Hip During Gait Flashcards
SAGITTAL: How much ROM does the hip have at initial contact?
- 30 degrees of hip flexion
- 20 degrees of thigh flexion
SAGITTAL: How much ROM does the pelvis have at initial contact in regards to tilting?
about 10 degrees of anterior tilt
SAGITTAL: How much ROM does the pelvis have during the whole gait cycle in regards to tilting?
- very minimal
- only about 2-4 degrees of pelvic tilt
SAGITTAL: Where is the ground reaction force in relation to the hip at initial contact?
anterior
SAGITTAL: What kind of external torque does the GRF make at the hip during initial contact?
external flexion torque
SAGITTAL: What kind of internal torque is occurring at the hip during initial contact?
internal extension torque to counteract the external flexion torque
SAGITTAL: What hip muscles are working during initial contact?
ALL extensor muscles are working
-mainly gluetus max and adductor magnus
SAGITTAL: What is the functional significance of initial contact?
- limb positioning for step length
- limb stabilization
REVIEW: describe loading response…GO!
- 0-10% of the gait cycle
- start: initial contact
- end: opposite toe off
- functional significance: weight acceptance
SAGITTAL: How much ROM does the hip have during loading response?
- hip doesn’t move during this phase
- hip stays in 30 degrees of flexion (20 degrees of thigh flexion)
SAGITTAL: Where is the GRF in relation to the hip during loading response?
GRF is still anterior to the hip joint
SAGITTAL: What kind of external torque does the GRF make at the hip during loading response?
external flexion torque
SAGITTAL: What kind of internal torque is occurring at the hip during loading response?
internal extension torque
SAGITTAL: What hip muscles are working during loading response and how are they working?
- glut. max, adductor magnus, hamstrings
- all are working isometrically because there is no movement at the hip during this phase
SAGITTAL: What is the functional significance of loading response at the hip?
- hip stabilization
- trunk posture maintained
- shock absorption is still occurring
REVIEW: describe what is going on in mid stance…GO!
- 10-30% of the gait cycle
- start: opposite toe off
- end: reference limb heel rise
- functional significance: single limb support
SAGITTAL: How much ROM does the hip have during mid stance?
- starts at 30 degrees of hip flexion
- ends in 10 degrees of flexion (thigh is at 0)
- overall movement is going into 20 degrees of extension
SAGITTAL: Where is the GRF in relation to the hip joint at the end of mid stance?
posterior
SAGITTAL: What kind of external torque does the GRF create at the hip during mid stance?
external extension torque
SAGITTAL: What kind of internal torque is occurring at the hip during mid stance?
internal flexion torque????
SAGITTAL: What kind of muscle activity is there during mid stance?
- the hip extensors work concentrically at the beginning of the phase because they are shortening
- they stop working towards the end of the phase because the GRF goes posterior to the hip joint
SAGITTAL: What is the functional significance of mid stance at the hip?
- hip stability
- forward progression of head, arms, and trunk
SAGITTAL: What is providing hip stability during mid stance?
passive forces which includes the anterior hip joint capsule (counteracts the external extension torque) and the weight of the body wanting to put you into extension
REVIEW: describe what is going on in terminal stance…GO!
- 30-50% of the gait cycle
- start: reference heel rise
- end: opposite initial contact
- functional significance: single limb support
SAGITTAL: How much ROM does the hip have during terminal stance?
- starts at 10 degrees of flexion
- ends in 10 degrees of hip extension (20 degrees of thigh extension)
- 20 degrees of total movement going into extension
- this is maximal extension
SAGITTAL: Where is the GRF in relation to the hip during terminal stance?
posterior
SAGITTAL: What kind of external torque is occurring during terminal stance?
external extension torque due to gravity activity acting on the weight of the body
SAGITTAL: What kind of muscle activity is there during terminal stance?
anterior fibers of the tensor fascia lata (TFL) are working because the anterior capsule can’t handle that much extension
SAGITTAL: What is the functional significance of terminal stance at the hip?
- hip stability
- forward progression
- maximize contralateral step length (trailing limb posture)
REVIEW: describe what is going on in pre-swing…GO!
- 50-60% of the gait cycle
- start: opposite initial contact
- end: reference toe off
- functional significance: limb advancement
SAGITTAL: How much ROM does the hip have during pre swing?
- starts at maximal extension (10 degrees of hip extension)
- ends in 0 degrees of hip flexion (10 degrees of thigh extension)
- total movement of 10 degrees going into flexion
SAGITTAL: Where is the GRF in relation to the hip during pre swing?
GRF is still posterior but is decreases because you are getting ready for single limb support
SAGITTAL: What kind of external torque is occurring during pre swing?
external extension torque but it is decreasing because you are going into single limb support
SAGITTAL: What kind of muscle activity is there during pre swing?
- adductor longus: doesn’t help too much because gravity and what is going on at the ankle and knee does most of the work
- rectus femoris: only in some patients
SAGITTAL: What is the functional significance of pre swing at the hip?
limb advancement: hip flexion assists with knee flexion to advance the limb
REVIEW: describe what is happening during initial swing…GO!!
- 60-73% of the gait cycle
- start: reference toe off
- end: feet adjacent
- functional significance: limb advancement
SAGITTAL: How much ROM does the hip have during initial swing?
- starts at 0 degrees of hip flexion
- ends in 25 degrees of hip flexion (15 degrees of thigh flexion)
SAGITTAL: Where is the GRF in relation to the hip joint during initial swing?
there is no GRF because the foot is not on the ground
SAGITTAL: What kind of external torque is occurring at the hip during initial swing?
there is only minor external torque due to the weight of the limb
SAGITTAL: What kind of internal torque is occurring at the hip during initial swing?
there is an internal flexion torque because you are going into flexion
SAGITTAL: What kind of muscle activity is occurring at the hip during initial swing?
iliacus, sartorius, gracilis, adductor longus are all working concentrically because they are shortening and working against gravity
SAGITTAL: What is the functional significance of initial swing at the hip?
limb advancement
REVIEW: describe what is happening during mid swing…GO!
- 73-87% of the gait cycle
- start: feet adjacent
- end: tibia vertical
- functional significance: limb advancement
SAGITTAL: How much ROM does the hip have during mid swing?
- starts at 25 degrees of hip flexion
- ends in 35 degrees of hip flexion (25 degrees of thigh flexion)
SAGITTAL: What kind of torque demand is there at the hip during mid swing?
- external FLEXION torque due to tibial advancement
- this is called interaction torque
SAGITTAL: What kind of muscle activity is occurring at the hip during mid swing?
hamstrings are working eccentrically to control the hip flexion and knee extension
SAGITTAL: What is the functional significance of mid swing at the hip?
- forward progression (via swing limb momentum)
- foot clearance
- eccentric muscle activity to get us ready to position the limb for the next phase
REVIEW: describe what is happening during terminal swing…GO!!
- 87-100% of the gait cycle
- start: tibia vertical
- end: initial contact
- functional significance: limb advancement
SAGITTAL: How much ROM does the hip get during terminal swing?
- starts at 35 degrees of hip flexion
- ends at 30 degrees of hip flexion (20 degrees of thigh flexion)
- total of 5 degrees of extension
SAGITTAL: What kind of torque demand is there at the hip during terminal stance?
the external flexion torque decreases to 0 so there isn’t an external torque
SAGITTAL: What kind of muscle activity is occurring at the hip during terminal swing?
- hamstrings will continue to decelerate the hip and limb
- hip extensors
- hip abductors
- all of these are kicking in to stabilize the leg for initial contact
SAGITTAL: What is the functional significance of terminal swing at the hip?
limb positioned for initial contact
FRONTAL: How much ROM does the hip have at initial contact?
hip is in neutral or slight adduction
FRONTAL: Where is the GRF in relation to the hip joint during initial contact?
GRF is medial to the hip
FRONTAL: What kind of external torque demands does the GRF create at the hip during initial contact?
external adduction torque
FRONTAL: What kind of muscle activity is occurring at the hip at initial contact?
- gluteus medius
- gluteus maximus
- TFL a little bit
- abductors have to work eccentrically to control the adduction
FRONTAL: What is the functional significance of initial contact at the hip?
stability during weight acceptance
FRONTAL: How much ROM does the hip have from 0-20% of the gait cycle?
- starts in neutral
- ends in about 5 degrees of hip adduction
- during this time, the pelvis drops on the non-weightbearing side
FRONTAL: Where is the GRF relative to the hip joint from 0-20% of the gait cycle?
GRF is still medial to the hip
FRONTAL: What kind of external torque is occurring at the hip during 0-20% of the gait cycle?
external adduction torque
FRONTAL: What kind of internal torque is need at the hip during 0-20% of the gait cycle to counteract the external torque?
internal abduction torque
FRONTAL: What kind of muscle activity is occurring at the hip during 0-20% of the gait cycle?
- hip abductors are working eccentrically
- these muscles are working really hard during this phase
FRONTAL: What is the functional significance of 0-20% of the gait cycle at the hip?
limb stability during weight acceptance and single limb support
FRONTAL: How much ROM does the hip have from 20-60% of the gait cycle?
- starts in 5 degrees of adduction
- ends in 5 degrees of abduction
- total motion is 10 degrees
Where is the movement in the frontal plane at the hip coming from?
pelvis and not the femur
-it is the elevation of the contralateral pelvis that contributes to the movement in the frontal plane)
FRONTAL: What kind of external torque is occurring at the hip during 20-60% of the gait cycle?
external adduction torque because the GRF is still medial to the hip joint
FRONTAL: What kind of internal torque is needed at the hip during 20-60% of the gait cycle?
internal abduction torque
FRONTAL: What kind of muscle activity is occurring at the hip during 20-60% of the gait cycle?
- 20-50%: hip abductors are working concentrically
- 50-60%: ipsilateral hip adductors and contralateral abductors
FRONTAL: What is the functional significance of 20-60% of the gait cycle at the hip?
- limb stability during single limb support
- weight transfer
FRONTAL: How much ROM does the hip have from 60-100% of the gait cycle?
- starts at 5 degrees of abduction
- ends at neutral (goes back to starting point)
- motion is in adduction
FRONTAL: What kind of external torque is occurring at the hip during 60-100% of the gait cycle?
this is negligible
-body segment weight acts as external torque
FRONTAL: What kind of muscle activity occurs at the hip during initial swing?
hip flexors/adductors
-iliacus, gracilis, adductor longus
FRONTAL: What kind of muscle activity occurs at the hip during terminal swing?
abductors at the end of this phase
-these start working because they are needed at initial contact
FRONTAL: What is the functional significance of 60-100% of the gait cycle at the hip?
limb positioned for initial contact
Where is the GRF in relation to the hip in the frontal plane throughout the whole gait cycle?
medial
TRANSVERSE: How much ROM does the hip have from 0-20% of the gait cycle?
- pelvis is in 5 degrees of forward rotation (right pelvis is anterior to the left if the right is the reference limb)
- femur is in medial rotation
- net hip joint medial rotation
TRANSVERSE: What kind of external torque is occurring at the hip during 0-20% of the gait cycle?
external medial rotation
TRANSVERSE: What kind of muscle activity is occurring at the hip during 0-20% of the gait cycle?
hip lateral rotators are working eccentrically because they are lengthening
TRANSVERSE: What is the functional significance of 0-20% of the gait cycle at the hip?
- shock absorption
- limb stabilization
TRANSVERSE: How much ROM does the hip have from 20-60% of the gait cycle?
- pelvis starts in 5 degrees of forward rotation and ends in 5 degrees of backward rotation (10 degrees of motion)
- femur laterally rotates
- net hip joint medial rotation (pelvis motion is moving more than the femur)
TRANSVERSE: What kind of external torque is occurring at the hip from 20-60% of the gait cycle?
external lateral rotation torque
TRANSVERSE: What kind of muscle activity is occurring at the hip from 20-60% of the gait cycle?
hip medial rotators are working but don’t know how
TRANSVERSE: What is the functional significance of 20-60% of the gait cycle at the hip?
contralateral limb advancement
TRANSVERSE: How much ROM occurs at the hip during 60-100% of the gait cycle?
- pelvis starts in 5 degrees of backward rotation and ends in 5 degrees of forward rotation (10 degrees of total motion)
- femur medially rotates
- net hip joint lateral rotation
TRANSVERSE: What kind of torque is occurring at the hip during 60-100% of the gait cycle?
none/negligible
TRANSVERSE: What kind of muscle activity is occurring at the hip during 60-100% of the gait cycle?
hip flexors and adductors; not really sure how they are working
TRANSVERSE: What is the functional significance of 60-100% of the gait cycle at the hip?
limb position for initial contact
