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Neurologic PT > Gait and Locomotion > Flashcards

Gait and Locomotion Flashcards

1
Q

What is the difference between gait and locomotion?

A

Gait: manner in which a person walks, characterized by rhythm, cadence, step, stride, and speed

Locomotion: ability to move from one place to another

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2
Q

What percentage of the gait cycle is spent in stance?

A

62%

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3
Q

What percentage of the gait cycle is spent in swing?

A

38%

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4
Q

List the 3 functional tasks involved in the gait cycle.

A

Weight acceptance (stance)
Single limb support (stance)
Swing limb advancement (swing)

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5
Q

What 2 sub-phases fall within the functional task of weight acceptance?

A

Initial contact

Loading response

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6
Q

What 2 sub-phases fall within the functional task of single limb support?

A

Midstance

Terminal stance

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7
Q

What 4 sub-phases fall within the functional task of swing limb advancement?

A

Pre-swing
Initial swing
Mid-swing
Terminal swing

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8
Q

What are the 3 task accomplishments during weight acceptance?

A

Stability
Forward progression
Shock absorption

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9
Q

What are the 2 task accomplishments during single limb support?

A

Stability

Forward progression

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10
Q

What are the 2 task accomplishments during swing limb advancement?

A

Foot clearance

Forward progression

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11
Q

Kinematics describe _____.

A

Movement

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12
Q

Kinetics describe ____.

A

Forces

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13
Q

List 1 example of a qualitative kinematic measure.

A

Observational Gait Analysis (OGA)

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14
Q

List 4 quantitative kinematic SPATIAL measures.

A
  1. Step length
  2. Stride length
  3. Step width
  4. Foot angle
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15
Q

List 3 quantitative kinematic TEMPORAL measures.

A
  1. Cadence
  2. Velocity
  3. Stride time
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16
Q

List the 4 prerequisites of functional gait.

A
  1. Stance stability: LE must be stable enough to accept and support body weight, especially during SLS
  2. Clearance in swing: Swing limb must “shorten” enough to clear the ground and advance forward
  3. Swing phase pre-positioning: Foot must be positioned during swing in preparation for contact and loading
  4. Adequate step length: Motion and control must occur at all segments to promote forward progression
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17
Q

What is the overall goal of functional gait?

A

Minimize energy expenditure and maximize efficiency

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18
Q

Explain the stance phase rocker progression.

A

Foot complex acts as a pivoting system to promote forward progression while maintaining stability

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19
Q

What are the critical events that take place during initial contact and loading response during weight acceptance?

A

Initial contact: heel first contact

Loading response

  1. Hip stability
  2. Controlled knee flexion
  3. Ankle PF
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20
Q

What are the critical events that take place during midstance and terminal stance during single limb support?

A

Midstance: Controlled tibial advancement

Terminal stance

  1. Controlled ankle DF with heel rise
  2. Trailing limb posture
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21
Q

What are the critical events that take place during preswing, initial swing, midswing, terminal swing during swing limb advancement? (ROM)

A

Preswing

  1. Passive knee flexion (40 deg)
  2. Ankle PF

Initial Swing

  1. Hip flexion (15 deg)
  2. Knee flexion (60 deg)

Midswing

  1. Hip flexion (25 deg)
  2. Ankle DF (0 deg)

Terminal Swing
1. Knee extension to neutral (5 deg)

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22
Q

What 3 tasks are affected by excessive PF?

A
  1. Weight acceptance
  2. Single limb support
  3. Swing limb advancement
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23
Q

What is the significance of excess PF in stance? (3)

A
  1. Poor position for heel rocker
  2. Decreases shock absorption
  3. Decreases forward tibial progression
24
Q

What is the significance of excess PF in swing? (2)

A
  1. Limits foot clearance

2. Interferes with foot position for contact

25
List 6 possible causes for excessive PF.
1. PF contracture 2. PF hypertonicity 3. Weak quads/pretibials 4. Impaired proprioception 5. Ankle pain 6. Lack of selective DF control in TSw
26
What task is affected by forefoot/foot flat contact?
Weight acceptance
27
What is the significance of forefoot/foot-flat contact? (3)
1. Poor position for heel rocker 2. Limits forward momentum of tibia 3. Decreases shock absorption (limits knee flexion)
28
What are 3 possible causes of forefoot contact?
1. Inc knee flexion in TSw 2. Weak quads (avoiding LR) 3. Excess PF in TSw
29
What task is affected by a foot slap?
Weight acceptance
30
What is the significant of foot slap? (2)
1. Decreases forward tibial progression | 2. Decreases shock absorption
31
What is a possible cause of foot slap?
Weak pretibials
32
What 3 tasks are affected by excessive knee flexion?
1. Weight acceptance 2. Single limb support 3. Swing limb advancement
33
What is the significance of excessive knee flexion in stance? (2)
1. Increases demand on PFs, quads, hip extensors | 2. Decreases limb stability
34
What is the significance of excessive knee flexion in swing? (2)
1. Decreases step length of reference limb | 2. Interferes with heel first contact
35
What 3 tasks are affected by excessive knee extension?
1. Weight acceptance 2. Single limb support 3. Swing limb advancement
36
What is the significance of excessive knee extension in stance? (3)
1. Decreases shock absorption 2. Decreases forward progression of tibia 3. Potential injury to posterior knee structures
37
What is the significance of excessive knee extension in swing?
1. May assist in achieving maximal knee extension
38
What is an extension thrust?
1. Forceful motion of knee towards extension | 2. Reduces demand on weak quads
39
List 6 possible causes of excessive knee extension.
1. Weak quads 2. Impaired proprioception 3. Quad hypertonicity 4. Intentional to increase limb stability/extend the knee 5. Secondary to forefoot contact with excess PF tightness 6. Secondary to excess PF
40
What 2 tasks are affected by limited hip flexion?
1. Weight acceptance | 2. Swing limb advancement
41
What is the significance of limited hip flexion (2)
1. May disturb normal LR by limiting knee flexion and ankle PF 2. Interferes with ability to clear foot, advance limb, and create forward momentum
42
List 10 possible causes of limited hip flexion.
1. Limited hip flexion achieved in TSw 2. Intentional to decrease demand on hip extensors 3. Weak hip flexors 4. Impaired motor control: inability to rapidly flex hip 5. ROM of straight leg raise < 40° 6. Hip extensor hypertonicity 7. Hip pain 8. Limited hip flexion ROM 9. Secondary: to foot drag 10. Secondary: to past retract in TSw
43
What is past retract?
A visible forward and then backward movement of the thigh during terminal swing
44
What task is affected by past retract? What is the significance?
Task affected: Swing limb advancement Significance: Decreases step length
45
A lateral trunk lean is typically seen with ____ gait.
Trendelenburg gait
46
Backward/forward rotation of the trunk during gait occurs secondary to inability to _____ the trunk/pelvis.
Disassociate the trunk and pelvis
47
Backwards trunk lean reduces the demands on the ____.
Hip extensors
48
Forward lean reduces demands on ______, allows “forward progression” over plantarflexed ankle.
Quadriceps
49
Ataxia is common with ____ pathology. List 2 characteristics of this gait pattern.
Common with cerebellar pathology 1. Staggering and unsteadiness 2. Wide BOS and exaggerated movements
50
Festinating gait is common with ____. List 2 characteristics of this gait pattern.
Common with PD 1. Walking on toes as though pushed 2. Starts slowly and increases in speed/frequency
51
Scissoring gait is common with ____, _____ and ____. List 2 characteristics of a scissoring gait pattern.
Common with CP, CVA, TBI. 1. Legs cross midline upon advancement 2. Tends to accompany adductor spasticity
52
List 3 characteristics of steppage gait.
1. Feet and toes are lifted through excess hip and knee flexion 2. Usually accompanied by a footslap on IC 3. Common with DF weakness, sensory/ proprioceptive deficits, and chronic polyneuropathies
53
_____ and _____ are very important principles of neuroplasticity that should be emphasized in locomotor training.
Specificity | Intensity
54
Explain the leap frog effect. (2)
1. Training of one motor task may affect performance of biomechanically separate tasks that utilize overlapping neural circuits 2. Improvements in non-walking tasks following intensive LT
55
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
56
_____ may be an effective in treating foot drop.
Peroneal nerve FES
57
_____ is the 6th vital sign.
Gait speed

Neurologic PT (11 decks)

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