Gait and Balance - E1 Flashcards
How much time is spent in double limb support?
20%
What is the ground reaction force
The forces applied to the foot by the ground (in equal magnitude & opp direction) occurring in the 3 axis, combining to form one force vector.
What are the joint positions at initial contact?
Ankle: 0-5 PF
Knee: 10-15 flex
Hip: 30 flex
What are the joint positions at loading response?
Ankle: 15 PF
Knee: 15 flex
Hip: 25 flex
What are the joint positions at midstance?
Ankle: 10 DF
Knee: 5 flex
Hip: 0 ext
What are the joint positions at terminal stance?
Ankle: Neutral 0
Knee: 0
Hip: 10-20 ext
What are the joint positions at pre-swing?
Ankle: 20 PF
Knee: 30 flex
Hip: 10 ext
What are the joint positions at Initial swing?
ankle: 10 PF
Knee: 60 flex
Hip: 20 flex
What are the joint positions at Midswing?
Ankle: neutral 0
Knee: 30 flex
Hip: 30 flex
What are the joint positions at Terminal swing?
Ankle: Neutral 0
Knee: 0 ext
Hip: 30 flex
What is happening at __A_ from initial contact to the loading response?
a) ankle DF
a) ankle DF - Eccentric to decelerate PF
What is happening at _B__ from initial contact to the loading response?
b) Quads
b) Quads - Eccentric to decelerate knee flexion
What is happening at __C_ from initial contact to the loading response?
c) HS and GluteMax
c) HS and GluteMax - Eccentric to decelerate hip flexion
What is happening at _D__ from initial contact to the loading response?
d) Hip abd
d) Hip abd - Eccentric/iso to decelerate pelvic drop and stabilize pelvis
What is happening at _E__ from initial contact to the loading response?
e) ES, TA, EAO
e) ES, TA, EAO - stabilize trunk during weight transfer and prevent jack-knifing
What is happening at the foot intrinsics from the loading response to midstance?
Foot intrinsics - Eccentrically lengthening as the foot pronates
Where does glute max and med activity peak?
During midstance
What is happening at ____ from the loading response to midstance?
- Ankle PF
Ankle PF: Eccentric - control DF in form of tibial advancement and develop potential energy
What is happening at ____ from the loading response to midstance?
- Quads
- Quads: Eccentric/Isometric control of lower leg
What is happening at ____ from the loading response to midstance?
- Hip abductors
- Hip abductors: continue their activity (decel pelv drop and stabilize pelvis), becoming isometric as continue to halt drop on CL side
What is happening at ____ from midstance to terminal stance?
- Foot intrinsics/ankle PF
- Foot intrinsics/PF: continue to eccentrically lengthen/eccentric control DF and develop PE, becoming isometric around 40% w/heel rise
What is happening at ____ from midstance to terminal stance?
-Hip abductors
Hip abductors- moves from isometric to concentric to elevate the pelvis in preparation of swing
What is happening at ____ from midstance to terminal stance?
-Adductor Longus
- Thought to have a role in pelvic rotation
What is happening at ____ from midstance to terminal stance?
- Iliopsoas
- Iliopsoas: eccentric control of hip extension w/spring-like loading to prep for swing phase
What is happening at ____ from midstance to terminal stance?
- Quads
- Quads: Inactive (GRF and PF are maintaining knee extension)
What is happening at __ in preswing?
- PF
- PF: Concentric push off w/supinated foot
What is happening in preswing?
Widespread mm activity
What is happening at __ in preswing?
-Hip flexors
Eccentric -> concentric to advance LE into swing
What is happening at __ in preswing?
- Knee flexors (biceps fem + gracilis)
Knee extensors:
Slow: concentric flex knee
Normal/fast: momentum only, no mm
What is happening at __ in preswing?
-Erector Spinae and trunk stabil
Control unwanted trunk mvmt and stabilize upper body
What is happening at __ in initial swing?
- Hip flexors + Knee extensors
Concentric to advance leg
What is happening at __ in initial swing?
- DF
Concentric activation for foot clearance
What is happening during midswing?
Most mm activity ceases EXCEPT DF w/inertia carrying the leg through
What is happening at __ during terminal swing?
- HS
HS - eccentric to decelerate swinging extremity
What is happening at __ during terminal swing?
- DF
DF: hold ankle in position for initial contact
What is happening at __ during terminal swing?
- Quads and hip Abd
Initiate activity just before foot touches ground to prep body for large GRF
General mm activation in Initial stance?
LE mm, particular 2-jt are absorbing E and controlling body from falling to ground (ECCENTRIC)
General mm activation in Late Stance?
LE mm develop tension through eccentric and concentric contractions as well as other leg moving forward
General mm activation in Swing phase?
Spring-like recoil of mm w/some concentric contraction to advance leg fwd and clear foot
List the 4 categories of abnormal gait patterns
1 - Pain
2 - MM weakness
3 - Lack of ROM in LE joints
4 - Neurological/Balance Impaired
Pain in abnormal gait
It is an antalgic pattern, w/shortened stride length, less stance t on involved limb
MM weakness in abnormal gait
Lack of eccentric control in stance phase, giving way or trunk compensation
Lack of ROM in abnormal gait
Limited/lack ROM in LE limits the normal gait pattern
Neurological/Balance impaired in abnormal gait
- Decreased coordination
- unable to initiate movement
- increased BOS
- postural sway
- syngergy patterns
- little to no mm activation concentrically
- increased compensations and use of devices
What is the 6th vital sign?
Gait speed
How do you test gait speed?
10M walk test
What is an increase/decrease in gait speed linked to?
Overall change - predicts mortality, decline, and physiological changes
Increase - greater quality of life
Decrease - increase fall risk
What are the minimum standards of gait speed?
- 300 m in less than 11.5 min (speed 0.45 m/s)
- 1.3 m/sec for 13-27 m (to cross street)
What are the phases of ascending stairs?
Stance phase - 64%
- Weight acceptance
- Pull up
- forward continuance
Swing phase - 36%
- foot clearance
- foot placement
What are the phases of descending stairs?
Stance phase
- Weight acceptance
- Forward continuance
- Controlled lowering
Swing phase
- leg pull through
- forward placement
What is the knee extensor moment for ascending and descending stairs?
3x that of walking
What is the role of the knee in
a) ascending stairs
b) descending stairs
a) generative (Forces)
b) absorptive
What is the roll of the quads in
a) ascending stairs
b) descending stairs
a) Concentric to raise
b) eccentric to lower
What occurs during the pull up phase of ascending stairs?
Period of SL support w/instability where body weight shifted from back leg to forward leg that is :
flexed at hip, knee, and ankle
What major mm are activated during the pull up phase of ascending stairs?
RF, VL, Soleus, and medial gastroc
What major mm are activated during descending stairs?
Eccentric RF, VL, soleus, and medial gastroc
+ peak hip abductor moment
What mm has its peak moment in stair descent?
Hip abductors
What is the relationship between speed and stance phase in running?
Inverse relation
What must be present in order for running to occur?
Float phase - period of time w/o limb contact
What are the two phases of running?
Stance phase (40%) and Float phase (60%)
