Gait - DSA Flashcards
Gait cycle
From heel strike to next heel strike of SAME foot
i.e. from left hell strike to left heel strike = 1 gait cycle
What provides maximum shock absorption during contact?
- Calcaneus everting and talus dropping/adducting to unlock midtarsal joints
Which muscles lower foot eccentrically to ground?
- Extensor digitorum longus
- Tibialis anterior
What’s the cycle progression of Mid-stance
Foot-flat to heel-off
Describe in detail mid-stance
Rearfoot fully pronates, metatarsals hit ground to bring foot flat on gound, and body’s center of gravity passes from behind to over foot
What happens to subtalar joint during mid-stance phase?
-Sub-talar joint resupinates (calcaneus everts and talus abducts), locking midtarsal joint, transforming foot from a shock absorber to a rigid lever
What muscle is an important restraint to overpronation and is an active foot supinator?
Tibialis posterior
What’s the definition of propulsion during gait cycle?
Heel-lift progresses to toe-off
Extension of which joint results in windlass effect of plantar fascia that elevates the arch an further assists in supination of the foot
Metatarsophalangeal (MTP) joint, especially 1st MTP (think powerful toe-off)
Proulsion phase concludes with?
Body weight moving over great toe at toe-off
What compromised 60% of the gait cycle
From heel strike (initial contact) to toe off (pre-swing)
During what phase do most problems occur?
- During stance phase
- Foot on ground and weight bearing
What compromises 40% of the gait cycle
- Swing phase
- From toe off to heel strike
Foot clearance in swing requirement?
- Ankle dorsiflexion
- Knee flexion
- Hip flexion
- Retain stability in stance
How is energy conserved during gait?
- Pelvic lift
- In early stance, as weight is transferred, hip on non-weight bearing side DROPS about 2”
What’s Antalgic gait?
- Painful joint
- Swing enhanced on affected side
- Stance phase shortened on affected side
What’s Arthrogenic gait?
- Stiff joint —> Circumduction
- Plantarflexion of foot opposite to affected side during stance phase to increase clearance (this raises the hip)
- Affected leg is circumducted (passive circular motion)
What’s Ataxic gait?
- Unsteady/uncoordinated
- Needs broad base of support
- Loss of sensation or control
Causes of ataxic gait?
- Vestibular
- Cerebellar abscess
- Friedreich’s ataxia
- Pontine-cerebellar atrophy
- Chronic mercury poisoning
- Posterior fossa tumor
- Wernicke’s syndrome
- Drugs
What’s Hemiplegic (circumduction) gait?
- Cerebrovascular event –> Semicircle
- Leg is stiff WITHOUT FLEXION at the knee or hip
- Leg rotated away from body then towards it creating a semicircle
- Seen in strokes and spinal cord injuries
What’s Parkinsonian (Festinating) gait?
- Shuffling! (small shuffling steps)
- Hypokinesia (general slowness of movement)
- Exhibited by SOME pt’s with Parkinson’s disease
Steppage gait?
- Foot drop + High stepping + Neuropathic
- Full foot drop
- Hip raised very high to clear toe
- Clomping sounds with high steps
What causes steppage gait?
- Peroneal nerve injury secondary to:
- Lumbar disc herniation
- Poliomyelitis
- MS
- Guillain-Barre syndrome
- Parkinson’s disease
Heel strike (R) = ? (L) Flat foot (R) = ? (L) Mid stance (R) = ? (L) Heel off (R) = ? (L)
Heel off
Toe off
Mid-swing
Heel strike
