Gait cont. Flashcards

1
Q

describe the positioning of the foot and ankle in the sagittal plane during IC

A

neutral to slight PF position

(heel rocker (1st rocker) is initated here)

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2
Q

describe the positioning of the foot and ankle in the sagittal plane during LR

A

5º of rapid PF to get foot flat on the floor

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3
Q

describe the positioning of the foot and ankle in the sagittal plane during the transition from MSt to TSt

A

this transition is a period of CKC DF to about 10º and MTP to 30º

(ankle and forefoot rocker occurs here)

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4
Q

describe the positioning of the foot and ankle in the sagittal plane during PSw

A

there is a transition from time of max DF position toward max PF position

max MTP extension to 60º

heel lift off is occuring

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5
Q

describe the positioning of the foot and ankle in the sagittal plane during ISw

A

DF to move the ankle away from max PF to about 5º of PF

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6
Q

describe the positioning of the foot and ankle in the sagittal plane during the transition of MSw to TSw

A

ankle continues to DF until it reaches a neutral position in preparation for heel strike during IC

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7
Q

what critical events must occur at the ankle during gait and at what phases?

A
  1. IC = heel first contact
  2. LR = ankle PF
  3. MSt = controlled tibial advancement
  4. TSt = controlled ankle DF with heel rise
  5. PSw = ankle PF
  6. MSw = foot clearance
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8
Q

what are the foot and ankle rockers?

A

3 different positions/movement sequences that all aim to move the foot and ankle through gait

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9
Q

List the 3 different foot and ankle rockers

A
  1. heel rocker (1st rocker)
  2. ankle rocker (2nd rocker)
  3. forefoot rocker (3rd rocker)
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10
Q

what occurs during heel rocker (1st rocker)?

A

motion of the foot from a DF to PF position during LR to achieve a flat foot

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11
Q

what occurs during the ankle rocker (2nd rocker)?

A

closed chain advancement of the tibia into a DF position over a fixed foot during MSt

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12
Q

what occurs during the forefoot rocker (3rd rocker)?

A

begins when COP is over the Metatarsals and heel lift occurs in TSt/PSw

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13
Q

what is the purpose of the rockers?

A

they allow for an efficient and smooth gait pattern

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14
Q

describe the positioning of the knee in the sagittal plane during IC

A

neutral to 5º of flexion

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15
Q

describe the positioning of the knee in the sagittal plane during LR

A

flexing to 15º (allows for shock absorption)

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16
Q

describe the positioning of the knee in the sagittal plane during MSt to TSt

A

extension back to 5º flexion/neutral

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17
Q

describe the positioning of the knee in the sagittal plane during PSw

A

rapid flexion to 40º

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18
Q

describe the positioning of the knee in the sagittal plane during ISw

A

more flexion to 60º

needed for limb clearance

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19
Q

describe the positioning of the knee in the sagittal plane during MSw

A

Rapid extension to 25º flexion

determines step length

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20
Q

describe the positioning of the knee in the sagittal plane during TSw

A

further extension to 5º/neutral

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21
Q

what are the critical events that must occur at the knee and which phases do they occur at?

A
  1. LR = controlled knee flexion
  2. PSw = passive knee flexion
  3. ISw = knee flexion
  4. TSw = knee extension
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22
Q

describe the positioning of the hip in the sagittal plane during IC → LR

A

20º flexion

(considered “leftover” from TSw)

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23
Q

describe the positioning of the hip in the sagittal plane during MSt

A

extension into a neutral hip position as the body progresses forward

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24
Q

describe the positioning of the hip in the sagittal plane during TSt

A

maximum (20º) hip extension occurs

the body is past the foot at this point as it begins to transition into PSw

25
Q

describe the position of the hip in the sagittal plane during PSw

A

flexion (from 20º extension) to about 10º of hip extension

(this is when there is a reversal from extension into flexion)

26
Q

describe the positioning of the hip in the sagittal plane during ISw

A

continued flexion to 15º

27
Q

describe the positioning of the hip in the sagittal plane during MSw → TSw

A

continued flexion to 25-30º

28
Q

what are the critical events that occur at the hip during gait? What phases do they occur at?

A
  1. LR = hip stability
  2. ISw = hip flexion
  3. MSw = hip flexion
29
Q

how much ROM is needed at the hip, knee and ankle for normal gait?

A
  1. hip = ~40º
    • flexion = 25
    • extension = 20
  2. knee = ~60º
    • flexion = 60
    • extension = 0
  3. ankle = 30º
    • DF = 10
    • PF = 20
30
Q

how is the COM displaced in the sagittal plane during gait?

A

vertically (~5 cm)

it is at it’s lowest during the halfway point of both double limb support stages

it is at it’s highest during the halfway point of both single limb support stages

31
Q

describe the position of the ankle in the frontal plane during IC

A

slight inversion of the hindfoot

32
Q

describe the positioning of the ankle in the frontal plane during LR → MSt

A

eversion of the hindfoot

pronation initially and then the forefoot follows hindfoot position

33
Q

describe the positioning of the foot and ankle in the frontal plane during TSt → PSw

A

inversion

allows for resupination and the foot becoming a rigid lever so that we can push off of it

34
Q

describe the positioning of the foot and ankle in the frontal plane during swing phase

A

really variable

can’t really ascribe normal positioning

35
Q

describe the positioning of the knee in the frontal plane during gait

A

not much movement with normal gait

(total = ~5-10º)

some genu varum/valgum may be observed

36
Q

describe the positioning of the hip in the frontal plane during IC

A

neutral ab/adduction

37
Q

describe the positioning of the hip in the frontal plane during LR → MSt

A

adduction during weight acceptance

a contalateral hip drop may be observed

38
Q

describe the positioning of the hips in the frontal plane during MSt → TSt

A

increased adduction (up to 15º)

weight shifts over to stance leg resulting in relative hip adduction (due to hip hike of swing leg)

39
Q

describe the horizontal plane motions of the trunk during gait

A

opposite rotation from pelvic motion

total excursion 7-9º

40
Q

describe the horizontal plane motions that occur at the hips during gait

A

forward rotation of the pelvis on the stnace limb occurs with hip flexion during swing

increases greater step length than that of hip flexion alone

41
Q

describe the horizontal plane motions that occur at the shoulder during gait

A

opposite sagittal plane motion from ipsilateral hip

motion is partially active and is mostly shoulder extension

the motion balances out rotational forces of the trunk

42
Q

how is the COM displaced in the horizontal plane during gait?

A

shifts from R to L crossing a midline point to stay over BOS

max shift towards the reference limb occurs at the end of mistance of the reference limb

the max shift away from the reference limb occurs during midswing of the reference limb

43
Q

List several possible gait deviations

A
  1. decreased great toe extension
  2. steppage gait/increased knee flexion
  3. foot flat contact
  4. circumduction
  5. increased lumbar lordosis
44
Q

what phases of the gait cycle is decreased great toe extension primarily impacting and what would it look like?

A
  1. phases = TSt and PSw
  2. patient does not complete forefoot rocker and ends stance phase noticeably early
45
Q

what is the cause of decreased great toe extension?

A
  1. joint hypomobility
  2. pain
  3. bone spur
  4. gouty arthritis
  5. plantar fasciitis
46
Q

what is the end result of a gait deviation like decreased great toe extension?

A

decreased push off

shortened stance time

47
Q

what phases of the gait cycle is steppage gait impacting and what does it look like?

A
  1. swing phase
  2. looks like increased hip and knee flexion with loss of ankle DF
48
Q

what are some potential causes of a gait deviation like steppage gait?

A
  1. foot drop/nerve disorder
  2. polyneuropathy
  3. equinus deformity
49
Q

what is the end result of a gait deviation like steppage gait?

A

prolonged swing phase

fall risk

decreased efficiency

50
Q

what phases of the gait cycle is foot flat contact primarily impacting and what would it look like?

A
  1. IC
  2. looks like the mid foot or forefoot make first contact with ground instead of the heel
51
Q

what are some potential causes of foot flat contact gait deviations?

A
  1. excessive knee flexion in late swing
  2. weak/impaired DF
52
Q

what is the end result of a gait deviation like foot flat contact?

A

absent heel rocker

(can have normal ankle rocker)

53
Q

what phases of the gait cycle are primarily impacted by the gait deviation: circumduction? What does it look like?

A
  1. phases = swing
  2. looks like a lateral whipping motion of the limb during swing at the hip
54
Q

what are some potential causes of the gait deviation circumduction?

A
  1. impaired knee flexion ROM
  2. impaired ankle DF ROM
55
Q

what is the end result of the gait deviation circumduction?

A

compensation for failure to functionally shorten the limb during swing = increased fall risk

56
Q

what phases of the gait cycle are primarily impacted by the gait deviation increased lumbar lordosis? What does it look like?

A
  1. TSt
  2. looks like increased lumbar lordosis during late stance phase
57
Q

what are some potential causes of the gait devaition of increased lumbar lordosis?

A
  1. hip flexor contracture
  2. Hip OA
58
Q

what is the end result of the gait deviation of increased lumbar lordosis?

A

lack of hip extension in terminal stance is compensated for increased lordosis in the spine