Gait and Assistive Devices Flashcards
What percentage of the gait cycle is made up of the stance phase?
60%
What percentage of the gait cycle is made up of the swing phase?
40%
List the events that take place during the stance phase using standard terms.
Heel strike Foot flat Midstance Heel off Toe off
List the events that take place during the swing phase using standard terms.
Acceleration
Midswing
Deceleration
List the events that take place during the stance phase using Rancho Los Amigos terms.
Initial contact Loading response Midstance Terminal stance Pre-swing
List the events that take place during the swing phase using Rancho Los Amigos terms.
Initial swing
Midswing
Terminal swing
What position should the trunk be in throughout the entire gait cycle?
Erect neutral
What position is the pelvis in during initial vs mid vs terminal swing?
Intial: 4-5 degrees of posterior rotation
Midswing: Neutral
Terminal: 4-5 degrees of anterior rotation
What position is the pelvis in during terminal stance?
4-5 degrees of posterior rotation
What position is the hip in, relative to rotation, abduction, and adduction, throughout the gait cycle?
Neutral rotation, abduction, and adduction
How many degrees of flexion is needed at the hip during intial vs mid vs terminal swing?
Initial: 20 degrees of hip flexion
Midswing: 20-30 degrees of hip flexion
Terminal swing: 30 degrees of hip flexion
What position is the hip in throughout the 5 stages of the stance phase?
Initial contact: 30 deg flexion Loading response: 30 deg flexion Midstance: extending to neutral Terminal stance: apparent hyperextension 10 deg Pre-swing: neutral extension
What position is the knee in during initial vs mid vs terminal swing?
Intial: 60 degrees flexion
Midswing: 60-30 degrees of flexion
Terminal: Extension to 0 degrees
What position is the knee in throughout the 5 stages of the stance phase?
Initial contact: Full extension Loading response: 15 degrees of flexion Midstance: extending to neutral Terminal stance: full extension Pre-swing: 35 degrees of flexion
What position is the ankle in during initial vs mid vs terminal swing?
Intial: 10 degrees plantarflexion
Midswing: Neutral
Terminal: Neutral
What position is the ankle in throughout the 5 stages of the stance phase?
Initial contact: neutral heel first
Loading response: 15 degrees of plantarflexion
Midstance: from PF to 10 degrees of dorsiflexion
Terminal stance: neutral
Pre-swing: 20 degrees of plantarflexion
What position are the toes in throughout the majority of the gait cycle?
Neutral
What position are the toes in during terminal stance and pre-swing?
Neutral IP
Extended MTP
How much hip flexion and extension are needed for normal gait?
Hip flexion: 0-30 degrees
Hip extension: 0-10 degrees
How much knee flexion and extension are needed for normal gait?
Knee flexion: 0-60 degrees
Knee extension: 0 degrees
How much ankle dorsiflexion and plantarflexion are needed for normal gait?
Dorsiflexion: 0-10 degrees
Plantarflexion: 0-20 degrees
What is the base of support?
The distance between the left and right foot during progression of gait.
What happens to the base of support as cadence increase?
Base of support decreases as cadence increases
What is the base of support, cadence, toe out, step length, and stride length for an average adult?
BOS = 2-4 inches Cadence = 110-120 steps per minute Toe out = 7 degrees Step length = 28 inches Stride length = 56 inches
What is the double support phase? When does it not exist?
The 2 times during the gait cycle where both feet are on the ground.
Does not exist with running
What is the single support phase? How many times does it occur during a single gait cycle?
Occurs when only one foot is on the ground
Occurs twice during a single gait cycle
What is the screw home mechanism? What is it’s purpose?
Describes the 5 degrees of tibial ER that occur during terminal knee extension.
Purpose: Lock the knee to provide increased stability of the knee joint during weight bearing activities.
Unlocking occurs through action of the popliteus.
What is the purpose of using a cane? What is the appropriate measurement for cane fitting?
Purpose: To widen BOS to improve balance
Fitting: Measure a point 6 inches to the side of the toes to the ulnar styloid or wrist crease to allow for 20-30 degrees of elbow flexion
List 2 purposes for using crutches. Describe the appropriate crutch fitting of the height and handgrips.
Purpose: Increase BOS for greater stability and relieve weight bearing on the LEs.
Height fitting: 6 inches in front and 2 inches lateral to the feet, axillary pads should sit 2-3 finger widths below the axilla
Handgrip height: At the level of the ulnar styloid or wrist crease to allow for 20-30 degrees of elbow flexion
Where is the cane held relative to the side of injury?
Cane is held in the hand opposite to the involved extremity.
Describe two point gait and delayed 2 point gait patterns to be used with cane.
2-point gait = cane and involved LE advance together followed by uninvolved LE
Delayed 2-point gait = cane is advanced first, followed by the involved LE and then the uninvolved LE
Describe 2-point, 3-point and 4 point gait patterns that can be used with crutches.
2 point = one crutch and opposite extremity move together, followed by the opposite crutch and extremity
3 point = crutches and involved LE are advanced together, then uninvolved LE
4 point = one crutch is advanced forward, followed by the contralateral LE, then the second crutch followed by the other contralateral LE
Describe the difference between swing through and swing to crutch gait patterns.
Swing to gait = crutches advance first and LEs swing forward to meet crutches
Swing through = crutches advance first, LE swing forward beyond the point of the crutch
List 2 purposes of using a walker. Describe the fitting of a walker.
Purpose: widen BOS to provide increased lateral and anterior stability, reduce weightbearing on one or both LEs
Fitting: Handgrip height should be at the level of the ulnar styloid or wrist crease to allow for 20-30 degrees of elbow flexion
What is the correct stair/curb negotiation pattern when using an assistive device?
Ascent = uninvolved LE ascends the step first, followed by the AD and the involved LE together
Descent = AD first, with the involved or followed by the involved LE. The uninvolved LE then follows to the lower step.
