Gait Basics Flashcards
When we are talking about a (step/stride), a (step/stride) can be described as my left foot is standing and then my right foot hits the ground.
step; step
A (step/stride) is when the same foot goes through the full gait cycle. So if my left foot is on the ground, the stride is finished when the (right/left) foot is back on the ground.
stride; left
(Cadence/Step length) is the number of steps per minute.
Cadence
(Step length/Step width) is the measure of the heel of one foot to to the heel of the other foot when walking.
Step length
(Step length/Step width) is the lateral distance between the feet. None of us walk on a tight rope. The width between the insteps of both feet after one step is the (step length/step width).
step width; step width
(Ground Reaction Force/Center of Pressure (COP)) is the point of application for ground reaction force
Center of Pressure
If I step and I hit my heel, the COP is on the (toes/heel). It is where the ground is reacting to the foot. As you go through the loading response and I shift onto my foot, the COP now changes. It goes from the heel to more on the middle of my foot, to my toe because that is where the GRF is acting.
heel
Between the person who has a fast gait speed compared to the person that has a slower GAIT speed, the person with a (faster/slower) GAIT speed will be more likely to have balance issues and more likely to be less confident when walking.
slower
Someone with a faster GAIT speed is someone who covers (smaller/larger) distances when they walk.
larger
(Slower/Faster) Gait speeds and (shorter/larger) step lengths can be used as a predictor of potential to fall.
Slower; shorter
Someone with a very short step length is not going to feel confident in the (single/two) leg portion of GAIT so they are going to want to get their foot down as (slow/fast) as possible, so their step length is going to be really small.
single; fast
The GAIT cycle starts from the moment the right leg hits the heel on the ground and this is called _____ contact and it is at _% of the GAIT cycle.
initial; 0
You go from initial contact to (loading response/mid stance) and this is starting to put weight through the foot.
loading response
(Loading response/ Mid stance) is when the body weight is over the foot
Mid stance
The stance phase is (shorter/longer) than the swing phase
longer
The first task of the stance phase is ____.
weight acceptance
The two periods of weight acceptance are _____ and _____ .
initial contact and loading response
The three functions of (weight acceptance/mid swing) - shock absorption, stability of the limb, and preserve forward progression.
weight acceptance
(Shock absorption/Preserve forward progression) – the ability to move forward fluidly through the GAIT cycle and not have constant herky jerky motions that can halter the forward progression.
Preserve forward progression
Initial contact is the beginning of (stance/swing) phase and is it at _% of the GAIT cycle.
stance; 0
Initial contact occurs (before/the instant) the foot hits the ground and you will be in (single/double) support.
the instant; double
(Single/Double) support – when my right heel hits the ground and my left leg is still on the ground
Double
The function of initial contact is to impact (acceleration/deacceleration). Without (acceleration/deacceleration) you will crumble to the ground. My impact is hitting the ground and with the contact from the foot, I’ll have to stop myself from falling, performing initial contact.
deacceleration; deacceleration
Loading response is %-% of the GAIT cycle and you will be in (single/double) support.
0-10; double
Initial contact to opposite toe off - (initial contact/loading response). You are getting initial contact with your right heel and your (right/left) limb is getting ready to toe off is the (initial contact/loading response).
loading response; left; loading response
The three functions of (loading response/mid swing) - shock absorption, stability of the limb, and preserve forward progression
loading response
The second task of the stance phase is (single/double) limb support.
single
Single limb support is when the right heel makes initial contact and the (right/left) foot toes off and the (right/left) foot makes contact again.
left; left
What are the two periods of single limb support?
Mid stance and terminal stance
Functions of (single limb support/mid stance) - support the body weight with the single limb and continue forward progression.
single limb support
Mid stance is %-% of the GAIT cycle and you will be in (single/double) limb support.
10-30%; single
Opposite toe off to heel rise - (loading response/mid stance). In (loading response/mid stance) the left foot is toeing off and the right heel pops up off of the ground and goes into a heel rise
mid stance; mid stance
Functions of (single limb support/mid stance) - stability of the limb and trunk and progression over the supporting foot.
Mid stance
Progression over the supporting foot - The COM is moving (posterior to the foot/over the foot). It was (posterior/over the foot) to it before and now it is over it until that right heel comes off of the ground.
over the foot; posterior
Terminal stance is %-% of the GAIT cycle and you will be in (single/double) limb support.
30-50% ; single
Heel rise to opposite initial contact (mid stance/terminal stance): In (mid/terminal) stance there is a heel rise on the right side and then the (right/left) heel makes initial contact and that will be the end of this stance.
terminal stance; terminal; left
Someone who has a stiff ankle after an ankle sprain would not have a normal heel rise, they will have an (early/late) heel rise (they pick up their ankle before getting it through its’ full ROM) potentially due to limited ankle (dorsiflexion/plantarflexion) ROM and this impacts the ____ stance.
early; dorsiflexion; terminal
Functions of (mid stance/terminal stance): Stability of the limb and trunk and progression beyond the supporting foot.
terminal stance
The swing limb advancement for the swing limb is starting (before/after) the stance is complete and it (begins/ends) with the foot contact of the swing leg.
before; ends
What are the four periods of swing limb advancement?
Pre-swing, initial swing, mid swing, and terminal swing
Functions of (swing limb advancement/pre-swing): forward progression and prepare for the next stance phase
swing limb advancement
Pre swing is %-% of the GAIT cycle and you are in (single/double) limb support.
50-60%; double
In (pre-swing/initial swing) the weight is all on the (right/left) leg and then transferred to the left leg. You are going from weight release to weight transfer. So the full weight is on the (right/left) on initial contact, then the weight is released over to the (right/left) foot and then fully transferred to the (right/left).
pre-swing; right; left; right; left; left
(Pre-swing/Initial swing) - opposite initial contact to toe off: the left foot is making initial contact and the right foot has toed off.
Pre-swing
The functions of (pre-swing/initial swing) - position the limb for swing and accelerate the progression
pre-swing
Initial swing is %% of the GAIT cycle and you will have (single/double) limb support.
60-73%; single
Toe off to feet adjacent (initial swing/mid swing): the (right/left) toes off until the feet are next to each other.
initial swing; right
Functions of (initial swing/ mid swing): Clear the floor and advance the limb from a trailing position.
initial swing
In someone who had drop foot, they would have a hard time (dorsiflexing/plantarflexing) in the (pre-swing/initial) swing. Their normal gait pattern would not be able to clear the ground with their toes during the (pre-swing/initial) swing phase.
dorsiflexing; initial; initial
Mid swing is -% of the GAIT cycle and you will have (single/double) limb support.
73-87%; single
Feet adjacent to tibia vertical (initial swing/mid swing): the feet goes from being right next to each other to the right leg swinging forward past this point.
mid swing
Functions of (mid swing/terminal swing): clear the floor and advance the limb
mid swing
Terminal swing is %-% of the GAIT cycle and you will be in (single/double) limb support.
87-100%; single
Tibia vertical to next initial contact - (mid swing/terminal swing).
terminal swing
Functions of (mid swing/terminal swing): advance the limb and prepare for stance.
terminal swing
The head, neck, trunk, and arms are the (locomotor/passenger) unit. The lower limbs and the pelvis are the (locomotor/passenger) unit. This can help describe what part of the body you are talking about when describing someone’s gait.
passenger; locomotor
During normal GAIT, the passenger unit has (minimal/maximal) muscle activity and the primary function is to maintain the stability of the (locomotor/passenger) unit.
minimal; passenger
The (locomotor/passenger) unit has 70% of the body’s mass.
passenger
In the passenger unit, balance depends on the (lower/upper) limb alignment. If the (lower/upper) limb alignment is off then the stability up top is off.
lower; lower
The locomotor unit is responsible for the stability of the (entire/lower) body.
entire
The lower limbs alternate their motions in order to support the (locomotor/passenger) unit which has very little muscle activation during GAIT.
passenger
The functions of the (locomotor/passenger) unit include: maintaining upright stability, progression of segments, shock absorption, and conserving energy by minimizing muscular action.
locomotor
If an individual’s GAIT is off you can be certain that (they are/ they are not) conserving energy, they are working extra hard.
they are not
Upright (longevity/stability) depends on the alignment and muscle activity
stability
The Center of Mass (COM) is the balance point within a segment. If the COM is not balanced above a supporting structure, you have to restrain it with muscle action. So if I am bent forward, my muscles are restraining me from falling (forward/backward).
forward
When the COM is balanced above the supporting structure = (passive/active) stability.
passive
The (active/passive) subsystem in certain joints might be what an individual relies on for upright stability. Some people with lower extremity issues, even spinal cord injuries can depend on their iliofemoral ligament and be somewhat functional/mobile. You don’t want to rely only on the passive subsystem.
passive
Challenges to upright stability include being (top/bottom) heavy (passenger unit is 70% of the mass), the supporting limbs are multisegmented, and the contour of the LE joints enhances (mobility/stability) and reduces (mobility/stability).
top; mobility; stability
The supporting limbs are multisegmented. I have a femur, I have a tibia, I have a foot, I have an ankle. All of those things make a kinetic chain so if one thing is wrong there it will be really hard to support everything (below/above). So you have this constant movement of your femur on your tibia, your tibia on your talus, and your talus going through pronation on your foot and all of those are challenging to upright stability.
above
A lot of times, the (anterior/posterior) capsule of the knee is what people will rely on for (passive/dynamic) stability. During stance phase, if their knee kind of pokes back they are getting support from the ( passive/dynamic) subsystem.
posterior; passive; passive
The (passive/dynamic) subsystem controls changes in the COM and creates joint moments which we refer to as internal forces. And these forces can vary a lot depending on the alignment of the joint at a particular snapshot in time.
dynamic
During the different phases of support you can see where some of these representative muscles are acting. Glute max is acting a lot during (single/double) support and during the (beginning/end) of swing phase.
double; end
____ are the idea that it is a particular point in the foot where the COP is. The sequence of events in the rockers allows the body to move smoothly and preserve progression and stability.
Rockers
The (ankle/heel) rocker happens at the beginning phase of contact and you use the round calcaneus to roll forward on. And then all of a sudden when the foot is flat, the tibia is rolling forward on the talus and it becomes an (ankle/heel) rocker. The concave tibia is moving on the convex talus.
heel; ankle
When I run out of room with the ankle rocker and you start to roll up on the forefoot, it is the (ankle/forefoot) rocker.
forefoot
The last part of the stance phase is when you lift the big toe up in the air and that is the (forefoot/toe) rocker.
toe
If you don’t have ankle dorsiflexion ROM because you had an ankle sprain, the rocker that will be affected is the (forefoot/ankle) rocker. These rockers can help you identify where the issue is.
ankle
If someone has painful plantar fasciitis it is possible that they won’t want to use the (ankle/forefoot) rocker because you are putting tension through the plantar fascia. They also might not want to use the (ankle/toe) rocker because of the windlass effect. Plantar fasciitis originates from the calcaneus. Some people will avoid initial contact and the (toe/heel) rocker because that will hit the point where that plantar fascia is uncomfortable. So this person would not be able to preserve progression and allow the body to move smoothly so you might see GAIT dysfunction.
forefoot; toe; heel
A normal GAIT cycle will include (two/all) of the rockers. You would smoothly transition between rockers.
all
During propulsive forces the body weight is falling forward and there are pulling forces from the muscles which include hip (flexion/extension) and knee (flexion/extension) happening reciprocally on both legs. So those are keeping our whole body propelling (moving) forward.
flexion; extension
If the COM moves (below/beyond) the margin of stability, you can fall forward or down. There is a point of no return when you lean forward and you will fall. What stops this is the (ligaments/muscles) and the (ligaments/muscles) provide shock absorption.
beyond; muscles; muscles
The foot compresses 1cm while the weight is on it during shock absorption. While the foot is absorbing shock (pronation/supination) is happening, so the foot is depressing or compressing down into the ground and falling towards the ground 1cm. This shock absorption (increases/reduces) impact.
pronation; reduces
During initial contact and loading response you are going to delay forefoot contact because you are using the (heel/ankle) rocker initiation. When the tibia moves forward that is the ankle rocker and that makes the knee (flex/extend) and equates to (less/more) shock absorption. There will be (reduced/increased) support of the trailing limb and that is going to yield control of the (ipsilateral/contralateral) pelvic drop. There is a certain amount of pelvic drop that you are going to get and it doesn’t always mean it is a bad thing. It is whether or not it is pathological or contributing to their pain as far as determining if it is bad or not.
heel; flex; more; reduced; contralateral
Initial contact is where you hit the ground and that creates a large GRF and that is the first peak of the stance phase graph which is (impact/active). The ground is reacting to the impact of the foot hitting the ground.
impact
When you are pushing off of the ground, that creates a large GRF and that is the second peak of the stance phase graph which is the terminal stance – preswing phase. This is (impact/active). The ground is reacting to the active (dorsi/plantar) flexors and the active hip (flexors/extensors) that are pushing off of the ground.
active; plantar; extensors
Efficiency is (work completed/energy expended) / (work completed/energy expended). You want the work completed to be (low/high) and the energy expended to be (low/high).
work completed/energy expended; high; low
If I am working lightly with my muscles by providing a continuation of me walking forward, that is maintaining efficiency. If I take a step and stop, take a step and stop, take a step and stop, I am not maintaining my efficiency.
Got it
The way we improve efficiency is by limiting lateral and vertical changes in (COM/COP) and have a select activation of muscles. Sometimes people will recruit extra muscles to walk and that is not good because it is not saving energy, it is expending it.
COM
The vertical displacement of your COM changes by about 3cm on average. It is highest during (single/double) limb support and lowest during (single/double) limb support. When I am up on one leg I will be up a little (shorter/taller) and when I come back down to two legs my COM would be (lower/higher).
single; double; taller; lower
The lateral displacement of your COM changes about 3.5cm on average. It is the most lateral during (mid stance/terminal stance) and that means during mid stance I have more of my weight on my foot. My COM would shift over to the (stance/swing) foot.
mid stance; stance
At initial contact you are neither anteriorly or posteriorly tilted. Hip extension brings (anterior/posterior) pelvic tilt and hip flexion brings about a (anterior/posterior) pelvic tilt and during initial contact you’ll be in a neutral position.
anterior; posterior
As you are moving from initial contact into hip flexion you’ll see that both hips are kind of in that flexion position and you will have a potentially small amount of a (anterior/posterior) pelvic tilt. And then both hips start to get to an extension position and you will get an anterior pelvic tilt and it just goes in that continuous cycle.
posterior; anterior
Pelvic obliquity is the height of the left iliac crest to the right (stance leg). So if the left side is lower that means the right hip is in (adduction/abduction) because it is an inferior lateral tilt. So on initial contact and you swing through, the left side of my pelvis drops and my right hip is in relative hip (adduction/abduction). And then what happens is, as I start to swing my leg through during swing phase I have to clear the ground, I have to dorsiflex my ankle, bend from my knee, and I also have to lift from my pelvis and that is when it starts to go from the left side lower to the left side higher as this happens. That correlates with hip (adduction/abduction) on the right side.
adduction; adduction; abduction
When we talk about the knee joint in the sagittal plane, we are going to talk about the knee being somewhere in between _ degrees of flexion and _ degrees of extension on initial contact. As I go into the loading response the knee will go into more (flexion/extension). As I go through swing phase it has to flex even (more/less) to clear the ground. And towards the very end of the GAIT cycle you will have knee (flexion/extension).
5; 0; flexion; more; extension
To walk normally, you only need roughly - degrees of knee flexion. So you can have a stiff knee that doesn’t bend a whole lot, but you need - degrees to get through the (stance/swing) phase. If not, you will be doing funky stuff to clear the ground.
60-65; 60-65; swing
When you land on your heel on initial contact you might not be 100% in neutral, so in the first 10% of GAIT you will have some (dorsi/plantar) flexion. As you start to put weight on it, you will spend the next 40% of the GAIT cycle in (dorsiflexion/plantar flexion). From 55%-80% of the GAIT cycle the ankle will go back to (dorsi/plantar) flexion and then finish the GAIT cycle in (dorsiflexion/neutral).
plantar; dorsiflexion; plantar; neutral
From 0-10% of the GAIT cycle the ankle is (inverted/everted). 10%-45% of the GAIT cycle the ankle is in (inversion/eversion) which is correlated with (pronation/supination) and that makes sense due to the shock absorption and weight going on that foot in these phases.
inverted; eversion; pronation
When the right foot toes off you will go into open chained (pronation/supination) and you will get (dorsi/plantar) flexion and calcaneal (inversion/eversion). This will occur from 45%-60-% of the GAIT cycle.
supination; plantar; inversion
