Gait - Desai Flashcards
avg. step length, stride length, cadence, speed
step: 14 -16 inches
stride: 28 - 32 inches (stride is foot to foot)
cadence: 90-120 steps / min (women higher by 6-9 steps)
avg. speed: 3 mph
gait cycle measured from
From heel strike to next heel strike of same foot
joints between tarsals and metatarsals
lisfranc joint
joints between talus/ calcaneus and navicular/ cuboid
midtarsal (chopart) joint
most problems occur during this phase of gait cycle
stance
stance phase
From heel strike (initial contact) to toe off (pre-swing)
• approximately 60% of gait cycle
• when foot is on ground and weight bearing
swing phase
From toe off to heel strike
• approximately 40% of gait cycle
• foot moves forward and is not weight bearing
this phase is longer lasting, how much % of the GC?
stance phase
60% of total
mid stance in one foot is usually coordinated with
mid swing on other
5 requirements of gait
- Stability in stance
- Foot clearance in swing
- Pre-position for initial contact
- Adequate step length
- Energy conservation
single limb supports whole body for a total of - % of gait cycle
80% total
40% each foot
how does body conserve energy during GC
center of gravity moves 2” up and down during gait cycle
- accomplished via pelvic list
- early stance, hip on non-weight bearing side DROPS about 2” (less energy now needed to lift leg mass)
innominate rotation for energy conservation
Innominate (pelvic) rotation
• as foot moves forward for heel strike, innominate rotates
forward (anteriorly) in a sagittal plane
• effect is to “lengthen” femur (some compensation for pelvic list)
lateral displacement of pelvis during GC for energy conservation
- 2 legged walk, feet hit about 2-4” apart
- only 1 foot on ground 80% of time (total both feet in cycle)
- center of mass has to compensate
- pelvis shifts laterally about 2”
- facilitates abduction of hip during stance
adopted limp to avoid pain on weight-bearing
structures
• characterized by a very short stance phase on
affected side
antalgic gait
etiology: Trauma • Osteoarthritis • Pelvic girdle pain • Coxalgia • Tarsal tunnel syndrome
antalgic gait
etiology:
Osteoarthritis of hip or knee joints
• Post orthopedic surgeries of hip or knee
arthrogenic gait
• Due to stiffness in affected joints (usually hip or knee) from
deformity/decreased joint space
• Plantar flexion of foot opposite to affected side to increase
clearance
• Affected leg is circumducted (passive circular motion)
• Step is usually shorter
arthrogenic gait
- unsteady, uncoordinated walk
- needs broad base of support
- wide base and feet thrown out
- loss of sensation or control
- may lurch or stagger
- pt often watches feet when walking
ataxic gait
etiology: Vestibular • Cerebellar abscess/hemorrhage • Friedreich’s ataxia • Pontine-cerebellar atrophy • Chronic mercury poisoning • Posterior fossa tumor • Wernicke’s syndrome (chronic alcohol abuse) • Drugs
ataxic gait
• characterized by small shuffling steps
• hypokinesia (general slowness of movement)
• in extreme cases, can have akinesia
• total loss of movement
• reduced stride length and walking speed while
cadence rate is increased
parkinsonian (festinating) gait
- full foot drop
- hip raised very high to clear toe
- usually a quiet gait
steppage (foot drop, hih stepping, neuropathic) gait
etiology: peroneal nerve injury as a result of: • lumbar disc herniation (most common) • poliomyelitis • multiple sclerosis • Guillain-Barre syndrome • Parkinson’s disease
steppage gait
• leg is stiff, without flexion at knee and ankle, and with
each step is rotated away from the body, then towards it,
forming a semicircle
hemiplegic gait
