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Biomechanics > Gait > Flashcards

Gait Flashcards

1
Q

IC-Ankle

A

Ankle at Neutral- Isometric Anterior Tibialis

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2
Q

LR- Ankle

A

10* PF- Eccentric Ant Tib. Calcaneal Eversion Unlocks the Foot during LR

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3
Q

MSt- Ankle

A

Ankle at neutral- Eccentric gastroc

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4
Q

TSt- Ankle

A

Eccentric gastroc-10* DF. During TSt and PSw, calcaneal inversion occurs to lock up foot for rigid push off

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5
Q

PSw- Ankle

A

15* PF-Concentric Gastroc-Soleus, During TSt and PSw, calcaneal inversion occurs to lock up foot for rigid push off

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6
Q

ISw-Ankle

A

0-5* PF- Concentric Ant Tib

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7
Q

MSw- Ankle

A

Neutral DF- Isometric Ant Tib

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8
Q

TSw-Ankle

A

Isometric Anterior Tib-Ankle at neutral

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9
Q

IC-Knee

A

Neutral- Isometric Quads

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10
Q

LR-Knee

A

20* Flexion, Eccentric Quads

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11
Q

MSt-Knee

A

Neutral- Concentric Quadriceps

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12
Q

TSt-Knee

A

5* Flexion-Quads/HS silent

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13
Q

PSw-Knee

A

40*Flexion- Concentric Popliteus/Gracilis/Sartorius

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14
Q

ISw-Knee

A

60* Flexion-Concentric HS

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15
Q

MSw-Knee

A

25* Flexion-Concentric Quads, Eccentric HS

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16
Q

TSw-Knee

A

Neutral Knee with Concentric quads and eccentric HS

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17
Q

IC-Hip

A

20* Flexion- Cocontraction Glute max

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18
Q

LR-Hip

A

17* Flexion- Concentric glute max with HS

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19
Q

MS-Hip

A

Neutral- relatively silent glute max and hips

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20
Q

TSt

A

20* Extension with Eccentric Iliopsoas

21
Q

PSw

A

10* Extension with Concentric Hip Flexors

22
Q

ISw

A

20* Flexion, Concentric Hip Flexors

23
Q

MSw

A

25* Flexion with concentric gracilis and adductor longus

24
Q

TSw

A

20* Flexion, Eccentric Gracilis

25
Q

Pelvis- IC

A

5* Forward Rotation

26
Q

Pelvis- LR

A

4* Pelvic Drop on NWB side. WB leg has eccentric glute med

27
Q

Pelvis-MSt

A

Neutral- WB leg concentric glute med

28
Q

Pelvis-TSt

A

5* Backward Rotation

29
Q

What happens to the trunk?

A
  1. Trunk moves from neutral to slight

extension throughout gait

  1. Arm swing and Leg swing are opposite

of each other

  1. Trunk rotation chases initial contact

*Lumbar spine rotation opposite to hip rotation

30
Q

Pathology-Foot Slap

A

an audible ”slap” on the ground immediately following

a heel strike

  • What should occur at initial contact?
  • Neutral ankle positioning with slow lowering to ankle

plantarflexion immediately afterwards

  • What is the impairment?
  • Poor dorsiflexion strength/Poor eccentric control

anterior tibialis

• No proper eccentric lowering of the foot to the

ground

31
Q

Pathology-Vaulting

A

Excessive ankle plantarflexion on the stance

limb in order to help clear the swing limb.

• What should occur at loading response to

midstance?

• Ankle moves from 10-15 degrees of

plantarflexion to neural ankle positioning

  • What is the impairment?
  • One limb is longer than the other, so in order to

clear the longer limb the patient must excessive

plantarflexion on the stance side.

• The longer limb is on the swing side

32
Q

Pathology-Early Heel Off

A

Early rise of the heel prior to completion of midstance

• Where is the ankle at midstance and what should

occur at midstance to terminal stance?

• Ankle is in neutral during midstance and transitions to

10-15 degrees dorsiflexion

  • What is the impairment?
  • There is a limitation in dorsiflexion mobility and therefore

the heel quickly moves into heel off

• Tightness/Spasticity of the plantarflexors, diminished

posterior glide of the talus

33
Q

Pathology-Delayed Heel Off

A

Delayed rise of the heel at the end of terminal

stance and beginning of pre-swing

  • What should occur at terminal stance?
  • Ankle moves to 10-15 degrees dorsiflexion
  • What is the impairment?
  • There is a excessive dorsiflexion mobility or the

plantarflexors lack strength required for propulsion

• Diminished plantarflexion strength, excessive

dorsiflexion mobility

34
Q

Pathology-Knee Extensor Thrust

A

A rapid and abrupt locking of knee into extension

  • What should occur at loading response?
  • Knee moves into 15-20 degrees of flexion
  • What is the impairment?
  • No proper eccentric lowering of the knee into flexion
  • Weak quadriceps, quad spasticity, PF spasticity
35
Q

Pathology- High Steppage

A

A quick and excessive increase in hip flexion

during initial swing in order to clear a long limb

• What should occur at pre-swing to initial

swing?

• Hip moves from 10 degrees of extension to 20

degrees of flexion

  • What is the impairment?
  • Compensatory swing strategy to clear a long limb
  • Decreased ankle dorsiflexion, diminished knee

flexion

36
Q

Pathology-Circumduction

A

A patient who performs abduction and a semi-circular

movement of the affected hip secondary to the inability

to achieve adequate clearance of the foot.

  • What should occur at pre-swing to initial swing?
  • Hip moves from 10 degrees of extension to 20 degrees

of flexion

  • What is the impairment?
  • The patient lacks hip mobility, knee, and ankle mobility

in order to clear the longer limb

• Diminished LE mobility in sagittal plane, diminished hip

strength

37
Q

Pathology- Trendelenberg

A

An abnormal lateral trunk lean towards the

stance limb during midstance.

  • What should occur during midstance?
  • Pelvis moves from 4 degrees to 0 degrees on

the swing side through concentric hip abductors

on the stance side.

  • What is the impairment?
  • Diminished hip abductor strength causes the body

to compensate by shifting the COM over the stance

limb

• Weak gluteus medius, minimus on the stance limb

38
Q

Pathology- Steppage Gait

A

Due to inability to DF ankles. Could be from herniation at L4-5

39
Q

Pathology- Diminished Forward Rotation

A

A diminished amount of forward rotation of

the pelvis which limits ipsilateral step

length.

• What should occur during midswing to

terminal swing?

• Pelvis moves from 0 degrees to 4 degrees on

the swing side.

  • What is the impairment?
  • Diminished hip/pelvis mobility or lack of

pelvic coordination

40
Q

Pathology- Diminished Backward Rotation

A

A diminished amount of backward rotation

of the pelvis which limits contralateral step

length.

• What should occur between midstance to

terminal stance?

• Pelvis should rotate backward from neutral to

5 degrees on the stance side.

  • What is the impairment?
  • Diminished hip/pelvis mobility or lack of

pelvic coordination

41
Q

Pathology- Backwards Trunk Lean

A

Excessive extension of the trunk during the early to

mid stance phases secondary to hip extensor

weakness.

• What should occur during heel strike through

midstance?

• The trunk moves maintain pretty close alignment with

the pelvis, slight extension throughout

  • What is the impairment?
  • Diminished hip extensor strength causes the body to

compensate by shifting the COM behind the pelvis

• Weak gluteus maximus on the stance limb

42
Q

Pathology- Forward Trunk Lean

A

Excessive forward trunk lean early to mid stance

phases secondary to lower extremity weakness

or diminished hip mobility.

• What should occur during loading response

through midstance?

• The trunk moves maintain pretty close alignment

with the pelvis, slight extension throughout

  • What is the impairment?
  • Diminished quad strength causes the body to

compensate by shifting the COM anterior to the

knee.

• Weak quadriceps or hip flexor contracture

43
Q

What is a cushioned heel?

A

What is a cushioned heel?

• The heel cushion controls the

lowering of the forefoot to the

ground during initial contact and

weight acceptance.

  • Too Soft Cushion Heels
  • Similar to a weak anterior

tibialis

  • Allows for a foot drop/slap
  • Absent Knee flexion @ heel

strike

• Think PF = Knee

extension

  • Hard or Stiff Cushion Heels
  • AKA ”dorsiflexed foot”
  • Think DF = Knee flexion
  • Excessive Knee flexion @ heel

strike to midstance

• Causes buckling @ knee and

patient will attempt to force

knee extension

44
Q
A
45
Q

What is an Extension Aide?

A

• Can be an elastic strap,

spring, or webbing that

assists the prosthesis in

achieve extension.

• Think of the EA “as kinda

like” pseudoquadriceps

Terminal Swing Impact

• Forcible impact as knee

goes into extension at end

of terminal swing phase,

just before heel strike

• Extension aid is set to high

*NPTE will say too little knee friction

46
Q

What is a socket wall?

A

High Medial Wall

• Patient wants to

reduce pressure on

pubic ramus

  • Abducted gait
  • Circumduction
  • Lateral Trunk

Bending

Unsupportive Lateral

Wall

• Patient wants to reach a

position of optimal

support on the prosthetic

side

  • Abducted gait
  • Lateral Trunk Bending

Socket Too

Loose/Inadequate

Suspension

•Socket is sliding off of

the leg during swing

phase

  • Pistoning
  • Circumducted
47
Q

Socket Positioning…

A

SOCKET FLEXION

  • Normal is 5-8 degrees
  • If excessive, creates knee

instability “buckling”

  • Gait Deviation
  • Excessive knee flexion
  • INSUFFICIENT SOCKET FLEXION
  • Abnormal!!!
  • If present, creates knee extension

and associated ankle

plantarflexion (prosthesis

plantarflexion)

  • Gait Deviation
  • Excessive knee extension
48
Q

Foot Placement…

A
  • Anteriorly Set Foot
  • Center of gravity line passes

anterior to the knee but posterior

to the foot during initial contact to

loading response creating an

extensor moment or knee

extension

  • Gait deviation
  • Excessive knee extension
  • Posteriorly Set Foot
  • Center of gravity line passes

posteriorly to the knee during

initial contact to loading response

creating an flexor moment or

knee flexion

  • Gait deviation
  • Knee buckling; excessive knee

flexion

Biomechanics (7 decks)

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