Gait: Hip, HAT Flashcards
What is the primary role of the hip for stance phase? What about swing phase?
stance phase = hip does trunk stabilization
swing phase = hip advances limb and helps foot clear floor
Describe the sagittal motion of the hip during the gait cycle.
- IC: hip flexed
- loading: flexed
- midstance: early, hip is flexed, then goes into extention
- terminal stance: hip fully extended
5: preswing: hip begins to go into some flexion
6: initial swing: flexed - midswing: hip flexion, facilitates passive knee flexion
- terminal swing: starts to switch into moving into extension
Describe the coronal motion of the hip joint during gait.
- 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
What gait phase occurs in the 60-70% range?
initial swing
At what point in gait is your contralateral pelvis higher (L higher)?
highest at preswing to initial swing; stance limb at peak abduction here
At what point is the L pelvis the lowest during gait?
during loading, b/c limb is at most adduction here
How much flexion/extension do we get at the thigh?
flexion: 25 degrees
extension: 20 degrees
How much flexion/extension do we get at the hip joint?
flexion: 30-40 degrees
extension: 10 degrees extension
Where do we get more extension, at the hip joint or the thigh? Why is this?
more at the thigh b/c we can anteriorly tilt and ER pelvis, allowing more thigh extension
Where do we get more flexion, and the hip joint or thigh?
more at hip joint: 30-40 degrees vs 25
What does the hip do for the body in stance and swing?
stance: stabilizes trunk in 3 planes
swing: limb advancement and foot clearance
T/F: During most of stance, the hip is externally rotated.
false, internally rotated more
Describe the pattern of IR and ER at the hip throughout the gait cycle.
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
How many degrees of hip flexion do we need during loading response?
30 degrees
In what phase does the HAT begin to have a forward progression in front of the foot?
midstance
Where are the GRFs at the hip during midstance?
posterior, so hip extensors quiet down
- abductors also quiet down since GRFs are pretty in line
What degrees of extension do we get at the thigh and hip during terminal stance?
thigh = 20 degrees extension hip = 10 degrees extension
What hip muscles are active in terminal stance?
TFL, resists adductor moment caused by weight shift as well as resists hip extension
Where are the GRFs at each joint during terminal stance?
anterior to ankle
through knee
posterior to hip
What muscles eccentrically control the motion at the hip in initial contact?
glutes and hams eccentrically control the hip flexion occuring
What knee muscles are active in initial contact?
- quads and glut max = concentric
- popliteus = eccentric
- all are controlling/creating knee extension in IC
What pelvis muscles are working in preswing?
contra glut med
When is the external oblique most active in gait?
midstance and terminal swing
Are you adducted or abducted in terminal stance?
abducted
Are you internally or externally rotated in midstance? terminal stance?
- going from internal to external rotation in midstance
- externally rotated in terminal stance
When do sartorius and gracilis play a role in gait?
they offset each other’s rotation during swing so that swing is neutral w/o rotation
How many degrees of total thigh rotation do we get for the femur, when combining the hip and pelvis motion?
15 degrees total thigh motion
- 8 at hip
- 7 at pelvis
When is iliopsoas most active during gait?
from preswing to initial swing: driving that forward momentum of the limb
What hip muscles are active in preswing? (4) (hint: think about motions occuring at hip during preswing)
iliopsoas, rectus femoris (do HE and control KE), adductor longus and gracilis (improve mediolateral stability)
What hip muscles are working during initial swing? (4)
- sartorius and gracilis: flex hip and knee and neutralize rotation
- rectus femoris
- iliopsoas
Describe hip muscle activity in the beginning of terminal phase and at the end.
hams start off by decelerating HF and KE
- then glut max and adductor magnus come in to control hip flexion and give stability, respectively
