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Gait Cycle Flashcards

1
Q

What is the gait cycle

A

Heel strike to heel strike

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2
Q

Goals of heel strike

A 
Lower forefoot to ground
Continue deceleration (reverse forward swing)
Preserve longitudinal arch of foot
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3
Q

During heel strike the ankle is ___ (eccentric contraction). What muscle does this

A

Dorsiflexion

Tibialis anterior

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4
Q

During heelstrike the hip is ____. What muscle does this

A

Extended

Gluteus Maximus

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5
Q

During heel strike, what preserves the longitudinal arch of the foot

A

Intrinsic foot msucles-flexor digital rum brevis

Long tendon of foot-tibialis anterior

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6
Q

What are the mechanical goals of the loading response (flat foot)

A

Accept weight
Decelerate mass (slow dorsiflexion)
Stabilize palvix
Preserve longitudinal arch of foot

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7
Q

During loading phase. What muscles accept weight. Give an example

A

Knee extensors. Quadriceps

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8
Q

During loading phase, the hip ____ to stabilize the pelvis. What muscles do this

A

Abducts

Gluteus menus and minimum and tensor fascia lata

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9
Q

During the loading response how do we decelerate mass. What muscles

A

Ankle plantarflexors like triceps surae(soleus and gastrocnemius)

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10
Q

Do=ruing loading response, how do we preserve the longitudinal arch of the foot

A

Intrinsic muscles ofthe foot-flexor digital rum brevis

Long tendons of the foot-tibialis posterior, long flexors of digits

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11
Q

Mechanical goals of midstance

A

Stabilize knee, control dorsiflexion (preserve momentum), stabilize pelvis, preserve longitudinal arch of foot

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12
Q

During midstance, the knee is stabilized by knee ___. Give example

A

Extensors

Quadriceps

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13
Q

During midstance, the ankle ___ control dorsiflexion. Give an example

A

Plantarflexors

Triceps surae

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14
Q

During midstance how do we stabilize the pelvis

A

Hip abductors like gluteus mediums, minimums and tensor fascia lata

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15
Q

During midstance how to we preserve the longitudinal arch

A

Same

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16
Q

What are the mechanical goals of terminal stance

A

Accelerate mass
Stabilize pelvis
Preserve arches of foot:fix forefoot

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17
Q

During terminal stance (heel off) the ankle ____ accelerate mass. Give example (concentric contraction)

A

Plantarflexors

Triceps surae

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18
Q

During terminal stance how do we stabilize the pelvis

A

Hip abductors like gluteus mediums and minimums and tensor fascia lata

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19
Q

During terminal stance, how do we preserve arches of the foot: fix forefoot

A

Intrinsic muscles of foot-adductor hallucis

Long tendons of foot-tibialis posterior;long flexors of digits

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20
Q

What are the mechanical goals of pressing (toe off)

A

Accelerate mass
Preserve arches of foot:fix forefoot
Decelerate thigh; prepare for swing

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21
Q

In pressing, how do we accelerate mass

A

Long flexors of digits like flexor hallucis longus and flexor digitorum longus

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22
Q

In preswing how do we preserve arches of foot:fix forefoot

A

Sa,e

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23
Q

In preswing how do we decelerate thigh; prepare for swing

A

Flexor of hip (eccentric contraction

Iliopsoas ; rectus femoris

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24
Q

What is the stance phase

A

Heel strike-preswing

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25
What is the swing phase
Initial swing-terminal swing
26
What are the mechanism goals of initial swing
Accelerate thigh and vary cadence | Clear foot
27
In initial swing how do we accolade thigh
Flex hip with iliopsoas and rectus femoris
28
In initial swing how do we clear foot
Ankle dorsiflexors like tibialis anterior
29
What are the mechanical goals of midswing
Clear foot
30
In midswing how do we clear the foot
Ankle dorsiflexion with tibialis anterior
31
What are the mechanical goals of terminal swing
Decelerate thigh Decelerate leg Position foot Extend knee to place foot (control stride) prepare for contact
32
In terminal swing how do we decelerate thigh
Hip extensors (eccentric contraction) like gluteus Maximus and hamstrings
33
In terminal swing how do we decelerate the leg
Knee flexors (eccentric contraction) like hamstring
34
In terminal swing how do we position the foot
Ankle dorsiflexors like tibialis anterior
35
In swing phase how do we extend the knee to place the foot (control stride); prepare for contact
Knee extensors like quadriceps
36
What is the average step length
14-16 inches
37
Average stride length
28-32 inches
38
What is stride
Same foot to same foot
39
What is average cadence
90-120 steps per minute
40
Do women or men have higher cadence
Women 6-9 steps per minute
41
Average walking speed
3 mph
42
Gait cycle definition
Heel strike to next heel strike of same foot
43
What are the 2 phases of gait
Stance and swing
44
What is stance
When foot is in contact with ground
45
What is swing
When foot is not in contact with the ground
46
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
47
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
48
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
49
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
50
What is propulsion
Heel lift progresses to toe off
51
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
52
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
53
During propulsion at toe off, the line of progression usually passes between 1 and 2 metatarsals that are in maximal ___-
Extension
54
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
55
60% of the gait cycle is
Stance
56
What phases are stance
Contact, loading response, midstance, terminal stance, preswing
57
What stage of stance is the shortest and what is longest
Initial contact | Preswing
58
40% of gait cycle is in
Swing
59
Initial contact
Establish contact with leading foot begins stance
60
Loading response
Shock absorption, begin weight bearing | Continue progression of forward movement
61
Mid stance
Limb and trunk stability | Progression over stationary foot
62
Terminal stance
Progression past stationary foot | Prepare for swing
63
Pre swing
Weight release from stationary foot | Position limb for swing
64
Initial swing
Prepare for foot clearance | Advance foot from trailing position
65
Mid swing
Foot clearance limb advancement
66
Terminal swing
Prepare for stance | Complete limb advancement
67
Requirements of gait
``` Stability in stance Foot clearance in swing Preposition for initial contact Adequate step length Energy conservation ```
68
How clear foot
Ankle dorsiflexion, knee flexion, hip flexion, retain stability in stance
69
How pre position for initial contact
Foot ankle knee and hip in alignment | Ready to place foot and absorb weight transfer
70
Step length too short
Expend energy and have minimal progress
71
Step length too long
Lose balance and strain ligaments and muscles
72
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
73
What is pelvic list
In early stance, as weight being transferred to foot, hip on non weight bearing side DROPS about 2 inches
74
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
75
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
76
Antalgic gait
Painful
77
Arthrogenic gait
Stiff
78
Ataxic gait
Unsteady
79
Hemiplegic gait
Semicircle
80
Parkinsonian gait
Shuffling
81
Steppage gait
Foot drop
82
Signs of antalgic gait
Swing enhanced on affected side Stance phase shortened on affected side Adopted limp to avoid pain on weight bearing side
83
Causes of antalgic gait
Trauma, osteoarthritis, pelvic girdle pain, coxalgia, tarsal tunnel syndrome
84
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
85
Causes of arthrogenic gait
Osteoarthritis of hip/knee | Post orthopedic surgeries of hip/knee
86
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
87
Causes of ataxic gait
``` Vestibularcerebellar abscess/hemorrhage Friedreichs ataxia’pontine cerebellar atrophy Chronic mercury poisoning Posterior fossa tumor Wernickes syndrome Drugs ```
88
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
89
Causes of hemiplegic gait
Strokes | Spinal cord injuries
90
Parkinsonian gait description
Small shuffling Hypokinesia(slow) Akinesia if extreme Reduced stride length and walking speed whole cadence rate is increased
91
Causes of parkinsonian gait (festinating)
Parkinson’s disease | Drugs(antipsychotics)
92
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
93
Causes of steppage gait
``` Peroneal nerve injury secondary to Lumbar disc herniation Poliomyelitis MS Guillain barre syndrome Parkinson’s ```

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