Gait, anatomy and physiology of walking Flashcards
How is walking both simple and complicated?
Simple - we do not have to think about it
Complicated - Involves many structures in the body
What structures in the body are involved in walking?
MSK - Muscles, tendons, bones, joints
Nervous system - Sensory, motor, autonomic, proprioception
Cardiovascular system - Heart and blood vessels
Special senses - Vision and hearing
What may problems with systems involved in walking affect?
Ability to walk
What does Gait describe?
Straight line walking/running Jumping Terrain adjustment Turning A combination of movements
How is the gait cycle divided?
Stride - Stance and swing
List the stages of the gait cycle
Initial contact Loading response Midstance Terminal stance Preswing Initial swing Midswing Terminal swing
Describe the position of joints in heel strike/initial contact phase (0-2%)
Foot in contact with the floor Hip flexion Neutral knee Ankle dorsiflexion Big toe in dorsiflexion
What is the heel strike/initial contact phase used for?
Slowing down and control of landing
Describe the joint position in loading response (2-12%)
Lots of eccentric contraction Hip flexion knee flexion Ankle dorsiflexion 1st MTPJ neutral
Describe the positions of muscles in initial contact
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
Describe the position of the muscles in the loading response
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
Describe joint position in mid stance (12-31%)
Hip neutral
Knee extension
Ankle neutral
1st MTPJ neutral
Describe muscle activities in mid stance (12-31%)
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
Describe joint position during terminal stance (31-50%)
Hip extension
Knee full extension
Ankle dorsiflexion
1st MTPJ neutral/dorsiflexion
Describe muscle activities in terminal stance
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
Describe joint position in pre swing phase (50-62%)
Hip neutral
Knee flexion
Ankle plantarflexion
1st MTPJ dorsiflexion
Describe muscle activities of pre-swing phase (50-62%)
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
Describe joint position in initial swing (62-75%)
Hip neutral/flexion
Knee flexion
Ankle neutral/dorsiflexion
1st MTPJ dorsiflexion/neutral
Describe muscle activities in initial swing (62-75%)
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
Describe joint position in mid swing (75-87%)
Hip flexion
Knee flexion
Ankle dorsiflexion
1st MTPJ dorsiflexion
Describe muscle activities in midswing (75-87%)
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
Describe joint position in terminal swing
Hip flexion
Knee flexion/neutral
Ankle dorsiflexion
1st MTPJ dorsiflexion
Describe muscle activities in terminal swing
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
What happens with an increase in speed?
Increase impact and stride length
Describe the stages of jumping
Acceleration - Powerful push off
During the jump
Deceleration - landing
What type of contraction occurs during acceleration?
Concentric
What type of contraction occurs during deceleration?
Eccentric
List some types of turing
Step turn
Ipsilateral pivot
Ipsilateral crossover
Which type of turning involves the most amount of steps?
Step turn
Define base of support
Area within an outline of all ground contact points
Define centre of mass
The average position of all parts of the system weighted according to their mass
When does terrain adjustment occur?
Stairs - up and down
Uneven surfaces
Various surface properties (eg. soft/hard/slippery)
What information does terrain adjustment require?
Sensory information
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
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
Name a screening tool for Gait
GALS
