Gait Flashcards
how much hip extension is needed during normal gait?
20 degrees
how much hip flexion is needed during normal gait?
30 degrees
how much knee flexion is needed during normal gait?
40 degrees during stance; 60 degrees during swing
how much ankle PF and DF are needed during normal gait?
10 degrees of DF
20 degrees of PF during stance
what key role do the quadriceps play during pre-swing?
they eccentrically contract to slow down the tibia
what key role do the hamstrings play during initial contact?
eccentrically contract to protect the knee from hyper extending
if you have a contracture with one motion, what happens to the opposite motion? why?
you have limited ROM in the opposite direction of a contracture; for example, a hip flexor contracture keeps the hip in a flexed position, thus limiting hip extension
what direction does muscle weakness cause limits in ROM?
the same direction as the muscle that’s affected; weak hip flexors limit hip flexion ROM
how does the posterior tibialis support the medial arch during gait?
the posterior tibialis is a PF and Invertor - thus is eccentrically controls pronation (dorsiflexion / eversion)
what can excessive plantarflexion cause to occur at the knee joint? what is a functional way to remember this?
(1) excessive PF can cause hyper extension of the knee (remember PF and knee extension go together)
(2) remember that wearing high heels causes knee to go into hyperextension
what are 3 substitutions that may occur due to excessive plantarflexion?
(1) premature heel off
(2) knee hyperextension
(3) forward trunk lean
(these maintain COM and prevent from falling backwards)
how do LOW walls on a prosthetic device present clinically?
LOW walls are like WEAK muscles (ex. a low anterior wall would present like weak quads)
how do HIGH walls on a prosthetic device present clinically?
HIGH walls are like TIGHT muscles (ex. a high anterior wall would present like tight hip flexors)
what is lordosis commonly caused by in patients with prosthetics?
high anterior wall, which presents like tight hip flexors and an increased lordosis
if a patient with a prosthetic complains of DISCOMFORT, what is the most likely cause?
HIGH WALLS = TIGHTNESS = discomfort
what is lordosis commonly caused by in patients with prosthetics?
high anterior wall, which presents like tight hip flexors and an increased lordosis
what direction does a heel whip occur with a prosthetic device?
whip occurs in the OPPOSITE direction of the hip / knee deviation
if a socket is too far posterior in a below knee amputee, what could this cause to happen?
(1) inability to fully flex knee
(2) excessive knee extension
if a socket is too far anterior in a below knee amputee, what could this cause to happen?
excessive knee flexion
if a socket is too far posterior in a below knee amputee, what could this cause to happen?
(1) inability to fully flex knee
(2) excessive knee extension
if a keel is too short, what can this cause?
excessive dorsiflexion
if a plantarflexion bumper is too SOFT what happens? what if it’s too HARD?
SOFT = excessive plantarflexion HARD = decreased plantarflexion
what are pressure SENSITIVE areas? where are these locations? (4)
- areas where pressure should not be applied with a prosthesis (no redness)
(1) anterior tibia
(2) anterior tibial crest
(3) fibular head and neck
(4) fibular nerve
what are pressure tolerant areas for fitting prosthetic devices? (4)
(1) patellar tendon
(2) medial tibial plateau
(3) tibial and fibular shafts
(4) distal end (rarely may be sensitive)
to which side do trunk leans typically occur? why?
(1) towards the painful side
(2) brings COG closer and puts less stress and work on the painful joint
