Gait Review Flashcards
What is a gait cycle?
initial heel contact of one foot to heel contact of the same foot
T/F Stride is synonymous with a gait cycle
True
What is a step?
is sequence of events that occurs within heel contacts of opposite feet
How many steps in 1 gait cycle?
2 steps
What % of stance phase?
60%
What % of Swing phase?
40%
What % of single-limb support?
80%
What % of double-limb support?
20%
What is stride length?
Distance between 2 successive heel contacts of the same foot
What is step length?
Distance between successive heel contacts of 2 different feet
What is degree of toe-out? What is normal?
Angle between line of progression of the body and a line intersecting the center of the heel and second toe
5-7 degrees is normal
What is step width? What is normal?
Lateral distance between heel centers of 2 consecutive foot contacts
Average is 8-10 cm
what is a potential cause of Asymmetric step length often observed in prosthetic users?
spending less time in stance phase on involved side
Asymmetric step length often observed in prosthetic users results in a shortened what on the noninvolved side?
shortening swing time and step length
What is stride time?
Time for a full gait cycle
What is step time?
Time for completion of a R or a L step
What is cadence?
Number of steps per minute
Also described as step rate
What is the best and most functional measurement of individuals walking ability?
Gait speed - Distance covered in a given amount of time
Gait speed decreased when what two things occur?
Reduced:
- step length (early prosthetic users)
- Cadence
T/F Common that individuals using prosthetic and/or orthotic devices have slower gait speed, and expend more energy while walking
True
What are some other common reasons for decreased gait speed in this population?
Tentative, poor gait training in early amputee, may not have had normal/quick speed pre surgery
What 2 keys features of IC/Loading response?
- Shock absorption (Plantarflexion, Knee flexion, Pronation, Hip adduction)
- Forward propulsion through hip extension
What 3 keys features of Midstance?
- Shock absorption
- Stabilize in single limb support
- Forward progression of tibia (closed chain dorsiflexion)
What 3 keys features of Terminal Stance?
- Continued stabilization in single limb support
- Forward propulsion through plantarflexion
- Forward progression
What 2 keys features of Pre-swing?
- Continued forward propulsion through plantarflexion
2. Continued forward progression
What 2 keys features of initial swing?
- Forward propulsion of swing leg through hip flexion
- Foot clearance (functionally shortening limb)
- Dorsiflexion
- Knee flexion
What key feature of mid swing?
Forward propulsion of swing leg through hip flexion
What key feature of terminal swing?
Prepare for initial contact
Controlled knee extension, Ankle positioned into less supination
Key muscle activity of hip extension?
Activated in terminal swing prior to initial contact to initiate hip extension and prepare LE for weight acceptance at the beginning of stance
(TF – initiate knee extension through hip extension )
Key muscle activity of hip flexion?
Advance lower extremity forward during initial swing & lift lower extremity to allow for toe clearance during swing
Key muscle activity of hip abductors?
Control the slight lowering of the contralateral pelvis on the side of the swing limb
Key muscle activity of hip adductors?
Assist with initiation of hip flexion after toe off
Key muscle activity of the knee extensors?
Eccentrically control knee flexion in loading response then act concentrically to extend the knee and support body in midstance
Key muscle activity of the knee flexors?
Decelerate knee extension in preparation for placement of the foot on the ground (IC)
Key muscle activity of the ankle dorsiflexors?
Eccentric activation to control plantar flexion of the ankle at initial contact until foot comes in contact with the ground (amputees don’t have these muscles to control DF)
Key muscle activity of the ankle plantar flexors?
- Eccentric contraction moving into midstance to control tibial advancement
- Concentric contraction at Terminal Stance and Preswing to propel forward (“push-off”)
Key muscle activity of the ankle invertors?
Eccentrically contracts to control pronation until midstance then concentrically contracts to supinate the foot for push-off in terminal stance/preswing
Key muscle activity of the ankle evertors?
Also active as co-contraction to counter strong inversion occurring during loading response to midstance
Loss of plantar flexors due to amputation or weakness can cause what 3 things during gait?
- Shorter contralateral step length
- Reduced gait speed
- Impaired balance
What phase(s) of gait will this be most noticeable with loss of plantar flexors?
Midstance – gastroc most active eccentric to prevent excessive tibial advancement
No prosthetic mechanism is needed to produce knee flexion given what two things?
- The individual can flex the hip – overactive hip flexion/contracture
- Ambulate fast enough to produce momentum – losing propulsion from ankle joint
What general characteristics of prosthetic gait will decrease?
Walking speed stride length cadence energy efficiency biomechanical efficiency
Pistoning, common cause for many TTA deviation caused by poor suspension, results in what 3 things?
- Decreased stability (feels like limb will fall off)
- Decreased confidence
- Excessive pressure/shearing forces
T/F For TF prosthetic users, gait cycle will be the same.
False, Shorter (more time in duel limb support to maximize stability)
In midstance of TF prosthetic gait, how does the femur help with balance?
Weight shift over prosthetic (balance from femur pushing laterally reducing demand of hip abd) = slow stance
During the swing phase of the prosthetic, how does the knee get into extension?
Pendulum effect by force from hip flexors – knee flexion into knee extension
T/F No matter the cause or level, amputees have increased metabolic costs for ambulation
True
Normal prosthetic gait is a function of what 4 characteristics?
- socket fit
- prosthetic alignment
- components
- user ability
