Gait Observation Flashcards
Locomotion is the ability to move from one place to another by generating a complex sequence of muscle activations that are _______, ______ and _______
stereotypical, repetitive and adaptable
What are the three essential requirements of locomotion?
Coordinated muscle activity
Maintain posture
Adaptable to environment and task
where is movement initiated
cerebral cortex
how many components form the functional basis for gait?
7
Movement is in a response to what?
external forces
A complex series of joint rotations that creates a smoth forward progression of COM is what?
gait
one gait cycle is from what to what?
R IC to R IC
what % of the gait cycle is double limb support?
20%
What two periods constitute the 20% of double limb support in the gait cycle
loading response: 0-10%
pre-swing: 50-60%
COM moves how much vertically?
horizontally?
5cm vertically
4cm horizontally
What would walking without knee flexion due to vertical displacement?
double it
runners with hip pain generally have a narrow or wide BOS?
narrow, their COM doesn’t move much
TSP stands for what?
temporal and spatial
Pros of TSP
Easy quantifiable
Qualitative screen
Functional outcome
Normal stride length in cm
144
Stride vs. step
stride: ipsilateral to ipsilateral
Step: ipsilateral to contralateral
Step width definition and normal distance in cm
lateral distance btwn heel centers
8-10cm
Normal foot angle
5-7 degrees or seeing lateral three toes
If someone has femoral anteversion, what would you expect to see at their foot angle?
Smaller foot angle due to IR hip
If someone has femoral retroversion, what would you expect to see at their foot angle?
Larger foot angle due to ER hip
Cadence definition
number of steps per minute/step rate
What % of the gait cycle is stance and what % is swing
60% stance
40% swing
How do you get how much time was spent in stance?
take a stride time (the correct way) and then we know that stance time is 60% of the gait cycle so multiply it by .60
how to get step time
take stride time (correct way) and split it in half
Normative times for the following descriptors of gait
Distance in m/min:
Cadence in step/sec and steps/min
Stride time
Step time
Distance: 80 m/min
Cadence: 1.87 steps/sec or 110 steps/min
Stride time: 1.1 sec
Step time: .55 sec
What do the objective measures of gait generally lack
quality of pattern
what are the two ways that humans increase walking speed
1) increase rate/cadence
2) increase step length
Critical component of IC (0%)
neutral ankle
Critical component of loading response (0-10%)
PF 10 degrees
Knee flexion 15 degrees
Critical component of midstance (10-30%)
Tibial advancement in sagittal plane
hip and pelvic control in frontal plane
Critical component of terminal stance (30-50%)
Heel rise
Ankle locked at 10% DF
Forward progression over foot
Critical component of pre-swing (50-60)
40 degrees of knee flexion
Critical component of initial swing 60-73%)
60 degrees of knee flexion
15 degrees of hip flexion
When is hip extension part of a critical component?
NEVER
Critical component of mid swing (73-87%)
25 degrees of hip flexion
ankle DF to 0
foot 1 cm off floor
Critical component of terminal swing (87-100%
30 degrees of hip flexion
15 degrees of knee extension
How many total degrees of motion in the sagittal plane does the ankle require?
30 degrees
10 degrees of DF at midstance
20 degrees of PF at toe off
In what part of the gait cycle does the 30 degrees of sagittal motion you need at the ankle come from
10 degrees DF in midstance
20 degrees of PF in toe off at pre-swing
(10 degrees of PF at loading for foot flat)
pattern of joint motion of the ankle in the sagittal plane
rapid PF, DF during forward propulsion all the way through the heel rising at the end of terminal stance (50%) where then it PF again for push off
Requirement of knee motion in the sagittal plane
60 degrees of knee flexion
Where does the 0-60 degrees of knee flexion needed come in the gait cycle
0-5 degrees: IC
60 degrees: swing phase
What does the graph of the knee joint motion look like?
double bump pattern
Requirement of hip motion in the sagittal plane
40-45
Where does the 40-45 degrees of hip motion in the sagittal plane come in the gait cycle
10 degrees of hip extension at terminal stance
30-35 degrees of hip flexion at initial contact
What is the trend of joint motion look like for the hip in the sagittal plane
starts in flexion rapidly moves to extension and then to flexion again
How much motion is required of the pelvis in the sagittal plane?
and how do we name this?
APT and PPT
6-8 degrees
2-4 degrees of pelvic tilt in each direction
If someone has weak hip extensors what will you see at their pelvis ?
extreme anterior tilt in order to shift trunk back and the GRF goes behind the hips and you don’t need your hip extensors
Describe the pattern of joint motion of the ankle in the frontal plane
starts in inversion –> rapidly everts through stance –> inverts again to push off
How is the GRF working on our foot after IC
pushing it into eversion
How much eversion (in degrees) occurs from heel contact through loading response
2-6 degrees
What phase of gait does the foot begin to invert? and how many degrees?
terminal stance
4-8 degrees of inversion
There are a few degrees of what motion in the fronal plane at the knee during swing phase of gait
ABD motion/valgus internal force
ADD/varus EXTERNAL force
How much frontal plane motion at the knee during stance
not much!
How do you talk about pelvic obliquity in the frontal plane?
hike and drop
What position is the pelvis in at initial contact in degrees?
neutral
During the loading response how many degrees of contralateral pelvic drop occur?
2-6 degrees
What motion does the contralateral hip do in the frontal plane during loading response?
Drop
What degrees of hike or drop is the pelvis in in the frontal plane during the stance phase (except for loading response)
neutral
At what point in the gait cycle can we say that the pelvis has hiked in the frontal plane
pre-swing through initial swing
Where is the pelvis in the frontal plane during midstance
neutral!!!!! it doesn’t hike until preswing
yes the ABD work concentrically to get it back to neutral in midstance!! but it doesn’t actually hike until pre-swing and initial swing
pelvis vs. hip in the frontal plane
pelvis: hike and drop
hip: ABD and ADD
How many degrees of motion does the hip have in the frontal plane?
10-15 degrees
How much hip ADD occurs from IC to leading response?
5 degrees
5 degrees of hip ABD or ADD jt. motion occur from IC to loading response?
hip ADD
Hip joint ADD occurs in response to what?
Hip jt. ADD occurs in response to contralateral pelvic drop
Pattern of hip in the frontal plane
ADD –> ABD
from mid stance to pre-swing where is the hip in the frontal plane
neutral
from pre-swing to initial swing what location is our pelvis in in the frontal plane?
Why?
ABD
Because the pelvis is in hike therefore relatively our hip is in jt ABD
What phase of gait is our hip in ABD in the frontal plane?
pre-swing and initial swing
At which point in the gait do the pelvis and hips change from drop and ADD to hike and ABD
pre-swing and initial swing
Transverse plane big point
its hard to analyze for all joints
What planes does foot motion generally occur in?
frontal and sagittal
what two planes of motion atthe knee are highly variable
frontal and transverse
When you make IC what position is your hip joint in the transverse plane
ER
As you transfer your weight over your leg, what position is your hip jt in in the transsverse plane?
IR
During wing, what postiion is the hip jt in in the transverse plane?
What does this effect down the chain?
moves into ER again which allows us to IC on the lateral aspect of our foot/inversion. and leads to being able to immediately evert.
What is the internal kinematic pattern of tibia, femur and pelvis during stance phase driven by?
motion of the pelvis in the frontal plane
Shoulder girdles rotate in the ______direction as the pelvis
opposite
R pelvis is forward _____ shoulders are back
L
trunk is maintained in what during gait
slight flexion
what is the amount of rotation/bend you see at the trunk in the frontal plane
<5 degrees IT SHOULD BE SMALL. if its not small then thy’re trunk to chnge the location of the GRF vecotr in relation to their hip joint to dictate the demand of their hip ABD
What plane does the greatest amount of trunk motion occur in
how many degrees?
transverse plane
7-9 degrees
Arms should do what during gait
swing
hip extension ipsilateral shoulder ______
hip extension, ipsilateral shoulder FLEXION
Arms play into what motion during gait
trunk rotation
