Gait, anatomy and physiology of walking Flashcards

1
Q

How is walking both simple and complicated?

A

Simple - we do not have to think about it

Complicated - Involves many structures in the body

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2
Q

What structures in the body are involved in walking?

A

MSK - Muscles, tendons, bones, joints
Nervous system - Sensory, motor, autonomic, proprioception
Cardiovascular system - Heart and blood vessels
Special senses - Vision and hearing

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3
Q

What may problems with systems involved in walking affect?

A

Ability to walk

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4
Q

What does Gait describe?

A
Straight line walking/running
Jumping
Terrain adjustment 
Turning 
A combination of movements
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5
Q

How is the gait cycle divided?

A

Stride - Stance and swing

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6
Q

List the stages of the gait cycle

A
Initial contact
Loading response
Midstance
Terminal stance 
Preswing 
Initial swing
Midswing
Terminal swing
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7
Q

Describe the position of joints in heel strike/initial contact phase (0-2%)

A
Foot in contact with the floor 
Hip flexion 
Neutral knee
Ankle dorsiflexion 
Big toe in dorsiflexion
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8
Q

What is the heel strike/initial contact phase used for?

A

Slowing down and control of landing

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9
Q

Describe the joint position in loading response (2-12%)

A
Lots of eccentric contraction 
Hip flexion 
knee flexion 
Ankle dorsiflexion 
1st MTPJ neutral
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10
Q

Describe the positions of muscles in initial contact

A

Hip extensors contract to control hip flexion via momentum

Gracilis contracts (isometric) to control hip flexion and knee extension

Knee flexors contract (concentric) start knee flexion

Knee extensors contract (eccentric) to control knee flexion

Ankle dorsiflexiors contract (eccentric) to prevent foot slapping

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11
Q

Describe the position of the muscles in the loading response

A

Hip extensors contract to start hip extension

Knee flexors contract (concentric) to keep the knee in flexion

Knee extensors contract (eccentric) to control knee in flexion

Gastrocnemius contracts to keep the knee in flexion

Ankle dorsiflexion contract (eccentric) to prevent foot slapping

Ankle plantarflexors contract (concentric) to bring foot in contact with the ground

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12
Q

Describe joint position in mid stance (12-31%)

A

Hip neutral
Knee extension
Ankle neutral
1st MTPJ neutral

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13
Q

Describe muscle activities in mid stance (12-31%)

A

Hip extensors contract (concentric) to keep hip in extension

Knee flexors contract (eccentric) to control knee extension via momentum

Grastrocnemius contracts (eccentric) to control knee extension via momentum

Ankle plantarflexrs contract (eccentric) to stabilise the foot

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14
Q

Describe joint position during terminal stance (31-50%)

A

Hip extension

Knee full extension

Ankle dorsiflexion

1st MTPJ neutral/dorsiflexion

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15
Q

Describe muscle activities in terminal stance

A

Hip flexors contract (eccentric) to control hip extension via momentum

Gastrocnemius contracts (eecentic) to control knee extension via momentum

Ankle plantarflexors contraction (eccentric) to control ankle dorsiflexion via body weight

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16
Q

Describe joint position in pre swing phase (50-62%)

A

Hip neutral

Knee flexion

Ankle plantarflexion

1st MTPJ dorsiflexion

17
Q

Describe muscle activities of pre-swing phase (50-62%)

A

Hip flexors contract (concentric) to start hip flexion

Gracilis contracts (concentric) to assist the knee in flexion

Gastrocnemius contracts (concentric) to bring the knee in flexion

Ankle plantarflexors contract (concentric) to propel body forward then ankle dorsiflexors contract (concentric) to keep foot off the ground

18
Q

Describe joint position in initial swing (62-75%)

A

Hip neutral/flexion

Knee flexion

Ankle neutral/dorsiflexion

1st MTPJ dorsiflexion/neutral

19
Q

Describe muscle activities in initial swing (62-75%)

A

Hip flexors contract (concentric) to keep hip in flexion

Gracilis contracts (concentric) to keep the knee in flexion

Ankle dorsiflexors contract (concentric) to keep foot off the ground

20
Q

Describe joint position in mid swing (75-87%)

A

Hip flexion

Knee flexion

Ankle dorsiflexion

1st MTPJ dorsiflexion

21
Q

Describe muscle activities in midswing (75-87%)

A

Hip extensors contract (eccentric) to control hip flexion

Gracilis contracts (concentric) to keep hip and knee in flexion

Knee flexors contract (concentiric) to keep the lower leg off the ground

Ankle dorsiflexion contract (concentric) to keep foot off ground

22
Q

Describe joint position in terminal swing

A

Hip flexion

Knee flexion/neutral

Ankle dorsiflexion

1st MTPJ dorsiflexion

23
Q

Describe muscle activities in terminal swing

A

Hip extensors contract (eccentric) to control hip flexion via momentum

Gracilis contracts (isometric) to control hip flexion and knee extension

Knee extensors contract (concentric) to bring the knee into extension

Ankle dorsiflexors contract (concentric) to keep foot off the ground

24
Q

What happens with an increase in speed?

A

Increase impact and stride length

25
Describe the stages of jumping
Acceleration - Powerful push off During the jump Deceleration - landing
26
What type of contraction occurs during acceleration?
Concentric
27
What type of contraction occurs during deceleration?
Eccentric
28
List some types of turing
Step turn Ipsilateral pivot Ipsilateral crossover
29
Which type of turning involves the most amount of steps?
Step turn
30
Define base of support
Area within an outline of all ground contact points
31
Define centre of mass
The average position of all parts of the system weighted according to their mass
32
When does terrain adjustment occur?
Stairs - up and down Uneven surfaces Various surface properties (eg. soft/hard/slippery)
33
What information does terrain adjustment require?
Sensory information
34
If you want a complete gait analysis what must you take into account?
Daily walking - to and from work/school/shops Activities - sports/dance Surfaces - smooth/uneven/soft/hard Straight line walking in clinic alone is insufficient Compensatory mechanism
35
List some conditions which may interrupt gait
MSK - arthritis, tendinopathy, ligament injury Neurological conditions - Parkinsons, cerebral palsy ,CVA, peripheral neuropathy Pain Behavioural issues Supply of energy
36
Name a screening tool for Gait
GALS