Gait cont. Flashcards
describe the positioning of the foot and ankle in the sagittal plane during IC
neutral to slight PF position
(heel rocker (1st rocker) is initated here)
describe the positioning of the foot and ankle in the sagittal plane during LR
5º of rapid PF to get foot flat on the floor
describe the positioning of the foot and ankle in the sagittal plane during the transition from MSt to TSt
this transition is a period of CKC DF to about 10º and MTP to 30º
(ankle and forefoot rocker occurs here)
describe the positioning of the foot and ankle in the sagittal plane during PSw
there is a transition from time of max DF position toward max PF position
max MTP extension to 60º
heel lift off is occuring
describe the positioning of the foot and ankle in the sagittal plane during ISw
DF to move the ankle away from max PF to about 5º of PF
describe the positioning of the foot and ankle in the sagittal plane during the transition of MSw to TSw
ankle continues to DF until it reaches a neutral position in preparation for heel strike during IC
what critical events must occur at the ankle during gait and at what phases?
- IC = heel first contact
- LR = ankle PF
- MSt = controlled tibial advancement
- TSt = controlled ankle DF with heel rise
- PSw = ankle PF
- MSw = foot clearance
what are the foot and ankle rockers?
3 different positions/movement sequences that all aim to move the foot and ankle through gait

List the 3 different foot and ankle rockers
- heel rocker (1st rocker)
- ankle rocker (2nd rocker)
- forefoot rocker (3rd rocker)
what occurs during heel rocker (1st rocker)?
motion of the foot from a DF to PF position during LR to achieve a flat foot
what occurs during the ankle rocker (2nd rocker)?
closed chain advancement of the tibia into a DF position over a fixed foot during MSt
what occurs during the forefoot rocker (3rd rocker)?
begins when COP is over the Metatarsals and heel lift occurs in TSt/PSw
what is the purpose of the rockers?
they allow for an efficient and smooth gait pattern
describe the positioning of the knee in the sagittal plane during IC
neutral to 5º of flexion
describe the positioning of the knee in the sagittal plane during LR
flexing to 15º (allows for shock absorption)
describe the positioning of the knee in the sagittal plane during MSt to TSt
extension back to 5º flexion/neutral
describe the positioning of the knee in the sagittal plane during PSw
rapid flexion to 40º
describe the positioning of the knee in the sagittal plane during ISw
more flexion to 60º
needed for limb clearance
describe the positioning of the knee in the sagittal plane during MSw
Rapid extension to 25º flexion
determines step length
describe the positioning of the knee in the sagittal plane during TSw
further extension to 5º/neutral
what are the critical events that must occur at the knee and which phases do they occur at?
- LR = controlled knee flexion
- PSw = passive knee flexion
- ISw = knee flexion
- TSw = knee extension
describe the positioning of the hip in the sagittal plane during IC → LR
20º flexion
(considered “leftover” from TSw)
describe the positioning of the hip in the sagittal plane during MSt
extension into a neutral hip position as the body progresses forward
describe the positioning of the hip in the sagittal plane during TSt
maximum (20º) hip extension occurs
the body is past the foot at this point as it begins to transition into PSw
describe the position of the hip in the sagittal plane during PSw
flexion (from 20º extension) to about 10º of hip extension
(this is when there is a reversal from extension into flexion)
describe the positioning of the hip in the sagittal plane during ISw
continued flexion to 15º
describe the positioning of the hip in the sagittal plane during MSw → TSw
continued flexion to 25-30º
what are the critical events that occur at the hip during gait? What phases do they occur at?
- LR = hip stability
- ISw = hip flexion
- MSw = hip flexion
how much ROM is needed at the hip, knee and ankle for normal gait?
- hip = ~40º
- flexion = 25
- extension = 20
- knee = ~60º
- flexion = 60
- extension = 0
- ankle = 30º
- DF = 10
- PF = 20
how is the COM displaced in the sagittal plane during gait?
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
describe the position of the ankle in the frontal plane during IC
slight inversion of the hindfoot
describe the positioning of the ankle in the frontal plane during LR → MSt
eversion of the hindfoot
pronation initially and then the forefoot follows hindfoot position
describe the positioning of the foot and ankle in the frontal plane during TSt → PSw
inversion
allows for resupination and the foot becoming a rigid lever so that we can push off of it
describe the positioning of the foot and ankle in the frontal plane during swing phase
really variable
can’t really ascribe normal positioning
describe the positioning of the knee in the frontal plane during gait
not much movement with normal gait
(total = ~5-10º)
some genu varum/valgum may be observed
describe the positioning of the hip in the frontal plane during IC
neutral ab/adduction
describe the positioning of the hip in the frontal plane during LR → MSt
adduction during weight acceptance
a contalateral hip drop may be observed
describe the positioning of the hips in the frontal plane during MSt → TSt
increased adduction (up to 15º)
weight shifts over to stance leg resulting in relative hip adduction (due to hip hike of swing leg)
describe the horizontal plane motions of the trunk during gait
opposite rotation from pelvic motion
total excursion 7-9º
describe the horizontal plane motions that occur at the hips during gait
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
describe the horizontal plane motions that occur at the shoulder during gait
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
how is the COM displaced in the horizontal plane during gait?
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
List several possible gait deviations
- decreased great toe extension
- steppage gait/increased knee flexion
- foot flat contact
- circumduction
- increased lumbar lordosis
what phases of the gait cycle is decreased great toe extension primarily impacting and what would it look like?
- phases = TSt and PSw
- patient does not complete forefoot rocker and ends stance phase noticeably early
what is the cause of decreased great toe extension?
- joint hypomobility
- pain
- bone spur
- gouty arthritis
- plantar fasciitis
what is the end result of a gait deviation like decreased great toe extension?
decreased push off
shortened stance time
what phases of the gait cycle is steppage gait impacting and what does it look like?
- swing phase
- looks like increased hip and knee flexion with loss of ankle DF
what are some potential causes of a gait deviation like steppage gait?
- foot drop/nerve disorder
- polyneuropathy
- equinus deformity
what is the end result of a gait deviation like steppage gait?
prolonged swing phase
fall risk
decreased efficiency
what phases of the gait cycle is foot flat contact primarily impacting and what would it look like?
- IC
- looks like the mid foot or forefoot make first contact with ground instead of the heel
what are some potential causes of foot flat contact gait deviations?
- excessive knee flexion in late swing
- weak/impaired DF
what is the end result of a gait deviation like foot flat contact?
absent heel rocker
(can have normal ankle rocker)
what phases of the gait cycle are primarily impacted by the gait deviation: circumduction? What does it look like?
- phases = swing
- looks like a lateral whipping motion of the limb during swing at the hip
what are some potential causes of the gait deviation circumduction?
- impaired knee flexion ROM
- impaired ankle DF ROM
what is the end result of the gait deviation circumduction?
compensation for failure to functionally shorten the limb during swing = increased fall risk
what phases of the gait cycle are primarily impacted by the gait deviation increased lumbar lordosis? What does it look like?
- TSt
- looks like increased lumbar lordosis during late stance phase
what are some potential causes of the gait devaition of increased lumbar lordosis?
- hip flexor contracture
- Hip OA
what is the end result of the gait deviation of increased lumbar lordosis?
lack of hip extension in terminal stance is compensated for increased lordosis in the spine