Gait and posture 1

Question 1

Gait

Answer 1

Translocates centre of body mass in direction of locomotion (walking), generally symmetrical need all body weight, cyclical activity (1 sec)

Question 2

Normal gait relies on

Answer 2

1. Joints
2. Muscles
3. Nerves
4. Vision

Question 3

Joints

Answer 3

Intact bones and well functioning joints

Question 4

Vision

Answer 4

Information about movement and surroundings, automatic balance, vestibular and auditory systems

Question 5

Everybody’s gait different due to

Answer 5

• Stride length
• Pelvic movement
• Upper body position

Question 6

Reasons for changes in elderly

Answer 6

Muscle start to atrophy, reduce strength and flexibility and loss of hearing and vision

Question 7

Changes in gait in elderly

Answer 7

Reduction in overall velocity and strep/stride length, not swing arms as much, decreased rotation of pelvis, flat footed

Question 8

Gait cycle

Answer 8

1 leg, heel strike, loading response, midstance, terminal stance (heel off), preswing (toe off), initial and mid-swing, terminal swing

Question 9

2 phases of gait cycle

Answer 9

1. Stance (60%, in contact with ground)

2. Swing (40%, in air)

Question 10

Start and end of stance phase marked by

Answer 10

Short period of double support (10%) - both feet on ground

Question 11

Stance phase

Answer 11

Heel strike, loading response, mid-stance, terminal stance, pre-swing

Question 12

Swing phase

Answer 12

Initial swing, mid-swing, terminal swing

Question 13

Isometric contraction

Answer 13

Contracts without changing in length (not moving it)

Question 14

Dynamic contraction

Answer 14

Contracts with a change in length

Question 15

2 types of dynamic contraction

Answer 15

1. Concentric - shorten

2. Eccentric - lengthens (control descent of arm)

Question 16

Heel strike

Answer 16

1st part, ankle dorsiflexed, lower foot carefully by eccentric contraction of tibilais anterior, deceleration of movement by gluteus maximus, longitudinal arch of foot maintain by intrinsic muscles, ankle and subtalar joint accommodate terrain

Question 17

Loading response

Answer 17

Foot flat on ground, all body weight on one limb, requires knee extension to prevent buckling under weight - quadriceps femoris contracts, continued hip extension and preservation of longitudinal arch

Question 18

Mid-stance

Answer 18

Opposite leg swings past, stabilise pelvis (gluteus medius and minimus and tensor fasia lata - abduct hip)

Question 19

Terminal stance

Answer 19

Heel starts to lift off grand, achieved by plantar flexors (soleus and gastrocnemius - triceps surae), accelerates mass forward

Question 20

Pre-swing (toe-off)

Answer 20

Powerful plantar flexion of digits - push off grand and accelerate mass forward, slowing of hip extension and preparation for hip flexion (eccentric contraction of rectus femoris)

Question 21

What is essential for toe-off?

Answer 21

Hallux/big toe, stabilised by adductor hallucis and adductor hallucis brevis

Question 22

Misaligned or missing hallux

Answer 22

Weak push off (apropulsive gait) > shorter stride length and decreased gait velocity

Question 23

Hallux valgus

Answer 23

Lateral deviation of hallux

Question 24

Hallux amputation often due to

Answer 24

Diabetes

Question 25

Initial and mid-swing

Answer 25

Hip flexion carries limb forward (iliopsoas and rectus femoris), toes and foot dorsiflexed so dont drag (tibilias anterior), and helped by knee flexion 65 degrees (hamstrings)

Question 26

Terminal swing

Answer 26

Knee flexion > extension (quadriceps), dorsiflexion of ankle (tibilalis anterior), eccentric contraction of hamstrings decelerates limb in prep for heel-strike

Question 27

Swing problems

Answer 27

If can’t shorten limb by knee flexion foot drop

Question 28

Remedy of swing problems

Answer 28

Swinging leg movement in arc (circumduction) to avoid dragging on ground

Question 29

Foot can’t dorsiflex

Answer 29

Footdrop - common perineal nerve

Question 30

Footdrop remedy

Answer 30

Flex knee higher/circumduct

Question 31

Stance limb

Answer 31

Internal rotation (gluteus medius and minimus, tensor fascia lata), also keep knee slightly flexed - minimises vertical rise

Question 32

Swing limb

Answer 32

External rotation (piriformis, quadratus femoris, obturator internus and externus, superior and inferior gemelli)

Question 33

Energy efficient

Answer 33

Minimises centre of gravity moving - only move forward

Question 34

Pelvic rotation reduces vertical drop

Answer 34

Just walk forward not up and down

Question 35

Pelvic drop

Answer 35

Helps minimise rise to COG as walk, gluteus medius and maximus minimise drop

Question 36

Trendelenberg gait caused by

Answer 36

Gluteus medius and maximus not working

Question 37

Trendelenberg gait sign of

Answer 37

Stroke, cerebral palsy (UMN), hip osteoarthritis, superior gluteal nerve damage

Question 38

Hip adduction

Answer 38

Minimises lateral shift, pull knee into midline, if not active very wide based gait knees not being drawn in

Question 39

Bipedial gait

Answer 39

Short legs, short arms, evolution (walking on hands and knees)