Gait: Hip, HAT

Question 1

What is the primary role of the hip for stance phase? What about swing phase?

Answer 1

stance phase = hip does trunk stabilization

swing phase = hip advances limb and helps foot clear floor

Question 2

Describe the sagittal motion of the hip during the gait cycle.

Answer 2

1. IC: hip flexed
2. loading: flexed
3. midstance: early, hip is flexed, then goes into extention
4. terminal stance: hip fully extended
   5: preswing: hip begins to go into some flexion
   6: initial swing: flexed
5. midswing: hip flexion, facilitates passive knee flexion
6. terminal swing: starts to switch into moving into extension

Question 3

Describe the coronal motion of the hip joint during gait.

Answer 3

• IC to midstance = adducted
• midstance = moves into abduction to raise contra pelvis
• midstance to preswing: continues to abduct
• initial swing to terminal swing: limb adducts

Question 4

What gait phase occurs in the 60-70% range?

Answer 4

initial swing

Question 5

At what point in gait is your contralateral pelvis higher (L higher)?

Answer 5

highest at preswing to initial swing; stance limb at peak abduction here

Question 6

At what point is the L pelvis the lowest during gait?

Answer 6

during loading, b/c limb is at most adduction here

Question 7

How much flexion/extension do we get at the thigh?

Answer 7

flexion: 25 degrees
extension: 20 degrees

Question 8

How much flexion/extension do we get at the hip joint?

Answer 8

flexion: 30-40 degrees
extension: 10 degrees extension

Question 9

Where do we get more extension, at the hip joint or the thigh? Why is this?

Answer 9

more at the thigh b/c we can anteriorly tilt and ER pelvis, allowing more thigh extension

Question 10

Where do we get more flexion, and the hip joint or thigh?

Answer 10

more at hip joint: 30-40 degrees vs 25

Question 11

What does the hip do for the body in stance and swing?

Answer 11

stance: stabilizes trunk in 3 planes
swing: limb advancement and foot clearance

Question 12

T/F: During most of stance, the hip is externally rotated.

Answer 12

false, internally rotated more

Question 13

Describe the pattern of IR and ER at the hip throughout the gait cycle.

Answer 13

IC to midstance: IR
midstance: switches gradually from IR to ER
late midstance to preswing: ER
preswing: start to go back to IR
swing: IR

Question 14

How many degrees of hip flexion do we need during loading response?

Answer 14

30 degrees

Question 15

In what phase does the HAT begin to have a forward progression in front of the foot?

Answer 15

midstance

Question 16

Where are the GRFs at the hip during midstance?

Answer 16

posterior, so hip extensors quiet down

- abductors also quiet down since GRFs are pretty in line

Question 17

What degrees of extension do we get at the thigh and hip during terminal stance?

Answer 17

thigh = 20 degrees extension
hip = 10 degrees extension

Question 18

What hip muscles are active in terminal stance?

Answer 18

TFL, resists adductor moment caused by weight shift as well as resists hip extension

Question 19

Where are the GRFs at each joint during terminal stance?

Answer 19

anterior to ankle
through knee
posterior to hip

Question 20

What muscles eccentrically control the motion at the hip in initial contact?

Answer 20

glutes and hams eccentrically control the hip flexion occuring

Question 21

What knee muscles are active in initial contact?

Answer 21

• quads and glut max = concentric
• popliteus = eccentric
  
  • all are controlling/creating knee extension in IC

Question 22

What pelvis muscles are working in preswing?

Answer 22

contra glut med

Question 23

When is the external oblique most active in gait?

Answer 23

midstance and terminal swing

Question 24

Are you adducted or abducted in terminal stance?

Answer 24

abducted

Question 25

Are you internally or externally rotated in midstance? terminal stance?

Answer 25

• going from internal to external rotation in midstance

- externally rotated in terminal stance

Question 26

When do sartorius and gracilis play a role in gait?

Answer 26

they offset each other’s rotation during swing so that swing is neutral w/o rotation

Question 27

How many degrees of total thigh rotation do we get for the femur, when combining the hip and pelvis motion?

Answer 27

15 degrees total thigh motion

• 8 at hip
• 7 at pelvis

Question 28

When is iliopsoas most active during gait?

Answer 28

from preswing to initial swing: driving that forward momentum of the limb

Question 29

What hip muscles are active in preswing? (4) (hint: think about motions occuring at hip during preswing)

Answer 29

iliopsoas, rectus femoris (do HE and control KE), adductor longus and gracilis (improve mediolateral stability)

Question 30

What hip muscles are working during initial swing? (4)

Answer 30

• sartorius and gracilis: flex hip and knee and neutralize rotation
• rectus femoris
• iliopsoas

Question 31

Describe hip muscle activity in the beginning of terminal phase and at the end.

Answer 31

hams start off by decelerating HF and KE

- then glut max and adductor magnus come in to control hip flexion and give stability, respectively