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OTA 130 - Kinesiology > Gait > Flashcards

Gait Flashcards

1
Q

Gait Cycle

A

The time from heel contact on one side of body to heel contact on same side of body. Contains two phases:

1) Swing Phase
2) Stance Phase

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2
Q

Single vs. Double Limb Support

A

SINGLE: when one leg is swinging through; only one leg in contact with ground.

DOUBLE: when both feet are in contact with the ground.

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3
Q

Stance Phase of Gait Cycle

A 
First phase of gait cycle.
• 60% of gait cycle
• 5 Stages (just be familiar):
- Initial contact (heel strike)
- Load response (foot flat)
- Midstance (single leg stance)
- Terminal stance (heel off)
- Preswing (toe off)
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4
Q

Initial Contact

A

First stage of the stance phase.
• Weight loading portion of stance phase
• Front foot contacting ground (heel strike); back foot bearing weight/absorbing shock
• Both feet in contact with ground (double limb support)

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5
Q

Load Response and Midstance

A

Middle stages (2-3) of stance phase.
• Front foot flat on ground (load response)
• Midstance is single limb support; able to accept full weight of body/balance
• Requires lateral hip stability and tibia positioned over the fixed foot* (usually where gait problems arise)

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6
Q

Terminal Stance and Preswing

A

Final two stages of stance phase.
• When back foot is preparing to leave ground, and body weight transfers to front leg
• When weight shifts, heel comes off ground
• Preswing happens when back toe pushes off, propelling leg forward

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7
Q

Swing Phase of Gait Cycle

A

2nd phase of Gait Cycle.
• Occurs when foot is not in contact with ground.
• 3 stages (just be familiar):
- Initial Swing (leg accelerates due to knee flexion/dorsiflexion of ankle)
- Mid-Swing (swing leg is next to weight bearing leg)
- Terminal Swing (when leg starts to slow down to prepare to weight-bear)

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8
Q

Abnormal Gait

A 
Refers to when any steps/stages of gait cycle are not functioning as described due to conditions such as:
• Decreased strength/balance/stability
• Pain (limp)
• Amputation
• LE surgery
• LE fracture
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9
Q

Trendelenberg Gait

A
  • Atypical gait that occurs during stance phase
  • Lateral thrust of pelvis due to weakness of gluteus medius/minimus (if right glutes are weak, left pelvis shows lateral thrust)
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10
Q

Footdrop Gait

A

Abnormal gait also called “steppage gait.”
• Occurs during swing phase
• caused by weakness/loss of dorsiflexion
• Compensates by lifting knee higher

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11
Q

Preparation for Ambulation of Pt.

A
  • Obtain informed consent for ambulation activities
  • Assess/evaluate pt.—know capabilities/limits (strength and balance)
  • Determine appropriate assistive device and gait pattern based on assessment, weight-bearing status and goals
  • Inspect the device for safety (Sharp parts? Good working order?)
  • Measure/adjust equipment for Pt.
  • Use gait belt and DO NOT LET GO when pt. is standing
  • Remove items in environment that may compromise safety (leg rests on w/c, rugs, obstacles)
  • Lock the w/c and bed
  • Always use good body mechanics and beware of YOUR posture as well as Pt.’s. (Can you catch them if they fall?)
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12
Q

Weight Bearing Terms

A 
NWB = Non Weight Bearing
TDWB = Touch Down Weight Bearing
TTWB = Toe Touch Weight Bearing
PWB = Partial Weight Bearing
WBAT = Weight Bearing as Tolerated
FWB = Full Weight Bearing
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13
Q

Supportive Assistive Devices, most to least stable

A
  • Most: Parallel bars
  • Walker
  • Axillary crutches
  • Forearm crutches
  • 2 canes
  • Least: 1 cane
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14
Q

Unilateral Assistive Devices, most to least supportive

A
  • Most: Hemiwalker
  • Large based quad cane
  • Small based quad cane
  • Least: Monopoint or Standard cane
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15
Q

Assistive Devices in order of most to least coordination required

A
  • Least: Parallel bars
  • Rolling Walker
  • Standard/Reciprocal Walker
  • Cane
  • Most: Crutches
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16
Q

Axillary Crutches

A

Crutches that go under armpit (2” from).
• Can be used to restrict weight bearing, on stairs, and may allow a more normal gait pattern/speed
• Pad is NOT for weight bearing; weight is borne through hands on hand grips

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17
Q

Loftstrand/Forearm Crutches

A

Longer term option than axillary crutches.
• Often easier to use during ADLs
• Used when Pt. doesn’t need trunk stability/support of axillary crutches, but needs more than a cane provides.
• Eliminate danger of injury to axillary vessels/nerves

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18
Q

Canes

A
  • May be metal or wood with single shaft and one handgrip.
  • Monopoint cane has one foot at base.
  • Quad cane has four feet at base, small or large size/width
  • Hemiwalker/Walkercane is considered in cane category
  • Not used for limiting weight bearing or NWB status; but, they do provide some support and assist with balance
19
Q

Walkers

A

Come in several styles including folding, rolling, reciprocal, and stair climbing. Standard walker has rubber tip at each of four legs and must be picked up to move.

Rolling Walker: When LOB or too much weakness in arms/legs to pick up standard walker. Has 2 or 4 wheels.

Reciprocal Walker: Designed so each side moves forward independently. Do not have to be picked up.

Platform Attachment: Used for individuals who cannot weight bear through wrist/hand due to injuries/deformities/etc. Should NOT be used to support flaccid arm.

20
Q

Errors when Measuring for Fit of Assistive Devices

A
  • Pt. evaluated with improper posture
  • Pt. elevates/hunches shoulders
  • Pt. drops shoulders, leans laterally, or flexes at hips
  • Measurement made without Pt.’s shoes on
21
Q

Reciprocal (Alternating) Gait Patterns with Assistive Devices

A

Most individuals move reciprocally (most typical gait used with devices).
• One foot at a time, alternating with walking aid. Hands and feet move separately/opposing
• Slow but stable, less stressful (on heart and upper limbs)
**INCLUDES: 4 pt., Mod 4 pt., 3 pt., 2 pt., Mod 2 pt. gaits

22
Q

4 Point Gait

A

Uses bilateral assistive devices/reciprocal walker.
• 4 separate movements
• (With left foot injury): Right crutch, left foot, left crutch, right foot
• Extremely slow since only 1 item moved at a time, leaving others stable/on ground.

23
Q

Modified 4 Point Gait

A

Similar to 4 Point pattern, but only one assistive device (ie: hemiwalker or crutch) is used (unilateral).
• 3 separate movements
• Device forward, opposite LE, then remaining loose arm/LE
• Single device typically placed on side OPPOSITE involved/injured LE

24
Q

3 Point Gait

A

Requires use of bilateral assistive devices: crutches, standard walker/rolling walker.
• Device(s) placed forward, then affected LE, taking body weight on the hands, then stepping through with non-affected foot.
• Crutches forward, then limbs.

25
Q

2 Point Gait

A

Requires use of bilateral assistive devices or reciprocal walker. “Cross Country Skiing”
• Very similar to 4 Point pattern, but only 2 movements.
• One UE/device moved simultaneously with opposite LE, then remaining UE/device with opposite LE.

26
Q

Modified 2 Point Gait

A

Similar to 2 Point pattern but only one assistive device (usually when moving down to a cane).
• Single device placed on Pt.’s non-involved side
• Device and involved LE move forward together, then non-involved foot.

27
Q

Simultaneous (Swinging) Gait Patterns (about)

A 
These patterns require use of a pair of axillary or forearm crutches. 
• Fast, but very energy consuming
• Usually used by younger/fitter clients
• Hard on upper body
**Not typically taught by OTAs!
28
Q

Simultaneous (Swinging) Gait Patterns (list)

A
  • Drag-to-Gait: both crutches advance, feet drag through on floor just behind crutches
  • Swing-to-Gait: Both crutches advance, followed by swinging of feet slightly off floor behind crutches
  • Swing-Through-Gait: Both crutches advance, feet swing through behind the crutches
29
Q

Transitional Movement

A

Changes of posture or movement from one position to another.

30
Q

Functional Mobility: in Home vs. Community

A

In the home: when client can ambulate distances greater than 50 feet with or without assistive devices.

In the community: when client can ambulate distances greater than 150 feet with or without assistive devices.

31
Q

Dynamic vs. Static Balance

A

DYNAMIC: with movement occurring or to move within a position; maintaining controlled position of head/body during movement.

STATIC: when no movement is occurring; ability to maintain steady position of head/body.

32
Q

Role of OT in lower extremities

A

OTPs may collaborate with PTs to:
• Reinforce PT in standing balance/safety
• Functional mobility using appropriate AE
• Functional transfer techniques
• ROM
• Observation of clinical factors, precautions, contraindications

33
Q

Degrees of Freedom

A

Ability of a joint to move in different planes. Uniaxial, triaxial, etc. Ex: The hip joint has three degrees of freedom (triaxial joint).

34
Q

Why ankle inversion/eversion are important

A

Used when body shifts weight, as well as provide better balance on uneven ground.

35
Q

Why ankle plantarflexion/dorsiflexion are important

A

Allow foot to clear ground during walking and enable proper foot placement when foot comes back down.

36
Q

Excursion

A

Wandering of body from the usual course of the center of gravity during gait. A consideration for functional ambulation. Could alter energy expenditure, stability and/or efficiency of walking.

37
Q

Circumduction

A

Nonfunctional gait pattern with foot drop. During swing phase, pelvis hikes while hip abducts on unsupported side. Leg advances by swinging out to side.

38
Q

Proper setting for axillary crutches on a Pt.

A

Axillary bar should be about 2 finger widths below the axilla.

39
Q

Transitional Movements

A

Changes of posture or movement from one position to another.

40
Q

Largest Phase of Gait Cycle

A

Stance Phase is 60% of gait cycle.

Foot in contact with the ground; 5 stages to this phase, from heel touch to toe off.

41
Q

Phase of Gait Cycle When Foot Not in Contact with Ground

A 
Swing Phase (2nd phase of gait cycle).
(3 Stages to this phase, from initial swing, mid-swing, to terminal swing)
42
Q

Preswing Stage of Gait Cycle

A

During the Stance Phase, Preswing occurs at the end when the pack toe pushes off the ground, propelling leg forward.

43
Q

Phase of Gait Cycle Where Most Gait Problems Arise

A

Midstance: Middle of Stance Phase, when weight shifts to a single limb.

OTA 130 - Kinesiology (15 decks)

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