue to activate concentrically to maintain DF
  • knee and hip muscle activity are minimal during this phase because forward momentum allows for limb advancement
34
Q

Terminal swing- muscle activity

A
  • ankle DF continue to contract concentrically
  • ankle invertors contract concentrically to prep the foot for initial contact
  • the quads contract concentrically to place the knee in extension for initial contact
  • HS act eccentrically to control the rate of knee extension
  • hip extensors eccentrically slow the rate of hip flexion and prep the limb for initial contact
35
Q

BOS

A

the distance between the left and right foot during progression of gait. The distance decreases as cadence increases. The average BOS for an adult is 2-4 inches.

36
Q

Cadence

A

the number of steps an individual will walk over a period of time. The average value for an adult is 110-120 steps per minute.

37
Q

Degree of toe-out

A

the angle formed by each foot’s line of progression and a line intersecting the center of the heel and second toe. The average degree of toe-out is 7°

38
Q

Double support phase

A

refers to the two times during a gait cycle where both feet are on the ground. The time of double support increases as the speed of gait decreases. This phase does not exist during running.

39
Q

Pelvic rotation

A

rotation of the pelvis occurs opposite the thorax in order to maintain balance and regulate speed. The average pelvic rotation during gait for an adult is a total of 8° (4° forward with the swing limb and 4° back with the stance)

40
Q

Single support phase

A

the single support phase occurs when one foot is on the ground and occurs twice during a single gait cycle

41
Q

Gait cycle

A

from initial contact of one limb to the next initial contact of the same limb

42
Q

step length

A

the distance between right heel strike and left heel strike. Adult average is 28 inches.

43
Q

stride length

A

distance between right heel strike and the following right heel strike. Adult average is 56 inches.

44
Q

Antalgic

A

stance time is decreased to avoid WB on the involved side due to pain. This is typically associated with a rapid and shorter swing phase of the uninvolved limb.

45
Q

Ataxic gait

A

characterized by staggering and unsteadiness. There is usually a wide BOS and movements are exaggerated.

46
Q

Cerebellar gait

A

a staggering gait pattern seen in cerebellar disease

47
Q

Circumduction gait

A

characterized by a circular motion to advance the leg during swing; may be used to compensate for insufficient hip or knee flexion or DF.

48
Q

Double step

A

alternate steps are of a different length or at a different rate

49
Q

equine

A

characterized by high steps; usually involves excessive activity of the gastrocnemius.

50
Q

festinating

A

a gait pattern where a pt walks on toes as though pushed. It starts slowly, increases, and may continue until the patient grasps an object in order to stop.

51
Q

Hemiplegic

A

pt abducts the paralyzed limb, swings it around, and bring it forward so the foot comes to the ground in front of them.

52
Q

Parkinsonian

A

marked by increased forward flexion of the trunk and knees; gait is shuffling with quick and small steps. Festinating may occur.

53
Q

Scissor

A

the legs cross midline upon advancement

54
Q

Spastic

A

stiff movement, toes seeming to catch and drag, legs held together, and hip and knee joints slightly flexed. Commonly seen in spastic paraplegia

55
Q

Steppage

A

feet and toes are lifted through hip and knee flexion to excessive heights; usually secondary to DF weakness.

56
Q

Tabetic

A

high stepping ataxic gait pattern in which the feet slap the ground

57
Q

Trendelenburg

A

denotes glute med weakness; excessive lateral trunk flexion and weight shifting over stance leg

58
Q

Vaulting

A

the swing leg advances by compensating through the combination of elevation of the pelvis and PF of the stance leg.

59
Q

Gait deviation causes: Foot slap

A
  • weak DF

* DF paralysis

60
Q

Gait deviation causes: toe down instead of heel strike

A
  • PF spasticity
  • PF contracture
  • weak DF
  • DF paralysis
  • leg length discrepency
  • hindfoot pain
61
Q

Gait deviation causes: clawing of toes

A
  • toe flexor spasticity

* positive support reflex

62
Q

Gait deviation causes: heel lift during midstance

A
  • insufficient DF range

* PF spasticity

63
Q

Gait deviation causes: no toe off

A
  • forefoot/toe pain
  • weak PF
  • weak toe flexors
  • insufficient PF ROM
64
Q

Gait deviation causes: exaggerated knee flexion at contact

A
  • weak quads
  • quads paralysis
  • HS spasticity
  • insufficient extension ROM
65
Q

Gait deviation causes: Hyperextension in stance

A
  • compensation for weak quads

* PF contracture

66
Q

Gait deviation causes: exaggerated knee flexion at terminal stance

A
  • knee flexion contracture

* hip flexion contracture

67
Q

Gait deviation causes: insufficient flexion with swing

A
  • knee effusion
  • quads extension spasticity
  • PF spasticity
  • insufficient flexion ROM
68
Q

Gait deviation causes: Excessive flexion with swing

A
  • flexor withdrawal reflex

* LE flexor synergy

69
Q

Gait deviation causes: insufficient hip flexion at initial contact

A
  • weak hip flexors
  • hip flexor paralysis
  • hip extensor spasticity
  • insufficient hip flexion ROM
70
Q

Gait deviation causes: insufficient hip extension at stance

A
  • insufficient hip extension ROM
  • hip flexion contracture
  • LE flexor synergy
71
Q

Gait deviation causes: Circumduction during swing

A
  • compensation for weak hip flexors
  • compensation for weak DF
  • compensation for weak HS
72
Q

Gait deviation causes: hip hiking during swing

A
  • compensation for weak DF
  • compensation for weak knee flexors
  • compensation for extensor synergy pattern
73
Q

Gait deviation causes: exaggerated hip flexion during swing

A
  • LE flexor synergy

* compensation for insufficient DF

Musculoskeletal (11 decks)

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