Gait and Assistive Devices

Question 1

What percentage of the gait cycle is made up of the stance phase?

Answer 1

60%

Question 2

What percentage of the gait cycle is made up of the swing phase?

Answer 2

40%

Question 3

List the events that take place during the stance phase using standard terms.

Answer 3

Heel strike
Foot flat
Midstance
Heel off 
Toe off

Question 4

List the events that take place during the swing phase using standard terms.

Answer 4

Acceleration
Midswing
Deceleration

Question 5

List the events that take place during the stance phase using Rancho Los Amigos terms.

Answer 5

Initial contact
Loading response
Midstance
Terminal stance
Pre-swing

Question 6

List the events that take place during the swing phase using Rancho Los Amigos terms.

Answer 6

Initial swing
Midswing
Terminal swing

Question 7

What position should the trunk be in throughout the entire gait cycle?

Answer 7

Erect neutral

Question 8

What position is the pelvis in during initial vs mid vs terminal swing?

Answer 8

Intial: 4-5 degrees of posterior rotation
Midswing: Neutral
Terminal: 4-5 degrees of anterior rotation

Question 9

What position is the pelvis in during terminal stance?

Answer 9

4-5 degrees of posterior rotation

Question 10

What position is the hip in, relative to rotation, abduction, and adduction, throughout the gait cycle?

Answer 10

Neutral rotation, abduction, and adduction

Question 11

How many degrees of flexion is needed at the hip during intial vs mid vs terminal swing?

Answer 11

Initial: 20 degrees of hip flexion
Midswing: 20-30 degrees of hip flexion
Terminal swing: 30 degrees of hip flexion

Question 12

What position is the hip in throughout the 5 stages of the stance phase?

Answer 12

Initial contact: 30 deg flexion
Loading response: 30 deg flexion
Midstance: extending to neutral
Terminal stance: apparent hyperextension 10 deg
Pre-swing: neutral extension

Question 13

What position is the knee in during initial vs mid vs terminal swing?

Answer 13

Intial: 60 degrees flexion
Midswing: 60-30 degrees of flexion
Terminal: Extension to 0 degrees

Question 14

What position is the knee in throughout the 5 stages of the stance phase?

Answer 14

Initial contact: Full extension
Loading response: 15 degrees of flexion
Midstance: extending to neutral 
Terminal stance: full extension
Pre-swing: 35 degrees of flexion

Question 15

What position is the ankle in during initial vs mid vs terminal swing?

Answer 15

Intial: 10 degrees plantarflexion
Midswing: Neutral
Terminal: Neutral

Question 16

What position is the ankle in throughout the 5 stages of the stance phase?

Answer 16

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

Question 17

What position are the toes in throughout the majority of the gait cycle?

Answer 17

Neutral

Question 18

What position are the toes in during terminal stance and pre-swing?

Answer 18

Neutral IP

Extended MTP

Question 19

How much hip flexion and extension are needed for normal gait?

Answer 19

Hip flexion: 0-30 degrees

Hip extension: 0-10 degrees

Question 20

How much knee flexion and extension are needed for normal gait?

Answer 20

Knee flexion: 0-60 degrees

Knee extension: 0 degrees

Question 21

How much ankle dorsiflexion and plantarflexion are needed for normal gait?

Answer 21

Dorsiflexion: 0-10 degrees
Plantarflexion: 0-20 degrees

Question 22

What is the base of support?

Answer 22

The distance between the left and right foot during progression of gait.

Question 23

What happens to the base of support as cadence increase?

Answer 23

Base of support decreases as cadence increases

Question 24

What is the base of support, cadence, toe out, step length, and stride length for an average adult?

Answer 24

BOS = 2-4 inches
Cadence = 110-120 steps per minute
Toe out = 7 degrees 
Step length = 28 inches
Stride length = 56 inches

Question 25

What is the double support phase? When does it not exist?

Answer 25

The 2 times during the gait cycle where both feet are on the ground.

Does not exist with running

Question 26

What is the single support phase? How many times does it occur during a single gait cycle?

Answer 26

Occurs when only one foot is on the ground

Occurs twice during a single gait cycle

Question 27

What is the screw home mechanism? What is it’s purpose?

Answer 27

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.

Question 28

What is the purpose of using a cane? What is the appropriate measurement for cane fitting?

Answer 28

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

Question 29

List 2 purposes for using crutches. Describe the appropriate crutch fitting of the height and handgrips.

Answer 29

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

Question 30

Where is the cane held relative to the side of injury?

Answer 30

Cane is held in the hand opposite to the involved extremity.

Question 31

Describe two point gait and delayed 2 point gait patterns to be used with cane.

Answer 31

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

Question 32

Describe 2-point, 3-point and 4 point gait patterns that can be used with crutches.

Answer 32

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

Question 33

Describe the difference between swing through and swing to crutch gait patterns.

Answer 33

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

Question 34

List 2 purposes of using a walker. Describe the fitting of a walker.

Answer 34

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

Question 35

What is the correct stair/curb negotiation pattern when using an assistive device?

Answer 35

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.