Gait Cycle Flashcards
What is the gait cycle
Heel strike to heel strike
Goals of heel strike
Lower forefoot to ground Continue deceleration (reverse forward swing) Preserve longitudinal arch of foot
During heel strike the ankle is ___ (eccentric contraction). What muscle does this
Dorsiflexion
Tibialis anterior
During heelstrike the hip is ____. What muscle does this
Extended
Gluteus Maximus
During heel strike, what preserves the longitudinal arch of the foot
Intrinsic foot msucles-flexor digital rum brevis
Long tendon of foot-tibialis anterior
What are the mechanical goals of the loading response (flat foot)
Accept weight
Decelerate mass (slow dorsiflexion)
Stabilize palvix
Preserve longitudinal arch of foot
During loading phase. What muscles accept weight. Give an example
Knee extensors. Quadriceps
During loading phase, the hip ____ to stabilize the pelvis. What muscles do this
Abducts
Gluteus menus and minimum and tensor fascia lata
During the loading response how do we decelerate mass. What muscles
Ankle plantarflexors like triceps surae(soleus and gastrocnemius)
Do=ruing loading response, how do we preserve the longitudinal arch of the foot
Intrinsic muscles ofthe foot-flexor digital rum brevis
Long tendons of the foot-tibialis posterior, long flexors of digits
Mechanical goals of midstance
Stabilize knee, control dorsiflexion (preserve momentum), stabilize pelvis, preserve longitudinal arch of foot
During midstance, the knee is stabilized by knee ___. Give example
Extensors
Quadriceps
During midstance, the ankle ___ control dorsiflexion. Give an example
Plantarflexors
Triceps surae
During midstance how do we stabilize the pelvis
Hip abductors like gluteus mediums, minimums and tensor fascia lata
During midstance how to we preserve the longitudinal arch
Same
What are the mechanical goals of terminal stance
Accelerate mass
Stabilize pelvis
Preserve arches of foot:fix forefoot
During terminal stance (heel off) the ankle ____ accelerate mass. Give example (concentric contraction)
Plantarflexors
Triceps surae
During terminal stance how do we stabilize the pelvis
Hip abductors like gluteus mediums and minimums and tensor fascia lata
During terminal stance, how do we preserve arches of the foot: fix forefoot
Intrinsic muscles of foot-adductor hallucis
Long tendons of foot-tibialis posterior;long flexors of digits
What are the mechanical goals of pressing (toe off)
Accelerate mass
Preserve arches of foot:fix forefoot
Decelerate thigh; prepare for swing
In pressing, how do we accelerate mass
Long flexors of digits like flexor hallucis longus and flexor digitorum longus
In preswing how do we preserve arches of foot:fix forefoot
Sa,e
In preswing how do we decelerate thigh; prepare for swing
Flexor of hip (eccentric contraction
Iliopsoas ; rectus femoris
What is the stance phase
Heel strike-preswing
What is the swing phase
Initial swing-terminal swing
What are the mechanism goals of initial swing
Accelerate thigh and vary cadence
Clear foot
In initial swing how do we accolade thigh
Flex hip with iliopsoas and rectus femoris
In initial swing how do we clear foot
Ankle dorsiflexors like tibialis anterior
What are the mechanical goals of midswing
Clear foot
In midswing how do we clear the foot
Ankle dorsiflexion with tibialis anterior
What are the mechanical goals of terminal swing
Decelerate thigh
Decelerate leg
Position foot
Extend knee to place foot (control stride) prepare for contact
In terminal swing how do we decelerate thigh
Hip extensors (eccentric contraction) like gluteus Maximus and hamstrings
In terminal swing how do we decelerate the leg
Knee flexors (eccentric contraction) like hamstring
In terminal swing how do we position the foot
Ankle dorsiflexors like tibialis anterior
In swing phase how do we extend the knee to place the foot (control stride); prepare for contact
Knee extensors like quadriceps
What is the average step length
14-16 inches
Average stride length
28-32 inches
What is stride
Same foot to same foot
What is average cadence
90-120 steps per minute
Do women or men have higher cadence
Women 6-9 steps per minute
Average walking speed
3 mph
Gait cycle definition
Heel strike to next heel strike of same foot
What are the 2 phases of gait
Stance and swing
What is stance
When foot is in contact with ground
What is swing
When foot is not in contact with the ground
At contact the ___ calcaneous strikes ground, and at point of impact, tibia ___ rotates, causing calcaneous to ____ and talus to ___ and ___ to unlock midtarsal joints and provide maximum shock absorption
Lateral
Internallly
Every
Drop adduct
The cycle progresses from flat foot to heel off as rear foot fully ___, metatarsals hit ground to bring foot flat on ground and body’s center of gravity passes from ___ to ___ the foot
Pronates
Behind to over
During midstance the subtalar joint ______ (calcaneous __ and talus ___) and locks midtarsal joints, transforming for from a shock absorber to a rigid lever
Resupinates
Everts
Abducts
In midstance, the posterior tibialis is an important restraint to overpronation and is an active foot ____. As the body passes over midfoot, it places ankle in maximal ____, putting a maximal preloads on the _____-___ complex
Supination
Dorsiflexion
Gastrocnemius-soleus
What is propulsion
Heel lift progresses to toe off
In propulsion, ___ of MTP joints, especially 1, result in what
Extension
Windlass effect of plantar fascia that elevates the arch and further assists in supination. Of the foot
In propulsion, the foot is no a rigid lever and used to propel the body forward by maximal contraction of what
Gastrocnemius soleus and hamstrings
During propulsion at toe off, the line of progression usually passes between 1 and 2 metatarsals that are in maximal ___-
Extension
During the swing phase, the foot ___ to keep toes from hitting the ground and ____ to position foot for lateral calcaneus to Make contact
Dorsiflexes
Supinate
60% of the gait cycle is
Stance
What phases are stance
Contact, loading response, midstance, terminal stance, preswing
What stage of stance is the shortest and what is longest
Initial contact
Preswing
40% of gait cycle is in
Swing
Initial contact
Establish contact with leading foot begins stance
Loading response
Shock absorption, begin weight bearing
Continue progression of forward movement
Mid stance
Limb and trunk stability
Progression over stationary foot
Terminal stance
Progression past stationary foot
Prepare for swing
Pre swing
Weight release from stationary foot
Position limb for swing
Initial swing
Prepare for foot clearance
Advance foot from trailing position
Mid swing
Foot clearance limb advancement
Terminal swing
Prepare for stance
Complete limb advancement
Requirements of gait
Stability in stance Foot clearance in swing Preposition for initial contact Adequate step length Energy conservation
How clear foot
Ankle dorsiflexion, knee flexion, hip flexion, retain stability in stance
How pre position for initial contact
Foot ankle knee and hip in alignment
Ready to place foot and absorb weight transfer
Step length too short
Expend energy and have minimal progress
Step length too long
Lose balance and strain ligaments and muscles
How do we conserve energy in gait cycle
Center of gravity moves less than 2 inches up and down
Pelvic list
Innominate rotation
Lateral displacement of pelvis
What is pelvic list
In early stance, as weight being transferred to foot, hip on non weight bearing side DROPS about 2 inches
Pelvic rotation
As foot moves forward for heel strike, Innominate rotates forewarn in sagittal plane
Effect is to lengthen femur
Rotation is 4 degrees and reverses in stance
Lateral displacement of pelvis
2 legged walk, feet hit about 2-4 inches apart
Only 1 foot on ground eighty percent of time
Center of mass has to compensate
Pelvis shifts 2 inches laterally
Facilitates abduction of hip during stance
Antalgic gait
Painful
Arthrogenic gait
Stiff
Ataxic gait
Unsteady
Hemiplegic gait
Semicircle
Parkinsonian gait
Shuffling
Steppage gait
Foot drop
Signs of antalgic gait
Swing enhanced on affected side
Stance phase shortened on affected side
Adopted limp to avoid pain on weight bearing side
Causes of antalgic gait
Trauma, osteoarthritis, pelvic girdle pain, coxalgia, tarsal tunnel syndrome
Signs of arthrogenic gait
Due to stiffness in affected joints, (usually hop or knee0 from deformity/decreased joint space
Plantar flexion fo foot opposite to affected side during stance phase to increase clearance
Affected lef is circumducted
Step is shorter
Not always painful
Causes of arthrogenic gait
Osteoarthritis of hip/knee
Post orthopedic surgeries of hip/knee
Signs of ataxia gait
Unsteady uncoordinated walk-lurch or stagger
Watches feet
Needs broad base of support-wide base and feet thrown out
Loss of sensation or control
Causes of ataxic gait
Vestibularcerebellar abscess/hemorrhage Friedreichs ataxia’pontine cerebellar atrophy Chronic mercury poisoning Posterior fossa tumor Wernickes syndrome Drugs
Hemiplegic gait sign (circumduction)
Leg is stiff without flexion at knee or hip
Leg rotated away from body then towards it creating a semicircle
May see upper extremity involvement
Causes of hemiplegic gait
Strokes
Spinal cord injuries
Parkinsonian gait description
Small shuffling
Hypokinesia(slow)
Akinesia if extreme
Reduced stride length and walking speed whole cadence rate is increased
Causes of parkinsonian gait (festinating)
Parkinson’s disease
Drugs(antipsychotics)
Description of steppage
Full foot drop
Hip raised very high to clear toe
Shoe foot may drag if not high enough
Clomping sound with high steps
Causes of steppage gait
Peroneal nerve injury secondary to Lumbar disc herniation Poliomyelitis MS Guillain barre syndrome Parkinson’s
