Gait and Locomotion Flashcards
What is the difference between gait and locomotion?
Gait: manner in which a person walks, characterized by rhythm, cadence, step, stride, and speed
Locomotion: ability to move from one place to another
What percentage of the gait cycle is spent in stance?
62%
What percentage of the gait cycle is spent in swing?
38%
List the 3 functional tasks involved in the gait cycle.
Weight acceptance (stance)
Single limb support (stance)
Swing limb advancement (swing)
What 2 sub-phases fall within the functional task of weight acceptance?
Initial contact
Loading response
What 2 sub-phases fall within the functional task of single limb support?
Midstance
Terminal stance
What 4 sub-phases fall within the functional task of swing limb advancement?
Pre-swing
Initial swing
Mid-swing
Terminal swing
What are the 3 task accomplishments during weight acceptance?
Stability
Forward progression
Shock absorption
What are the 2 task accomplishments during single limb support?
Stability
Forward progression
What are the 2 task accomplishments during swing limb advancement?
Foot clearance
Forward progression
Kinematics describe _____.
Movement
Kinetics describe ____.
Forces
List 1 example of a qualitative kinematic measure.
Observational Gait Analysis (OGA)
List 4 quantitative kinematic SPATIAL measures.
- Step length
- Stride length
- Step width
- Foot angle
List 3 quantitative kinematic TEMPORAL measures.
- Cadence
- Velocity
- Stride time
List the 4 prerequisites of functional gait.
- Stance stability: LE must be stable enough to accept and support body weight, especially during SLS
- Clearance in swing: Swing limb must “shorten” enough to clear the ground and advance forward
- Swing phase pre-positioning: Foot must be positioned during swing in preparation for contact and loading
- Adequate step length: Motion and control must occur at all segments to promote forward progression
What is the overall goal of functional gait?
Minimize energy expenditure and maximize efficiency
Explain the stance phase rocker progression.
Foot complex acts as a pivoting system to promote forward progression while maintaining stability
What are the critical events that take place during initial contact and loading response during weight acceptance?
Initial contact: heel first contact
Loading response
- Hip stability
- Controlled knee flexion
- Ankle PF
What are the critical events that take place during midstance and terminal stance during single limb support?
Midstance: Controlled tibial advancement
Terminal stance
- Controlled ankle DF with heel rise
- Trailing limb posture
What are the critical events that take place during preswing, initial swing, midswing, terminal swing during swing limb advancement? (ROM)
Preswing
- Passive knee flexion (40 deg)
- Ankle PF
Initial Swing
- Hip flexion (15 deg)
- Knee flexion (60 deg)
Midswing
- Hip flexion (25 deg)
- Ankle DF (0 deg)
Terminal Swing
1. Knee extension to neutral (5 deg)
What 3 tasks are affected by excessive PF?
- Weight acceptance
- Single limb support
- Swing limb advancement
What is the significance of excess PF in stance? (3)
- Poor position for heel rocker
- Decreases shock absorption
- Decreases forward tibial progression
What is the significance of excess PF in swing? (2)
- Limits foot clearance
2. Interferes with foot position for contact
List 6 possible causes for excessive PF.
- PF contracture
- PF hypertonicity
- Weak quads/pretibials
- Impaired proprioception
- Ankle pain
- Lack of selective DF control in TSw
What task is affected by forefoot/foot flat contact?
Weight acceptance
What is the significance of forefoot/foot-flat contact? (3)
- Poor position for heel rocker
- Limits forward momentum of tibia
- Decreases shock absorption (limits knee flexion)
What are 3 possible causes of forefoot contact?
- Inc knee flexion in TSw
- Weak quads (avoiding LR)
- Excess PF in TSw
What task is affected by a foot slap?
Weight acceptance
What is the significant of foot slap? (2)
- Decreases forward tibial progression
2. Decreases shock absorption
What is a possible cause of foot slap?
Weak pretibials
What 3 tasks are affected by excessive knee flexion?
- Weight acceptance
- Single limb support
- Swing limb advancement
What is the significance of excessive knee flexion in stance? (2)
- Increases demand on PFs, quads, hip extensors
2. Decreases limb stability
What is the significance of excessive knee flexion in swing? (2)
- Decreases step length of reference limb
2. Interferes with heel first contact
What 3 tasks are affected by excessive knee extension?
- Weight acceptance
- Single limb support
- Swing limb advancement
What is the significance of excessive knee extension in stance? (3)
- Decreases shock absorption
- Decreases forward progression of tibia
- Potential injury to posterior knee structures
What is the significance of excessive knee extension in swing?
- May assist in achieving maximal knee extension
What is an extension thrust?
- Forceful motion of knee towards extension
2. Reduces demand on weak quads
List 6 possible causes of excessive knee extension.
- Weak quads
- Impaired proprioception
- Quad hypertonicity
- Intentional to increase limb stability/extend the knee
- Secondary to forefoot contact with excess PF tightness
- Secondary to excess PF
What 2 tasks are affected by limited hip flexion?
- Weight acceptance
2. Swing limb advancement
What is the significance of limited hip flexion (2)
- May disturb normal LR by limiting knee flexion and ankle PF
- Interferes with ability to clear foot, advance limb, and create forward momentum
List 10 possible causes of limited hip flexion.
- Limited hip flexion achieved in TSw
- Intentional to decrease demand on hip extensors
- Weak hip flexors
- Impaired motor control: inability to rapidly flex hip
- ROM of straight leg raise < 40°
- Hip extensor hypertonicity
- Hip pain
- Limited hip flexion ROM
- Secondary: to foot drag
- Secondary: to past retract in TSw
What is past retract?
A visible forward and then backward movement of the thigh during terminal swing
What task is affected by past retract? What is the significance?
Task affected: Swing limb advancement
Significance: Decreases step length
A lateral trunk lean is typically seen with ____ gait.
Trendelenburg gait
Backward/forward rotation of the trunk during gait occurs secondary to inability to _____ the trunk/pelvis.
Disassociate the trunk and pelvis
Backwards trunk lean reduces the demands on the ____.
Hip extensors
Forward lean reduces demands on ______, allows “forward progression” over plantarflexed ankle.
Quadriceps
Ataxia is common with ____ pathology. List 2 characteristics of this gait pattern.
Common with cerebellar pathology
- Staggering and unsteadiness
- Wide BOS and exaggerated movements
Festinating gait is common with ____. List 2 characteristics of this gait pattern.
Common with PD
- Walking on toes as though pushed
- Starts slowly and increases in speed/frequency
Scissoring gait is common with ____, _____ and ____. List 2 characteristics of a scissoring gait pattern.
Common with CP, CVA, TBI.
- Legs cross midline upon advancement
- Tends to accompany adductor spasticity
List 3 characteristics of steppage gait.
- Feet and toes are lifted through excess hip and knee flexion
- Usually accompanied by a footslap on IC
- Common with DF weakness, sensory/ proprioceptive deficits, and chronic polyneuropathies
_____ and _____ are very important principles of neuroplasticity that should be emphasized in locomotor training.
Specificity
Intensity
Explain the leap frog effect. (2)
- Training of one motor task may affect performance of biomechanically separate tasks that utilize overlapping neural circuits
- Improvements in non-walking tasks following intensive LT
True or False: The STEPS trial found that resisted cycling is better than task specific locomotor training in improving gait speed and walking distance.
FALSE
Task specific locomotor training > resisted cycling
_____ may be an effective in treating foot drop.
Peroneal nerve FES
_____ is the 6th vital sign.
Gait speed
