Gait - Normal Flashcards
Stance - percent of cycle
62
Entire limb is in contact w/ ground
Swing -percent of cycle
38
Period of time foot is off ground
Initial contact - general
Instant foot contacts ground
Functional test - weight acceptance
Initial contact rom
Hip 20 flex
Pelvis 5 forward rotation
Knee 5 flex
Ankle 0
Initial contact muscle
Hip ext
Knee quads - active in prep for LR
Ankle pretib muscles - maintain foot position in prep for LR
Loading repsonse
0-12% cycle
Double limb support
Functional: weight acceptance
Loading response rom
Hip: 20° flexion
•Pelvis 5° fwd rotation –
Knee: 15° flexion –
Ankle: 5° PF
Loading repsonse - muscle hip
Hip: Extensors and Abductors
• Peak activity of TFL, glut med, glut min and glut max—stabilizing the pelvis in the frontal plane
Frontal plane stability is BIG in LR
At the hip there is both a flexion and adduction
torque that is counteracted
Loading repsonse muscle knee and ankle
Knee: Eccentric quadriceps (peak activity)
– Ankle: Pretibial muscles act eccentrically
(anterior tib peaks)
• Heel rocker: Pretibial muscles pull the tibia
forward, creating momentum and initiating knee flexion
Midstance - general
12-31% gait cycle
Progress over single, stable limb
FT: single limb support
Midstance ROM
Hip neutral
Pelvis rotates back to neutral
Knee 5 flex
Ankle 5DF
Midstance muscle hip
Hip: no saggital (ext torque)
Frontal hip abductors
Midstance muscle knee
Quads initially until extension torque begins
Midstance muscle ankle
Soleus and gastroc actively control forward progression of tibia
Ankle rocker
Terminal stance general
31-50% gait cycle
Continued progression over single limb, weight transferred to forefoot as heel lifts
FT single limb support
Terminal stance ROM
Hip: 20° apparent hyperextension Pelvis: ant tilt, 5° back rot – Knee: 5° flex—unchanged from MSt – Ankle:10° DF • MTP joints extend to 30°
Terminal stance muscle
Hip: No activity (hip extension torque
continues to keep the joint stable) – Knee: No activity -Calf muscles continue to restrain the tibia, thereby
stabilizing the knee.
Ankle: Calf muscles peak to prevent forward tibial collapse and to allow the heel to rise
• Forefoot rocker: contributes to
contralateral step length
Pre-swing general
50-62% gait cycle
Second period of double limb support
FT: functional limb advance-
Pre-swing ROM
Hip: 10° hyperextension
Pelvis: 5° back rot –Knee: Rapid flex 40°
Ankle: 15° PF
MTP ext to 60°
Pre-swing muscle
Hip: Adductors flex femur
Knee: No significant activity—knee flexion is passive –
Ankle: Calf muscles cease early in PSw
• Residual PF activity and passive tension contribute to the ankle moving into PF
Initial swing general
62-75% gait cycle
Thought advances as foot lifts
FT: swing limb advancement
Initial swing ROM
Hip: 15° flex
Pelvis: 5° back rotation –
Knee: 60° flex –
Ankle: 5° PF
Initial swing muscle
Hip: Hip flexors peak in activity as they
progress the limb –
Knee: Knee flexors are active and knee
flexion is aided by the flexion at the hip –
Ankle: Pre-tibial muscles initiate DF
Midswing
Foot clears ground by 1 cm
Tibia moves to vertical
FT: swing limb advancement
Midswing ROM
Hip: 25° flex
Pelvis: neutral rotation –
Knee: 25° –
Ankle: neutral
Midswing muscle
Hip: Flexors continue from ISw initially, then hamstrings become active late in the phase –
Knee: Flexors—help control the rate of knee
extension (which is occurring due to
momentum) –
Ankle: Pre-tibials
Terminal swing
87-100% gait cycle
Knee ext, limb prepares for contact
FT swing limb advancement
Terminal swing ROM
Hip: 20° flexion
• Pelvis: 5° fwd rotation –
Knee: 5° flexion (neutral) –
Ankle: remains at neutral
Terminal swing muscle
Hip: Hamstrings-peak activity to decelerate the leg –
Knee: Quadriceps-concentric knee extension –Ankle: Pre-tibials are active to assure a heel
contact for IC
Weight acceptance accomplishment
*Forward progression
Stability
*Shock absorption
Weight acceptance critical events
IC: heel first contact
LR: hip stability, *controlled knee flexion, ankle PF
Single limb support accomplishments
Stability
*Forward progression
Single limb support critical events
MSt: *controlled tibial advancement
TSt: *controlled ankle DF w/ heel rise;trailing limb
Swing limb advancement accomplishments
Foot clearance
*Limb advancement
Swing limb advancement critical events
PSw: *passive knee flex to 40, Ankle PF
ISw: hip flex 15, *knee flex 60
MSw: further hip flexion to 25, *ankle DF to 0
TSw: knee extension to 5
“Normal” gait velocity
80m/min
Ambulation velocity in stroke pop.
Household <0.4
Limited community 0.4-0.8
Full community >0.8
