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Analysis of Movement > Gait: intro, ankle, knee > Flashcards

Gait: intro, ankle, knee Flashcards

1
Q

What what phase, stance or swing, do we spend most of our time on the limb of focus?

A

60% of time in stance phase

40% of time in swing

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2
Q

What is the difference between step length and stride length? What are normal values?

A
  • step length = right foot to left foot: 72 cm

- stride length = right foot to right foot: 144 cm

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3
Q

When is the first phase of double-limb support?

A

loading

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4
Q

How many degrees of foot angle are normal?

A

5-7 degrees of toe-out

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5
Q

If someone has a greater than normal angle of toe out, what is this called?

A

duck toe

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6
Q

What is cadence?

A

number of steps per minute; a temporal descriptor of gait

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7
Q

What are the 3 temporal descriptors of gait?

A

cadence
step time
stride time

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8
Q

What is gait cycle time also called?

A

stride time

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9
Q

T/F: Step length = gait cycle step.

A

false, stride length = gait cycle step

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10
Q

What are normal values for step width?

A

8-10cm

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11
Q

When increasing walking speed, what happens to stance time and swing time?

A

With increased walking speed

  • stance time decreases
  • swing time increases
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12
Q

T/F: Step length increases when we increase walk speed.

A

true

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13
Q

T/F: With the gait cycle, we start with more concentric activity, and then switch to eccentric activity towards the end of the cycle.

A

false, we go from eccentric to concentric

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14
Q

What percentage does initial contact consist of in the gait cycle?

A

0-2%

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15
Q

Where are the ground reaction forces for initial contact?

A

posterior to ankle
anterior to knee
slightly anterior to hip

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16
Q

When is the first double-limb support period?

A

loading response of stance

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17
Q

Where are GRFs in loading response?

A

posterior to knee
posterior to ankle
slightly anterior to hip

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18
Q

How long does loading last for?

A

from initial contact until the other foot is lifted for swing

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19
Q

What muscles are extremely important in the loading phase?

A

the knee extensors!! GRF is posterior to knee here, and KEs must eccentrically control this knee flexion

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20
Q

When is the second double stance phase?

A

preswing

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21
Q

What percentage of the gait cycle is loading?

A

0-10%

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22
Q

When does the first half of single limb support occur?

A

midstance

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23
Q

Where is the opposite limb when the stance limb is in midstance?

A

midswing

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24
Q

What is the position of the limb in early midstance, and then late midstance?

A 
early = knee flexed, hip flexed
late = knee extended, hip extended
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25
Q

What two muscles make up 93% of the potential plantar flexor torque?

A

gastroc and soleus

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26
Q

What muscles preserve the heel rocker?

A

DFs

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27
Q

At what phase of gait are we in if the foot is in digigrade?

A

terminal stance

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28
Q

Describe the activity of the plantar flexors during gait cycle.

A
  • most active in beginning during loading and through midstance to eccentrically control DF
  • turn on slightly during preswing when the 2nd arc of plantar flexion occurs, but mostly passive recoil is used for push off (from the stretch they just got during DF)
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29
Q

What muscle markedly increases its activity in midstance to control pronation?

A

tib posterior

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30
Q

When during gait does PF internal torque peak?

A

at push off, then drops off

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31
Q

Where are GRFs during loading response?

A

posterior to ankle
posterior to knee
slightly anterior to hip

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32
Q

When does the first arc of ankle PF occur in gait?

A

during loading response: get a quick 10 degrees as the foot drops to the floor (controlled by DFs)

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33
Q

What should the position of the heel be in at initial contact to activate the heel rocker?

A

90 degrees

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34
Q

Where are the GRFs at the ankle during midstance?

A

anterior to ankle, so PFs need to eccentrically control this dorsiflexion happening in midstance

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35
Q

What muscle fixes the first met, and when during gait is this important?

A

fib longus fixes first met during terminal stance to take advantage of the forefoot rocker

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36
Q

How much sagittal motion is needed at the 1st MTP during gait?

A

55 degrees: windlass effect must occur

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37
Q

How many degrees of hip flexion do we need in swing?

A

40 degrees

38
Q

How many degrees of knee flexion do we need during the stance phase of gait?

A

20 degrees

39
Q

When looking at midtarsal motion during gait, what are you looking for?

A

watch the arch fall or rise abnormally during gait cycle, this is the motion at the midtarsal joint

40
Q

At what point after loading does recovery of the arch of the foot occur?

A

with heel rise, so during terminal stance

41
Q

What motion of the tibia allows for the collapse of the arch? When in gait does this happen?

A

IR of tibia during loading to early midstance causes the arch to be lost

42
Q

When during gait is the peak of eversion?

A

during early midstance

43
Q

What is the position of the foot during swing?

A

dorsiflexed and inverted

44
Q

If a patient has hallux rigidis, what would be compromised in their gait?

A

preswing is affected: no toe rocker for push off, so you lose momentum

45
Q

What axes need to be parallel to allow pronation of the foot?

A

talonavicular and calcaneocuboid

46
Q

Plantigrade is related to what phase of gait? What kind of support is it called?

A

midstance: foot flat support

47
Q

T/F: Medial plantar surface is where weight should be loaded in flat foot support, or plantigrade.

A

false, should load on lateral side of foot

48
Q

What muscles do foot inversion?

A

tib anterior, tib posterior, soleus

49
Q

When does the tib posterior activity peak?

A

peaks in LS and mid terminal stance

50
Q

When does soleus activity peak?

A

starts in loading, and then rises during midstance and terminal stance

51
Q

Which is larger, inversion or eversion torque?

A

inversion is larger -> 20-45% of gait cycle

eversion = 0-20%

52
Q

What muscles do eversion?

A

gastroc, fib longus and brevis, EDL, EHL

- activity ranges between LR and TS because they control supination and do pronation

53
Q

What is the sequence of foot support?

A

heel -> lateral aspect of foot -> across forefoot -> to 1st met -> push off!

54
Q

How much knee flexion do we need for swing phase versus stance phase?

A

need 60 degrees KF for swing, 20 for stance

55
Q

Terminal stance consists of what percentage of gait?

A

31-50%`

56
Q

Mid stance consists of what percentage of gait?

A

12-31%

57
Q

In what plane does the knee have most motion?

A

sagittal = KF and KE

58
Q

T/F: When limb is in stance, it’s in slight abduction.

A

true, physiological valgus

59
Q

What provides shock absorption during gait?

A

20 deg knee flexion, abduction, plantar flexion

60
Q

How does the external torque change at the knee as the limb moves forward?

A

GRFs go from being anterior to the knee to being posterior to the knee

61
Q

With internal rotation, does this lock or unlock the knee?

A

IR unlocks the knee, gives knee flexion during loading to midstance

62
Q

An internally rotated knee means what for the foot position?

A

foot is pronated

63
Q

T/F: Knee is mostly in ER during stance.

A

false, mostly in IR during stance, knee isn’t locked

64
Q

At what point during gait does the knee move from internal rotation to external rotation?

A

becomes ER at push off (preswing) to allow foot to be supinated and rigid

65
Q

When we describe knee rotation, what are we specifically talking about in terms of bones?

A

rotation of tibia relative to femur

66
Q

What thigh muscles kick in at IC to ensure knee extension?

A

vastus medialis and lateralis, gluteus max via IT band, rectus femoris; some slight hamstring activity to prevent hyperextension

67
Q

What muscle works to counteract adduction during initial contact?

A

TFL; fires before glut med because it’s smaller

68
Q

Describe the knee flexor activity throughout the gait cycle.

A
  • eccentrically controls hyperextension during initial contact and then quiets down during midstance
  • concentrically fires during preswing and swing phase to flex knee
  • eccentrically controls KE during terminal swing also
69
Q

What is the difference between the biceps femoris short head and long head? Which one activates first?

A
  • short head only does knee flexion, long head does knee flexion and hip extension
  • short head activates first for knee flexion
70
Q

What knee muscle is active through virtually the entire gait cycle?

A

popliteus

71
Q

What quad muscle is also active in toe-off while the others quiet down?

A

rectus femoris to allow hip flexion; other ones do knee extension, and you don’t have that in this phase, you have knee flexion

72
Q

In initial contact, are the quads concentric or eccentric? What’s their purpose in this phase?

A

quads concentrically contract in initial contact to provide stable weight bearing

73
Q

During loading, are the quads concentric or eccentric? What’s their purpose in this phase?

A

quads eccentrically contract during loading to control knee flexion to 20 degrees, giving shock absorption

74
Q

When are the quads most active?

A

during initial contact through loading, then rectus femoris activates during toe off to give hip flexion for swing

75
Q

How many degrees of total rotation do we get at the knee during gait?

A

8 degrees of total IR/ER

76
Q

Describe the locking and unlocking of the knee during gait.

A
  • IC to MS: knee is unlocking
  • MS to PS: knee begins to lock for push off
  • PS to midswing: knee begins unlocking for swing (b/c it’s in flexion)
  • midswing to terminal swing: preparing for IC so it starts to go towards locking
77
Q

What external moment, ab or adduction, is occuring to the leg in midstance?

A

adductor moment b/c the GRFs are medial to the knee; this is why TFL must kick in to prevent that

78
Q

Where are the GRFs in terminal stance?

A

way anterior to ankle
run through knee
slightly posterior to hip

79
Q

Maximal knee extension occurs in what phase?

A
  • terminal stance, and then you move quickly into knee flexion and plantar flexion
  • allows you to have maximal step length
80
Q

What muscle slows down the passive knee flexion occuring in preswing?

A

rectus femoris: GRFs are very posterior to knee in preswing, so rectus femoris has to control that knee flexion

81
Q

Where are the GRFs for the knee and ankle in preswing?

A

very anterior to ankle

very posterior to knee

82
Q

T/F: Gastroc is very active in preswing.

A

false, only slightly active
- you don’t need it too much for PF due to passive recoil, and you don’t need it for KF too much due to passive KF occuring

83
Q

What are the roles of rectus femoris?

A

eccentric control of knee flexion and hip extension

84
Q

Forward free fall of the body occurs in what phase?

A

terminal stance

85
Q

What critical events must happen in terminal stance?

A

use of forefoot rocker, controlled dorsiflexion by PFs, forward free fall of body with trailing limb

86
Q

What critical events must occur in preswing?

A

toe rocker, passive knee flexion

87
Q

What critical events must happen in initial swing?

A

knee flexion and hip flexion

88
Q

Rectus femoris is especially active in what phase?

A

in preswing because it decelerates the passive knee flexion occuring

89
Q

What allows for the knee flexion in initial swing?

A

forward momentum of thigh, biceps femoris short head, gracilis, and sartorius

90
Q

Describe the sagittal motion of the knee during the entire gait cycle.

A
  1. IC = extended to allow stable weight bearing
  2. loading = flexed to allow shock absorption
  3. midstance = goes from flexed to extended
  4. terminal stance = extended
  5. preswing = passively flexed
  6. initial swing = flexion via thigh momentum and BFSH, gracilis, sartorius
  7. midswing = goes into passive knee extention via hip flexion

Analysis of Movement (14 decks)

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