gait analysis 1 Flashcards
temporal spatial parameters
vial signs of gait
Speed = 1.2–1.5 m/s
Cadence = 120 steps / min
Stride length = 1.2–1.5 m
Symmetrical
Quality: smooth, flowing, rhythmical
TUG
6MWT
Outcome measures
clincial factors for normal gait
bony alignment muscle and tendon length muscle power selective control and coordination muscle tone vestibular function vision proprioception higher level of executive function vision vestibular function
Gait assessment
clinical exam
observational gait analysis
outcome measures
clinical exam
bony allignment - contracture limb length bony orientation goniometry ROM - goniometry muscle tone - slow and fast stretch MAS tardieu scale power oxford scale Co-ordination cerebellar tests SCALE sensation / proprioception JPS light touch pin prik reflexes - babinski response balance - timed stance test
outcome measures
3-d gait analysis
•Temporal-spatial parameters
•Kinematics
•Kinetics
timed walk test
•10m walk test
•TUG
•6 minute walk test
video
•Qualitative comparison
observational tools •Edinburgh visual gait score •Wisconsin Gait Scale (WGS) •Gait Assessment and Intervention Tool (GAIT) •Rivermead Visual Gait Assessment (RVGA)
pre requisites for normal gait
Stability in stance Foot clearance in swing Pre-positioning for initial contact Step length Energy conservation
Normal gait
1. initial contact
moment of collision
TASK: allignment of lower limb for effective loading repsonse
Trunk: half a stride length behind heel
normal gait: stance
2. loading response
trunk advancement over supporting leg
hip extensors
ankle PF 5 deg
knee flexion 10-20 degrees
STJ eversion/ midfoot pronation
loose bag of bones
0-10% peiod of double support
Task: weight acceptance, shock absorption
normal gait: stance
3. mid stance
task: stability during single leg stance, progression over stationary foot
10-30% GC
trunk advances from behind to over supporting limb (hip extensors)
hip reaches 0 degrees flex to ext.
pelvis at max upward obliquity 10 degrees
CoM falls medial to supporting leg - hip abductors
knee extends fully
ankle moves from 10 degrees PF to 10 degrees DF - soleus
Normal gait: stance
4. Terminal stance
30-50% GC
task: maintenance of stability, progression of trunk past supporting foot
hip reaches peak extension knee starts to flex ankle - peak DF 10-15 degrees heel starts to rise
subtalar joint inverts, midfoot supinates
Normalgait
5. pre swing
TIME: 50–62% GC
Second period of double support
TASK: Weight transfer,
alignment of limb for swing
Rapid ankle plantarflexion from 10–15° DF to 20–25° PF in 10 ms
gastroc + soleus
midfoot supination tightens plantar fascia Tib post
–> rigid lever for propulsion
hip flexes to 0 deg
iliopsoas
knee reaches 30-40 deg flexion - rect fem
- initial swing
62-75% gait cycle time TASKS: Foot clearance; limb advancement
hip flexion - iliopsoas
peak knee flexion - 60-70 degrees
rect fem
ankle DF to neutral - Tib ant
- mid swing
TASKS: Limb advancement TIME: 75–90% GC
This phase continues mostly due to momentum
hip flexion ceases at 30-40 degrees
knee starts to re-extend under pendular action
ankle remains in neutral
- terminal swing
90-100%
completion of limb advancement, prep for stance
hip remains 30-40 degrees flexion
knee reaches full extension - hamstrings
ankle remains in neutral TA