Gait Detailed (ROM, GRF, Muscle Action)

Question 1

Initial Contact Ankle

Answer 1

Ankle neutral/slightly dorsiflexedGRF Posterior to the ankle

Question 2

Loading Response (0-12%) Ankle

Answer 2

ROM:Ankle reaches 5 degrees of plantarflexion at the middle of LRReaches neutral at end of LR (12%)GRF:@ IC, Sagittal PlaneGRF Posterior to ankle at initial contact@ IC, Frontal PlaneGRF Lateral to subtalar jointMuscle Action:@IC, Sagittal PlanePretibial muscles eccentrically contract to produce internal dorsiflexor momentTibialis AnteriorExtensor Digitorum LongusExtensor Hallicus Longus@IC, Frontal PlaneTibialis posterior contracts eccentrically to produce internal inversion moment

Question 3

Midstance (12-31%) Ankle

Answer 3

ROM: Ankle reaches 5 degrees of dorsiflexion at the middle of midstanceGRF: GRF is anterior to the ankle creating external dorsiflexor momentMuscle Action: Sagittal PlaneEccentric contraction of plantarflexorsTricpes SuraeTibialis PosteriorFrontal PlanePeroneals active to stabilize single limb support

Question 4

Terminal Stance at Ankle (31-50%)

Answer 4

ROM: Ankle reaches 10 degrees of dorsiflexion at the end of terminal stanceGRF: GRF even more anterior to the ankle, creating larger external dorsiflexor momentMuscle Action:Sagittal PlanePeak muscle activity of plantarflexors to generate internal plantarflexor momentTriceps SuraeTibialis PosteiorFrontal Peroneals still active to stabilize subtalar joint in single limb support

Question 5

Preswing (50-62%)

Answer 5

ROM: Begins dorsiflexed but plantarflexes to 15 degrees by the end of preswingGRF: GRF still anterior to ankle. Has less affect on ankle joint because it is partially unweightedMuscle Action:SagittalDorsiflexors start to concentrically fire late preswing to prepare for foot clearanceTibialis AnteriorExtensor Digitorum LongusExtensor Hallicus LongusFrontalNo muscle action

Question 6

Swing (62-100%)

Answer 6

ROM:Dorsiflexes to 5 degrees plantarflexed by the end of Initial swingContinues to dorsiflex, reaching neutral by the beginning of Midswing, maintained through terminal swingGRF:NoneMuscle Action:Dorsiflexors reach have peak muscle activity Tibialis AnteriorExtensor Digitorum LongusExtensor Hallicus Longus

Question 7

Loading Response (0-12%) Knee

Answer 7

ROM:@IC Knee neutral or flexed 5 degreesKnee flexes to 15 degrees by late loading responseGRF:@IC, early LRGRF anterior to knee joint, thus creating external extension torqueThrough loading response, GRF moves posterior to the knee, creating external flexion torqueMuscle Action:Through loading responseQuadriceps eccentrically contract to create internal knee extension momentVastus IntermediusVastus LateralisVastus MedialisHamstrings active to assist with hip positionGracilisBiceps FemorisSemimembranosusSemitendinosus

Question 8

Midstance (12-31%) Knee

Answer 8

ROM: Knee extends to 5 degrees of flexion by late midstanceGRF:GRF anterior to the knee a very minimal distanceMuscle Action:NoneVery small extensor external extensor moment counteracted by ligaments and the posterior capsule

Question 9

Terminal Stance (31-50%) Knee

Answer 9

ROM: Knee continues to be in 5 degrees of flexion until late terminal stanceGRF:GRF moving further anterior to the knee creating greater external extensor momentMuscle Action:Biceps femoris eccentrically contracting to prevent hyperextension, peak eccentric contraction

Question 10

Pre Swing (50-62%) Knee

Answer 10

ROM: Knee flexes to 40 degrees by late preswing which contributes to foot clearance during swingGRF:GRF posterior to the knee creating external knee flexion moment Muscle Action:Rectus femoris performs peak eccentric contraction to restrain rapid passive knee flexion

Question 11

Initail Swing (62-75%) Knee

Answer 11

ROM: Knee flexes to 60 degrees to assist with toe clearanceGRF:NoneMuscle Action:Peak concentric contraction of knee flexors Biceps Femoris Gracilis Sartorius

Question 12

Midswing (75-87%)

Answer 12

ROM: Knee extends to 25 degrees of flexionGRF:NoneMuscle Action:Gracilis and Biceps Femoris eccentrically contract to control passive extension of knee (tibial momentum)

Question 13

Terminal swing (87-100%)

Answer 13

ROM: Knee extends to 5 degrees of flexion by late terminal swingTO achieve maximal step lengthGRF:NoneMuscle Action:Quadriceps contract to ensure enough knee extension is achieved before ICVastus IntermediusVastus LateralisVastus MedialisHamstrings have peak eccentric contraction to slow thigh downGracilisBiceps FemorisSemimembranosusSemitendinosus

Question 14

Loading Response (0-12%) Hip

Answer 14

ROM: Hip is flexed 20 degreesUntil late loading response it begins extendingGRF: GRF is Anterior to the hip creating external hip flexor momentMuscle Activity:Sagittal PlaneHip extensors and hamstrings eccentrically contract to create internal hip extensor momentGluteus MaximusAdductor MagnusBiceps FemorisSemimembranosusSemitendinosusFrontal PlaneHip Abductors eccentrically contract to stabilize pelvisTensor Fascia LataeGluteus mediusGluteus minimusUpper Gluteus maximus fibers

Question 15

Midstance (12-31%) Hip

Answer 15

ROM:Hip extends to neutral by late midstanceGRF:GRF goes through the hip, no external momentMuscle Activity:Sagittal planeNo muscles contracting Frontal PlaneHip Abductors firing to stabilize pelvis during single limb supportTensor Fascia LataeGluteus MediusGluteus Maximus Upper fibers

Question 16

Terminal stance (31-50%) Hip

Answer 16

ROM:Hip reaches 20 degrees hyperextension by late terminal stance Allowing body to advance pass footGRF:GRF is posterior to hip creating an external extensor momentMuscle Activity:Sagittal planeNo muscle needed to create internal flexor momentIlliofemoral ligament anterior to the hip joint create a passive momentFrontal planeSome tensor fascia latae activity

Question 17

Preswing (50-62%) Hip

Answer 17

ROM:Hip flexes to 15 degrees hyperextension by the end of PreswingGRF:GRF plays minimal role because foot is partially not weight bearingMuscle Activity:HIp flexors concentrically contract to advance thighAdductor longusGracilisSartorius

Question 18

Initial Swing (60-75%) Hip

Answer 18

ROM:Hip continues to flex to 15 degrees of flexion by the end of Initial swingGRF:NoneMuscle Activity:Hip flexors create peak concentric contraction to advance thighRectus femorisIlliacusAdductor longusGracilisSartorius

Question 19

MidSwing (75-87%) Hip

Answer 19

ROM:Hip continues to flex until it reaches 25 degrees of flexion at the middle of midswing after which it begins to extend GRF:NoneMuscle Activity:Gracilis is active to maintain thigh advancementHamstrings start to eccentrically contract to decelerate thigh

Question 20

Terminal Swing (87-100%)

Answer 20

ROM:Hip is extending to 20 degrees of hip flexion where it prepares for initial contactHip reachesGRF:NoneMuscle Activity:Hamstrings need peak power to decelerate legBiceps FemorisSemimembranosusSemitendinosusGluteals start to contract to prepare for initial contact in frontal planeTensor Fascia LataeGluteus mediusGluteus minimusUpper Gluteus maximus fibers

Question 21

Kyphosis Normal ROM

Answer 21

20-40 degs